AMN Healthcare Services (AMN) 10-K 20 Feb 25 2024 FY Annual report Financial data

COVER

COVER - USD ($)	12 Months Ended
	Dec. 31, 2024	Feb. 18, 2025	Jun. 30, 2024
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2024
Current Fiscal Year End Date	--12-31
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 Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
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
ICFR Auditor Attestation Flag	true
Document Financial Statement Error Correction	false
Entity Shell Company	false
Entity Public Float			$ 1,934,078,967
Entity Common Stock, Shares Outstanding (excluding treasury shares)		38,189,048
Documents Incorporated by Reference	Portions of the registrant’s definitive proxy statement for the annual meeting of stockholders scheduled to be held on May 2, 2025 have been incorporated by reference into Part III of this Form 10-K.
Entity Central Index Key	0001142750
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	FY
Amendment Flag	false

Audit Information

Audit Information	12 Months Ended
	Dec. 31, 2024
Audit Information [Abstract]
Auditor Name	KPMG LLP
Auditor Location	San Diego, California
Auditor Firm ID	185

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 10,649	$ 32,935
Accounts receivable, net of allowances of $32,421 and $32,233 at December 31, 2024 and 2023, respectively	437,817	623,488
Accounts receivable, subcontractor	70,481	117,703
Prepaid expenses	22,510	21,889
Other current assets	53,458	45,670
Total current assets	594,915	841,685
Restricted cash, cash equivalents and investments	71,840	68,845
Fixed assets, net of accumulated depreciation of $360,795 and $285,081 at December 31, 2024 and 2023, respectively	186,270	191,385
Other assets	258,053	236,796
Deferred income taxes, net	25,829	0
Goodwill	897,456	1,111,549
Intangible assets, net of accumulated amortization of $534,822 and $442,052 at December 31, 2024 and 2023, respectively	381,364	474,134
Total assets	2,415,727	2,924,394
Current liabilities:
Accounts payable and accrued expenses	184,311	343,847
Accrued compensation and benefits	287,544	278,536
Other current liabilities	73,930	33,738
Total current liabilities	545,785	656,121
Revolving credit facility	210,000	460,000
Notes payable, net of unamortized fees and premium	845,872	844,688
Deferred income taxes, net	0	23,350
Other long-term liabilities	107,450	108,979
Total liabilities	1,709,107	2,093,138
Commitments and contingencies
Stockholders’ equity:
Preferred stock, $0.01 par value; 10,000 shares authorized; none issued and outstanding at December 31, 2024 and 2023	0	0
Common stock, $0.01 par value; 200,000 shares authorized; 50,692 issued and 38,079 outstanding at December 31, 2024 and 50,423 issued and 37,810 outstanding at December 31, 2023	507	504
Additional paid-in capital	528,471	506,543
Treasury stock, at cost; 12,613 shares at December 31, 2024 and 2023	(1,127,043)	(1,127,043)
Retained earnings	1,304,696	1,451,675
Accumulated other comprehensive loss	(11)	(423)
Total stockholders’ equity	706,620	831,256
Total liabilities and stockholders’ equity	$ 2,415,727	$ 2,924,394

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Accounts receivable, allowance	$ 32,421	$ 32,233
Accumulated depreciation	360,795	285,081
Accumulated amortization	$ 534,822	$ 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)	50,692,000	50,423,000
Common stock, shares outstanding (in shares)	38,079,000	37,810,000
Treasury stock (in shares)	12,613,000	12,613,000

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Statement of Comprehensive Income [Abstract]
Revenue	$ 2,983,781	$ 3,789,254	$ 5,243,242
Cost of revenue	2,064,405	2,539,673	3,526,558
Gross profit	919,376	1,249,581	1,716,684
Operating expenses:
Selling, general and administrative	632,489	756,238	936,576
Depreciation and amortization (exclusive of depreciation included in cost of revenue)	167,103	154,914	133,007
Goodwill impairment losses	222,457	0	0
Total operating expenses	1,022,049	911,152	1,069,583
Income (loss) from operations	(102,673)	338,429	647,101
Interest expense, net, and other	69,901	54,140	40,398
Income (loss) before income taxes	(172,574)	284,289	606,703
Income tax expense (benefit)	(25,595)	73,610	162,653
Net income (loss)	(146,979)	210,679	444,050
Other comprehensive income (loss):
Unrealized gains (losses) on available-for-sale securities, net, and other	412	516	(644)
Other comprehensive income (loss)	412	516	(644)
Comprehensive income (loss)	$ (146,567)	$ 211,195	$ 443,406
Net income (loss) per common share:
Basic (in dollars per share)	$ (3.85)	$ 5.38	$ 9.96
Diluted (in dollars per share)	$ (3.85)	$ 5.36	$ 9.90
Weighted average common shares outstanding:
Basic (in shares)	38,188	39,173	44,591
Diluted (in shares)	38,188	39,341	44,870

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Treasury Stock	Retained Earnings	Accumulated Other Comprehensive Loss
Beginning balance (in shares) at Dec. 31, 2021		49,849,000
Beginning balance at Dec. 31, 2021	$ 1,162,027	$ 498	$ 486,709	$ (121,831)	$ 796,946	$ (295)
Beginning balance (in shares) at Dec. 31, 2021				(2,586,000)
Statement of Stockholders' Equity [Roll Forward]
Repurchase of common stock (in shares)	(5,644,000)			(5,644,000)
Repurchase of common stock	$ (576,767)			$ (576,767)
Equity awards vested, net of shares withheld for taxes (in shares)		260,000
Equity awards vested, net of shares withheld for taxes	(15,098)	$ 3	(15,101)
Share-based compensation	30,066		30,066
Comprehensive income (loss)	443,406				444,050	(644)
Ending balance (in shares) at Dec. 31, 2022		50,109,000
Ending balance at Dec. 31, 2022	$ 1,043,634	$ 501	501,674	$ (698,598)	1,240,996	(939)
Ending balance (in shares) at Dec. 31, 2022				(8,230,000)
Statement of Stockholders' Equity [Roll Forward]
Repurchase of common stock (in shares)	(4,383,000)			(4,383,000)
Repurchase of common stock	$ (428,445)			$ (428,445)
Equity awards vested, net of shares withheld for taxes (in shares)		314,000
Equity awards vested, net of shares withheld for taxes	(13,148)	$ 3	(13,151)
Share-based compensation	18,020		18,020
Comprehensive income (loss)	$ 211,195				210,679	516
Ending balance (in shares) at Dec. 31, 2023	37,810,000	50,423,000
Ending balance at Dec. 31, 2023	$ 831,256	$ 504	506,543	$ (1,127,043)	1,451,675	(423)
Ending balance (in shares) at Dec. 31, 2023	(12,613,000)			(12,613,000)
Statement of Stockholders' Equity [Roll Forward]
Repurchase of common stock (in shares)	0
Equity awards vested, net of shares withheld for taxes (in shares)		191,000
Equity awards vested, net of shares withheld for taxes	$ (4,774)	$ 2	(4,776)
Shares purchased and issued under employee stock purchase plan (in shares)		78,000
Shares purchased and issued under employee stock purchase plan	3,388	$ 1	3,387
Share-based compensation	23,317		23,317
Comprehensive income (loss)	$ (146,567)				(146,979)	412
Ending balance (in shares) at Dec. 31, 2024	38,079,000	50,692,000
Ending balance at Dec. 31, 2024	$ 706,620	$ 507	$ 528,471	$ (1,127,043)	$ 1,304,696	$ (11)
Ending balance (in shares) at Dec. 31, 2024	(12,613,000)			(12,613,000)

