AMN Healthcare Services (AMN) 10-Q 7 Nov 24 2024 Q3 Quarterly report Financial data

COVER

COVER - shares	9 Months Ended
	Sep. 30, 2024	Nov. 05, 2024
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 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)		38,073,722
Entity Central Index Key	0001142750
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q3
Amendment Flag	false

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 30,550	$ 32,935
Accounts receivable, net of allowances of $31,199 and $32,233 at September 30, 2024 and December 31, 2023, respectively	451,062	623,488
Accounts receivable, subcontractor	68,566	117,703
Prepaid expenses	17,073	21,889
Other current assets	45,015	45,670
Total current assets	612,266	841,685
Restricted cash, cash equivalents and investments	72,167	68,845
Fixed assets, net of accumulated depreciation of $341,040 and $285,081 at September 30, 2024 and December 31, 2023, respectively	196,902	191,385
Other assets	267,266	236,796
Goodwill	1,116,815	1,111,549
Intangible assets, net of accumulated amortization of $513,785 and $442,052 at September 30, 2024 and December 31, 2023, respectively	402,400	474,134
Total assets	2,667,816	2,924,394
Current liabilities:
Accounts payable and accrued expenses	213,206	343,847
Accrued compensation and benefits	281,683	278,536
Other current liabilities	23,657	33,738
Total current liabilities	518,546	656,121
Revolving credit facility	285,000	460,000
Notes payable, net of unamortized fees and premium	845,576	844,688
Deferred income taxes, net	17,270	23,350
Other long-term liabilities	110,759	108,979
Total liabilities	1,777,151	2,093,138
Commitments and contingencies
Stockholders’ equity:
Preferred stock, $0.01 par value; 10,000 shares authorized; none issued and outstanding at September 30, 2024 and December 31, 2023	0	0
Common stock, $0.01 par value; 200,000 shares authorized; 50,631 issued and 38,018 outstanding at September 30, 2024 and 50,423 issued and 37,810 outstanding at December 31, 2023	506	504
Additional paid-in capital	525,029	506,543
Treasury stock, at cost; 12,613 shares at September 30, 2024 and December 31, 2023	(1,127,043)	(1,127,043)
Retained earnings	1,492,229	1,451,675
Accumulated other comprehensive loss	(56)	(423)
Total stockholders’ equity	890,665	831,256
Total liabilities and stockholders’ equity	$ 2,667,816	$ 2,924,394

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Accounts receivable, net of allowances	$ 31,199	$ 32,233
Accumulated depreciation	341,040	285,081
Accumulated amortization	$ 513,785	$ 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)	50,631,000	50,423,000
Common stock, shares outstanding (in shares)	38,018,000	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		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Statement of Comprehensive Income [Abstract]
Revenue	$ 687,509	$ 853,463	$ 2,249,072	$ 2,970,985
Cost of revenue	474,454	563,957	1,548,684	1,982,352
Gross profit	213,055	289,506	700,388	988,633
Operating expenses:
Selling, general and administrative	149,681	163,405	473,567	570,775
Depreciation and amortization (exclusive of depreciation included in cost of revenue)	41,122	39,175	126,942	113,599
Total operating expenses	190,803	202,580	600,509	684,374
Income from operations	22,252	86,926	99,879	304,259
Interest expense, net, and other	14,444	11,541	46,787	33,975
Income before income taxes	7,808	75,385	53,092	270,284
Income tax expense	819	22,211	12,538	72,094
Net income	6,989	53,174	40,554	198,190
Other comprehensive income:
Unrealized gains on available-for-sale securities, net, and other	101	133	367	329
Other comprehensive income	101	133	367	329
Comprehensive income	$ 7,090	$ 53,307	$ 40,921	$ 198,519
Net income per common share:
Basic (in dollars per share)	$ 0.18	$ 1.39	$ 1.06	$ 5.01
Diluted (in dollars per share)	$ 0.18	$ 1.39	$ 1.06	$ 4.99
Weighted average common shares outstanding:
Basic (in shares)	38,200	38,147	38,163	39,547
Diluted (in shares)	38,287	38,325	38,247	39,734

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	(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	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		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]
Comprehensive income	198,519
Ending balance (in shares) at Sep. 30, 2023		50,387
Ending balance at Sep. 30, 2023	817,169	$ 504	505,170	$ (1,127,081)	1,439,186	(610)
Ending balance (in shares) at Sep. 30, 2023				(12,613)
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	60,956				60,906	50
Ending balance (in shares) at Jun. 30, 2023		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)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Repurchase of common stock	(219)		40,000	$ (40,219)
Repurchase of common stock (in shares)				(261)
Equity awards vested, net of shares withheld for taxes (in shares)		48
Equity awards vested, net of shares withheld for taxes	(2,522)	$ 1	(2,523)
Share-based compensation	306		306
Comprehensive income	53,307				53,174	133
Ending balance (in shares) at Sep. 30, 2023		50,387
Ending balance at Sep. 30, 2023	$ 817,169	$ 504	505,170	$ (1,127,081)	1,439,186	(610)
Ending balance (in shares) at Sep. 30, 2023				(12,613)
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		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)
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]
Comprehensive income	$ 40,921
Ending balance (in shares) at Sep. 30, 2024	38,018	50,631
Ending balance at Sep. 30, 2024	$ 890,665	$ 506	525,029	$ (1,127,043)	1,492,229	(56)
Ending balance (in shares) at Sep. 30, 2024	(12,613)			(12,613)
Beginning balance (in shares) at Mar. 31, 2024		50,537
Beginning balance at Mar. 31, 2024	$ 854,191	$ 505	512,065	$ (1,127,043)	1,469,003	(339)
Beginning balance (in shares) at Mar. 31, 2024				(12,613)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Equity awards vested, net of shares withheld for taxes (in shares)		43
Equity awards vested, net of shares withheld for taxes	(108)	$ 1	(109)
Shares issued under employee stock purchase plan (in shares)		33
Share-based compensation	6,357		6,357
Comprehensive income	16,419				16,237	182
Ending balance (in shares) at Jun. 30, 2024		50,613
Ending balance at Jun. 30, 2024	876,859	$ 506	518,313	$ (1,127,043)	1,485,240	(157)
Ending balance (in shares) at Jun. 30, 2024				(12,613)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Equity awards vested, net of shares withheld for taxes (in shares)		18
Equity awards vested, net of shares withheld for taxes	(469)	$ 0	(469)
Shares purchased under employee stock purchase plan	1,630		1,630
Share-based compensation	5,555		5,555
Comprehensive income	$ 7,090				6,989	101
Ending balance (in shares) at Sep. 30, 2024	38,018	50,631
Ending balance at Sep. 30, 2024	$ 890,665	$ 506	$ 525,029	$ (1,127,043)	$ 1,492,229	$ (56)
Ending balance (in shares) at Sep. 30, 2024	(12,613)			(12,613)

