COVER
COVER - shares | 3 Months Ended | |
Mar. 31, 2024 | May 07, 2024 | |
Cover [Abstract] | ||
Document Type | 10-Q | |
Document Quarterly Report | true | |
Document Period End Date | Mar. 31, 2024 | |
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, $0.01 par value | |
Trading Symbol | AMN | |
Security Exchange Name | NYSE | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Large Accelerated Filer | |
Entity Small Business | false | |
Entity Emerging Growth Company | false | |
Entity Shell Company | false | |
Entity Common Stock, Shares Outstanding (excluding treasury shares) | 37,997,167 | |
Entity Central Index Key | 0001142750 | |
Current Fiscal Year End Date | --12-31 | |
Document Fiscal Year Focus | 2024 | |
Document Fiscal Period Focus | Q1 | |
Amendment Flag | false |
CONDENSED CONSOLIDATED BALANCE
CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Current assets: | ||
Cash and cash equivalents | $ 50,560 | $ 32,935 |
Accounts receivable, net of allowances of $31,796 and $32,233 at March 31, 2024 and December 31, 2023, respectively | 578,647 | 623,488 |
Accounts receivable, subcontractor | 97,516 | 117,703 |
Prepaid expenses | 25,281 | 21,889 |
Other current assets | 38,742 | 45,670 |
Total current assets | 790,746 | 841,685 |
Restricted cash, cash equivalents and investments | 71,912 | 68,845 |
Fixed assets, net of accumulated depreciation of $304,689 and $285,081 at March 31, 2024 and December 31, 2023, respectively | 194,537 | 191,385 |
Other assets | 252,397 | 236,796 |
Goodwill | 1,114,757 | 1,111,549 |
Intangible assets, net of accumulated amortization of $466,938 and $442,052 at March 31, 2024 and December 31, 2023, respectively | 449,248 | 474,134 |
Total assets | 2,873,597 | 2,924,394 |
Current liabilities: | ||
Accounts payable and accrued expenses | 316,016 | 343,847 |
Accrued compensation and benefits | 280,513 | 278,536 |
Other current liabilities | 27,374 | 33,738 |
Total current liabilities | 623,903 | 656,121 |
Revolving credit facility | 425,000 | 460,000 |
Notes payable, net of unamortized fees and premium | 844,984 | 844,688 |
Deferred income taxes, net | 15,472 | 23,350 |
Other long-term liabilities | 110,047 | 108,979 |
Total liabilities | 2,019,406 | 2,093,138 |
Commitments and contingencies | ||
Stockholders’ equity: | ||
Preferred stock, $0.01 par value; 10,000 shares authorized; none issued and outstanding at March 31, 2024 and December 31, 2023 | 0 | 0 |
Common stock, $0.01 par value; 200,000 shares authorized; 50,537 issued and 37,924 outstanding at March 31, 2024 and 50,423 issued and 37,810 outstanding at December 31, 2023 | 505 | 504 |
Additional paid-in capital | 512,065 | 506,543 |
Treasury stock, at cost; 12,613 shares at March 31, 2024 and December 31, 2023 | (1,127,043) | (1,127,043) |
Retained earnings | 1,469,003 | 1,451,675 |
Accumulated other comprehensive loss | (339) | (423) |
Total stockholders’ equity | 854,191 | 831,256 |
Total liabilities and stockholders’ equity | $ 2,873,597 | $ 2,924,394 |
CONDENSED CONSOLIDATED BALANC_2
CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Statement of Financial Position [Abstract] | ||
Accounts receivable, allowance | $ 31,796 | $ 32,233 |
Accumulated depreciation | 304,689 | 285,081 |
Accumulated amortization | $ 466,938 | $ 442,052 |
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) | 50,537,000 | 50,423,000 |
Common stock, shares outstanding (in shares) | 37,924,000 | 37,810,000 |
Treasury stock (in shares) | 12,613,000 | 12,613,000 |
CONDENSED CONSOLIDATED STATEMEN
CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Statement of Comprehensive Income [Abstract] | ||
Revenue | $ 820,878 | $ 1,126,223 |
Cost of revenue | 563,372 | 757,377 |
Gross profit | 257,506 | 368,846 |
Operating expenses: | ||
Selling, general and administrative | 174,842 | 205,599 |
Depreciation and amortization (exclusive of depreciation included in cost of revenue) | 42,719 | 37,577 |
Total operating expenses | 217,561 | 243,176 |
Income from operations | 39,945 | 125,670 |
Interest expense, net, and other | 16,628 | 10,259 |
Income before income taxes | 23,317 | 115,411 |
Income tax expense | 5,989 | 31,301 |
Net income | 17,328 | 84,110 |
Other comprehensive income: | ||
Unrealized gains on available-for-sale securities, net, and other | 84 | 146 |
Other comprehensive income | 84 | 146 |
Comprehensive income | $ 17,412 | $ 84,256 |
Net income per common share: | ||
Basic (in dollars per share) | $ 0.45 | $ 2.03 |
Diluted (in dollars per share) | $ 0.45 | $ 2.02 |
Weighted average common shares outstanding: | ||
Basic (in shares) | 38,114 | 41,378 |
Diluted (in shares) | 38,197 | 41,570 |
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, 2022 | 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) | |||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||
Repurchase of common stock (in shares) | (1,768) | |||||
Repurchase of common stock | (176,300) | $ (176,300) | ||||
Equity awards vested, net of shares withheld for taxes (in shares) | 127 | |||||
Equity awards vested, net of shares withheld for taxes | (6,134) | $ 1 | (6,135) | |||
Share-based compensation | 10,318 | 10,318 | ||||
Comprehensive income | 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, 2023 | 37,810 | 50,423 | ||||
Beginning balance at Dec. 31, 2023 | $ 831,256 | $ 504 | 506,543 | $ (1,127,043) | 1,451,675 | (423) |
Beginning balance (in shares) at Dec. 31, 2023 | (12,613) | (12,613) | ||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||
Equity awards vested, net of shares withheld for taxes (in shares) | 114 | |||||
Equity awards vested, net of shares withheld for taxes | $ (3,973) | $ 1 | (3,974) | |||
Shares purchased under employee stock purchase plan | 1,757 | 1,757 | ||||
Share-based compensation | 7,739 | 7,739 | ||||
Comprehensive income | $ 17,412 | 17,328 | 84 | |||
Ending balance (in shares) at Mar. 31, 2024 | 37,924 | 50,537 | ||||
Ending balance at Mar. 31, 2024 | $ 854,191 | $ 505 | $ 512,065 | $ (1,127,043) | $ 1,469,003 | $ (339) |
Ending balance (in shares) at Mar. 31, 2024 | (12,613) | (12,613) |
CONDENSED CONSOLIDATED STATEM_3
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 3 Months Ended | ||
Mar. 31, 2024 | Mar. 31, 2023 | ||
Cash flows from operating activities: | |||
Net income | $ 17,328 | $ 84,110 | |
Adjustments to reconcile net income to net cash provided by operating activities: | |||
Depreciation and amortization (inclusive of depreciation included in cost of revenue) | 44,517 | 38,834 | |
Non-cash interest expense and other | 534 | 505 | |
Change in fair value of contingent consideration liabilities | 0 | 80 | |
Increase in allowance for credit losses and sales credits | 388 | 25,447 | |
Provision for deferred income taxes | (7,661) | (6,639) | |
Share-based compensation | 7,739 | 10,318 | |
Loss on disposal or impairment of long-lived assets | 10 | 1,849 | |
Net loss on investments in available-for-sale securities | 64 | 81 | |