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Cash flows from operating activities:
Net income (loss)		$ (146,979)	$ 210,679	$ 444,050
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization (inclusive of depreciation included in cost of revenue)		173,779	160,927	137,111
Non-cash interest expense and other		11,910	8,821	5,330
Change in fair value of contingent consideration liabilities		0	2,430	(2,930)
Increase in allowance for credit losses and sales credits		3,296	23,913	57,999
Provision for deferred income taxes		(51,067)	(12,933)	(24,615)
Share-based compensation		23,317	18,020	30,066
Net loss (gain) on deferred compensation balances		(1,225)	465	(526)
Goodwill impairment losses		222,457	0	0
Loss on disposal or impairment of long-lived assets		65	8,053	1,560
Net loss on investments in available-for-sale securities		200	302	749
Non-cash lease expense		(1,244)	1,619	5,497
Changes in assets and liabilities, net of effects from acquisitions:
Accounts receivable		176,227	70,033	57,921
Accounts receivable, subcontractor		47,222	151,023	(29,007)
Income taxes receivable		(4,012)	3,793	(8,875)
Prepaid expenses		(1,976)	(1,542)	53,806
Other current assets		(8,530)	4,197	17,775
Other assets		87	(3,177)	210
Accounts payable and accrued expenses		(154,890)	(183,517)	48,782
Accrued compensation and benefits		(11,310)	(80,135)	(10,506)
Other liabilities		44,431	(10,248)	(126,566)
Deferred revenue		(1,340)	(558)	(4,098)
Net cash provided by operating activities		320,418	372,165	653,733
Cash flows from investing activities:
Purchase and development of fixed assets		(80,891)	(103,687)	(75,831)
Purchase of investments		(1,383)	0	(13,152)
Proceeds from sale and maturity of investments		9,099	9,894	14,384
Proceeds from sale of equity investment		0	77	68
Payments to fund deferred compensation plan		(8,412)	(24,902)	(21,518)
Cash paid for acquisitions, net of cash and restricted cash received		0	(292,175)	(69,570)
Cash paid for other intangibles		0	(1,700)	(5,091)
Cash received for working capital settlement of prior year acquisition		1,649	0	0
Net cash used in investing activities		(79,938)	(412,493)	(170,710)
Cash flows from financing activities:
Payments on revolving credit facility		(375,000)	(355,000)	0
Proceeds from revolving credit facility		125,000	815,000	0
Payments on loans payable		0	(300)	0
Repurchase of common stock	[1]	0	(424,744)	(576,767)
Payment of excise tax on share repurchases		(3,701)	0	0
Payment of financing costs		(973)	(3,579)	0
Earn-out payments to settle contingent consideration liabilities for prior acquisitions		0	(7,500)	0
Cash paid for shares withheld for taxes		(4,774)	(13,148)	(15,098)
Net cash provided by (used in) financing activities		(259,448)	10,729	(591,865)
Net decrease in cash, cash equivalents and restricted cash		(18,968)	(29,599)	(108,842)
Cash, cash equivalents and restricted cash at beginning of year		108,273	137,872	246,714
Cash, cash equivalents and restricted cash at end of year		89,305	108,273	137,872
Supplemental disclosures of cash flow information:
Cash paid for amounts included in the measurement of operating lease liabilities		10,354	9,311	13,337
Cash paid for interest (net of $606, $1,229 and $703 capitalized in 2024, 2023 and 2022, respectively)		61,034	48,101	37,518
Cash paid for income taxes		28,152	78,256	213,807
Acquisitions:
Fair value of tangible assets acquired in acquisitions, net of cash and restricted cash received		0	48,941	2,604
Goodwill		0	175,770	42,990
Intangible assets		0	92,000	40,200
Liabilities assumed		0	(24,536)	(8,224)
Contingent consideration liabilities		0	0	(8,000)
Net cash paid for acquisitions		0	292,175	69,570
Supplemental disclosures of non-cash investing and financing activities:
Purchase of fixed assets recorded in accounts payable and accrued expenses		3,198	8,130	5,643
Excise tax payable on share repurchases		0	3,701	0
Right-of-use assets obtained in exchange for operating lease liabilities		$ 5,043	$ 36,560	$ 5,680
[1]The difference between the amount reported for the year ended December 31, 2023 and the corresponding amount presented in the consolidated statements of stockholders’ equity is due to accrued excise tax payable on share repurchases which was recorded within treasury stock. The excise tax was paid during the year ended December 31, 2024.

CONSOLIDATED STATEMENTS OF CA_2

CONSOLIDATED STATEMENTS OF CASH FLOWS (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Statement of Cash Flows [Abstract]
Interest capitalized	$ 606	$ 1,229	$ 703