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands		9 Months Ended
		Sep. 30, 2024	Sep. 30, 2023
Cash flows from operating activities:
Net income		$ 40,554	$ 198,190
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization (inclusive of depreciation included in cost of revenue)		132,305	117,795
Non-cash interest expense and other		1,601	1,587
Change in fair value of contingent consideration liabilities		0	2,430
Increase in allowance for credit losses and sales credits		5,556	31,968
Provision for deferred income taxes		(5,908)	8,495
Share-based compensation		19,651	15,442
Loss on disposal or impairment of long-lived assets		42	1,793
Net loss on investments in available-for-sale securities		197	228
Net gain on deferred compensation balances		(1,189)	(300)
Non-cash lease expense		(903)	1,146
Changes in assets and liabilities, net of effects from acquisitions:
Accounts receivable		162,958	77,572
Accounts receivable, subcontractor		49,137	92,750
Income taxes receivable		(3,603)	8,875
Prepaid expenses		3,462	344
Other current assets		163	3,793
Other assets		365	(1,103)
Accounts payable and accrued expenses		(131,796)	(122,763)
Accrued compensation and benefits		(16,082)	(78,290)
Other liabilities		(10,301)	52,503
Deferred revenue		1,395	840
Net cash provided by operating activities		247,604	413,295
Cash flows from investing activities:
Purchase and development of fixed assets		(64,671)	(73,831)
Proceeds from sale and maturity of investments		5,699	9,894
Proceeds from sale of equity investment		0	77
Payments to fund deferred compensation plan		(8,412)	(24,902)
Cash received for working capital settlement of prior year acquisition		1,649	0
Net cash used in investing activities		(65,735)	(88,762)
Cash flows from financing activities:
Payments on revolving credit facility		(260,000)	(330,000)
Proceeds from revolving credit facility		85,000	425,000
Repurchase of common stock	[1]	0	(424,744)
Payment of financing costs		0	(3,579)
Earn-out payments to settle contingent consideration liabilities for prior acquisitions		0	(7,500)
Cash paid for shares withheld for taxes		(4,550)	(11,943)
Net cash used in financing activities		(179,550)	(352,766)
Net increase (decrease) in cash, cash equivalents and restricted cash		2,319	(28,233)
Cash, cash equivalents and restricted cash at beginning of period		108,273	137,872
Cash, cash equivalents and restricted cash at end of period		110,592	109,639
Supplemental disclosures of cash flow information:
Cash paid for amounts included in the measurement of operating lease liabilities		7,844	6,891
Cash paid for interest (net of $509 and $1,026 capitalized for the nine months ended September 30, 2024 and 2023, respectively)		38,125	25,087
Cash paid for income taxes		21,675	10,833
Supplemental disclosures of non-cash investing and financing activities:
Purchase of fixed assets recorded in accounts payable and accrued expenses		9,589	14,841
Excise tax payable on share repurchases		0	3,739
Right-of-use assets obtained in exchange for operating lease liabilities		$ 4,969	$ 25,794
[1]The difference between the amount reported for the nine months ended September 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	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Statement of Cash Flows [Abstract]
Interest capitalized	$ 509	$ 1,026

BASIS OF PRESENTATION

BASIS OF PRESENTATION	9 Months Ended
	Sep. 30, 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. September 30, 2024 December 31, 2023 Cash and cash equivalents $ 30,550 $ 32,935 Restricted cash and cash equivalents (included in other current assets) 18,004 22,056 Restricted cash, cash equivalents and investments 72,167 68,845 Total cash, cash equivalents and restricted cash and investments 120,721 123,836 Less restricted investments (10,129) (15,563) Total cash, cash equivalents and restricted cash $ 110,592 $ 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 5,664 5,464 Amounts written off charged against the allowance (6,698) (2,948) Balance as of September 30, $ 31,199 $ 34,426