Net loss (gain) on deferred compensation balances | (381) | 41 | |
Non-cash lease expense | (799) | (228) | |
Changes in assets and liabilities, net of effects from acquisitions: | |||
Accounts receivable | 41,367 | (37,376) | |
Accounts receivable, subcontractor | 20,187 | (7,929) | |
Income taxes receivable | 5,350 | 8,875 | |
Prepaid expenses | (3,392) | (7,988) | |
Other current assets | 772 | (115) | |
Other assets | 86 | 221 | |
Accounts payable and accrued expenses | (33,006) | (9,557) | |
Accrued compensation and benefits | (6,365) | (71,038) | |
Other liabilities | (5,712) | 11,903 | |
Deferred revenue | 360 | 2,040 | |
Net cash provided by operating activities | 81,386 | 43,434 | |
Cash flows from investing activities: | |||
Purchase and development of fixed assets | (18,145) | (17,487) | |
Proceeds from sale and maturity of investments | 1,207 | 2,007 | |
Payments to fund deferred compensation plan | (4,461) | (16,951) | |
Net cash used in investing activities | (21,399) | (32,431) | |
Cash flows from financing activities: | |||
Payments on revolving credit facility | (50,000) | (70,000) | |
Proceeds from revolving credit facility | 15,000 | 210,000 | |
Repurchase of common stock | [1] | 0 | (174,744) |
Payment of financing costs | 0 | (3,579) | |
Cash paid for shares withheld for taxes | (3,973) | (6,134) | |
Net cash used in financing activities | (38,973) | (44,457) | |
Net increase (decrease) in cash, cash equivalents and restricted cash | 21,014 | (33,454) | |
Cash, cash equivalents and restricted cash at beginning of period | 108,273 | 137,872 | |
Cash, cash equivalents and restricted cash at end of period | 129,287 | 104,418 | |
Supplemental disclosures of cash flow information: | |||
Cash paid for amounts included in the measurement of operating lease liabilities | 2,805 | 2,610 | |
Cash paid for interest (net of $198 and $288 capitalized for the three months ended March 31, 2024 and 2023, respectively) | 7,543 | 1,053 | |
Cash paid for income taxes | 4,309 | 5,404 | |
Supplemental disclosures of non-cash investing and financing activities: | |||
Purchase of fixed assets recorded in accounts payable and accrued expenses | 12,777 | 6,849 | |
Excise tax payable on share repurchases | 0 | 1,556 | |
Right-of-use assets obtained in exchange for operating lease liabilities | $ 2,338 | $ 577 | |
[1]The difference between the amount reported for the three months ended March 31, 2023 and the corresponding amount presented in the condensed consolidated statements of stockholders’ equity is due to accrued excise tax payable on share repurchases recorded within treasury stock. |
CONDENSED CONSOLIDATED STATEM_4
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Parenthetical) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Statement of Cash Flows [Abstract] | ||
Interest capitalized | $ 198 | $ 288 |
BASIS OF PRESENTATION
BASIS OF PRESENTATION | 3 Months Ended |
Mar. 31, 2024 | |
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, 2023, contained in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2023, filed with the Securities and Exchange Commission on February 22, 2024 (the “2023 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 goodwill and intangible assets purchased in a business combination, asset impairments, accruals for self-insurance, contingent liabilities such as legal accruals, and income taxes. The Company bases these estimates on the information that is currently available and on various other assumptions that it believes are reasonable under the circumstances. Actual results could differ from those estimates under different assumptions or conditions. Cash, 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 include cash, corporate bonds and commercial paper that serve as collateral for the Company’s captive insurance subsidiary claim payments. See Note (7), “Fair Value Measurement” for additional information. The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the accompanying condensed consolidated balance sheets and related notes to the amounts presented in the accompanying condensed consolidated statements of cash flows. March 31, 2024 December 31, 2023 Cash and cash equivalents $ 50,560 $ 32,935 Restricted cash and cash equivalents (included in other current assets) 21,251 22,056 Restricted cash, cash equivalents and investments 71,912 68,845 Total cash, cash equivalents and restricted cash and investments 143,723 123,836 Less restricted investments (14,436) (15,563) Total cash, cash equivalents and restricted cash $ 129,287 $ 108,273 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: 2024 2023 Balance as of January 1, $ 32,233 $ 31,910 Provision for expected credit losses 4,019 6,938 Amounts written off charged against the allowance (4,456) (1,112) Balance as of March 31, $ 31,796 $ 37,736 |
ACQUISITIONS
ACQUISITIONS | 3 Months Ended |
Mar. 31, 2024 | |
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 the analysis of the information that has been made available through March 31, 2024. 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. MSDR Acquisition On November 30, 2023, the Company completed its acquisition of MSI Systems Corp. and DrWanted.com LLC (together, “MSDR”), two healthcare staffing companies that specialize in locum tenens and advanced practice. The initial purchase price of $292,818 consisted entirely of cash consideration paid upon acquisition. The acquisition was funded through borrowings under the Company’s $750,000 secured revolving credit facility (the “Senior Credit Facility”). The results of MSDR have been included in the Company’s physician and leadership solutions segment since the date of acquisition. The preliminary allocation of the $292,818 purchase price consisted of (1) $45,547 of fair value of tangible assets acquired, which included $643 cash received, (2) $23,707 of liabilities assumed, (3) $92,000 of identified intangible assets, and (4) $178,978 of goodwill, of which $92,438 is deductible for tax purposes. The provisional items include the final working capital settlement and the assessment of additional information to finalize the measurement of certain assets acquired and liabilities assumed, which primarily consist of income tax matters, operating leases and insurance reserves. The intangible assets acquired have a weighted average useful life of approximately seven 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 $ 54,300 7 - 10 Tradenames and trademarks 26,400 3 Staffing databases 11,300 5 $ 92,000 |
REVENUE RECOGNITION
REVENUE RECOGNITION | 3 Months Ended |
Mar. 31, 2024 | |
Revenue from Contract with Customer [Abstract] | |