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2024
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies (a) General AMN Healthcare Services, Inc. was incorporated in Delaware on November 10, 1997. AMN Healthcare Services, Inc. and its subsidiaries (collectively, the “Company”) provide healthcare workforce solutions and staffing services at acute and sub-acute care hospitals and other healthcare facilities throughout the United States. (b) Principles of Consolidation The accompanying consolidated financial statements include the accounts of AMN Healthcare Services, Inc. and its wholly-owned subsidiaries. All significant intercompany balances and transactions have been eliminated in consolidation. (c) Use of Estimates The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America 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 consolidated 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 indefinite-lived intangible assets, professional liability reserve, 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. (d) Cost of Revenue Cost of revenue represents costs directly associated with the earnings of revenue and are comprised primarily of compensation, benefits, housing, travel and allowance costs for healthcare professionals and medically qualified interpreters. (e) Selling, General and Administrative Expenses Selling, general and administrative expenses consist predominantly of compensation and benefits costs for corporate employees, in additional to professional service fees, legal matter accruals, and other overhead costs. Unallocated corporate overhead is a subset of selling, general and administrative expenses and is comprised of indirect costs related to certain corporate functions that are not allocated to the Company’s reportable segments. (f) Cash and Cash Equivalents The Company considers all highly liquid investments with an original maturity of three months or less to be cash equivalents. Cash and cash equivalents include currency on hand, deposits with financial institutions, money market funds, and other highly liquid investments. See Note (3) , “Fair Value Measurement” for additional information. (g) Restricted Cash, Cash Equivalents and Investments Restricted cash, cash equivalents and investments primarily include cash, corporate bonds and commercial paper that serve as collateral for the Company’s captive insurance subsidiary claim payments. See Note (3) , “Fair Value Measurement” for additional information. The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the accompanying consolidated balance sheets and related notes to the amounts presented in the accompanying consolidated statements of cash flows. December 31, 2024 December 31, 2023 Cash and cash equivalents $ 10,649 $ 32,935 Restricted cash and cash equivalents (included in other current assets) 14,984 22,056 Restricted cash, cash equivalents and investments 71,840 68,845 Total cash, cash equivalents and restricted cash and investments 97,473 123,836 Less restricted investments (8,168) (15,563) Total cash, cash equivalents and restricted cash $ 89,305 $ 108,273 The Company released $25,000 of restricted cash held at its captive insurance subsidiary in January 2025, which was used to repay a portion of the outstanding borrowings under the Senior Credit Facility (as defined in Note (2) below). As the restriction was in effect as of December 31, 2024 and the entire outstanding debt balance is classified as a noncurrent liability in the consolidated balance sheet, the noncurrent classification of the restricted cash was maintained as of December 31, 2024. (h) Fixed Assets The Company records furniture, equipment, leasehold improvements and capitalized software at cost less accumulated amortization and depreciation. The Company records equipment acquired under finance leases at the present value of the future minimum lease payments. The Company capitalizes major additions and improvements, and it expenses maintenance and repairs when incurred. The Company calculates depreciation on furniture, equipment and software using the straight-line method based on the estimated useful lives of the related assets (typically three The Company capitalizes costs it incurs to develop software during the application development stage. Application development stage costs generally include costs associated with software configuration, coding, installation and testing. The Company also capitalizes costs of significant upgrades and enhancements that result in additional functionality, whereas it expenses as incurred costs for maintenance and minor upgrades and enhancements. The Company amortizes capitalized costs using the straight-line method over three The Company assesses long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset group to the future undiscounted net cash flows that are expected to be generated by the asset group. If such asset group is considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the asset group exceeds the fair value of the asset group. The Company reports assets to be disposed of at the lower of the carrying amount or fair value less costs to sell. (i) Leases The Company recognizes operating lease right-of-use assets and liabilities at commencement date based on the present value of the future minimum lease payments over the lease term. Leases with an initial term of 12 months or less are not recorded on the balance sheet in accordance with the short-term lease recognition exemption. The Company applies the practical expedient to not separate lease and non-lease components for all leases that qualify. The rates implicit in the Company’s lease arrangements are generally not readily determinable and as such, the Company uses its incremental borrowing rate as the discount rate to measure its lease liabilities. The incremental borrowing rate is determined for each operating lease based on the Company’s borrowing capabilities over a similar term of the lease arrangement, which is estimated by utilizing the Company’s credit rating and the effects of full collateralization. Lease expense is recognized on a straight-line basis over the lease term. Operating lease right-of-use assets are included in other assets, and operating lease liabilities are included in other current liabilities and other long-term liabilities in the consolidated balance sheets. (j) Goodwill The Company records as goodwill the portion of the purchase price that exceeds the fair value of net assets of entities acquired. The Company evaluates goodwill annually for impairment at the reporting unit level and whenever circumstances occur indicating that goodwill may be impaired. The Company may first perform an optional qualitative assessment to determine whether it is more likely than not that the fair value of a reporting unit is less than its carrying amount. If, after assessing the totality of events and circumstances, the Company determines that it is more likely than not that the fair value of the reporting unit is greater than its carrying amount, the quantitative impairment test is unnecessary. If a reporting unit does not pass the qualitative assessment, then the Company performs a quantitative test in which the reporting unit’s carrying amount is compared to its fair value. The amount by which the carrying amount of the goodwill exceeds its fair value is recognized as an impairment loss. See Note (3) , “Fair Value Measurement” for additional information. (k) Intangible Assets Intangible assets consist of identifiable intangible assets acquired through acquisitions, which include tradenames and trademarks, customer relationships, staffing databases, developed technology and non-compete agreements. The Company amortizes intangible assets, other than those with an indefinite life, using the straight-line method over their useful lives. The Company amortizes non-compete agreements using the straight-line method over the lives of the related agreements. The Company reviews for impairment intangible assets with estimable useful lives whenever events or changes in circumstances indicate that the carrying amount may not be recoverable. The Company does not amortize indefinite-lived intangible assets and instead reviews them for impairment annually . The Company may first perform a qualitative assessment to determine whether it is more likely than not that an indefinite-lived intangible asset is impaired. If, after assessing the totality of events and circumstances, the Company determines that it is more likely than not that the indefinite-lived intangible asset is not impaired, no quantitative fair value measurement is necessary. If a quantitative fair value measurement calculation is required for an indefinite-lived intangible asset, the Company compares its fair value with its carrying amount. If the carrying amount exceeds the fair value, the Company records the excess as an impairment loss. (l) Insurance Reserves The Company maintains an accrual for professional liability that is included in accounts payable and accrued expenses and other long-term liabilities in the consolidated balance sheets. The expense is included in the selling, general and administrative expenses in the consolidated statements of comprehensive income (loss). The Company determines the adequacy of this accrual by evaluating its historical experience and trends, loss reserves established by the Company’s insurance carriers, management and third-party administrators, and independent actuarial studies. The Company obtains actuarial studies on a semi-annual basis that use the Company’s actual claims data and industry data to assist the Company in determining the adequacy of its reserves each year. For periods between the actuarial studies, the Company records its accruals based on loss rates provided in the most recent actuarial study and management’s review of loss history and trends. Liabilities include provisions for estimated incurred but not yet reported (“IBNR”) losses, as well as provisions for known claims. IBNR reserve estimates involve the use of assumptions that are primarily based upon historical loss experience, industry data and other actuarial assumptions. The Company maintains insurance programs through its wholly-owned captive insurance subsidiary, which primarily provides coverage, on an occurrence basis, for professional liability within its nurse and allied solutions segment. In addition, the Company maintains excess insurance coverage through a commercial carrier for losses above the per occurrence retention. Losses covered by excess insurance are included in the accrual for professional liability, as the Company remains liable to the extent commercial carriers do not meet their obligations. The Company maintains an accrual for workers’ compensation, which is included in accrued compensation and benefits and other long-term liabilities in the consolidated balance sheets. The expense relating to healthcare professionals is included in cost of revenue, while the expense relating to corporate employees is included in the selling, general and administrative expenses in the consolidated statements of comprehensive income (loss). The Company determines the adequacy of this accrual by evaluating its historical experience and trends, loss reserves established by the Company’s insurance carriers and third-party administrators, and independent actuarial studies. The Company obtains actuarial studies on a semi-annual basis that use the Company’s payroll and historical claims data, as well as industry data, to determine the appropriate reserve for both reported claims and IBNR claims for each policy year. For periods between the actuarial studies, the Company records its accruals based on loss rates provided in the most recent actuarial study. (m) 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. See additional information below regarding the Company’s revenue disaggregated by service type. 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 recognizes assets from incremental costs to obtain a contract with a customer and costs incurred to fulfill a contract with a customer, which are deferred and amortized using the portfolio approach on a straight line basis over the average period of benefit consistent with the timing of transfer of services to the customer. 