AMN Healthcare Services (AMN) 10-Q 4 Aug 23 2023 Q2 Quarterly report Financial data

Cover Page

Cover Page - shares	6 Months Ended
	Jun. 30, 2023	Aug. 02, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 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	2999 Olympus Boulevard
Entity Address, Address Line Two	Suite 500
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)		37,988,128
Entity Central Index Key	0001142750
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q2
Amendment Flag	false

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 7,013	$ 64,524
Accounts receivable, net of allowances of $36,401 and $31,910 at June 30, 2023 and December 31, 2022, respectively	579,926	675,650
Accounts receivable, subcontractor	168,231	268,726
Prepaid expenses	17,965	18,708
Other current assets	34,101	66,037
Total current assets	807,236	1,093,645
Restricted cash, cash equivalents and investments	71,564	61,218
Fixed assets, net of accumulated depreciation of $250,150 and $227,617 at June 30, 2023 and December 31, 2022, respectively	177,417	149,276
Other assets	219,781	172,016
Goodwill	935,779	935,364
Intangible assets, net of accumulated amortization of $401,217 and $361,327 at June 30, 2023 and December 31, 2022, respectively	432,366	476,832
Total assets	2,644,143	2,888,351
Current liabilities:
Accounts payable and accrued expenses	327,538	476,452
Accrued compensation and benefits	261,629	333,244
Other current liabilities	84,548	48,237
Total current liabilities	673,715	857,933
Revolving credit facility	190,000	0
Notes payable, net of unamortized fees and premium	844,097	843,505
Deferred income taxes, net	6,986	22,713
Other long-term liabilities	163,048	120,566
Total liabilities	1,877,846	1,844,717
Commitments and contingencies
Stockholders’ equity:
Preferred stock, $0.01 par value; 10,000 shares authorized; none issued and outstanding at June 30, 2023 and December 31, 2022	0	0
Common stock, $0.01 par value; 200,000 shares authorized; 50,339 issued and 37,987 outstanding at June 30, 2023 and 50,109 issued and 41,879 outstanding at December 31, 2022	503	501
Additional paid-in capital	467,387	501,674
Treasury stock, at cost; 12,352 and 8,230 shares at June 30, 2023 and December 31, 2022, respectively	(1,086,862)	(698,598)
Retained earnings	1,386,012	1,240,996
Accumulated other comprehensive loss	(743)	(939)
Total stockholders’ equity	766,297	1,043,634
Total liabilities and stockholders’ equity	$ 2,644,143	$ 2,888,351

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Accounts receivable, allowance	$ 36,401	$ 31,910
Accumulated depreciation	250,150	227,617
Accumulated amortization	$ 401,217	$ 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)	50,339,000	50,109,000
Common stock, shares outstanding (in shares)	37,987,000	41,879,000
Treasury stock (in shares)	12,352,000	8,230,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Comprehensive Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Statement of Comprehensive Income [Abstract]
Revenue	$ 991,299	$ 1,426,607	$ 2,117,522	$ 2,979,145
Cost of revenue	661,018	966,370	1,418,395	2,022,740
Gross profit	330,281	460,237	699,127	956,405
Operating expenses:
Selling, general and administrative	201,771	244,430	407,370	502,009
Depreciation and amortization (exclusive of depreciation included in cost of revenue)	36,847	32,274	74,424	62,930
Total operating expenses	238,618	276,704	481,794	564,939
Income from operations	91,663	183,533	217,333	391,466
Interest expense, net, and other	12,175	10,080	22,434	19,669
Income before income taxes	79,488	173,453	194,899	371,797
Income tax expense	18,582	49,653	49,883	101,989
Net income	60,906	123,800	145,016	269,808
Other comprehensive income (loss):
Unrealized gains (losses) on available-for-sale securities, net, and other	50	332	196	(575)
Other comprehensive income (loss)	50	332	196	(575)
Comprehensive income	$ 60,956	$ 124,132	$ 145,212	$ 269,233
Net income per common share:
Basic (in dollars per share)	$ 1.56	$ 2.78	$ 3.60	$ 5.90
Diluted (in dollars per share)	$ 1.55	$ 2.77	$ 3.58	$ 5.87
Weighted average common shares outstanding:
Basic (in shares)	39,151	44,504	40,258	45,702
Diluted (in shares)	39,341	44,740	40,454	45,972

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	(228,024)			$ (228,024)
Repurchase of common stock (in shares)				(2,298)
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, 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]
Comprehensive income (loss)	269,233
Ending balance (in shares) at Jun. 30, 2022		50,032
Ending balance at Jun. 30, 2022	1,039,344	$ 500	496,682	$ (523,722)	1,066,754	(870)
Ending balance (in shares) at Jun. 30, 2022				(6,760)
Beginning balance (in shares) at Mar. 31, 2022		50,013
Beginning balance at Mar. 31, 2022	1,080,932	$ 500	488,535	$ (349,855)	942,954	(1,202)
Beginning balance (in shares) at Mar. 31, 2022				(4,884)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Repurchase of common stock	(173,867)			$ (173,867)
Repurchase of common stock (in shares)				(1,876)
Equity awards vested, net of shares withheld for taxes (in shares)		19
Equity awards vested, net of shares withheld for taxes	(366)		(366)
Share-based compensation	8,513		8,513
Comprehensive income (loss)	124,132				123,800	332
Ending balance (in shares) at Jun. 30, 2022		50,032
Ending balance at Jun. 30, 2022	$ 1,039,344	$ 500	496,682	$ (523,722)	1,066,754	(870)
Ending balance (in shares) at Jun. 30, 2022				(6,760)
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	$ (176,300)			$ (176,300)
Repurchase of common stock (in shares)				(1,768)
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		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)
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]
Comprehensive income (loss)	$ 145,212
Ending balance (in shares) at Jun. 30, 2023	37,987	50,339
Ending balance at Jun. 30, 2023	$ 766,297	$ 503	467,387	$ (1,086,862)	1,386,012	(743)
Ending balance (in shares) at Jun. 30, 2023	(12,352)			(12,352)
Beginning balance (in shares) at Mar. 31, 2023		50,236
Beginning balance at Mar. 31, 2023	$ 955,774	$ 502	505,857	$ (874,898)	1,325,106	(793)
Beginning balance (in shares) at Mar. 31, 2023				(9,998)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Repurchase of common stock	(251,964)		(40,000)	$ (211,964)
Repurchase of common stock (in shares)				(2,354)
Equity awards vested, net of shares withheld for taxes (in shares)		103
Equity awards vested, net of shares withheld for taxes	(3,287)	$ 1	(3,288)
Share-based compensation	4,818		4,818
Comprehensive income (loss)	$ 60,956				60,906	50
Ending balance (in shares) at Jun. 30, 2023	37,987	50,339
Ending balance at Jun. 30, 2023	$ 766,297	$ 503	$ 467,387	$ (1,086,862)	$ 1,386,012	$ (743)
Ending balance (in shares) at Jun. 30, 2023	(12,352)			(12,352)