REVENUE RECOGNITION | REVENUE RECOGNITION Revenue primarily consists of fees earned from the temporary staffing and permanent placement of healthcare professionals, executives, and leaders (clinical and operational). The Company also generates revenue from technology-enabled services, including language interpretation and vendor management systems, and talent planning and acquisition services, including recruitment process outsourcing. The Company recognizes revenue when control of its services is transferred to its customers, in an amount that reflects the consideration the Company expects to be entitled to receive in exchange for those services. Revenue from temporary staffing services is recognized as the services are rendered by clinical and non-clinical healthcare professionals. Under the Company’s managed services program (“MSP”) arrangements, the Company manages all or a part of a customer’s supplemental workforce needs utilizing its own network of healthcare professionals along with those of third-party subcontractors. Revenue and the related direct costs under MSP arrangements are recorded in accordance with the accounting guidance on reporting revenue gross as a principal versus net as an agent. When the Company uses subcontractors and acts as an agent, revenue is recorded net of the related subcontractor’s expense. Revenue from permanent placement and recruitment process outsourcing services is recognized as the services are rendered. Depending on the arrangement, the Company’s technology-enabled service revenue is recognized either as the services are rendered or ratably over the applicable arrangement’s service period. The Company’s customers are primarily billed as services are rendered. Any fees billed in advance of being earned are recorded as deferred revenue. While payment terms vary by the type of customer and the services rendered, the term between invoicing and when payment is due is not significant. The Company has elected to apply the following practical expedients and optional exemptions related to contract costs and revenue recognition: • Recognize incremental costs of obtaining a contract with amortization periods of one year or less as expense when incurred. These costs are recorded within selling, general and administrative expenses. • Recognize revenue in the amount of consideration that the Company has a right to invoice the customer if that amount corresponds directly with the value to the customer of the Company’s services completed to date. • Exemptions from disclosing the value of unsatisfied performance obligations for (i) contracts with an original expected length of one year or less, (ii) contracts for which revenue is recognized in the amount of consideration that the Company has a right to invoice for services performed and (iii) contracts for which variable consideration is allocated entirely to a wholly unsatisfied performance obligation or to a wholly unsatisfied promise to transfer a distinct service that forms part of a single performance obligation. See Note (5), “Segment Information,” for additional information regarding the Company’s revenue disaggregated by service type. |
NET INCOME PER COMMON SHARE
NET INCOME PER COMMON SHARE | 3 Months Ended |
Mar. 31, 2024 | |
Earnings Per Share [Abstract] | |
NET INCOME PER COMMON SHARE | NET INCOME PER COMMON SHARE Basic net income per common share is calculated by dividing net income by the weighted average number of common shares outstanding during the reporting period. The following table sets forth the computation of basic and diluted net income per common share: Three Months Ended March 31, 2024 2023 Net income $ 17,328 $ 84,110 Net income per common share - basic $ 0.45 $ 2.03 Net income per common share - diluted $ 0.45 $ 2.02 Weighted average common shares outstanding - basic 38,114 41,378 Plus dilutive effect of potential common shares 83 192 Weighted average common shares outstanding - diluted 38,197 41,570 The dilutive effect of potential shares primarily includes outstanding share-based awards, which consists of restricted stock units, performance restricted stock units, and obligations under the Company’s employee stock purchase plan (the “ESPP”). Share-based awards to purchase 408 and 243 shares of common stock were not included in the above calculation of diluted net income per common share for the three months ended March 31, 2024 and 2023, respectively, because the effect of these instruments was anti-dilutive. |
SEGMENT INFORMATION
SEGMENT INFORMATION | 3 Months Ended |
Mar. 31, 2024 | |
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, and allied staffing (including 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, and outsourced solutions businesses. The Company’s chief operating decision maker relies on internal management reporting processes that provide revenue and operating income by reportable segment for making financial decisions and allocating resources. Segment operating income represents income before income taxes plus depreciation, amortization of intangible assets, share-based compensation, interest expense, net, and other, and unallocated corporate overhead. The Company’s management does not evaluate, manage or measure performance of segments using asset information; accordingly, asset information by segment is not prepared or disclosed. The following table provides a reconciliation of revenue and operating income by reportable segment to consolidated results and was derived from each segment’s internal financial information as used for corporate management purposes: Three Months Ended March 31, 2024 2023 Revenue Nurse and allied solutions $ 519,297 $ 824,480 Physician and leadership solutions 188,797 165,757 Technology and workforce solutions 112,784 135,986 $ 820,878 $ 1,126,223 Segment operating income Nurse and allied solutions $ 53,342 $ 113,445 Physician and leadership solutions 22,222 25,100 Technology and workforce solutions 44,270 67,010 119,834 205,555 Unallocated corporate overhead 27,633 30,733 Depreciation and amortization 42,719 37,577 Depreciation (included in cost of revenue) 1,798 1,257 Share-based compensation 7,739 10,318 Interest expense, net, and other 16,628 10,259 Income before income taxes $ 23,317 $ 115,411 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, 2024 $ 382,420 $ 328,570 $ 400,559 $ 1,111,549 Goodwill adjustment for MSDR acquisition — 3,208 — 3,208 Balance, March 31, 2024 $ 382,420 $ 331,778 $ 400,559 $ 1,114,757 Accumulated impairment loss as of December 31, 2023 and March 31, 2024 $ 154,444 $ 60,495 $ — $ 214,939 Disaggregation of Revenue The following tables present the Company’s revenue disaggregated by service type: Three Months Ended March 31, 2024 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 334,369 $ — $ — $ 334,369 Labor disruption services 28 — — 28 Local staffing 12,498 — — 12,498 Allied staffing 169,756 — — 169,756 Locum tenens staffing — 145,242 — 145,242 Interim leadership staffing — 30,272 — 30,272 Temporary staffing 516,651 175,514 — 692,165 Permanent placement 2,646 13,283 — 15,929 Language services — — 71,422 71,422 Vendor management systems — — 29,063 29,063 Other technologies — — 5,828 5,828 Technology-enabled services — — 106,313 106,313 Talent planning and acquisition — — 6,471 6,471 Total revenue $ 519,297 $ 188,797 $ 112,784 $ 820,878 Three Months Ended March 31, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 592,677 $ — $ — $ 592,677 Labor disruption services 5,702 — — 5,702 Local staffing 25,272 — — 25,272 Allied staffing 196,125 — — 196,125 Locum tenens staffing — 106,703 — 106,703 Interim leadership staffing — 40,242 — 40,242 Temporary staffing 819,776 146,945 — 966,721 Permanent placement 4,704 18,812 — 23,516 Language services — — 61,676 61,676 Vendor management systems — — 54,173 54,173 Other technologies — — 7,347 7,347 Technology-enabled services — — 123,196 123,196 Talent planning and acquisition — — 12,790 12,790 Total revenue $ 824,480 $ 165,757 $ 135,986 $ 1,126,223 |