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. (n) 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. The following table provides a reconciliation of activity in the allowance for expected credit losses for accounts receivable: 2024 2023 Balance as of January 1, $ 32,233 $ 31,910 Provision for expected credit losses 6,549 5,544 Amounts written off charged against the allowance (6,361) (5,221) Balance as of December 31, $ 32,421 $ 32,233 (o) Concentration of Credit Risk The majority of the Company’s business activity is with hospitals located throughout the United States. Credit is extended based on the evaluation of each entity’s financial condition. One customer primarily within the Company’s nurse and allied solutions segment comprised approximately 16%, 17% and 18% of the consolidated revenue of the Company for the years ended December 31, 2024, 2023 and 2022, respectively. The Company’s cash and cash equivalents and restricted cash, cash equivalents and investments accounts are financial instruments that are exposed to concentration of credit risk. The Company maintains most of its cash, cash equivalents and investment balances (both unrestricted and restricted) with high-credit quality and federally insured institutions. However, cash equivalents and restricted cash equivalents and investment balances may be invested in non-federally insured money market funds, commercial paper and corporate bonds. As of December 31, 2024 and 2023, there were $97,473 and $123,836, respectively, of cash, cash equivalents and restricted cash, cash equivalents and investments, a portion of which was invested in non-federally insured commercial paper and corporate bonds. See Note (3) , “Fair Value Measurement,” for additional information. (p) Income Taxes The Company records income taxes using the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax basis. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in the period the changes are enacted. In assessing the realizability of deferred tax assets, the Company considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. The Company considers the scheduled reversal of deferred tax liabilities (including the impact of available carryback and carryforward periods), projected future taxable income, and tax-planning strategies in making this assessment. The Company recognizes the effect of income tax positions only if it is more likely than not that such positions will be sustained. Recognized income tax positions are measured at the largest amount that is greater than 50% likely of being realized. Changes in recognition or measurement are reflected in the period in which the change in judgment occurs. The Company records interest and penalties related to unrecognized tax benefits in income tax expense. (q) Fair Value of Financial Instruments The carrying amounts of the Company’s cash equivalents and restricted cash equivalents and investments approximate their respective fair values due to the short-term nature and liquidity of these financial instruments. The fair value of the Company’s equity investment is measured using observable prices for identical or similar investments of the same issuer when such transactions are identified, which is more fully described in Note (3) , “Fair Value Measurement.” As it relates to the Company’s 2027 Notes and 2029 Notes (as defined in Note (8) and Note (3) , respectively, below), fair value disclosure is detailed in Note (3) , “Fair Value Measurement.” See Note (8) , “Notes Payable and Credit Agreement,” for additional information. The fair value of the Company’s long-term self-insurance accruals cannot be estimated because the Company cannot reasonably determine the timing of future payments. (r) Share-Based Compensation The Company accounts for its share-based employee compensation plans by expensing the estimated fair value of share-based awards on a straight-line basis over the requisite employee service period, which typically is the vesting period, except for awards granted to retirement-eligible employees, which are expensed on an accelerated basis. Restricted stock units (“RSUs”) typically vest over a three-year period. Share-based compensation cost of RSUs is measured by the market value of the Company’s common stock on the date of grant, and the Company records share-based compensation expense only for those awards that are expected to vest. Performance restricted stock units (“PRSUs”) primarily consist of PRSUs that contain performance conditions dependent on defined targets of the Company’s adjusted EBITDA, with a range of 0% to 200% of the target amount granted to be issued under the award. Share-based compensation cost for these PRSUs is measured by the market value of the Company’s common stock on the date of grant, and the amount recognized is adjusted for estimated achievement of the performance conditions. A limited amount of PRSUs contain a market condition dependent upon the Company’s relative and absolute total stockholder return over a three-year period, typically with a range of 0% to 175% (and certain awards with a range of 0% to 200%) of the target amount granted to be issued under the award. Share-based compensation cost for these PRSUs is measured using the Monte-Carlo simulation valuation model and is not adjusted for the achievement, or lack thereof, of the market conditions. Share-based compensation cost for purchase rights granted under the Company’s employee stock purchase plan is measured using the Black-Scholes model and the related employee contributions are included in accrued compensation and benefits in the consolidated balance sheets. See Note (11) , “Share-Based Compensation,” for additional information. (s) Net Income (Loss) per Common Share The following table sets forth the computation of basic and diluted net income (loss) per common share for the years ended December 31, 2024, 2023 and 2022, respectively: Years Ended December 31, 2024 2023 2022 Net income (loss) $ (146,979) $ 210,679 $ 444,050 Net income (loss) per common share - basic $ (3.85) $ 5.38 $ 9.96 Net income (loss) per common share - diluted $ (3.85) $ 5.36 $ 9.90 Weighted average common shares outstanding - basic 38,188 39,173 44,591 Plus dilutive effect of potential common shares — 168 279 Weighted average common shares outstanding - diluted 38,188 39,341 44,870 Anti-dilutive potential common shares excluded from diluted weighted average common shares outstanding 85 88 19 The dilutive effect of potential shares and anti-dilutive potential common shares primarily include outstanding share-based awards, which consists of restricted stock units, performance restricted stock units, and obligations under the Company’s employee stock purchase plan. (t) 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 (“CODM”) for the purpose of evaluating performance and allocating resources. The Company’s Chief Executive Officer and its Chief Financial Officer and Chief Operating Officer serve as the Company’s CODM. 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 (“VMS”), workforce optimization, and outsourced solutions businesses. The Company’s CODM relies on internal management reporting processes that provide revenue, gross profit and operating income by reportable segment. These financial measures are used by the CODM to evaluate segment performance, monitor variances between periods and against projections, make key operating decisions, and allocate resources such as capital and personnel to each segment. The CODM does not evaluate or measure performance of segments using asset information; accordingly, asset information by segment is not prepared or disclosed. The following tables provide reconciliations of revenue, gross profit and operating income by reportable segment to consolidated results and were derived from each segment’s internal financial information as used for corporate management purposes. Segment operating income represents income (loss) before income taxes plus depreciation, amortization of intangible assets, share-based compensation, goodwill impairment losses, interest expense, net, and other, and unallocated corporate overhead. Year Ended December 31, 2024 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Revenue $ 1,815,718 $ 728,608 $ 439,455 $ 2,983,781 Cost of revenue 1,371,660 511,959 180,786 2,064,405 Gross profit 444,058 216,649 258,669 919,376 Segment selling, general and administrative expenses 270,467 137,600 91,590 499,657 Depreciation (included in cost of revenue) — — (6,676) (6,676) Segment operating income $ 173,591 $ 79,049 $ 173,755 426,395 Unallocated corporate overhead 109,515 Depreciation and amortization 167,103 Depreciation (included in cost of revenue) 6,676 Share-based compensation 23,317 Goodwill impairment losses 222,457 Interest expense, net, and other 69,901 Loss before income taxes $ (172,574) Year Ended December 31, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Revenue $ 2,624,509 $ 669,701 $ 495,044 $ 3,789,254 Cost of revenue 1,932,099 440,230 167,344 2,539,673 Gross profit 692,410 229,471 327,700 1,249,581 Segment selling, general and administrative expenses 330,252 134,505 118,977 583,734 Depreciation (included in cost of revenue) — — (6,013) (6,013) Segment operating income $ 362,158 $ 94,966 $ 214,736 671,860 Unallocated corporate overhead 154,484 Depreciation and amortization 154,914 Depreciation (included in cost of revenue) 6,013 Share-based compensation 18,020 Interest expense, net, and other 54,140 Income before income taxes $ 284,289 Year Ended December 31, 2022 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Revenue $ 3,982,453 $ 697,946 $ 562,843 $ 5,243,242 Cost of revenue 2,934,738 456,996 134,824 3,526,558 Gross profit 1,047,715 240,950 428,019 1,716,684 Segment selling, general and administrative expenses 471,489 148,619 132,733 752,841 Depreciation (included in cost of revenue) — — (4,104) (4,104) Segment operating income $ 576,226 $ 92,331 $ 299,390 967,947 Unallocated corporate overhead 153,669 Depreciation and amortization 133,007 Depreciation (included in cost of revenue) 4,104 Share-based compensation 30,066 Interest expense, net, and other 40,398 Income before income taxes $ 606,703 The following tables present the Company’s revenue disaggregated by service type: Year Ended December 31, 2024 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 1,084,398 $ — $ — $ 1,084,398 Labor disruption services 63,316 — — 63,316 Local staffing 45,517 — — 45,517 Allied staffing 610,661 — — 610,661 Locum tenens staffing — 566,351 — 566,351 Interim leadership staffing — 115,672 — 115,672 Temporary staffing 1,803,892 682,023 — 2,485,915 Permanent placement (1) 11,826 46,585 — 58,411 Language services — — 298,241 298,241 Vendor management systems — — 104,277 104,277 Other technologies — — 21,195 21,195 Technology-enabled services — — 423,713 423,713 Talent planning and acquisition — — 15,742 15,742 Total revenue $ 1,815,718 $ 728,608 $ 439,455 $ 2,983,781 Year Ended December 31, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 1,806,653 $ — $ — $ 1,806,653 Labor disruption services 13,303 — — 13,303 Local staffing 76,553 — — 76,553 Allied staffing 709,632 — — 709,632 Locum tenens staffing — 464,797 — 464,797 Interim leadership staffing — 136,953 — 136,953 Temporary staffing 2,606,141 601,750 — 3,207,891 Permanent placement (1) 18,368 67,951 — 86,319 Language services — — 260,121 260,121 Vendor management systems — — 169,370 169,370 Other technologies — — 24,222 24,222 Technology-enabled services — — 453,713 453,713 Talent planning and acquisition — — 41,331 41,331 Total revenue $ 2,624,509 $ 669,701 $ 495,044 $ 3,789,254 Year Ended December 31, 2022 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 2,912,677 $ — $ — $ 2,912,677 Labor disruption services 112,160 — — 112,160 Local staffing 142,724 — — 142,724 Allied staffing 806,491 — — 806,491 Locum tenens staffing — 428,133 — 428,133 Interim leadership staffing — 184,819 — 184,819 Temporary staffing 3,974,052 612,952 — 4,587,004 Permanent placement (1) 8,401 84,994 — 93,395 Language services — — 216,120 216,120 Vendor management systems — — 265,525 265,525 Other technologies — — 29,553 29,553 Technology-enabled services — — 511,198 511,198 Talent planning and acquisition — — 51,645 51,645 Total revenue $ 3,982,453 $ 697,946 $ 562,843 $ 5,243,242 (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: Years Ended December 31, 2024 2023 2022 International nurse staffing (1) $ 165,875 $ 208,132 $ 161,992 International nurse permanent placement (2) 11,826 18,368 8,401 Total international nurse revenue $ 177,701 $ 226,500 $ 170,393 (1) Included in “Travel nurse staffing” as presented in the preceding tables. (2) Included in “Permanent placement” as presented in the preceding tables. (u) Recently Adopted Accounting Pronouncements In November 2023, the FASB issued Accounting Standards Update (“ASU”) 2023-07, “Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures,” which expands the breadth and frequency of reportable segment disclosure requirements, primarily through enhanced disclosures about significant segment expenses. The new guidance requires public entities to disclose, on an annual and interim basis, significant segment expenses that are regularly provided to the chief operating decision maker (“CODM”), the amount and composition of other segment items by reportable segment, any additional measures of a segment’s profit or loss used by the CODM when assessing performance and deciding how to allocate resources, and the CODM’s title and position. Additionally, public entities will be required to provide in interim periods all disclosures about a r