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands		6 Months Ended
		Jun. 30, 2023	Jun. 30, 2022
Cash flows from operating activities:
Net income		$ 145,016	$ 269,808
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization (inclusive of depreciation included in cost of revenue)		77,068	64,757
Non-cash interest expense and other		1,038	953
Change in fair value of contingent consideration liabilities		2,430	580
Increase in allowance for credit losses and sales credits		29,432	13,803
Provision for deferred income taxes		(15,780)	3,421
Share-based compensation		15,136	19,772
Loss on disposal or impairment of long-lived assets		1,933	479
Net loss on investments in available-for-sale securities		155	536
Net gain on deferred compensation balances		(577)	(39)
Non-cash lease expense		(240)	3,542
Changes in assets and liabilities, net of effects from acquisitions:
Accounts receivable		65,906	(3,535)
Accounts receivable, subcontractor		100,495	(7,988)
Income taxes receivable		8,875	(1,022)
Prepaid expenses		743	45,083
Other current assets		1,820	15,338
Other assets		894	1,002
Accounts payable and accrued expenses		(159,862)	29,461
Accrued compensation and benefits		(84,837)	73,349
Other liabilities		50,887	(104,729)
Deferred revenue		569	106
Net cash provided by operating activities		241,101	424,677
Cash flows from investing activities:
Purchase and development of fixed assets		(43,936)	(30,811)
Purchase of investments		0	(10,659)
Proceeds from sale and maturity of investments		6,987	9,085
Proceeds from sale of equity investment		0	68
Payments to fund deferred compensation plan		(17,910)	(12,584)
Cash paid for acquisitions, net of cash and restricted cash received		0	(69,801)
Cash paid for other intangibles		0	(1,060)
Net cash used in investing activities		(54,859)	(115,762)
Cash flows from financing activities:
Payments on revolving credit facility		(220,000)	0
Proceeds from revolving credit facility		410,000	0
Repurchase of common stock	[1]	(424,744)	(401,891)
Payment of financing costs		(3,579)	0
Cash paid for shares withheld for taxes		(9,421)	(9,797)
Net cash used in financing activities		(247,744)	(411,688)
Net decrease in cash, cash equivalents and restricted cash		(61,502)	(102,773)
Cash, cash equivalents and restricted cash at beginning of period		137,872	246,714
Cash, cash equivalents and restricted cash at end of period		76,370	143,941
Supplemental disclosures of cash flow information:
Cash paid for amounts included in the measurement of operating lease liabilities		4,929	7,922
Cash paid for interest (net of $658 and $254 capitalized for the six months ended June 30, 2023 and 2022, respectively)		22,652	18,887
Cash paid for income taxes		9,736	120,660
Acquisitions:
Fair value of tangible assets acquired in acquisitions, net of cash and restricted cash received		0	2,731
Goodwill		0	43,301
Intangible assets		0	40,200
Liabilities assumed		0	(8,431)
Contingent consideration liabilities		0	(8,000)
Net cash paid for acquisitions		0	69,801
Supplemental disclosures of non-cash investing and financing activities:
Purchase of fixed assets recorded in accounts payable and accrued expenses		10,928	7,562
Excise tax payable on share repurchases		3,520	0
Right-of-use assets obtained in exchange for operating lease liabilities		$ 26,214	$ 3,590
[1]The difference between the amount reported for the six months ended June 30, 2023 and the corresponding amounts 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	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Statement of Cash Flows [Abstract]
Interest capitalized	$ 658	$ 254