ACQUISITIONS

ACQUISITIONS	9 Months Ended
	Sep. 30, 2024
Business Combination, Asset Acquisition, and Joint Venture Formation [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 September 30, 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. During the second quarter of 2024, $1,649 was returned to the Company in respect of the final working capital settlement. The preliminary allocation of the $291,169 purchase price, which was reduced by the final working capital settlement during the second quarter of 2024, consisted of (1) $43,323 of fair value of tangible assets acquired, which included $643 cash received, (2) $25,190 of liabilities assumed, (3) $92,000 of identified intangible assets, and (4) $181,036 of goodwill, of which $92,208 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 and operating leases. 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	9 Months Ended
	Sep. 30, 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 are recorded in accordance with the accounting guidance on reporting revenue gross as a principal versus net as an agent. Revenue is recorded on a gross basis when the Company utilizes its own network of healthcare professionals (including nurses, allied healthcare professionals, locum tenens, and executive and leadership interim staff). Conversely, when the Company uses subcontractors under an MSP arrangement 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. Revenue for the language services business is recorded on a gross basis. Under vendor management systems arrangements, revenue is recorded on a net basis as an agent because other companies are primarily responsible for providing the staffing services, for which the Company is entitled a percentage fee. 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	9 Months Ended
	Sep. 30, 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 September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Net income $ 6,989 $ 53,174 $ 40,554 $ 198,190 Net income per common share - basic $ 0.18 $ 1.39 $ 1.06 $ 5.01 Net income per common share - diluted $ 0.18 $ 1.39 $ 1.06 $ 4.99 Weighted average common shares outstanding - basic 38,200 38,147 38,163 39,547 Plus dilutive effect of potential common shares 87 178 84 187 Weighted average common shares outstanding - diluted 38,287 38,325 38,247 39,734 Anti-dilutive potential common shares excluded from diluted weighted average common shares outstanding 411 43 392 84 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”). In the second quarter of 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. In the third quarter of 2023, the Company received a final delivery of approximately 261 additional shares of its common stock, representing the final settlement of the ASR agreement. 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 reflected the fair value of the shares received upon initial delivery, and (2) a reduction in additional paid-in capital, which reflected the pending settlement of the ASR agreement. The reduction in additional paid-in capital was reclassified to treasury stock during the three months ended September 30, 2023 upon final settlement. Additional information regarding the Company’s share repurchase program and the shares repurchased thereunder (including the ASR) is disclosed in Part II, Item 8, “Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note (b), Capital Stock—Treasury Stock” of the 2023 Annual Report.

SEGMENT INFORMATION

SEGMENT INFORMATION	9 Months Ended
	Sep. 30, 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 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 September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Revenue Nurse and allied solutions $ 399,368 $ 573,426 $ 1,361,064 $ 2,086,921 Physician and leadership solutions 180,605 159,554 555,467 501,540 Technology and workforce solutions 107,536 120,483 332,541 382,524 $ 687,509 $ 853,463 $ 2,249,072 $ 2,970,985 Segment operating income Nurse and allied solutions $ 35,110 $ 82,882 $ 134,659 $ 299,320 Physician and leadership solutions 18,134 21,609 62,017 73,165 Technology and workforce solutions 41,948 50,664 133,477 173,297 95,192 155,155 330,153 545,782 Unallocated corporate overhead 24,335 27,196 78,318 108,286 Depreciation and amortization 41,122 39,175 126,942 113,599 Depreciation (included in cost of revenue) 1,928 1,552 5,363 4,196 Share-based compensation 5,555 306 19,651 15,442 Interest expense, net, and other 14,444 11,541 46,787 33,975 Income before income taxes $ 7,808 $ 75,385 $ 53,092 $ 270,284 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 — 5,266 — 5,266 Balance, September 30, 2024 $ 382,420 $ 333,836 $ 400,559 $ 1,116,815 Accumulated impairment loss as of December 31, 2023 and September 30, 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 September 30, 2024 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 243,745 $ — $ — $ 243,745 Labor disruption services 486 — — 486 Local staffing 10,494 — — 10,494 Allied staffing 140,872 — — 140,872 Locum tenens staffing — 141,716 — 141,716 Interim leadership staffing — 28,862 — 28,862 Temporary staffing 395,597 170,578 — 566,175 Permanent placement (1) 3,771 10,027 — 13,798 Language services — — 75,009 75,009 Vendor management systems — — 25,018 25,018 Other technologies — — 5,044 5,044 Technology-enabled services — — 105,071 105,071 Talent planning and acquisition — — 2,465 2,465 Total revenue $ 399,368 $ 180,605 $ 107,536 $ 687,509 Three Months Ended September 30, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 384,102 $ — $ — $ 384,102 Labor disruption services 777 — — 777 Local staffing 16,991 — — 16,991 Allied staffing 167,622 — — 167,622 Locum tenens staffing — 112,514 — 112,514 Interim leadership staffing — 30,910 — 30,910 Temporary staffing 569,492 143,424 — 712,916 Permanent placement (1) 3,934 16,130 — 20,064 Language services — — 66,406 66,406 Vendor management systems — — 38,116 38,116 Other technologies — — 5,052 5,052 Technology-enabled services — — 109,574 109,574 Talent planning and acquisition — — 10,909 10,909 Total revenue $ 573,426 $ 159,554 $ 120,483 $ 853,463 Nine Months Ended September 30, 2024 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 854,746 $ — $ — $ 854,746 Labor disruption services 886 — — 886 Local staffing 33,786 — — 33,786 Allied staffing 462,001 — — 462,001 Locum tenens staffing — 429,700 — 429,700 Interim leadership staffing — 89,373 — 89,373 Temporary staffing 1,351,419 519,073 — 1,870,492 Permanent placement (1) 9,645 36,394 — 46,039 Language services — — 221,749 221,749 Vendor management systems — — 81,671 81,671 Other technologies — — 15,993 15,993 Technology-enabled services — — 319,413 319,413 Talent planning and acquisition — — 13,128 13,128 Total revenue $ 1,361,064 $ 555,467 $ 332,541 $ 2,249,072 Nine Months Ended September 30, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 1,453,988 $ — $ — $ 1,453,988 Labor disruption services 11,515 — — 11,515 Local staffing 61,038 — — 61,038 Allied staffing 545,959 — — 545,959 Locum tenens staffing — 341,129 — 341,129 Interim leadership staffing — 107,553 — 107,553 Temporary staffing 2,072,500 448,682 — 2,521,182 Permanent placement (1) 14,421 52,858 — 67,279 Language services — — 191,732 191,732 Vendor management systems — — 138,843 138,843 Other technologies — — 18,191 18,191 Technology-enabled services — — 348,766 348,766 Talent planning and acquisition — — 33,758 33,758 Total revenue $ 2,086,921 $ 501,540 $ 382,524 $ 2,970,985 The following table presents the Company’s international nurse revenue by service type: Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 International nurse staffing (1) $ 41,376 $ 53,990 $ 129,668 $ 155,454 International nurse permanent placement (2) 3,771 3,934 9,645 14,421 Total international nurse revenue $ 45,147 $ 57,924 $ 139,313 $ 169,875 (1) Included in “Travel nurse staffing” as presented in the preceding tables.