Acquisitions

Acquisitions	12 Months Ended
	Dec. 31, 2024
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract]
Acquisitions	Acquisitions The Company accounted for each 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 applicable date of acquisition. Since the applicable date of acquisition, the Company has revised the allocation of the purchase price to the tangible and intangible assets acquired and liabilities assumed based on analysis of information that has been made available through December 31, 2024 or the end of the one-year measurement period, whichever is earlier. Allocations continue to be updated through the measurement period, if necessary. The goodwill recognized for these acquisitions 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 recognizes acquisition-related costs in selling, general and administrative expenses in the consolidated statements of comprehensive income (loss). For each acquisition, 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”), provided for under the Amended Credit Agreement (as defined in Note (8) below). 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 allocation of the $291,169 purchase price, which was reduced by the final working capital settlement and was finalized during the fourth quarter of 2024, consisted of (1) $41,406 of fair value of tangible assets acquired, which included $562 cash received, (2) $26,371 of liabilities assumed, (3) $92,000 of identified intangible assets, and (4) $184,134 of goodwill, of which $94,762 is deductible for tax purposes. 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 Connetics Acquisition On May 13, 2022, the Company completed its acquisition of Connetics Communications, LLC (“Connetics”), which specializes in the direct hire recruitment and permanent placement of international nurse and allied health professionals with healthcare facilities in the United States. The initial purchase price of $78,764 included (1) $70,764 cash consideration paid upon acquisition, funded through cash on hand, and (2) contingent consideration (earn-out payment) of up to $12,500 with an estimated fair value of $8,000 as of the acquisition date. The contingent earn-out payment is based on the operating results of Connetics for the twelve months ending May 31, 2023, which resulted in a payment of $7,500 in the third quarter of 2023. The results of Connetics have been included in the Company’s nurse and allied solutions segment since the date of acquisition. During the fourth quarter of 2022, $231 was returned to the Company in respect of the final working capital settlement. The allocation of the $78,533 purchase price, which was reduced by the final working capital settlement and was finalized during the second quarter of 2023, consisted of (1) $3,172 of fair value of tangible assets acquired, which included $963 cash received, (2) $8,244 of liabilities assumed, (3) $40,200 of identified intangible assets, and (4) $43,405 of goodwill, of which $42,905 is deductible for tax purposes. The intangible assets acquired have a weighted average useful life of approximately thirteen years. The following table summarizes the fair value and useful life of each intangible asset acquired as of the acquisition date: Fair Value Useful Life (in years) Identifiable intangible assets Customer relationships $ 32,800 15 Staffing database 4,200 5 Tradenames and trademarks 3,200 5 $ 40,200

Fair Value Measurement

Fair Value Measurement	12 Months Ended
	Dec. 31, 2024
Fair Value Disclosures [Abstract]
Fair Value Measurement	Fair Value Measurement Fair value represents the price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. When determining fair value, the Company considers the principal or most advantageous market in which the Company would conduct a transaction, in addition to the assumptions that market participants would use when pricing the related assets or liabilities, including non-performance risk. A three-level hierarchy prioritizes the inputs to valuation techniques used to measure fair value and requires an entity to maximize the use of observable inputs and minimize the use of unobservable inputs when measuring fair value. The three levels of the fair value hierarchy are as follows: Level 1 —Quoted prices in active markets for identical assets or liabilities. Level 2 —Observable inputs other than Level 1 prices such as quoted prices for similar assets or liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. Level 3 —Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities. There were no transfers between the three levels of the fair value hierarchy during the years ended December 31, 2024, 2023 and 2022. 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’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 deferred compensation plan is more fully described in Note (9) , “Retirement Plans.” 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 December 31, 2024 As of December 31, 2023 Commercial paper $ 64,580 $ 48,206 Total classified as restricted cash equivalents $ 64,580 $ 48,206 Commercial paper $ 1,399 $ — Corporate bonds 6,769 15,563 Total classified as restricted investments $ 8,168 $ 15,563 The fair value of our available-for-sale securities as of December 31, 2024, by remaining contractual maturities, are presented in the following table: Fair Value Due in one year or less $ 5,770 Due after one year through five years 2,398 $ 8,168 Expected maturities may differ from stated due dates because borrowers may have the ability to call or prepay obligations with or without call or prepayment penalties. The Company’s contingent consideration liabilities are measured at fair value using 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 consolidated statements of comprehensive income (loss). There were no contingent consideration liabilities outstanding as of December 31, 2024 and 2023. The following tables present information about the above-referenced assets and liabilities and indicate the fair value hierarchy of the valuation techniques utilized to determine such fair value: Fair Value Measurements as of December 31, 2024 Fair Value Measurements as of December 31, 2023 Assets (Liabilities) Level 1 Level 2 Level 3 Total Level 1 Level 2 Level 3 Total Deferred compensation $ (191,006) $ — $ — $ (191,006) $ (165,574) $ — $ — $ (165,574) Corporate bonds — 6,769 — 6,769 — 15,563 — 15,563 Commercial paper — 65,979 — 65,979 — 48,206 — 48,206 Assets Measured on a Non-Recurring Basis The Company applies fair value techniques on a non-recurring basis associated with valuing identifiable intangible assets acquired through acquisitions and potential impairment losses related to its goodwill, indefinite-lived intangible assets, long-lived assets, and equity investments. The fair value of identifiable intangible assets are determined using either the income approach (the relief-from-royalty method, multi-period excess earnings method or with-and-without method) or the cost approach (replacement cost method). These valuation approaches use a combination of assumptions, including Level 3 inputs, such as (i) forecasted revenue, growth rates and customer attrition rates, (ii) forecasted operating expenses and profit margins, and (iii) royalty rates and discount rates used to present value the forecasted cash flows. The Company evaluates goodwill and indefinite-lived intangible assets annually for impairment and whenever events or changes in circumstances indicate that it is more likely than not that an impairment exists. The Company determines the fair value of its reporting units based on a combination of inputs, including the market capitalization of the Company, as well as Level 3 inputs such as discounted cash flows, which are not observable from the market, directly or indirectly. The Company determines the fair value of indefinite-lived intangible assets using the income approach (relief-from-royalty method) based on Level 3 inputs. Refer to Note ( 4 ) “Goodwill and Identifiable Intangible Assets” for additional details. 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. When the Company identifies price changes in orderly transactions for identical or similar investments of the same issuer, the investment is measured at fair value. To determine whether a security of the same issuer is similar to the Company’s equity investment, the Company considers other information available 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 consolidated statements of comprehensive income (loss). As of December 31, 2024, the Company has recognized cumulative upward adjustments and cumulative downward adjustments (including impairments) of $14,033 and $19,860, respectively. The balance of the equity investment was $2,773 and $12,503 as of December 31, 2024 and 2023, respectively. 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 2027 Notes (as defined in Note (8) below) 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, which are more fully described in Note (8) , “Notes Payable and Credit Agreement,” are presented in the following table: As of December 31, 2024 As of December 31, 2023 Carrying Estimated Carrying Estimated 2027 Notes $ 500,000 $ 473,750 $ 500,000 $ 468,750 2029 Notes 350,000 312,375 350,000 314,125 The fair value of the Company’s long-term self-insurance accruals cannot be estimated as the Company cannot reasonably determine the timing of future payments.