Basis of Presentation

Basis of Presentation	6 Months Ended
	Jun. 30, 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 and restricted investments with an original maturity of three months or less to be cash equivalents and restricted cash equivalents, respectively. Cash and cash equivalents include currency on hand, deposits with financial institutions, money market funds 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. June 30, 2023 December 31, 2022 Cash and cash equivalents $ 7,013 $ 64,524 Restricted cash and cash equivalents (included in other current assets) 15,992 37,225 Restricted cash, cash equivalents and investments 71,564 61,218 Total cash, cash equivalents and restricted cash and investments 94,569 162,967 Less restricted investments (18,199) (25,095) Total cash, cash equivalents and restricted cash $ 76,370 $ 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 7,007 1,280 Amounts written off charged against the allowance (2,516) (596) Balance as of June 30, $ 36,401 $ 7,522 The increase in the provision for expected credit losses for the six months ended June 30, 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	6 Months Ended
	Jun. 30, 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 June 30, 2023. 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 and expected to be paid in the third quarter of 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 allocation of the $78,533 purchase price, which was reduced by the final working capital settlement and was finalized during the second quarter of 2023, consisted of (1) $3,172 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) $43,405 of goodwill, of which $35,405 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	6 Months Ended
	Jun. 30, 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	6 Months Ended
	Jun. 30, 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 June 30, Six Months Ended June 30, 2023 2022 2023 2022 Net income $ 60,906 $ 123,800 $ 145,016 $ 269,808 Net income per common share - basic $ 1.56 $ 2.78 $ 3.60 $ 5.90 Net income per common share - diluted $ 1.55 $ 2.77 $ 3.58 $ 5.87 Weighted average common shares outstanding - basic 39,151 44,504 40,258 45,702 Plus dilutive effect of potential common shares 190 236 196 270 Weighted average common shares outstanding - diluted 39,341 44,740 40,454 45,972 Share-based awards to purchase 78 and 227 shares of common stock were not included in the above calculation of diluted net income per common share for the three and six months ended June 30, 2023, respectively, because the effect of these instruments was anti-dilutive. Share-based awards to purchase 60 and 48 shares of common stock were not included in the above calculation of diluted net income per common share for the three and six months ended June 30, 2022, respectively, because the effect of these instruments was anti-dilutive. Accelerated Share Repurchase On May 8, 2023, the Company entered into an accelerated share repurchase (“ASR”) agreement with a counterparty whereupon the Company prepaid $200,000 and received an initial delivery of 1,760 shares of its common stock, which was 80% of the prepayment amount based on a price of $90.89 per share. Under the terms of the ASR, the total number of shares delivered and average price per share will be determined upon settlement based on the volume weighted average price over the term of the ASR agreement, less an agreed upon discount and subject to customary acceleration adjustments. At settlement, the Company may receive additional shares of its common stock or, under certain circumstances, the Company may be required to make a cash payment or deliver shares of its common stock to the counterparty, with the method of settlement at the Company’s election. The final settlement of the ASR will be completed no later than the fourth quarter of 2023, subject to acceleration at the counterparty’s discretion, which could be completed as early as the third quarter of 2023. During the three months ended June 30, 2023, the prepayment was recognized as a reduction to stockholders’ equity, consisting of (1) an increase in treasury stock, which reflects the fair value of the shares received upon initial delivery, and (2) a reduction in additional paid-in capital, which reflects the pending settlement of the ASR agreement. The effect of the potential share settlement of the ASR agreement was not included in the calculation of diluted net income per common share for the three and six months ended June 30, 2023 because the effect was anti-dilutive.

Segment Information

Segment Information	6 Months Ended
	Jun. 30, 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 June 30, Six Months Ended June 30, 2023 2022 2023 2022 Revenue Nurse and allied solutions $ 689,015 $ 1,101,478 $ 1,513,495 $ 2,329,517 Physician and leadership solutions 176,229 175,697 341,986 355,203 Technology and workforce solutions 126,055 149,432 262,041 294,425 $ 991,299 $ 1,426,607 $ 2,117,522 $ 2,979,145 Segment operating income Nurse and allied solutions $ 102,993 $ 160,870 $ 216,438 $ 355,959 Physician and leadership solutions 26,456 19,995 51,556 40,376 Technology and workforce solutions 55,623 82,501 122,633 161,381 185,072 263,366 390,627 557,716 Unallocated corporate overhead 50,357 38,073 81,090 81,721 Depreciation and amortization 36,847 32,274 74,424 62,930 Depreciation (included in cost of revenue) 1,387 973 2,644 1,827 Share-based compensation 4,818 8,513 15,136 19,772 Interest expense, net, and other 12,175 10,080 22,434 19,669 Income before income taxes $ 79,488 $ 173,453 $ 194,899 $ 371,797 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 415 — — 415 Balance, June 30, 2023 $ 382,420 $ 152,800 $ 400,559 $ 935,779 Accumulated impairment loss as of December 31, 2022 and June 30, 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 June 30, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 477,209 $ — $ — $ 477,209 Labor disruption services 5,036 — — 5,036 Local staffing 18,775 — — 18,775 Allied staffing 182,212 — — 182,212 Locum tenens staffing — 121,912 — 121,912 Interim leadership staffing — 36,401 — 36,401 Temporary staffing 683,232 158,313 — 841,545 Permanent placement 5,783 17,916 — 23,699 Language services — — 63,650 63,650 Vendor management systems — — 46,554 46,554 Other technologies — — 5,792 5,792 Technology-enabled services — — 115,996 115,996 Talent planning and acquisition — — 10,059 10,059 Total revenue $ 689,015 $ 176,229 $ 126,055 $ 991,299 Three Months Ended June 30, 2022 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 775,668 $ — $ — $ 775,668 Labor disruption services 83,070 — — 83,070 Local staffing 33,394 — — 33,394 Allied staffing 207,309 — — 207,309 Locum tenens staffing — 105,936 — 105,936 Interim leadership staffing — 47,606 — 47,606 Temporary staffing 1,099,441 153,542 — 1,252,983 Permanent placement 2,037 22,155 — 24,192 Language services — — 53,291 53,291 Vendor management systems — — 75,144 75,144 Other technologies — — 6,839 6,839 Technology-enabled services — — 135,274 135,274 Talent planning and acquisition — — 14,158 14,158 Total revenue $ 1,101,478 $ 175,697 $ 149,432 $ 1,426,607 Six Months Ended June 30, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 1,069,886 $ — $ — $ 1,069,886 Labor disruption services 10,738 — — 10,738 Local staffing 44,047 — — 44,047 Allied staffing 378,337 — — 378,337 Locum tenens staffing — 228,615 — 228,615 Interim leadership staffing — 76,643 — 76,643 Temporary staffing 1,503,008 305,258 — 1,808,266 Permanent placement 10,487 36,728 — 47,215 Language services — — 125,326 125,326 Vendor management systems — — 100,727 100,727 Other technologies — — 13,139 13,139 Technology-enabled services — — 239,192 239,192 Talent planning and acquisition — — 22,849 22,849 Total revenue $ 1,513,495 $ 341,986 $ 262,041 $ 2,117,522 Six Months Ended June 30, 2022 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 1,745,777 $ — $ — $ 1,745,777 Labor disruption services 83,070 — — 83,070 Local staffing 77,451 — — 77,451 Allied staffing 421,182 — — 421,182 Locum tenens staffing — 218,608 — 218,608 Interim leadership staffing — 91,960 — 91,960 Temporary staffing 2,327,480 310,568 — 2,638,048 Permanent placement 2,037 44,635 — 46,672 Language services — — 102,529 102,529 Vendor management systems — — 150,166 150,166 Other technologies — — 14,497 14,497 Technology-enabled services — — 267,192 267,192 Talent planning and acquisition — — 27,233 27,233 Total revenue $ 2,329,517 $ 355,203 $ 294,425 $ 2,979,145