NOTES PAYABLE AND CREDIT AGREEM

NOTES PAYABLE AND CREDIT AGREEMENT	9 Months Ended
	Sep. 30, 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. As reported in the Company’s Current Report on Form 8-K filed on November 7, 2024, on November 5, 2024, the Company entered into the fourth amendment to its credit agreement which increased the consolidated net leverage ratio covenant for the year ending December 31, 2025. 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	9 Months Ended
	Sep. 30, 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 nine months ended September 30, 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 September 30, 2024 As of December 31, 2023 Commercial paper $ 55,101 $ 48,206 Corporate bonds — — Total classified as restricted cash equivalents $ 55,101 $ 48,206 Commercial paper $ — $ — Corporate bonds 10,129 15,563 Total classified as restricted investments $ 10,129 $ 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 September 30, 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 September 30, 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 $ (188,738) $ — $ — $ (188,738) $ (165,574) $ — $ — $ (165,574) Corporate bonds — 10,129 — 10,129 — 15,563 — 15,563 Commercial paper — 55,101 — 55,101 — 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 is 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. As of September 30, 2024, the Company has recognized cumulative upward adjustments and cumulative downward adjustments (including impairments) of $14,033 and $10,130, respectively. The balance of the equity investment was $12,503 as of both September 30, 2024 and December 31, 2023. There were no material impairment charges recorded during the nine months ended September 30, 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 September 30, 2024 As of December 31, 2023 Carrying Estimated Carrying Estimated 2027 Notes $ 500,000 $ 486,875 $ 500,000 $ 468,750 2029 Notes 350,000 326,375 350,000 314,125

INCOME TAXES

INCOME TAXES	9 Months Ended
	Sep. 30, 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 September 30, 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	9 Months Ended
	Sep. 30, 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. The Company reached an agreement to settle this matter in its entirety and accordingly recorded an accrual amounting to $62,000. Final approval of the settlement was granted in the second quarter of 2024, and the Company disbursed the settlement amount in the third quarter of 2024.

BALANCE SHEET DETAILS

BALANCE SHEET DETAILS	9 Months Ended
	Sep. 30, 2024
Balance Sheet Related Disclosures [Abstract]
BALANCE SHEET DETAILS	BALANCE SHEET DETAILS The consolidated balance sheets detail is as follows: September 30, 2024 December 31, 2023 Other current assets: Restricted cash and cash equivalents $ 18,004 $ 22,056 Income taxes receivable 8,953 5,350 Other 18,058 18,264 Other current assets $ 45,015 $ 45,670 Fixed assets: Furniture and equipment $ 86,776 $ 71,815 Software 435,064 388,812 Leasehold improvements 16,102 15,839 537,942 476,466 Accumulated depreciation (341,040) (285,081) Fixed assets, net $ 196,902 $ 191,385 Other assets: Life insurance cash surrender value $ 193,736 $ 162,780 Operating lease right-of-use assets 33,689 34,543 Other 39,841 39,473 Other assets $ 267,266 $ 236,796 Accounts payable and accrued expenses: Trade accounts payable $ 44,033 $ 54,128 Subcontractor payable 72,024 122,983 Accrued expenses 75,928 82,257 Loss contingencies 7,963 69,837 Professional liability reserve 6,416 7,761 Other 6,842 6,881 Accounts payable and accrued expenses $ 213,206 $ 343,847 Accrued compensation and benefits: Accrued payroll $ 52,437 $ 53,633 Accrued bonuses and commissions 23,800 31,236 ESPP contributions 53 950 Workers compensation reserve 6,169 12,130 Deferred compensation 188,738 165,574 Other 10,486 15,013 Accrued compensation and benefits $ 281,683 $ 278,536 Other current liabilities: Client deposits $ — $ 8,707 Operating lease liabilities 6,363 7,993 Deferred revenue 12,738 11,303 Other 4,556 5,735 Other current liabilities $ 23,657 $ 33,738 Other long-term liabilities: Workers compensation reserve $ 22,531 $ 21,169 Professional liability reserve 37,283 36,891 Operating lease liabilities 37,477 37,603 Other 13,468 13,316 Other long-term liabilities $ 110,759 $ 108,979

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ 6,989	$ 53,174	$ 40,554	$ 198,190