Goodwill and Identifiable Intan

Goodwill and Identifiable Intangible Assets	12 Months Ended
	Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Identifiable Intangible Assets	Goodwill and Identifiable Intangible Assets As of December 31, 2024 and 2023, the Company had the following acquired intangible assets: As of December 31, 2024 As of December 31, 2023 Gross Accumulated Net Gross Accumulated Net Intangible assets subject to amortization: Staffing databases $ 52,336 $ (39,879) $ 12,457 $ 52,336 $ (33,398) $ 18,938 Customer relationships 532,048 (247,550) 284,498 532,048 (210,606) 321,442 Tradenames and trademarks 284,488 (204,159) 80,329 284,488 (161,656) 122,832 Non-compete agreements 9,399 (7,783) 1,616 9,399 (6,727) 2,672 Acquired technology 37,915 (35,451) 2,464 37,915 (29,665) 8,250 $ 916,186 $ (534,822) $ 381,364 $ 916,186 $ (442,052) $ 474,134 Aggregate amortization expense for intangible assets was $92,770 and $89,756 for the years ended December 31, 2024 and 2023, respectively. Based on the net carrying amount of intangible assets subject to amortization, the estimated future amortization expense as of December 31, 2024 is as follows: Amount Year ending December 31, 2025 $ 75,633 Year ending December 31, 2026 67,108 Year ending December 31, 2027 56,069 Year ending December 31, 2028 35,889 Year ending December 31, 2029 27,166 Thereafter 119,499 $ 381,364 The Company performed its annual goodwill impairment test as of October 31, 2024. Due to a sustained decline in market capitalization in the fourth quarter, the Company performed a quantitative impairment test for its three reporting units: nurse and allied solutions, physician and leadership solutions, and technology and workforce solutions. The Company engaged a third-party valuation specialist to assist in determining the fair value of each reporting unit, which was estimated using an equal weighting of the income and market approaches. The discounted cash flow method (within the income approach) requires the use of Level 3 inputs, including (i) estimated future cash flows based on internally-developed forecasts of revenue, expenses and profit margins, (ii) estimated long-term growth rates, and (iii) determination of the Company’s weighted average cost of capital that reflects the relative risk of the cash flows for each reporting unit. The guideline public company method (within the market approach) derives valuation multiples based on the market capitalization of similar publicly traded companies to apply to the forecasted financial metrics of each reporting unit. The market multiples used are revenue and earnings before interest, taxes, depreciation, and amortization (EBITDA). In addition, as the fair values determined under the guideline public company method represent a noncontrolling interest, a control premium was applied to arrive at the estimated fair value of each reporting unit on a controlling basis. The annual test resulted in goodwill impairment losses for the nurse and allied solutions and physician and leadership solutions reporting units. Consideration was first given to Company’s long-lived assets, and no impairment was recognized on such assets as the future undiscounted cash flows were in excess of the carrying amount of each asset group tested for impairment. The decline in the fair value of the nurse and allied solutions reporting unit below its carrying amount resulted from changes in estimated future cash flows due to a continued decline in demand (primarily in the travel nurse staffing business) and gross margin pressures driven by higher provider pay packages. As a result, an impairment loss of $104,777 was recorded to goodwill of the nurse and allied solutions reporting unit. The decline in the fair value of the physician and leadership solutions reporting unit below its carrying amount resulted from changes in estimated future cash flows due to gross margin pressures in the locum tenens staffing business driven by higher provider pay packages and a continued decline in demand for the healthcare interim leadership staffing, executive search, and physician permanent placement businesses. As a result, an impairment loss of $81,946 was recorded to goodwill of the physician and leadership solutions reporting unit. Recognition of the non-cash goodwill impairment losses resulted in income tax benefits which generated additional deferred tax assets of $18,506 and $17,228 that increased the carrying amount of the nurse and allied solutions and physician and leadership solutions reporting units, respectively. Incremental impairment losses of the same amounts were required to reduce the carrying amounts of the reporting units to their previously determined fair values. After recognition of these incremental charges, the goodwill impairment losses were $222,457 in total. Following the annual goodwill impairment test as of October 31, 2024, the Company did not identify any events or circumstances during the final two months of the year ended December 31, 2024 that indicated it may be more likely than not that the fair value of its reporting units were reduced below their respective carrying amounts. The following table summarizes the activity related to the carrying value of goodwill by reportable segment: Nurse and Allied Physician and Leadership Technology and Workforce Solutions Total Balance, January 1, 2023 $ 382,005 $ 152,800 $ 400,559 $ 935,364 Goodwill adjustment for Connetics acquisition 415 — — 415 Goodwill from MSDR acquisition — 175,770 — 175,770 Balance, December 31, 2023 382,420 328,570 400,559 1,111,549 Goodwill adjustment for MSDR acquisition — 8,364 — 8,364 Goodwill impairment losses (123,283) (99,174) — (222,457) Balance, December 31, 2024 $ 259,137 $ 237,760 $ 400,559 $ 897,456 Accumulated impairment loss as of December 31, 2023 $ 154,444 $ 60,495 $ — $ 214,939 Accumulated impairment loss as of December 31, 2024 $ 277,727 $ 159,669 $ — $ 437,396

Leases

Leases	12 Months Ended
	Dec. 31, 2024
Leases [Abstract]
Leases	Leases The Company leases certain office facilities, data centers, and equipment under various operating leases. The Company’s short-term leases (with initial lease terms of 12 months or less) are primarily related to housing arrangements for healthcare professionals on assignment. Certain leases include one or more options to renew, with renewal terms that can extend the lease term up to 10 years. Additionally, certain leases also include options to terminate the leases within 2 years. In the first quarter of 2022, the Company entered into a lease agreement for an office building located in Dallas, Texas, with future undiscounted lease payments of approximately $29,514, excluding lease incentives. The lease commenced upon substantial completion of the construction of the office building in June 2023. The initial term of the lease is approximately eleven years with options to renew during the lease term. The Company recognized a right-of-use asset and operating lease liability of $15,782 and $22,713, respectively, at lease commencement, which reflects the utilization of a tenant improvement allowance of $6,931 accounted for as a lease incentive. The components of lease expense were as follows: Years Ended December 31, 2024 2023 2022 Operating lease cost $ 9,204 $ 9,610 $ 16,439 Short-term lease cost 2,437 3,738 5,787 Variable and other lease cost 2,469 2,789 3,129 Net lease cost $ 14,110 $ 16,137 $ 25,355 The maturities of lease liabilities as of December 31, 2024 were as follows: Operating Leases Year ending December 31, 2025 $ 8,715 Year ending December 31, 2026 7,580 Year ending December 31, 2027 7,672 Year ending December 31, 2028 7,866 Year ending December 31, 2029 5,861 Thereafter 12,486 Total lease payments 50,180 Less imputed interest (8,255) Present value of lease liabilities $ 41,925 The weighted average remaining lease term and discount rate as of December 31, 2024 and 2023 were as follows: December 31, 2024 2023 Weighted average remaining lease term 7 years 7 years Weighted average discount rate 5.6 % 5.3 %

Balance Sheet Details

Balance Sheet Details	12 Months Ended
	Dec. 31, 2024
Balance Sheet Related Disclosures [Abstract]
Balance Sheet Details	Balance Sheet Details The consolidated balance sheets detail is as follows: December 31, 2024 2023 Other current assets: Restricted cash and cash equivalents $ 14,984 $ 22,056 Income taxes receivable 11,683 5,350 Other 26,791 18,264 Other current assets $ 53,458 $ 45,670 Fixed assets: Furniture and equipment $ 90,970 $ 71,815 Software 440,034 388,812 Leasehold improvements 16,061 15,839 547,065 476,466 Accumulated depreciation (360,795) (285,081) Fixed assets, net $ 186,270 $ 191,385 Other assets: Life insurance cash surrender value $ 194,350 $ 162,780 Operating lease right-of-use assets 32,115 34,543 Other 31,588 39,473 Other assets $ 258,053 $ 236,796 Accounts payable and accrued expenses: Trade accounts payable $ 31,356 $ 54,128 Subcontractor payable 69,563 122,983 Accrued expenses 57,263 82,257 Loss contingencies 2,999 69,837 Professional liability reserve 8,395 7,761 Other 14,735 6,881 Accounts payable and accrued expenses $ 184,311 $ 343,847 Accrued compensation and benefits: Accrued payroll $ 46,896 $ 53,633 Accrued bonuses and commissions 25,988 31,236 ESPP contributions 812 950 Workers compensation reserve 9,954 12,130 Deferred compensation 191,006 165,574 Other 12,888 15,013 Accrued compensation and benefits $ 287,544 $ 278,536 Other current liabilities: Deferred revenue $ 10,014 $ 11,303 Client deposits 56,341 8,707 Operating lease liabilities 6,200 7,993 Other 1,375 5,735 Other current liabilities $ 73,930 $ 33,738 December 31, 2024 2023 Other long-term liabilities: Workers compensation reserve $ 18,445 $ 21,169 Professional liability reserve 38,307 36,891 Operating lease liabilities 35,725 37,603 Other 14,973 13,316 Other long-term liabilities $ 107,450 $ 108,979