Notes Payable and Credit Agreem

Notes Payable and Credit Agreement	6 Months Ended
	Jun. 30, 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	6 Months Ended
	Jun. 30, 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 six months ended June 30, 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 and corporate bonds. The commercial paper is measured at observable market prices for identical securities that are traded in less active markets, which are Level 2 inputs. The corporate bonds 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. The following table presents the fair value of commercial paper and corporate bonds issued and outstanding: As of June 30, 2023 As of December 31, 2022 Commercial paper $ 40,495 $ 31,536 Corporate bonds — — Total classified as restricted cash equivalents $ 40,495 $ 31,536 Commercial paper $ — $ — Corporate bonds 18,199 25,095 Total classified as restricted investments $ 18,199 $ 25,095 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 table presents 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 June 30, 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 $ 649 $ — $ — $ 649 $ 36,895 $ — $ — $ 36,895 Deferred compensation (150,339) — — (150,339) (128,465) — — (128,465) Corporate bonds — 18,199 — 18,199 — 25,095 — 25,095 Commercial paper — 40,495 — 40,495 — 31,536 — 31,536 Acquisition contingent consideration liabilities — — (7,500) (7,500) — — (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 June 30, 2023 and December 31, 2022. There were no material impairment charges recorded during the six months ended June 30, 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 June 30, 2023 As of December 31, 2022 Carrying Estimated Carrying Estimated 2027 Notes $ 500,000 $ 461,250 $ 500,000 $ 460,000 2029 Notes 350,000 305,375 350,000 300,125

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 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 June 30, 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	6 Months Ended
	Jun. 30, 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. The Company has reached an agreement to settle this matter in its entirety and is awaiting court approval. Accordingly, the Company has recorded an accrual for this matter amounting to $62,000. 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 was made in the second quarter of 2023. Loss contingencies accrued as of both June 30, 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. The lease commenced upon substantial completion of the construction of the office building in June 2023. The initial term of the lease is approximately eleven years with options to renew during the lease term. The Company recognized a right-of-use asset and operating lease liability of $15,782 and $22,713, respectively, at lease commencement, which reflects the utilization of a tenant improvement allowance of $6,931 accounted for as a lease incentive.

Balance Sheet Details

Balance Sheet Details	6 Months Ended
	Jun. 30, 2023
Balance Sheet Related Disclosures [Abstract]
Balance Sheet Details	BALANCE SHEET DETAILS The consolidated balance sheets detail is as follows: June 30, 2023 December 31, 2022 Other current assets: Restricted cash and cash equivalents $ 15,992 $ 37,225 Income taxes receivable — 8,875 Other 18,109 19,937 Other current assets $ 34,101 $ 66,037 Fixed assets: Furniture and equipment $ 61,042 $ 51,408 Software 353,379 323,418 Leasehold improvements 13,146 2,067 427,567 376,893 Accumulated depreciation (250,150) (227,617) Fixed assets, net $ 177,417 $ 149,276 Other assets: Life insurance cash surrender value $ 148,089 $ 117,139 Operating lease right-of-use assets 30,080 16,266 Other 41,612 38,611 Other assets $ 219,781 $ 172,016 Accounts payable and accrued expenses: Trade accounts payable $ 54,531 $ 78,057 Subcontractor payable 168,090 295,259 Accrued expenses 78,332 73,885 Loss contingencies 10,976 14,638 Professional liability reserve 7,652 7,756 Other 7,957 6,857 Accounts payable and accrued expenses $ 327,538 $ 476,452 Accrued compensation and benefits: Accrued payroll $ 55,662 $ 63,857 Accrued bonuses and commissions 28,113 96,760 Workers compensation reserve 12,294 12,113 Deferred compensation 150,339 128,465 Other 15,221 32,049 Accrued compensation and benefits $ 261,629 $ 333,244 Other current liabilities: Acquisition related liabilities $ 7,500 $ 5,070 Income taxes payable 46,675 — Client deposits 1,938 21,466 Operating lease liabilities 8,603 8,090 Deferred revenue 12,390 11,825 Other 7,442 1,786 Other current liabilities $ 84,548 $ 48,237 Other long-term liabilities: Workers compensation reserve $ 22,593 $ 23,841 Professional liability reserve 37,290 36,214 Operating lease liabilities 30,233 9,360 Other 72,932 51,151 Other long-term liabilities $ 163,048 $ 120,566

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Pay vs Performance Disclosure
Net income	$ 60,906	$ 123,800	$ 145,016	$ 269,808

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Jun. 30, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Basis of Presentation (Policies