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Sep. 30, 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)	9 Months Ended
	Sep. 30, 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 are recorded in accordance with the accounting guidance on reporting revenue gross as a principal versus net as an agent. Revenue is recorded on a gross basis when the Company utilizes its own network of healthcare professionals (including nurses, allied healthcare professionals, locum tenens, and executive and leadership interim staff). Conversely, when the Company uses subcontractors under an MSP arrangement 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. Revenue for the language services business is recorded on a gross basis. Under vendor management systems arrangements, revenue is recorded on a net basis as an agent because other companies are primarily responsible for providing the staffing services, for which the Company is entitled a percentage fee. 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 nine months ended September 30, 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 is 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 September 30, 2024 As of December 31, 2023 Carrying Estimated Carrying Estimated 2027 Notes $ 500,000 $ 486,875 $ 500,000 $ 468,750 2029 Notes 350,000 326,375 350,000 314,125

BASIS OF PRESENTATION (Tables)

BASIS OF PRESENTATION (Tables)	9 Months Ended
	Sep. 30, 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. September 30, 2024 December 31, 2023 Cash and cash equivalents $ 30,550 $ 32,935 Restricted cash and cash equivalents (included in other current assets) 18,004 22,056 Restricted cash, cash equivalents and investments 72,167 68,845 Total cash, cash equivalents and restricted cash and investments 120,721 123,836 Less restricted investments (10,129) (15,563) Total cash, cash equivalents and restricted cash $ 110,592 $ 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 5,664 5,464 Amounts written off charged against the allowance (6,698) (2,948) Balance as of September 30, $ 31,199 $ 34,426

ACQUISITIONS (Tables)

ACQUISITIONS (Tables)	9 Months Ended
	Sep. 30, 2024
Business Combination, Asset Acquisition, and Joint Venture Formation [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)	9 Months Ended
	Sep. 30, 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 September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Net income $ 6,989 $ 53,174 $ 40,554 $ 198,190 Net income per common share - basic $ 0.18 $ 1.39 $ 1.06 $ 5.01 Net income per common share - diluted $ 0.18 $ 1.39 $ 1.06 $ 4.99 Weighted average common shares outstanding - basic 38,200 38,147 38,163 39,547 Plus dilutive effect of potential common shares 87 178 84 187 Weighted average common shares outstanding - diluted 38,287 38,325 38,247 39,734 Anti-dilutive potential common shares excluded from diluted weighted average common shares outstanding 411 43 392 84

SEGMENT INFORMATION (Tables)

SEGMENT INFORMATION (Tables)	9 Months Ended
	Sep. 30, 2024
Segment Reporting [Abstract]
Schedule of Reconciliation of Revenue and 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 September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Revenue Nurse and allied solutions $ 399,368 $ 573,426 $ 1,361,064 $ 2,086,921 Physician and leadership solutions 180,605 159,554 555,467 501,540 Technology and workforce solutions 107,536 120,483 332,541 382,524 $ 687,509 $ 853,463 $ 2,249,072 $ 2,970,985 Segment operating income Nurse and allied solutions $ 35,110 $ 82,882 $ 134,659 $ 299,320 Physician and leadership solutions 18,134 21,609 62,017 73,165 Technology and workforce solutions 41,948 50,664 133,477 173,297 95,192 155,155 330,153 545,782 Unallocated corporate overhead 24,335 27,196 78,318 108,286 Depreciation and amortization 41,122 39,175 126,942 113,599 Depreciation (included in cost of revenue) 1,928 1,552 5,363 4,196 Share-based compensation 5,555 306 19,651 15,442 Interest expense, net, and other 14,444 11,541 46,787 33,975 Income before income taxes $ 7,808 $ 75,385 $ 53,092 $ 270,284
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 — 5,266 — 5,266 Balance, September 30, 2024 $ 382,420 $ 333,836 $ 400,559 $ 1,116,815 Accumulated impairment loss as of December 31, 2023 and September 30, 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 September 30, 2024 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 243,745 $ — $ — $ 243,745 Labor disruption services 486 — — 486 Local staffing 10,494 — — 10,494 Allied staffing 140,872 — — 140,872 Locum tenens staffing — 141,716 — 141,716 Interim leadership staffing — 28,862 — 28,862 Temporary staffing 395,597 170,578 — 566,175 Permanent placement (1) 3,771 10,027 — 13,798 Language services — — 75,009 75,009 Vendor management systems — — 25,018 25,018 Other technologies — — 5,044 5,044 Technology-enabled services — — 105,071 105,071 Talent planning and acquisition — — 2,465 2,465 Total revenue $ 399,368 $ 180,605 $ 107,536 $ 687,509 Three Months Ended September 30, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 384,102 $ — $ — $ 384,102 Labor disruption services 777 — — 777 Local staffing 16,991 — — 16,991 Allied staffing 167,622 — — 167,622 Locum tenens staffing — 112,514 — 112,514 Interim leadership staffing — 30,910 — 30,910 Temporary staffing 569,492 143,424 — 712,916 Permanent placement (1) 3,934 16,130 — 20,064 Language services — — 66,406 66,406 Vendor management systems — — 38,116 38,116 Other technologies — — 5,052 5,052 Technology-enabled services — — 109,574 109,574 Talent planning and acquisition — — 10,909 10,909 Total revenue $ 573,426 $ 159,554 $ 120,483 $ 853,463 Nine Months Ended September 30, 2024 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 854,746 $ — $ — $ 854,746 Labor disruption services 886 — — 886 Local staffing 33,786 — — 33,786 Allied staffing 462,001 — — 462,001 Locum tenens staffing — 429,700 — 429,700 Interim leadership staffing — 89,373 — 89,373 Temporary staffing 1,351,419 519,073 — 1,870,492 Permanent placement (1) 9,645 36,394 — 46,039 Language services — — 221,749 221,749 Vendor management systems — — 81,671 81,671 Other technologies — — 15,993 15,993 Technology-enabled services — — 319,413 319,413 Talent planning and acquisition — — 13,128 13,128 Total revenue $ 1,361,064 $ 555,467 $ 332,541 $ 2,249,072 Nine Months Ended September 30, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 1,453,988 $ — $ — $ 1,453,988 Labor disruption services 11,515 — — 11,515 Local staffing 61,038 — — 61,038 Allied staffing 545,959 — — 545,959 Locum tenens staffing — 341,129 — 341,129 Interim leadership staffing — 107,553 — 107,553 Temporary staffing 2,072,500 448,682 — 2,521,182 Permanent placement (1) 14,421 52,858 — 67,279 Language services — — 191,732 191,732 Vendor management systems — — 138,843 138,843 Other technologies — — 18,191 18,191 Technology-enabled services — — 348,766 348,766 Talent planning and acquisition — — 33,758 33,758 Total revenue $ 2,086,921 $ 501,540 $ 382,524 $ 2,970,985 (1) Includes revenue from international nurse permanent placement, physician permanent placement and executive search. The following table presents the Company’s international nurse revenue by service type: Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 International nurse staffing (1) $ 41,376 $ 53,990 $ 129,668 $ 155,454 International nurse permanent placement (2) 3,771 3,934 9,645 14,421 Total international nurse revenue $ 45,147 $ 57,924 $ 139,313 $ 169,875 (1) Included in “Travel nurse staffing” as presented in the preceding tables. (2) Included in “Permanent placement” as presented in the preceding tables.