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2024
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The provision for income taxes from operations for the years ended December 31, 2024, 2023 and 2022 consists of the following: Years Ended December 31, 2024 2023 2022 Current income taxes: Federal $ 20,430 $ 65,877 $ 145,217 State 5,042 20,666 42,051 Total 25,472 86,543 187,268 Deferred income taxes: Federal (36,685) (10,203) (20,173) State (14,382) (2,730) (4,442) Total (51,067) (12,933) (24,615) Provision (benefit) for income taxes from operations $ (25,595) $ 73,610 $ 162,653 The Company’s income tax expense differs from the amount that would have resulted from applying the federal statutory rate of 21% for 2024, 2023 and 2022 to pretax income (loss) from operations because of the effect of the following items during the years ended December 31, 2024, 2023 and 2022: Years Ended December 31, 2024 2023 2022 Tax expense at federal statutory rate $ (36,241) $ 59,701 $ 127,390 State taxes, net of federal benefit (7,379) 14,170 29,711 Non-deductible expenses 2,110 3,010 — Share-based compensation 513 (944) (2,383) Unrecognized tax benefit 1,328 1,957 3,245 Company-owned life insurance policies (4,855) (4,428) 4,094 Tax credits (1,289) (3,172) (2,741) Goodwill impairment losses 18,054 — — Other, net 2,164 3,316 3,337 Income tax expense (benefit) from operations $ (25,595) $ 73,610 $ 162,653 The tax effects of temporary differences that give rise to significant portions of deferred tax assets and liabilities are presented below as of December 31, 2024 and 2023: December 31, 2024 2023 Deferred tax assets: Share-based compensation $ 6,394 $ 5,461 Deferred compensation 48,821 41,976 Accrued bonus 5,546 2,585 Accrued expenses 10,783 11,426 Operating lease liabilities 10,954 11,296 Net operating losses 5,314 4,809 Loss contingencies 563 813 Workers compensation insurance 5,273 5,997 Professional services expenses 179 16,242 Provision for expected credit losses 8,415 9,161 Sales credits 5,960 6,896 Other 3,995 1,516 Total deferred tax assets $ 112,197 $ 118,178 Deferred tax liabilities: Intangible assets $ (65,251) $ (111,590) Fixed assets (8,662) (14,947) Operating lease right-of-use assets (8,395) (8,539) Other (4,060) (6,452) Total deferred tax liabilities $ (86,368) $ (141,528) Net deferred tax asset (liability) $ 25,829 $ (23,350) In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. Management believes it is more likely than not that the Company will realize the benefits of its deferred tax assets. The amount of federal net operating losses (“NOL”) carryforward that is available for use in years subsequent to December 31, 2024 is $18,700, which begins to expire by 2030. The amount of state NOL carryforward that is available for use in years subsequent to December 31, 2024 is $27,000, which begins to expire by 2036. A summary of the changes in the amount of unrecognized tax benefits (excluding interest and penalties) for 2024, 2023 and 2022 is as follows: 2024 2023 2022 Beginning balance of unrecognized tax benefits $ 8,689 $ 6,980 $ 4,067 Additions based on tax positions related to the current year 978 1,873 1,464 Additions based on tax positions of prior years 266 491 1,966 Reductions due to lapse of applicable statute of limitation (484) (655) (517) Ending balance of unrecognized tax benefits $ 9,449 $ 8,689 $ 6,980 At December 31, 2024, if recognized, approximately $10,467 net of $1,848 of temporary differences would affect the effective tax rate (including interest and penalties). The Company recognizes interest related to unrecognized tax benefits in income tax expense. The Company had approximately $2,861, $1,942 and $1,390 of accrued interest related to unrecognized tax benefits at December 31, 2024, 2023 and 2022, respectively. The amount of interest expense recognized in 2024, 2023 and 2022 was $920, $552 and $826, respectively. The Company is subject to taxation in the U.S. and various states and foreign jurisdictions. With few exceptions, as of December 31, 2024, the Company is no longer subject to state, local or foreign examinations by tax authorities for tax years before 2011, and the Company is no longer subject to U.S. federal income or payroll tax examinations for tax years before 2021. 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. CARES Act Pursuant to the business tax provisions in the Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”), the Company deferred payment of the employer’s share of payroll taxes of $48,452. Approximately half of such taxes was paid during the fourth quarter of 2021 and the remaining balance was paid during the fourth quarter of 2022.

Notes Payable and Credit Agreem

Notes Payable and Credit Agreement	12 Months Ended
	Dec. 31, 2024
Debt Disclosure [Abstract]
Notes Payable and Credit Agreement	Notes Payable and Credit Agreement (a) The Company ’ s Credit Agreement and Revolving Credit Facility On February 10, 2023, the Company entered into the third amendment to its credit agreement (the “Third Amendment”). The Third Amendment (together with the credit agreement, the first amendment and the second amendment, collectively, the “Amended Credit Agreement”) 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 to 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. 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. The obligations of the Company under the Amended Credit Agreement are secured by substantially all of the assets of the Company. Borrowings under the Senior Credit Facility bear interest at floating rates, at the Company’s option, based upon either SOFR plus a spread of 1.00% to 1.75% or a base rate plus a spread of 0.00% to 0.75%. The applicable spread is determined quarterly based upon the Company’s consolidated net leverage ratio (as calculated per the Amended Credit Agreement). The Senior Credit Facility, which includes a $125,000 sublimit for the issuance of letters of credit and a $75,000 sublimit for swingline loans, is available for working capital, capital expenditures, permitted acquisitions and general corporate purposes. (b) The Company ’ s 4.625% Senior Notes Due 2027 On August 13, 2020, the Company completed the issuance of an additional $200,000 aggregate principal amount of 4.625% senior notes due 2027 (the “New 2027 Notes”), which were issued at a price of 101.000% of the aggregate principal amount. The New 2027 Notes were issued pursuant to the existing indenture, dated as of October 1, 2019, under which the Company previously issued $300,000 aggregate principal amount of 4.625% senior notes due 2027 (the “Existing 2027 Notes” and together with the New 2027 Notes, the “2027 Notes”). The New 2027 Notes are being treated as a single series with the Existing 2027 Notes and have the same terms (other than issue price, issue date and the date from which interest accrues) as those of the Existing 2027 Notes. The 2027 Notes are unsecured obligations of the Company and the interest is fixed at 4.625% and payable semi-annually in arrears on April 1 and October 1 of each year, commencing October 1, 2020 with respect to the New 2027 Notes. The aggregate principal amount of the 2027 Notes matures on October 1, 2027. (c) The Company ’ s 4.000% Senior Notes Due 2029 On October 20, 2020, the Company completed the issuance of $350,000 aggregate principal amount of the 2029 Notes, which mature on April 15, 2029. The 2029 Notes are unsecured obligations of the Company and the interest is fixed at 4.000% and payable semi-annually in arrears on April 15 and October 15 of each year, commencing April 15, 2021. (d) Debt Balances Outstanding debt balances as of December 31, 2024 and 2023 consisted of the following: As of December 31, 2024 2023 Senior Credit Facility $ 210,000 $ 460,000 2027 Notes 500,000 500,000 2029 Notes 350,000 350,000 Total debt outstanding 1,060,000 1,310,000 Less unamortized fees and premium (4,128) (5,312) Long-term portion of notes payable $ 1,055,872 $ 1,304,688 At December 31, 2024, with $20,358 of outstanding letters of credit collateralized by the Senior Credit Facility, there was $519,642 of available credit under the Senior Credit Facility. The interest rate for the outstanding borrowings under the Senior Credit Facility was 6.0% on a SOFR basis as of December 31, 2024. The repayment of a portion of the outstanding borrowings under the Senior Credit Facility subsequent to December 31, 2024 is detailed in Note (1) (g), “Summary of Significant Accounting Policies—Restricted Cash, Cash Equivalents and Investments.” (e) Letters of Credit At December 31, 2024, the Company maintained outstanding standby letters of credit totaling $20,912 as collateral in relation to its workers’ compensation insurance agreements and a corporate office lease agreement. Of the $20,912 outstanding letters of credit, the Company has collateralized $554 in cash and cash equivalents and the remaining $20,358 is collateralized by the Senior Credit Facility. Outstanding standby letters of credit at December 31, 2023 totaled $21,312.