Basis of Presentation (Policies)	6 Months Ended
	Jun. 30, 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 and restricted investments with an original maturity of three months or less to be cash equivalents and restricted cash equivalents, respectively. Cash and cash equivalents include currency on hand, deposits with financial institutions, money market funds 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	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 six months ended June 30, 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 and corporate bonds. The commercial paper is measured at observable market prices for identical securities that are traded in less active markets, which are Level 2 inputs. The corporate bonds 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. The following table presents the fair value of commercial paper and corporate bonds issued and outstanding: As of June 30, 2023 As of December 31, 2022 Commercial paper $ 40,495 $ 31,536 Corporate bonds — — Total classified as restricted cash equivalents $ 40,495 $ 31,536 Commercial paper $ — $ — Corporate bonds 18,199 25,095 Total classified as restricted investments $ 18,199 $ 25,095 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 table presents 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 June 30, 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 $ 649 $ — $ — $ 649 $ 36,895 $ — $ — $ 36,895 Deferred compensation (150,339) — — (150,339) (128,465) — — (128,465) Corporate bonds — 18,199 — 18,199 — 25,095 — 25,095 Commercial paper — 40,495 — 40,495 — 31,536 — 31,536 Acquisition contingent consideration liabilities — — (7,500) (7,500) — — (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. 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 June 30, 2023 As of December 31, 2022 Carrying Estimated Carrying Estimated 2027 Notes $ 500,000 $ 461,250 $ 500,000 $ 460,000 2029 Notes 350,000 305,375 350,000 300,125

Basis of Presentation (Tables)

Basis of Presentation (Tables)	6 Months Ended
	Jun. 30, 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. June 30, 2023 December 31, 2022 Cash and cash equivalents $ 7,013 $ 64,524 Restricted cash and cash equivalents (included in other current assets) 15,992 37,225 Restricted cash, cash equivalents and investments 71,564 61,218 Total cash, cash equivalents and restricted cash and investments 94,569 162,967 Less restricted investments (18,199) (25,095) Total cash, cash equivalents and restricted cash $ 76,370 $ 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 7,007 1,280 Amounts written off charged against the allowance (2,516) (596) Balance as of June 30, $ 36,401 $ 7,522

Acquisitions (Tables)

Acquisitions (Tables)	6 Months Ended
	Jun. 30, 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)	6 Months Ended
	Jun. 30, 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 June 30, Six Months Ended June 30, 2023 2022 2023 2022 Net income $ 60,906 $ 123,800 $ 145,016 $ 269,808 Net income per common share - basic $ 1.56 $ 2.78 $ 3.60 $ 5.90 Net income per common share - diluted $ 1.55 $ 2.77 $ 3.58 $ 5.87 Weighted average common shares outstanding - basic 39,151 44,504 40,258 45,702 Plus dilutive effect of potential common shares 190 236 196 270 Weighted average common shares outstanding - diluted 39,341 44,740 40,454 45,972

Segment Information (Tables)

Segment Information (Tables)	6 Months Ended
	Jun. 30, 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 June 30, Six Months Ended June 30, 2023 2022 2023 2022 Revenue Nurse and allied solutions $ 689,015 $ 1,101,478 $ 1,513,495 $ 2,329,517 Physician and leadership solutions 176,229 175,697 341,986 355,203 Technology and workforce solutions 126,055 149,432 262,041 294,425 $ 991,299 $ 1,426,607 $ 2,117,522 $ 2,979,145 Segment operating income Nurse and allied solutions $ 102,993 $ 160,870 $ 216,438 $ 355,959 Physician and leadership solutions 26,456 19,995 51,556 40,376 Technology and workforce solutions 55,623 82,501 122,633 161,381 185,072 263,366 390,627 557,716 Unallocated corporate overhead 50,357 38,073 81,090 81,721 Depreciation and amortization 36,847 32,274 74,424 62,930 Depreciation (included in cost of revenue) 1,387 973 2,644 1,827 Share-based compensation 4,818 8,513 15,136 19,772 Interest expense, net, and other 12,175 10,080 22,434 19,669 Income before income taxes $ 79,488 $ 173,453 $ 194,899 $ 371,797
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 415 — — 415 Balance, June 30, 2023 $ 382,420 $ 152,800 $ 400,559 $ 935,779 Accumulated impairment loss as of December 31, 2022 and June 30, 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 June 30, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 477,209 $ — $ — $ 477,209 Labor disruption services 5,036 — — 5,036 Local staffing 18,775 — — 18,775 Allied staffing 182,212 — — 182,212 Locum tenens staffing — 121,912 — 121,912 Interim leadership staffing — 36,401 — 36,401 Temporary staffing 683,232 158,313 — 841,545 Permanent placement 5,783 17,916 — 23,699 Language services — — 63,650 63,650 Vendor management systems — — 46,554 46,554 Other technologies — — 5,792 5,792 Technology-enabled services — — 115,996 115,996 Talent planning and acquisition — — 10,059 10,059 Total revenue $ 689,015 $ 176,229 $ 126,055 $ 991,299 Three Months Ended June 30, 2022 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 775,668 $ — $ — $ 775,668 Labor disruption services 83,070 — — 83,070 Local staffing 33,394 — — 33,394 Allied staffing 207,309 — — 207,309 Locum tenens staffing — 105,936 — 105,936 Interim leadership staffing — 47,606 — 47,606 Temporary staffing 1,099,441 153,542 — 1,252,983 Permanent placement 2,037 22,155 — 24,192 Language services — — 53,291 53,291 Vendor management systems — — 75,144 75,144 Other technologies — — 6,839 6,839 Technology-enabled services — — 135,274 135,274 Talent planning and acquisition — — 14,158 14,158 Total revenue $ 1,101,478 $ 175,697 $ 149,432 $ 1,426,607 Six Months Ended June 30, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 1,069,886 $ — $ — $ 1,069,886 Labor disruption services 10,738 — — 10,738 Local staffing 44,047 — — 44,047 Allied staffing 378,337 — — 378,337 Locum tenens staffing — 228,615 — 228,615 Interim leadership staffing — 76,643 — 76,643 Temporary staffing 1,503,008 305,258 — 1,808,266 Permanent placement 10,487 36,728 — 47,215 Language services — — 125,326 125,326 Vendor management systems — — 100,727 100,727 Other technologies — — 13,139 13,139 Technology-enabled services — — 239,192 239,192 Talent planning and acquisition — — 22,849 22,849 Total revenue $ 1,513,495 $ 341,986 $ 262,041 $ 2,117,522 Six Months Ended June 30, 2022 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 1,745,777 $ — $ — $ 1,745,777 Labor disruption services 83,070 — — 83,070 Local staffing 77,451 — — 77,451 Allied staffing 421,182 — — 421,182 Locum tenens staffing — 218,608 — 218,608 Interim leadership staffing — 91,960 — 91,960 Temporary staffing 2,327,480 310,568 — 2,638,048 Permanent placement 2,037 44,635 — 46,672 Language services — — 102,529 102,529 Vendor management systems — — 150,166 150,166 Other technologies — — 14,497 14,497 Technology-enabled services — — 267,192 267,192 Talent planning and acquisition — — 27,233 27,233 Total revenue $ 2,329,517 $ 355,203 $ 294,425 $ 2,979,145