NOTES PAYABLE AND CREDIT AGREEM
NOTES PAYABLE AND CREDIT AGREEMENT | 3 Months Ended |
Mar. 31, 2024 | |
Debt Disclosure [Abstract] | |
NOTES PAYABLE AND CREDIT AGREEMENT | NOTES PAYABLE AND CREDIT AGREEMENT On 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 Senior Credit Facility to February 10, 2028, (ii) an increase of the Senior Credit Facility from $400,000 to $750,000, and (iii) a transition from LIBOR to a Secured Overnight Financing Rate (“SOFR”)-based interest rate. Additional information regarding the Senior Credit Facility and the amended credit agreement 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 2023 Annual Report. |
FAIR VALUE MEASUREMENT
FAIR VALUE MEASUREMENT | 3 Months Ended |
Mar. 31, 2024 | |
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 2023 Annual Report. The Company has not changed the valuation techniques or inputs it uses for its fair value measurement during the three months ended March 31, 2024. Assets and Liabilities Measured on a Recurring Basis From time to time, 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 March 31, 2024 As of December 31, 2023 Commercial paper $ 48,247 $ 48,206 Corporate bonds — — Total classified as restricted cash equivalents $ 48,247 $ 48,206 Commercial paper $ — $ — Corporate bonds 14,436 15,563 Total classified as restricted investments $ 14,436 $ 15,563 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. There were no contingent consideration liabilities outstanding as of both March 31, 2024 and December 31, 2023. 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 March 31, 2024 Fair Value Measurements as of December 31, 2023 Assets (Liabilities) Level 1 Level 2 Level 3 Total Level 1 Level 2 Level 3 Total Deferred compensation $ (178,412) $ — $ — $ (178,412) $ (165,574) $ — $ — $ (165,574) Corporate bonds — 14,436 — 14,436 — 15,563 — 15,563 Commercial paper — 48,247 — 48,247 — 48,206 — 48,206 Assets Measured on a Non-Recurring Basis The Company applies fair value techniques on a non-recurring basis associated with identifiable intangible assets acquired through acquisitions and valuing potential impairment losses related to its goodwill, indefinite-lived intangible assets, long-lived assets, and equity investments. The fair value of identifiable intangible assets are determined using either the income approach (the relief-from-royalty method, multi-period excess earnings method or with-and-without method) or the cost approach (replacement cost method). These valuation approaches use a combination of assumptions, including Level 3 inputs, such as (i) forecasted revenue, growth rates and customer attrition rates, (ii) forecasted operating expenses and profit margins, and (iii) royalty rates and discount rates used to present value the forecasted cash flows. 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 $12,503 as of both March 31, 2024 and December 31, 2023. There were no material impairment charges recorded during the three months ended March 31, 2024 and 2023. 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 2023 Annual Report. As of March 31, 2024 As of December 31, 2023 Carrying Estimated Carrying Estimated 2027 Notes $ 500,000 $ 473,750 $ 500,000 $ 468,750 2029 Notes 350,000 313,250 350,000 314,125 |
INCOME TAXES
INCOME TAXES | 3 Months Ended |
Mar. 31, 2024 | |
Income Tax Disclosure [Abstract] | |
INCOME TAXES | INCOME TAXES The Company is subject to taxation in the U.S. and various states and foreign jurisdictions. With few exceptions, as of March 31, 2024, 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 2020. The Company believes its liability for unrecognized tax benefits and contingent tax issues is adequate with respect to all open years. Notwithstanding the foregoing, the Company could adjust its provision for income taxes and contingent tax liability based on future developments. |
COMMITMENTS AND CONTINGENCIES
COMMITMENTS AND CONTINGENCIES | 3 Months Ended |
Mar. 31, 2024 | |
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, representative 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 and representative 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, which was preliminarily approved in the fourth quarter of 2023. The Company expects final approval at the end of the second quarter of 2024. Accordingly, the Company has recorded an accrual for this matter amounting to $62,000. The Company is currently unable to estimate the possible loss or range of loss beyond amounts already accrued. Loss contingencies accrued are included in accounts payable and accrued expenses and other long-term liabilities in the consolidated balance sheets. |
BALANCE SHEET DETAILS
BALANCE SHEET DETAILS | 3 Months Ended |
Mar. 31, 2024 | |
Balance Sheet Related Disclosures [Abstract] | |
BALANCE SHEET DETAILS | BALANCE SHEET DETAILS The consolidated balance sheets detail is as follows: March 31, 2024 December 31, 2023 Other current assets: Restricted cash and cash equivalents $ 21,251 $ 22,056 Income taxes receivable — 5,350 Other 17,491 18,264 Other current assets $ 38,742 $ 45,670 Fixed assets: Furniture and equipment $ 75,686 $ 71,815 Software 407,298 388,812 Leasehold improvements 16,242 15,839 499,226 476,466 Accumulated depreciation (304,689) (285,081) Fixed assets, net $ 194,537 $ 191,385 Other assets: Life insurance cash surrender value $ 177,403 $ 162,780 Operating lease right-of-use assets 35,397 34,543 Other 39,597 39,473 Other assets $ 252,397 $ 236,796 Accounts payable and accrued expenses: Trade accounts payable $ 48,238 $ 54,128 Subcontractor payable 94,889 122,983 Accrued expenses 86,766 82,257 Loss contingencies 70,820 69,837 Professional liability reserve 7,625 7,761 Other 7,678 6,881 Accounts payable and accrued expenses $ 316,016 $ 343,847 Accrued compensation and benefits: Accrued payroll $ 59,052 $ 53,633 Accrued bonuses and commissions 21,595 31,236 ESPP contributions 72 950 Workers compensation reserve 10,931 12,130 Deferred compensation 178,412 165,574 Other 10,451 15,013 Accrued compensation and benefits $ 280,513 $ 278,536 Other current liabilities: Income taxes payable $ 3,790 $ — Client deposits 833 8,707 Operating lease liabilities 6,633 7,993 Deferred revenue 11,681 11,303 Other 4,437 5,735 Other current liabilities $ 27,374 $ 33,738 Other long-term liabilities: Workers compensation reserve $ 20,739 $ 21,169 Professional liability reserve 37,400 36,891 Operating lease liabilities 39,019 37,603 Other 12,889 13,316 Other long-term liabilities $ 110,047 $ 108,979 |