FAIR VALUE MEASUREMENT (Tables)

FAIR VALUE MEASUREMENT (Tables)	9 Months Ended
	Sep. 30, 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 September 30, 2024 As of December 31, 2023 Commercial paper $ 55,101 $ 48,206 Corporate bonds — — Total classified as restricted cash equivalents $ 55,101 $ 48,206 Commercial paper $ — $ — Corporate bonds 10,129 15,563 Total classified as restricted investments $ 10,129 $ 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 September 30, 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 $ (188,738) $ — $ — $ (188,738) $ (165,574) $ — $ — $ (165,574) Corporate bonds — 10,129 — 10,129 — 15,563 — 15,563 Commercial paper — 55,101 — 55,101 — 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 September 30, 2024 As of December 31, 2023 Carrying Estimated Carrying Estimated 2027 Notes $ 500,000 $ 486,875 $ 500,000 $ 468,750 2029 Notes 350,000 326,375 350,000 314,125

BALANCE SHEET DETAILS (Tables)

BALANCE SHEET DETAILS (Tables)	9 Months Ended
	Sep. 30, 2024
Balance Sheet Related Disclosures [Abstract]
Schedule of Supplemental Balance Sheet Disclosures	The consolidated balance sheets detail is as follows: September 30, 2024 December 31, 2023 Other current assets: Restricted cash and cash equivalents $ 18,004 $ 22,056 Income taxes receivable 8,953 5,350 Other 18,058 18,264 Other current assets $ 45,015 $ 45,670 Fixed assets: Furniture and equipment $ 86,776 $ 71,815 Software 435,064 388,812 Leasehold improvements 16,102 15,839 537,942 476,466 Accumulated depreciation (341,040) (285,081) Fixed assets, net $ 196,902 $ 191,385 Other assets: Life insurance cash surrender value $ 193,736 $ 162,780 Operating lease right-of-use assets 33,689 34,543 Other 39,841 39,473 Other assets $ 267,266 $ 236,796 Accounts payable and accrued expenses: Trade accounts payable $ 44,033 $ 54,128 Subcontractor payable 72,024 122,983 Accrued expenses 75,928 82,257 Loss contingencies 7,963 69,837 Professional liability reserve 6,416 7,761 Other 6,842 6,881 Accounts payable and accrued expenses $ 213,206 $ 343,847 Accrued compensation and benefits: Accrued payroll $ 52,437 $ 53,633 Accrued bonuses and commissions 23,800 31,236 ESPP contributions 53 950 Workers compensation reserve 6,169 12,130 Deferred compensation 188,738 165,574 Other 10,486 15,013 Accrued compensation and benefits $ 281,683 $ 278,536 Other current liabilities: Client deposits $ — $ 8,707 Operating lease liabilities 6,363 7,993 Deferred revenue 12,738 11,303 Other 4,556 5,735 Other current liabilities $ 23,657 $ 33,738 Other long-term liabilities: Workers compensation reserve $ 22,531 $ 21,169 Professional liability reserve 37,283 36,891 Operating lease liabilities 37,477 37,603 Other 13,468 13,316 Other long-term liabilities $ 110,759 $ 108,979

BASIS OF PRESENTATION - Reconci

BASIS OF PRESENTATION - Reconciliation of Cash, Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023	Sep. 30, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Cash and cash equivalents	$ 30,550	$ 32,935
Restricted cash and cash equivalents (included in other current assets)	18,004	22,056
Restricted cash, cash equivalents and investments	72,167	68,845
Total cash, cash equivalents and restricted cash and investments	120,721	123,836
Less restricted investments	(10,129)	(15,563)
Total cash, cash equivalents and restricted cash	$ 110,592	$ 108,273	$ 109,639	$ 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	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Accounts Receivable, Allowance for Credit Loss [Roll Forward]
Beginning balance	$ 32,233	$ 31,910
Provision for expected credit losses	5,664	5,464
Amounts written off charged against the allowance	(6,698)	(2,948)
Ending balance	$ 31,199	$ 34,426