Fair Value Measurement (Tables)

Fair Value Measurement (Tables)	6 Months Ended
	Jun. 30, 2023
Fair Value Disclosures [Abstract]
Schedule of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis	The following table presents the fair value of commercial paper and corporate bonds issued and outstanding: As of June 30, 2023 As of December 31, 2022 Commercial paper $ 40,495 $ 31,536 Corporate bonds — — Total classified as restricted cash equivalents $ 40,495 $ 31,536 Commercial paper $ — $ — Corporate bonds 18,199 25,095 Total classified as restricted investments $ 18,199 $ 25,095 Fair Value Measurements as of June 30, 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 $ 649 $ — $ — $ 649 $ 36,895 $ — $ — $ 36,895 Deferred compensation (150,339) — — (150,339) (128,465) — — (128,465) Corporate bonds — 18,199 — 18,199 — 25,095 — 25,095 Commercial paper — 40,495 — 40,495 — 31,536 — 31,536 Acquisition contingent consideration liabilities — — (7,500) (7,500) — — (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 June 30, 2023 As of December 31, 2022 Carrying Estimated Carrying Estimated 2027 Notes $ 500,000 $ 461,250 $ 500,000 $ 460,000 2029 Notes 350,000 305,375 350,000 300,125

Balance Sheet Details (Tables)

Balance Sheet Details (Tables)	6 Months Ended
	Jun. 30, 2023
Balance Sheet Related Disclosures [Abstract]
Schedule of Supplemental Balance Sheet Disclosures	The consolidated balance sheets detail is as follows: June 30, 2023 December 31, 2022 Other current assets: Restricted cash and cash equivalents $ 15,992 $ 37,225 Income taxes receivable — 8,875 Other 18,109 19,937 Other current assets $ 34,101 $ 66,037 Fixed assets: Furniture and equipment $ 61,042 $ 51,408 Software 353,379 323,418 Leasehold improvements 13,146 2,067 427,567 376,893 Accumulated depreciation (250,150) (227,617) Fixed assets, net $ 177,417 $ 149,276 Other assets: Life insurance cash surrender value $ 148,089 $ 117,139 Operating lease right-of-use assets 30,080 16,266 Other 41,612 38,611 Other assets $ 219,781 $ 172,016 Accounts payable and accrued expenses: Trade accounts payable $ 54,531 $ 78,057 Subcontractor payable 168,090 295,259 Accrued expenses 78,332 73,885 Loss contingencies 10,976 14,638 Professional liability reserve 7,652 7,756 Other 7,957 6,857 Accounts payable and accrued expenses $ 327,538 $ 476,452 Accrued compensation and benefits: Accrued payroll $ 55,662 $ 63,857 Accrued bonuses and commissions 28,113 96,760 Workers compensation reserve 12,294 12,113 Deferred compensation 150,339 128,465 Other 15,221 32,049 Accrued compensation and benefits $ 261,629 $ 333,244 Other current liabilities: Acquisition related liabilities $ 7,500 $ 5,070 Income taxes payable 46,675 — Client deposits 1,938 21,466 Operating lease liabilities 8,603 8,090 Deferred revenue 12,390 11,825 Other 7,442 1,786 Other current liabilities $ 84,548 $ 48,237 Other long-term liabilities: Workers compensation reserve $ 22,593 $ 23,841 Professional liability reserve 37,290 36,214 Operating lease liabilities 30,233 9,360 Other 72,932 51,151 Other long-term liabilities $ 163,048 $ 120,566

Basis of Presentation - Reconci

Basis of Presentation - Reconciliation of Cash, Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022	Jun. 30, 2022	Dec. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Cash and cash equivalents	$ 7,013	$ 64,524
Restricted cash and cash equivalents (included in other current assets)	15,992	37,225
Restricted cash, cash equivalents and investments	71,564	61,218
Total cash, cash equivalents and restricted cash and investments	94,569	162,967
Less restricted investments	(18,199)	(25,095)
Total cash, cash equivalents and restricted cash	$ 76,370	$ 137,872	$ 143,941	$ 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	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Accounts Receivable, Allowance for Credit Loss [Roll Forward]
Beginning balance	$ 31,910	$ 6,838
Provision for expected credit losses	7,007	1,280
Amounts written off charged against the allowance	(2,516)	(596)
Ending balance	$ 36,401	$ 7,522