Pay vs Performance Disclosure
Pay vs Performance Disclosure - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Pay vs Performance Disclosure | ||
Net Income (Loss) | $ 17,328 | $ 84,110 |
Insider Trading Arrangements
Insider Trading Arrangements | 3 Months Ended |
Mar. 31, 2024 | |
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) | 3 Months Ended |
Mar. 31, 2024 | |
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 goodwill and intangible assets purchased in a business combination, asset impairments, accruals for self-insurance, contingent liabilities such as legal accruals, and income taxes. The Company bases these estimates on the information that is currently available and on various other assumptions that it believes are reasonable under the circumstances. Actual results could differ from those estimates under different assumptions or conditions. |
Cash, 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 include 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 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 | 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. |
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 2023 Annual Report. The Company has not changed the valuation techniques or inputs it uses for its fair value measurement during the three months ended March 31, 2024. Assets and Liabilities Measured on a Recurring Basis From time to time, 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. Assets Measured on a Non-Recurring Basis The Company applies fair value techniques on a non-recurring basis associated with identifiable intangible assets acquired through acquisitions and valuing potential impairment losses related to its goodwill, indefinite-lived intangible assets, long-lived assets, and equity investments. The fair value of identifiable intangible assets are determined using either the income approach (the relief-from-royalty method, multi-period excess earnings method or with-and-without method) or the cost approach (replacement cost method). These valuation approaches use a combination of assumptions, including Level 3 inputs, such as (i) forecasted revenue, growth rates and customer attrition rates, (ii) forecasted operating expenses and profit margins, and (iii) royalty rates and discount rates used to present value the forecasted cash flows. 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 2023 Annual Report. As of March 31, 2024 As of December 31, 2023 Carrying Estimated Carrying Estimated 2027 Notes $ 500,000 $ 473,750 $ 500,000 $ 468,750 2029 Notes 350,000 313,250 350,000 314,125 |
BASIS OF PRESENTATION (Tables)
BASIS OF PRESENTATION (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Schedule of Reconciliation of Cash, Cash Equivalents and Restricted Cash | The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the accompanying condensed consolidated balance sheets and related notes to the amounts presented in the accompanying condensed consolidated statements of cash flows. March 31, 2024 December 31, 2023 Cash and cash equivalents $ 50,560 $ 32,935 Restricted cash and cash equivalents (included in other current assets) 21,251 22,056 Restricted cash, cash equivalents and investments 71,912 68,845 Total cash, cash equivalents and restricted cash and investments 143,723 123,836 Less restricted investments (14,436) (15,563) Total cash, cash equivalents and restricted cash $ 129,287 $ 108,273 |
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: 2024 2023 Balance as of January 1, $ 32,233 $ 31,910 Provision for expected credit losses 4,019 6,938 Amounts written off charged against the allowance (4,456) (1,112) Balance as of March 31, $ 31,796 $ 37,736 |
ACQUISITIONS (Tables)
ACQUISITIONS (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Business Combination and Asset Acquisition [Abstract] | |
Schedule of Fair Value and Useful life of Intangible Assets Acquired | 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 $ 54,300 7 - 10 Tradenames and trademarks 26,400 3 Staffing databases 11,300 5 $ 92,000 |
NET INCOME PER COMMON SHARE (Ta
NET INCOME PER COMMON SHARE (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Earnings Per Share [Abstract] | |
Schedule of Computation of Basic and Diluted Net Income Per Common Share | The following table sets forth the computation of basic and diluted net income per common share: Three Months Ended March 31, 2024 2023 Net income $ 17,328 $ 84,110 Net income per common share - basic $ 0.45 $ 2.03 Net income per common share - diluted $ 0.45 $ 2.02 Weighted average common shares outstanding - basic 38,114 41,378 Plus dilutive effect of potential common shares 83 192 Weighted average common shares outstanding - diluted 38,197 41,570 |
SEGMENT INFORMATION (Tables)
SEGMENT INFORMATION (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Segment Reporting [Abstract] | |
Schedule of Reconciliation of Revenue and Segment Operating Income by Reportable Segment | The following table provides a reconciliation of revenue and operating income by reportable segment to consolidated results and was derived from each segment’s internal financial information as used for corporate management purposes: Three Months Ended March 31, 2024 2023 Revenue Nurse and allied solutions $ 519,297 $ 824,480 Physician and leadership solutions 188,797 165,757 Technology and workforce solutions 112,784 135,986 $ 820,878 $ 1,126,223 Segment operating income Nurse and allied solutions $ 53,342 $ 113,445 Physician and leadership solutions 22,222 25,100 Technology and workforce solutions 44,270 67,010 119,834 205,555 Unallocated corporate overhead 27,633 30,733 Depreciation and amortization 42,719 37,577 Depreciation (included in cost of revenue) 1,798 1,257 Share-based compensation 7,739 10,318 Interest expense, net, and other 16,628 10,259 Income before income taxes $ 23,317 $ 115,411 |
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, 2024 $ 382,420 $ 328,570 $ 400,559 $ 1,111,549 Goodwill adjustment for MSDR acquisition — 3,208 — 3,208 Balance, March 31, 2024 $ 382,420 $ 331,778 $ 400,559 $ 1,114,757 Accumulated impairment loss as of December 31, 2023 and March 31, 2024 $ 154,444 $ 60,495 $ — $ 214,939 |