ACQUISITIONS - MSDR Acquisition

ACQUISITIONS - MSDR Acquisition (Details)		3 Months Ended
	Nov. 30, 2023 USD ($) company	Jun. 30, 2024 USD ($)	Sep. 30, 2024 USD ($)	Dec. 31, 2023 USD ($)	Feb. 10, 2023 USD ($)	Feb. 09, 2023 USD ($)
Business Acquisition [Line Items]
Goodwill			$ 1,116,815,000	$ 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	$ 291,169,000
Cash returned to the company for final working capital settlement		1,649,000
Fair value of tangible assets acquired		43,323,000
Cash received		643,000
Liabilities assumed		25,190,000
Identifiable intangible assets	$ 92,000,000	92,000,000
Goodwill		181,036,000
Goodwill expected to be deductible for tax purposes		$ 92,208,000
Intangible assets acquired, weighted average useful life	7 years

ACQUISITIONS - Fair Value and U

ACQUISITIONS - Fair Value and Useful life of Intangible Assets Acquired (Details) - MSDR - USD ($) $ in Thousands	Jun. 30, 2024	Nov. 30, 2023
Acquired Finite-Lived Intangible Assets [Line Items]
Fair Value	$ 92,000	$ 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 - C

NET INCOME PER COMMON SHARE - Computation of Basic and Diluted Net Income Per Common Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Earnings Per Share [Abstract]
Net income - basic	$ 6,989	$ 53,174	$ 40,554	$ 198,190
Net income - diluted	$ 6,989	$ 53,174	$ 40,554	$ 198,190
Net income per common share - basic (in dollars per share)	$ 0.18	$ 1.39	$ 1.06	$ 5.01
Net income per common share - diluted (in dollars per share)	$ 0.18	$ 1.39	$ 1.06	$ 4.99
Weighted average common shares outstanding - basic (in shares)	38,200	38,147	38,163	39,547
Plus dilutive effect of potential common shares (in shares)	87	178	84	187
Weighted average common shares outstanding - diluted (in shares)	38,287	38,325	38,247	39,734
Anti-dilutive potential common shares excluded from diluted weighted average common shares outstanding (in shares)	411	43	392	84

NET INCOME PER COMMON SHARE - N

NET INCOME PER COMMON SHARE - Narrative (Details) - Accelerated Share Repurchase Agreement - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Sep. 30, 2023	Jun. 30, 2023	May 08, 2023
Share Repurchase Program [Line Items]
Accelerated share repurchases, prepaid amount			$ 200,000
Accelerated share repurchases, initial delivery, shares (in shares)		1,760
Accelerated share repurchases, final delivery, shares (in shares)	261

SEGMENT INFORMATION- Narrative

SEGMENT INFORMATION- Narrative (Details)	9 Months Ended
	Sep. 30, 2024 segment
Segment Reporting [Abstract]
Number of reportable segments	3

SEGMENT INFORMATION - Reconcili

SEGMENT INFORMATION - Reconciliation of Revenue and Operating Income by Reportable Segment (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	$ 687,509	$ 853,463	$ 2,249,072	$ 2,970,985
Segment operating income	22,252	86,926	99,879	304,259
Depreciation and amortization	41,122	39,175	126,942	113,599
Depreciation (included in cost of revenue)	1,928	1,552	5,363	4,196
Share-based compensation	5,555	306	19,651	15,442
Interest expense, net, and other	14,444	11,541	46,787	33,975
Income before income taxes	7,808	75,385	53,092	270,284
Nurse and allied solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	399,368	573,426	1,361,064	2,086,921
Physician and leadership solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	180,605	159,554	555,467	501,540
Technology and workforce solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	107,536	120,483	332,541	382,524
Operating segments
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	687,509	853,463	2,249,072	2,970,985
Segment operating income	95,192	155,155	330,153	545,782
Operating segments | Nurse and allied solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	399,368	573,426	1,361,064	2,086,921
Segment operating income	35,110	82,882	134,659	299,320
Operating segments | Physician and leadership solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	180,605	159,554	555,467	501,540
Segment operating income	18,134	21,609	62,017	73,165
Operating segments | Technology and workforce solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	107,536	120,483	332,541	382,524
Segment operating income	41,948	50,664	133,477	173,297
Unallocated corporate overhead
Segment Reporting, Revenue Reconciling Item [Line Items]
Unallocated corporate overhead	$ 24,335	$ 27,196	$ 78,318	$ 108,286

SEGMENT INFORMATION - Goodwill

SEGMENT INFORMATION - Goodwill by Reportable Segment (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2024	Dec. 31, 2023
Goodwill [Roll Forward]
Goodwill, beginning balance	$ 1,111,549
Goodwill, ending balance	1,116,815
Accumulated impairment loss	214,939	$ 214,939
MSDR
Goodwill [Roll Forward]
Goodwill adjustment for MSDR acquisition	5,266
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 MSDR acquisition	0
Physician and Leadership Solutions
Goodwill [Roll Forward]
Goodwill, beginning balance	328,570
Goodwill, ending balance	333,836
Accumulated impairment loss	60,495	60,495
Physician and Leadership Solutions | MSDR
Goodwill [Roll Forward]
Goodwill adjustment for MSDR acquisition	5,266
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 MSDR acquisition	$ 0