Acquisitions - Connetics Acquis

Acquisitions - Connetics Acquisition (Details) - USD ($) $ in Thousands		3 Months Ended		6 Months Ended
	May 13, 2022	Jun. 30, 2023	Dec. 31, 2022	Jun. 30, 2023
Business Acquisition [Line Items]
Fair value of contingent earn-out		$ 7,500	$ 5,070	$ 7,500
Goodwill		935,779	935,364	935,779
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		3,172		3,172
Cash received		963		963
Liabilities assumed		8,244		8,244
Identifiable intangible assets	40,200	40,200		40,200
Goodwill		43,405		43,405
Goodwill expected to be deductible for tax purposes		$ 35,405		$ 35,405
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 - S

Net Income Per Common Share - Schedule of Computation of Basic and Diluted Net Income Per Common Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Earnings Per Share [Abstract]
Net income	$ 60,906	$ 123,800	$ 145,016	$ 269,808
Net income per common share - basic (in dollars per share)	$ 1.56	$ 2.78	$ 3.60	$ 5.90
Net income per common share - diluted (in dollars per share)	$ 1.55	$ 2.77	$ 3.58	$ 5.87
Weighted average common shares outstanding - basic (in shares)	39,151	44,504	40,258	45,702
Plus dilutive effect of potential common shares (in shares)	190	236	196	270
Weighted average common shares outstanding - diluted (in shares)	39,341	44,740	40,454	45,972

Net Income Per Common Share - N

Net Income Per Common Share - Narrative (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands		3 Months Ended		6 Months Ended
	May 08, 2023	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Common stock excluded from calculation of EPS (in shares)		78	60	227	48
Accelerated Share Repurchase Agreement
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Accelerated share repurchases, prepaid amount	$ 200,000
Accelerated share repurchases, initial delivery, shares (in share)	1,760
Accelerated share repurchases, shares repurchased, percentage	80%
Accelerated share repurchases, price paid per share (in dollars per share)	$ 90.89

Segment Information - Narrative

Segment Information - Narrative (Details)	6 Months Ended
	Jun. 30, 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		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	$ 991,299	$ 1,426,607	$ 2,117,522	$ 2,979,145
Segment operating income	91,663	183,533	217,333	391,466
Depreciation and amortization	36,847	32,274	74,424	62,930
Depreciation (included in cost of revenue)	1,387	973	2,644	1,827
Share-based compensation	4,818	8,513	15,136	19,772
Interest expense, net, and other	12,175	10,080	22,434	19,669
Income before income taxes	79,488	173,453	194,899	371,797
Nurse and allied solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	689,015	1,101,478	1,513,495	2,329,517
Physician and leadership solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	176,229	175,697	341,986	355,203
Technology and workforce solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	126,055	149,432	262,041	294,425
Operating segments
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	991,299	1,426,607	2,117,522	2,979,145
Segment operating income	185,072	263,366	390,627	557,716
Operating segments | Nurse and allied solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	689,015	1,101,478	1,513,495	2,329,517
Segment operating income	102,993	160,870	216,438	355,959
Operating segments | Physician and leadership solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	176,229	175,697	341,986	355,203
Segment operating income	26,456	19,995	51,556	40,376
Operating segments | Technology and workforce solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	126,055	149,432	262,041	294,425
Segment operating income	55,623	82,501	122,633	161,381
Unallocated corporate overhead
Segment Reporting, Revenue Reconciling Item [Line Items]
Unallocated corporate overhead	$ 50,357	$ 38,073	$ 81,090	$ 81,721

Segment Information - Summary o

Segment Information - Summary of Goodwill by Reportable Segment (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2023	Dec. 31, 2022
Goodwill [Roll Forward]
Goodwill, beginning balance	$ 935,364
Goodwill, ending balance	935,779
Accumulated impairment loss	214,939	$ 214,939
Connetics Communications, LLC
Goodwill [Roll Forward]
Goodwill adjustment	415
Goodwill, ending balance	43,405
Nurse and Allied Solutions
Goodwill [Roll Forward]
Goodwill, beginning balance	382,005
Goodwill, ending balance	382,420
Accumulated impairment loss	154,444	154,444
Nurse and Allied Solutions | Connetics Communications, LLC
Goodwill [Roll Forward]
Goodwill adjustment	415
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		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Segment Reporting Information [Line Items]
Revenue	$ 991,299	$ 1,426,607	$ 2,117,522	$ 2,979,145
Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	689,015	1,101,478	1,513,495	2,329,517
Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	176,229	175,697	341,986	355,203
Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	126,055	149,432	262,041	294,425
Travel nurse staffing
Segment Reporting Information [Line Items]
Revenue	477,209	775,668	1,069,886	1,745,777
Travel nurse staffing | Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	477,209	775,668	1,069,886	1,745,777
Travel nurse staffing | Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Travel nurse staffing | Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Labor disruption services
Segment Reporting Information [Line Items]
Revenue	5,036	83,070	10,738	83,070
Labor disruption services | Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	5,036	83,070	10,738	83,070
Labor disruption services | Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Labor disruption services | Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Local staffing
Segment Reporting Information [Line Items]
Revenue	18,775	33,394	44,047	77,451
Local staffing | Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	18,775	33,394	44,047	77,451
Local staffing | Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Local staffing | Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Allied staffing
Segment Reporting Information [Line Items]
Revenue	182,212	207,309	378,337	421,182
Allied staffing | Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	182,212	207,309	378,337	421,182
Allied staffing | Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Allied staffing | Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Locum tenens staffing
Segment Reporting Information [Line Items]
Revenue	121,912	105,936	228,615	218,608
Locum tenens staffing | Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Locum tenens staffing | Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	121,912	105,936	228,615	218,608
Locum tenens staffing | Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Interim leadership staffing
Segment Reporting Information [Line Items]
Revenue	36,401	47,606	76,643	91,960
Interim leadership staffing | Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Interim leadership staffing | Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	36,401	47,606	76,643	91,960
Interim leadership staffing | Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Temporary staffing
Segment Reporting Information [Line Items]
Revenue	841,545	1,252,983	1,808,266	2,638,048
Temporary staffing | Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	683,232	1,099,441	1,503,008	2,327,480
Temporary staffing | Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	158,313	153,542	305,258	310,568
Temporary staffing | Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Permanent placement
Segment Reporting Information [Line Items]
Revenue	23,699	24,192	47,215	46,672
Permanent placement | Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	5,783	2,037	10,487	2,037
Permanent placement | Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	17,916	22,155	36,728	44,635
Permanent placement | Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Language services
Segment Reporting Information [Line Items]
Revenue	63,650	53,291	125,326	102,529
Language services | Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Language services | Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Language services | Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	63,650	53,291	125,326	102,529
Vendor management systems
Segment Reporting Information [Line Items]
Revenue	46,554	75,144	100,727	150,166
Vendor management systems | Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Vendor management systems | Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Vendor management systems | Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	46,554	75,144	100,727	150,166
Other technologies
Segment Reporting Information [Line Items]
Revenue	5,792	6,839	13,139	14,497
Other technologies | Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Other technologies | Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Other technologies | Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	5,792	6,839	13,139	14,497
Technology-enabled services
Segment Reporting Information [Line Items]
Revenue	115,996	135,274	239,192	267,192
Technology-enabled services | Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Technology-enabled services | Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Technology-enabled services | Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	115,996	135,274	239,192	267,192
Talent planning and acquisition
Segment Reporting Information [Line Items]
Revenue	10,059	14,158	22,849	27,233
Talent planning and acquisition | Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Talent planning and acquisition | Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Talent planning and acquisition | Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	$ 10,059	$ 14,158	$ 22,849	$ 27,233