Schedule of Disaggregation of Revenue | The following tables present the Company’s revenue disaggregated by service type: Three Months Ended March 31, 2024 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 334,369 $ — $ — $ 334,369 Labor disruption services 28 — — 28 Local staffing 12,498 — — 12,498 Allied staffing 169,756 — — 169,756 Locum tenens staffing — 145,242 — 145,242 Interim leadership staffing — 30,272 — 30,272 Temporary staffing 516,651 175,514 — 692,165 Permanent placement 2,646 13,283 — 15,929 Language services — — 71,422 71,422 Vendor management systems — — 29,063 29,063 Other technologies — — 5,828 5,828 Technology-enabled services — — 106,313 106,313 Talent planning and acquisition — — 6,471 6,471 Total revenue $ 519,297 $ 188,797 $ 112,784 $ 820,878 Three Months Ended March 31, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 592,677 $ — $ — $ 592,677 Labor disruption services 5,702 — — 5,702 Local staffing 25,272 — — 25,272 Allied staffing 196,125 — — 196,125 Locum tenens staffing — 106,703 — 106,703 Interim leadership staffing — 40,242 — 40,242 Temporary staffing 819,776 146,945 — 966,721 Permanent placement 4,704 18,812 — 23,516 Language services — — 61,676 61,676 Vendor management systems — — 54,173 54,173 Other technologies — — 7,347 7,347 Technology-enabled services — — 123,196 123,196 Talent planning and acquisition — — 12,790 12,790 Total revenue $ 824,480 $ 165,757 $ 135,986 $ 1,126,223 |
FAIR VALUE MEASUREMENT (Tables)
FAIR VALUE MEASUREMENT (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
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 March 31, 2024 As of December 31, 2023 Commercial paper $ 48,247 $ 48,206 Corporate bonds — — Total classified as restricted cash equivalents $ 48,247 $ 48,206 Commercial paper $ — $ — Corporate bonds 14,436 15,563 Total classified as restricted investments $ 14,436 $ 15,563 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 March 31, 2024 Fair Value Measurements as of December 31, 2023 Assets (Liabilities) Level 1 Level 2 Level 3 Total Level 1 Level 2 Level 3 Total Deferred compensation $ (178,412) $ — $ — $ (178,412) $ (165,574) $ — $ — $ (165,574) Corporate bonds — 14,436 — 14,436 — 15,563 — 15,563 Commercial paper — 48,247 — 48,247 — 48,206 — 48,206 |
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 2023 Annual Report. As of March 31, 2024 As of December 31, 2023 Carrying Estimated Carrying Estimated 2027 Notes $ 500,000 $ 473,750 $ 500,000 $ 468,750 2029 Notes 350,000 313,250 350,000 314,125 |
BALANCE SHEET DETAILS (Tables)
BALANCE SHEET DETAILS (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Balance Sheet Related Disclosures [Abstract] | |
Schedule of Supplemental Balance Sheet Disclosures | The consolidated balance sheets detail is as follows: March 31, 2024 December 31, 2023 Other current assets: Restricted cash and cash equivalents $ 21,251 $ 22,056 Income taxes receivable — 5,350 Other 17,491 18,264 Other current assets $ 38,742 $ 45,670 Fixed assets: Furniture and equipment $ 75,686 $ 71,815 Software 407,298 388,812 Leasehold improvements 16,242 15,839 499,226 476,466 Accumulated depreciation (304,689) (285,081) Fixed assets, net $ 194,537 $ 191,385 Other assets: Life insurance cash surrender value $ 177,403 $ 162,780 Operating lease right-of-use assets 35,397 34,543 Other 39,597 39,473 Other assets $ 252,397 $ 236,796 Accounts payable and accrued expenses: Trade accounts payable $ 48,238 $ 54,128 Subcontractor payable 94,889 122,983 Accrued expenses 86,766 82,257 Loss contingencies 70,820 69,837 Professional liability reserve 7,625 7,761 Other 7,678 6,881 Accounts payable and accrued expenses $ 316,016 $ 343,847 Accrued compensation and benefits: Accrued payroll $ 59,052 $ 53,633 Accrued bonuses and commissions 21,595 31,236 ESPP contributions 72 950 Workers compensation reserve 10,931 12,130 Deferred compensation 178,412 165,574 Other 10,451 15,013 Accrued compensation and benefits $ 280,513 $ 278,536 Other current liabilities: Income taxes payable $ 3,790 $ — Client deposits 833 8,707 Operating lease liabilities 6,633 7,993 Deferred revenue 11,681 11,303 Other 4,437 5,735 Other current liabilities $ 27,374 $ 33,738 Other long-term liabilities: Workers compensation reserve $ 20,739 $ 21,169 Professional liability reserve 37,400 36,891 Operating lease liabilities 39,019 37,603 Other 12,889 13,316 Other long-term liabilities $ 110,047 $ 108,979 |
BASIS OF PRESENTATION - Reconci
BASIS OF PRESENTATION - Reconciliation of Cash, Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 | Mar. 31, 2023 | Dec. 31, 2022 |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | ||||
Cash and cash equivalents | $ 50,560 | $ 32,935 | ||
Restricted cash and cash equivalents (included in other current assets) | 21,251 | 22,056 | ||
Restricted cash, cash equivalents and investments | 71,912 | 68,845 | ||
Total cash, cash equivalents and restricted cash and investments | 143,723 | 123,836 | ||
Less restricted investments | (14,436) | (15,563) | ||
Total cash, cash equivalents and restricted cash | $ 129,287 | $ 108,273 | $ 104,418 | $ 137,872 |
BASIS OF PRESENTATION - Recon_2
BASIS OF PRESENTATION - Reconciliation of Activity in Allowance for Credit Losses for Accounts Receivable (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Accounts Receivable, Allowance for Credit Loss [Roll Forward] | ||
Beginning balance | $ 32,233 | $ 31,910 |
Provision for expected credit losses | 4,019 | 6,938 |
Amounts written off charged against the allowance | (4,456) | (1,112) |
Ending balance | $ 31,796 | $ 37,736 |
ACQUISITIONS - MSDR Acquisition
ACQUISITIONS - MSDR Acquisition (Details) | Nov. 30, 2023 USD ($) company | Mar. 31, 2024 USD ($) | Dec. 31, 2023 USD ($) | Feb. 10, 2023 USD ($) | Feb. 09, 2023 USD ($) |
Business Acquisition [Line Items] | |||||
Goodwill | $ 1,114,757,000 | $ 1,111,549,000 | |||
Revolving Credit Facility | Line of Credit | |||||
Business Acquisition [Line Items] | |||||
Maximum borrowing capacity | $ 750,000,000 | $ 750,000,000 | $ 400,000,000 | ||
MSDR | |||||
Business Acquisition [Line Items] | |||||
Number of healthcare staffing companies | company | 2 | ||||
Purchase price | $ 292,818,000 | ||||
Fair value of tangible assets acquired | 45,547,000 | ||||
Cash received | 643,000 | ||||
Liabilities assumed | 23,707,000 | ||||
Identifiable intangible assets | 92,000,000 | ||||
Goodwill | 178,978,000 | ||||
Goodwill expected to be deductible for tax purposes | $ 92,438,000 | ||||
Intangible assets acquired, weighted average useful life | 7 years |
ACQUISITIONS - Schedule of Inta
ACQUISITIONS - Schedule of Intangible Assets Acquired (Details) - MSDR $ in Thousands | Nov. 30, 2023 USD ($) |
Acquired Finite-Lived Intangible Assets [Line Items] | |
Fair Value | $ 92,000 |
Customer relationships | |
Acquired Finite-Lived Intangible Assets [Line Items] | |
Fair Value | $ 54,300 |
Customer relationships | Minimum | |
Acquired Finite-Lived Intangible Assets [Line Items] | |
Useful Life | 7 years |
Customer relationships | Maximum | |
Acquired Finite-Lived Intangible Assets [Line Items] | |
Useful Life | 10 years |
Tradenames and trademarks | |
Acquired Finite-Lived Intangible Assets [Line Items] | |
Fair Value | $ 26,400 |
Useful Life | 3 years |
Staffing databases | |
Acquired Finite-Lived Intangible Assets [Line Items] | |
Fair Value | $ 11,300 |