SEGMENT INFORMATION - Disaggreg

SEGMENT INFORMATION - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Segment Reporting Information [Line Items]
Revenue	$ 687,509	$ 853,463	$ 2,249,072	$ 2,970,985
Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	399,368	573,426	1,361,064	2,086,921
Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	180,605	159,554	555,467	501,540
Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	107,536	120,483	332,541	382,524
Travel nurse staffing
Segment Reporting Information [Line Items]
Revenue	243,745	384,102	854,746	1,453,988
Travel nurse staffing | Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	243,745	384,102	854,746	1,453,988
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	486	777	886	11,515
Labor disruption services | Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	486	777	886	11,515
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	10,494	16,991	33,786	61,038
Local staffing | Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	10,494	16,991	33,786	61,038
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	140,872	167,622	462,001	545,959
Allied staffing | Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	140,872	167,622	462,001	545,959
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	141,716	112,514	429,700	341,129
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	141,716	112,514	429,700	341,129
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	28,862	30,910	89,373	107,553
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	28,862	30,910	89,373	107,553
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	566,175	712,916	1,870,492	2,521,182
Temporary staffing | Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	395,597	569,492	1,351,419	2,072,500
Temporary staffing | Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	170,578	143,424	519,073	448,682
Temporary staffing | Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Permanent placement
Segment Reporting Information [Line Items]
Revenue	13,798	20,064	46,039	67,279
Permanent placement | Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	3,771	3,934	9,645	14,421
Permanent placement | Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	10,027	16,130	36,394	52,858
Permanent placement | Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Language services
Segment Reporting Information [Line Items]
Revenue	75,009	66,406	221,749	191,732
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	75,009	66,406	221,749	191,732
Vendor management systems
Segment Reporting Information [Line Items]
Revenue	25,018	38,116	81,671	138,843
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	25,018	38,116	81,671	138,843
Other technologies
Segment Reporting Information [Line Items]
Revenue	5,044	5,052	15,993	18,191
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	5,044	5,052	15,993	18,191
Technology-enabled services
Segment Reporting Information [Line Items]
Revenue	105,071	109,574	319,413	348,766
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	105,071	109,574	319,413	348,766
Talent planning and acquisition
Segment Reporting Information [Line Items]
Revenue	2,465	10,909	13,128	33,758
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	2,465	10,909	13,128	33,758
International nurse
Segment Reporting Information [Line Items]
Revenue	45,147	57,924	139,313	169,875
International nurse staffing
Segment Reporting Information [Line Items]
Revenue	41,376	53,990	129,668	155,454
International nurse permanent placement
Segment Reporting Information [Line Items]
Revenue	$ 3,771	$ 3,934	$ 9,645	$ 14,421

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 - Assets

FAIR VALUE MEASUREMENT - Assets and Liabilities at Fair Value (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Thousands	Sep. 30, 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	$ 55,101	$ 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	55,101	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	55,101	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	55,101	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	10,129	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	$ 10,129	$ 15,563

FAIR VALUE MEASUREMENT - Narrat

FAIR VALUE MEASUREMENT - Narrative (Details) - USD ($)	9 Months Ended
	Sep. 30, 2024	Sep. 30, 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
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]
Cumulative upward adjustments	14,033,000
Cumulative downward adjustments	10,130,000
Equity investment balance	12,503,000		$ 12,503,000
Acquisition contingent consideration liabilities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liabilities	$ 0		$ 0

FAIR VALUE MEASUREMENT - Financ

FAIR VALUE MEASUREMENT - Financial Assets and Liabilities (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Thousands	Sep. 30, 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	$ 10,129	$ 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	10,129	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	55,101	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	55,101	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	(188,738)	(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	(188,738)	(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	Sep. 30, 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	486,875	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	$ 326,375	$ 314,125

COMMITMENTS AND CONTINGENCIES (

COMMITMENTS AND CONTINGENCIES (Details) $ in Thousands	Sep. 30, 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	Sep. 30, 2024	Dec. 31, 2023
Other current assets:
Restricted cash and cash equivalents	$ 18,004	$ 22,056
Income taxes receivable	8,953	5,350
Other	18,058	18,264
Other current assets	45,015	45,670
Fixed assets:
Furniture and equipment	86,776	71,815
Software	435,064	388,812
Leasehold improvements	16,102	15,839
Fixed assets, gross	537,942	476,466
Accumulated depreciation	(341,040)	(285,081)
Fixed assets, net	196,902	191,385
Other assets:
Life insurance cash surrender value	193,736	162,780
Operating lease right-of-use assets	33,689	34,543
Other	39,841	39,473
Other assets	267,266	236,796
Accounts payable and accrued expenses:
Trade accounts payable	44,033	54,128
Subcontractor payable	72,024	122,983
Accrued expenses	75,928	82,257
Loss contingencies	7,963	69,837
Professional liability reserve	6,416	7,761
Other	6,842	6,881
Accounts payable and accrued expenses	213,206	343,847
Accrued compensation and benefits:
Accrued payroll	52,437	53,633
Accrued bonuses and commissions	23,800	31,236
ESPP contributions	53	950
Workers compensation reserve	6,169	12,130
Deferred compensation	188,738	165,574
Other	10,486	15,013
Accrued compensation and benefits	281,683	278,536
Other current liabilities:
Client deposits	0	8,707
Operating lease liabilities	6,363	7,993
Deferred revenue	12,738	11,303
Other	4,556	5,735
Other current liabilities	23,657	33,738
Other long-term liabilities:
Workers compensation reserve	22,531	21,169
Professional liability reserve	37,283	36,891
Operating lease liabilities	37,477	37,603
Other	13,468	13,316
Other long-term liabilities	$ 110,759	$ 108,979