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 - Schedu

Fair Value Measurement - Schedule of Assets and Liabilities at Fair Value (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
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	$ 40,495	$ 31,536
Level 2 | 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	40,495	31,536
Level 2 | Restricted Cash Equivalents
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	40,495	31,536
Level 2 | Restricted Cash Equivalents | 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	40,495	31,536
Level 2 | Restricted Cash Equivalents | 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	0	0
Level 2 | Restricted Investments
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	18,199	25,095
Level 2 | Restricted Investments | 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	0	0
Level 2 | Restricted Investments | 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	$ 18,199	$ 25,095

Fair Value Measurement - Financ

Fair Value Measurement - Financial Assets and Liabilities (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Thousands	Jun. 30, 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	$ (150,339)	$ (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	(150,339)	(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	(7,500)	(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	(7,500)	(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	649	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	649	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	18,199	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	18,199	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	40,495	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	40,495	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 - Narrat

Fair Value Measurement - Narrative (Details) - USD ($)	6 Months Ended
	Jun. 30, 2023	Jun. 30, 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

Fair Value Measurement - Fair V

Fair Value Measurement - Fair Value of Financial Instruments (Details) - Senior Notes - USD ($) $ in Thousands	Jun. 30, 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	461,250	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	$ 305,375	$ 300,125

Commitments and Contingencies (

Commitments and Contingencies (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022	Mar. 31, 2022
Commitments and Contingencies [Line Items]
Operating lease right-of-use assets	$ 30,080	$ 16,266
Office Building
Commitments and Contingencies [Line Items]
Future undiscounted lease payments			$ 29,514
Lease term			11 years
Operating lease right-of-use assets	15,782
Operating lease, liability	22,713
Tenant improvement, allowance commitment	6,931
Wage and Hour claims | Pending Litigation
Commitments and Contingencies [Line Items]
Litigation matters accrual	$ 62,000

Balance Sheet Details (Details)

Balance Sheet Details (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Other current assets:
Restricted cash and cash equivalents	$ 15,992	$ 37,225
Income taxes receivable	0	8,875
Other	18,109	19,937
Other current assets	34,101	66,037
Fixed assets:
Furniture and equipment	61,042	51,408
Software	353,379	323,418
Leasehold improvements	13,146	2,067
Fixed assets, gross	427,567	376,893
Accumulated depreciation	(250,150)	(227,617)
Fixed assets, net	177,417	149,276
Other assets:
Life insurance cash surrender value	148,089	117,139
Operating lease right-of-use assets	30,080	16,266
Other	41,612	38,611
Other assets	219,781	172,016
Accounts payable and accrued expenses:
Trade accounts payable	54,531	78,057
Subcontractor payable	168,090	295,259
Accrued expenses	78,332	73,885
Loss contingencies	10,976	14,638
Professional liability reserve	7,652	7,756
Other	7,957	6,857
Accounts payable and accrued expenses	327,538	476,452
Accrued compensation and benefits:
Accrued payroll	55,662	63,857
Accrued bonuses and commissions	28,113	96,760
Workers compensation reserve	12,294	12,113
Deferred compensation	150,339	128,465
Other	15,221	32,049
Accrued compensation and benefits	261,629	333,244
Other current liabilities:
Acquisition related liabilities	7,500	5,070
Income taxes payable	46,675	0
Client deposits	1,938	21,466
Operating lease liabilities	8,603	8,090
Deferred revenue	12,390	11,825
Other	7,442	1,786
Other current liabilities	84,548	48,237
Other long-term liabilities:
Workers compensation reserve	22,593	23,841
Professional liability reserve	37,290	36,214
Operating lease liabilities	30,233	9,360
Other	72,932	51,151
Other long-term liabilities	$ 163,048	$ 120,566