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 | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Earnings Per Share [Abstract] | ||
Net income - basic | $ 17,328 | $ 84,110 |
Net income - diluted | $ 17,328 | $ 84,110 |
Net income per common share - basic (in dollars per share) | $ 0.45 | $ 2.03 |
Net income per common share - diluted (in dollars per share) | $ 0.45 | $ 2.02 |
Weighted average common shares outstanding - basic (in shares) | 38,114 | 41,378 |
Plus dilutive effect of potential common shares (in shares) | 83 | 192 |
Weighted average common shares outstanding - diluted (in shares) | 38,197 | 41,570 |
NET INCOME PER COMMON SHARE - N
NET INCOME PER COMMON SHARE - Narrative (Details) - shares shares in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Earnings Per Share [Abstract] | ||
Common stock excluded from calculation of EPS (in shares) | 408 | 243 |
SEGMENT INFORMATION- Narrative
SEGMENT INFORMATION- Narrative (Details) | 3 Months Ended |
Mar. 31, 2024 segment | |
Segment Reporting [Abstract] | |
Number of reportable segments | 3 |
SEGMENT INFORMATION - Reconcili
SEGMENT INFORMATION - Reconciliation of Revenue and Segment Operating Income by Reportable Segment (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Segment Reporting, Revenue Reconciling Item [Line Items] | ||
Revenue | $ 820,878 | $ 1,126,223 |
Segment operating income | 39,945 | 125,670 |
Depreciation and amortization | 42,719 | 37,577 |
Depreciation (included in cost of revenue) | 1,798 | 1,257 |
Share-based compensation | 7,739 | 10,318 |
Interest expense, net, and other | 16,628 | 10,259 |
Income before income taxes | 23,317 | 115,411 |
Nurse and allied solutions | ||
Segment Reporting, Revenue Reconciling Item [Line Items] | ||
Revenue | 519,297 | 824,480 |
Physician and leadership solutions | ||
Segment Reporting, Revenue Reconciling Item [Line Items] | ||
Revenue | 188,797 | 165,757 |
Technology and workforce solutions | ||
Segment Reporting, Revenue Reconciling Item [Line Items] | ||
Revenue | 112,784 | 135,986 |
Operating segments | ||
Segment Reporting, Revenue Reconciling Item [Line Items] | ||
Revenue | 820,878 | 1,126,223 |
Segment operating income | 119,834 | 205,555 |
Operating segments | Nurse and allied solutions | ||
Segment Reporting, Revenue Reconciling Item [Line Items] | ||
Revenue | 519,297 | 824,480 |
Segment operating income | 53,342 | 113,445 |
Operating segments | Physician and leadership solutions | ||
Segment Reporting, Revenue Reconciling Item [Line Items] | ||
Revenue | 188,797 | 165,757 |
Segment operating income | 22,222 | 25,100 |
Operating segments | Technology and workforce solutions | ||
Segment Reporting, Revenue Reconciling Item [Line Items] | ||
Revenue | 112,784 | 135,986 |
Segment operating income | 44,270 | 67,010 |
Unallocated corporate overhead | ||
Segment Reporting, Revenue Reconciling Item [Line Items] | ||
Unallocated corporate overhead | $ 27,633 | $ 30,733 |
SEGMENT INFORMATION - Summary o
SEGMENT INFORMATION - Summary of Goodwill by Reportable Segment (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Dec. 31, 2023 | |
Goodwill [Roll Forward] | ||
Goodwill, beginning balance | $ 1,111,549 | |
Goodwill, ending balance | 1,114,757 | |
Accumulated impairment loss | 214,939 | $ 214,939 |
MSDR | ||
Goodwill [Roll Forward] | ||
Goodwill adjustment for acquisition | 3,208 | |
Nurse and Allied Solutions | ||
Goodwill [Roll Forward] | ||
Goodwill, beginning balance | 382,420 | |
Goodwill, ending balance | 382,420 | |
Accumulated impairment loss | 154,444 | 154,444 |
Nurse and Allied Solutions | MSDR | ||
Goodwill [Roll Forward] | ||
Goodwill adjustment for acquisition | 0 | |
Physician and Leadership Solutions | ||
Goodwill [Roll Forward] | ||
Goodwill, beginning balance | 328,570 | |
Goodwill, ending balance | 331,778 | |
Accumulated impairment loss | 60,495 | 60,495 |
Physician and Leadership Solutions | MSDR | ||
Goodwill [Roll Forward] | ||
Goodwill adjustment for acquisition | 3,208 | |
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 | MSDR | ||
Goodwill [Roll Forward] | ||
Goodwill adjustment for acquisition | $ 0 |
SEGMENT INFORMATION - Disaggreg
SEGMENT INFORMATION - Disaggregation of Revenue (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Segment Reporting Information [Line Items] | ||
Revenue | $ 820,878 | $ 1,126,223 |
Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 519,297 | 824,480 |
Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 188,797 | 165,757 |
Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 112,784 | 135,986 |
Travel nurse staffing | ||
Segment Reporting Information [Line Items] | ||
Revenue | 334,369 | 592,677 |
Travel nurse staffing | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 334,369 | 592,677 |
Travel nurse staffing | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Travel nurse staffing | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Labor disruption services | ||
Segment Reporting Information [Line Items] | ||
Revenue | 28 | 5,702 |
Labor disruption services | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 28 | 5,702 |
Labor disruption services | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Labor disruption services | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Local staffing | ||
Segment Reporting Information [Line Items] | ||
Revenue | 12,498 | 25,272 |
Local staffing | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 12,498 | 25,272 |
Local staffing | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Local staffing | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Allied staffing | ||
Segment Reporting Information [Line Items] | ||
Revenue | 169,756 | 196,125 |
Allied staffing | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 169,756 | 196,125 |
Allied staffing | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Allied staffing | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Locum tenens staffing | ||
Segment Reporting Information [Line Items] | ||
Revenue | 145,242 | 106,703 |
Locum tenens staffing | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Locum tenens staffing | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 145,242 | 106,703 |
Locum tenens staffing | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Interim leadership staffing | ||
Segment Reporting Information [Line Items] | ||
Revenue | 30,272 | 40,242 |
Interim leadership staffing | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Interim leadership staffing | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 30,272 | 40,242 |
Interim leadership staffing | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Temporary staffing | ||
Segment Reporting Information [Line Items] | ||
Revenue | 692,165 | 966,721 |
Temporary staffing | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 516,651 | 819,776 |
Temporary staffing | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 175,514 | 146,945 |
Temporary staffing | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Permanent placement | ||
Segment Reporting Information [Line Items] | ||
Revenue | 15,929 | 23,516 |
Permanent placement | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 2,646 | 4,704 |
Permanent placement | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 13,283 | 18,812 |
Permanent placement | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Language services | ||
Segment Reporting Information [Line Items] | ||
Revenue | 71,422 | 61,676 |
Language services | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Language services | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Language services | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 71,422 | 61,676 |
Vendor management systems | ||
Segment Reporting Information [Line Items] | ||
Revenue | 29,063 | 54,173 |
Vendor management systems | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Vendor management systems | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Vendor management systems | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 29,063 | 54,173 |
Other technologies | ||
Segment Reporting Information [Line Items] | ||
Revenue | 5,828 | 7,347 |
Other technologies | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Other technologies | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Other technologies | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 5,828 | 7,347 |
Technology-enabled services | ||
Segment Reporting Information [Line Items] | ||
Revenue | 106,313 | 123,196 |
Technology-enabled services | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Technology-enabled services | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Technology-enabled services | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 106,313 | 123,196 |
Talent planning and acquisition | ||
Segment Reporting Information [Line Items] | ||
Revenue | 6,471 | 12,790 |
Talent planning and acquisition | Nurse and Allied Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Talent planning and acquisition | Physician and Leadership Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | 0 | 0 |
Talent planning and acquisition | Technology and Workforce Solutions | ||
Segment Reporting Information [Line Items] | ||
Revenue | $ 6,471 | $ 12,790 |
NOTES PAYABLE AND CREDIT AGRE_2
NOTES PAYABLE AND CREDIT AGREEMENT (Details) - USD ($) | Nov. 30, 2023 | Feb. 10, 2023 | Feb. 09, 2023 |
Revolving Credit Facility | Line of Credit | |||
Debt Instrument [Line Items] | |||
Maximum borrowing capacity | $ 750,000,000 | $ 750,000,000 | $ 400,000,000 |
FAIR VALUE MEASUREMENT - Schedu
FAIR VALUE MEASUREMENT - Schedule of Assets and Liabilities at Fair Value (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
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 | $ 48,247 | $ 48,206 |
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 | 48,247 | 48,206 |
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 | 48,247 | 48,206 |
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 | 48,247 | 48,206 |
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 | 14,436 | 15,563 |
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 | $ 14,436 | $ 15,563 |
FAIR VALUE MEASUREMENT - Narrat
FAIR VALUE MEASUREMENT - Narrative (Details) - USD ($) | 3 Months Ended | ||||
Mar. 31, 2024 | Mar. 31, 2023 | Dec. 31, 2023 | Oct. 20, 2020 | Aug. 13, 2020 | |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Asset impairment charges | $ 0 | $ 0 | |||
Acquisition contingent consideration liabilities | |||||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||||
Contingent consideration liabilities | 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 | $ 12,503,000 | $ 12,503,000 |
FAIR VALUE MEASUREMENT - Financ
FAIR VALUE MEASUREMENT - Financial Assets and Liabilities (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
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 | $ 14,436 | $ 15,563 |
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 | 14,436 | 15,563 |
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 | 48,247 | 48,206 |
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 | 48,247 | 48,206 |
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 |
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 | (178,412) | (165,574) |
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 | (178,412) | (165,574) |
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 |
FAIR VALUE MEASUREMENT - Fair V
FAIR VALUE MEASUREMENT - Fair Value of Financial Instruments (Details) - Senior Notes - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
2027 Notes | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Carrying Amount | $ 500,000 | $ 500,000 |
Estimated Fair Value | 473,750 | 468,750 |
2029 Notes | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Carrying Amount | 350,000 | 350,000 |
Estimated Fair Value | $ 313,250 | $ 314,125 |
COMMITMENTS AND CONTINGENCIES (
COMMITMENTS AND CONTINGENCIES (Details) $ in Thousands | Mar. 31, 2024 USD ($) |
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 | Mar. 31, 2024 | Dec. 31, 2023 |
Other current assets: | ||
Restricted cash and cash equivalents | $ 21,251 | $ 22,056 |
Income taxes receivable | 0 | 5,350 |
Other | 17,491 | 18,264 |
Other current assets | 38,742 | 45,670 |
Fixed assets: | ||
Furniture and equipment | 75,686 | 71,815 |
Software | 407,298 | 388,812 |
Leasehold improvements | 16,242 | 15,839 |
Fixed assets, gross | 499,226 | 476,466 |
Accumulated depreciation | (304,689) | (285,081) |
Fixed assets, net | 194,537 | 191,385 |
Other assets: | ||
Life insurance cash surrender value | 177,403 | 162,780 |
Operating lease right-of-use assets | 35,397 | 34,543 |
Other | 39,597 | 39,473 |
Other assets | 252,397 | 236,796 |
Accounts payable and accrued expenses: | ||
Trade accounts payable | 48,238 | 54,128 |
Subcontractor payable | 94,889 | 122,983 |
Accrued expenses | 86,766 | 82,257 |
Loss contingencies | 70,820 | 69,837 |
Professional liability reserve | 7,625 | 7,761 |
Other | 7,678 | 6,881 |
Accounts payable and accrued expenses | 316,016 | 343,847 |
Accrued compensation and benefits: | ||
Accrued payroll | 59,052 | 53,633 |
Accrued bonuses and commissions | 21,595 | 31,236 |
ESPP contributions | 72 | 950 |
Workers compensation reserve | 10,931 | 12,130 |
Deferred compensation | 178,412 | 165,574 |
Other | 10,451 | 15,013 |
Accrued compensation and benefits | 280,513 | 278,536 |
Other current liabilities: | ||
Income taxes payable | 3,790 | 0 |
Client deposits | 833 | 8,707 |
Operating lease liabilities | 6,633 | 7,993 |
Deferred revenue | 11,681 | 11,303 |
Other | 4,437 | 5,735 |
Other current liabilities | 27,374 | 33,738 |
Other long-term liabilities: | ||
Workers compensation reserve | 20,739 | 21,169 |
Professional liability reserve | 37,400 | 36,891 |
Operating lease liabilities | 39,019 | 37,603 |
Other | 12,889 | 13,316 |
Other long-term liabilities | $ 110,047 | $ 108,979 |