Retirement Plans

Retirement Plans	12 Months Ended
	Dec. 31, 2024
Retirement Benefits [Abstract]
Retirement Plans	Retirement Plans The Company maintains the AMN Services 401(k) Retirement Savings Plan (the “AMN Plan”), which the Company believes complies with the IRC Section 401(k) provisions. The AMN Plan covers all employees that meet certain age and other eligibility requirements. A discretionary matching contribution is determined by the Company each year. Employer contribution expenses incurred under the AMN Plan were $4,004, $5,673 and $31,409 for the years ended December 31, 2024, 2023 and 2022, respectively. Employer contribution expenses for the year ended December 31, 2022 included one-time contributions and a temporary increase to the discretionary matching contribution for a portion of the year. The Company has a deferred compensation plan for certain executives and employees (the “Plan”). The Plan is not intended to be tax qualified and is an unfunded plan. The Plan is composed of deferred compensation and all related income and losses attributable thereto. Discretionary matching contributions to the Plan are made that vest incrementally so that the employee is fully vested in the match following five years of employment with the Company. Under the Plan, participants can defer up to 80% of their base salary, 90% of their variable compensation and 100% of their vested RSUs or vested PRSUs. A discretionary matching contribution is determined by the Company each year. Employer contributions under the Plan were $6,849, $10,822 and $18,023 for the years ended December 31, 2024, 2023 and 2022, respectively. Employer contribution expenses for the year ended December 31, 2022 included one-time contributions and a temporary increase to the discretionary matching contribution for a portion of the year. In connection with the administration of the Plan, the Company has purchased company-owned life insurance policies insuring the lives of certain officers and employees. The cash surrender value of these policies was $194,350 and $162,780 at December 31, 2024 and 2023, respectively. The cash surrender value of these insurance policies is included in other assets in the consolidated balance sheets.

Capital Stock

Capital Stock	12 Months Ended
	Dec. 31, 2024
Equity [Abstract]
Capital Stock	Capital Stock (a) Preferred Stock The Company has 10,000 shares of preferred stock authorized for issuance in one or more series (including preferred stock designated as Series A Conditional Convertible Preferred Stock), at a par value of $0.01 per share. At December 31, 2024 and 2023, no shares of preferred stock were outstanding. (b) Treasury Stock On November 1, 2016, the Company’s board of directors approved a share repurchase program under which the Company may repurchase up to $150,000 of its outstanding common stock. On November 10, 2021, February 17, 2022, June 15, 2022, and February 16, 2023, the Company announced increases to the share repurchase program totaling $1,200,000 for a total of $1,350,000 of repurchase authorization, of which $226,658 remained on the repurchase program as of December 31, 2024. The amount and timing of the purchases will depend on a number of factors including the price of the Company’s shares, trading volume, Company performance, Company liquidity, general economic and market conditions and other factors that the Company’s management believes are relevant. The share repurchase program does not require the purchase of any minimum number of shares and may be suspended or discontinued at any time. The Company intends to make all repurchases and to administer the plan in accordance with applicable laws and regulatory guidelines, including Rule 10b-18 of the Exchange Act, and in compliance with its debt instruments. Repurchases may be made from cash on hand, free cash flow generated from the Company’s business or from the Company’s Senior Credit Facility. Repurchases may be made from time to time through open market purchases or privately negotiated transactions. Repurchases may also be made pursuant to one or more plans established pursuant to Rule 10b5-1 under the Exchange Act that would permit shares to be repurchased when the Company might otherwise be precluded from doing so under the Company’s securities trading policy. During the year ended December 31, 2024, the Company did not repurchase any shares of its common stock. The total number of shares repurchased, average price per share (excluding broker’s fees), and total cost (excluding the effect of excise taxes) for the years ended December 31, 2023 and 2022 were as follows: Years Ended December 31, 2023 2022 Number of shares repurchased 4,383 5,644 Average price per share $ 96.90 $ 102.16 Total cost of share repurchases $ 424,744 $ 576,767 During the year ended December 31, 2023, the Company repurchased 2,362 shares of its common stock through the open market at an average price of $95.13 per share (excluding broker’s fees) for an aggregate purchase price of $224,744 (excluding the effect of excise taxes). Additionally, on May 8, 2023, the Company entered into an accelerated share repurchase (“ASR”) agreement with a counterparty whereupon the Company prepaid $200,000 and received an initial delivery of 1,760 shares of its common stock, which was 80% of the prepayment amount based on a price of $90.89 per share. On August 10, 2023, the Company received a final delivery of approximately 261 additional shares of its common stock, representing the remaining 20% of the prepayment and the final settlement of the ASR agreement. The total number of shares received and average price per share of $98.97 was based on the volume-weighted average price over the term of the ASR agreement, less an agreed upon discount. The Company recognized the shares delivered pursuant to the ASR as increases to treasury stock in the consolidated statements of stockholders’ equity during the year ended December 31, 2023. The shares repurchased during the year ended December 31, 2022 were all through the open market.

Share-Based Compensation

Share-Based Compensation	12 Months Ended
	Dec. 31, 2024
Share-Based Payment Arrangement [Abstract]
Share-Based Compensation	Share-Based Compensation (a) Equity Award Plans Equity Plan The Company established the AMN Healthcare Equity Plan (as amended or amended and restated from time to time, the “Equity Plan”), which has been approved by the Company’s stockholders. Any shares to be issued under the Equity Plan will be issued by the Company from authorized but unissued common stock or shares of common stock reacquired by the Company. As of December 31, 2024 and 2023, 1,668 and 2,264 shares of common stock were reserved for future grants under the Equity Plan, respectively. Employee Stock Purchase Plan During 2023, the Company established the AMN Healthcare Services, Inc. Employee Stock Purchase Plan (the “ESPP”) which authorizes the issuance of up to 1,000 shares of the Company’s common stock. The ESPP provides eligible employees with the opportunity to purchase shares of the Company’s common stock at a discount through payroll deductions during a six-month purchase period. Shares are purchased at 85% of the fair market value of the Company’s common stock on the offering date or the purchase date of the applicable purchase period, whichever is lower. Employee contributions were $3,250 and $950 for the years ended December 31, 2024 and 2023, respectively. There were 78 shares issued under the ESPP during the year ended December 31, 2024 and the number of shares remaining available for future issuance was 922 as of December 31, 2024. No purchases were made and no shares were issued under the ESPP during the year ended December 31, 2023. Other Plans From time to time, the Company grants, and has granted, key employees inducement awards outside of the Equity Plan (collectively, “Other Plans”), which have recently consisted of RSUs. Although these awards are not made under the Equity Plan, the key terms and conditions of the grant are typically the same as equity awards made under the Equity Plan. (b) Share-Based Compensation Restricted Stock Units RSUs and PRSUs (subject to performance conditions being achieved) granted under the Equity Plan generally entitle the holder to receive, at the end of a vesting period, a specified number of shares of the Company’s common stock. The following table summarizes RSU and PRSU activity for the years ended December 31, 2024, 2023 and 2022: Number of Shares Weighted Average Unvested at January 1, 2022 755 $ 78.13 Granted—RSUs 200 $ 109.66 Granted—PRSUs (1) 190 $ 92.65 Vested (405) $ 72.43 Canceled/forfeited (75) $ 82.13 Unvested at December 31, 2022 665 $ 94.79 Granted—RSUs 196 $ 95.67 Granted—PRSUs (1) 176 $ 109.74 Vested (349) $ 89.76 Canceled/forfeited (87) $ 104.14 Unvested at December 31, 2023 601 $ 101.01 Granted—RSUs 443 $ 61.30 Granted—PRSUs (1) 259 $ 70.73 Vested (234) $ 89.64 Canceled/forfeited (156) $ 90.66 Unvested at December 31, 2024 913 $ 77.81 (1) PRSUs granted included both the PRSUs granted during the year at the target amount and the additional shares of prior period granted PRSUs vested during the year in excess of the target shares. As of December 31, 2024, there was $32,003 unrecognized compensation cost related to unvested RSUs and PRSUs. The Company expects to recognize such cost over a period of 1.9 years. As of December 31, 2024 and 2023, the aggregate intrinsic value of the RSUs and PRSUs outstanding was $21,834 and $44,979, respectively. Share-Based Compensation Total share-based compensation expense for the years ended December 31, 2024, 2023 and 2022 was as follows: Years Ended December 31, 2024 2023 2022 Share-based employee compensation, before tax $ 23,317 $ 18,020 $ 30,066 Related income tax benefits (6,062) (4,685) (7,817) Share-based employee compensation, net of tax $ 17,255 $ 13,335 $ 22,249

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies 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.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Pay vs Performance Disclosure
Net Income (Loss) Attributable to Parent	$ (146,979)	$ 210,679	$ 444,050

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Dec. 31, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Insider Trading Policies and Pr

Insider Trading Policies and Procedures	12 Months Ended
	Dec. 31, 2024
Insider Trading Policies and Procedures [Line Items]
Insider Trading Policies and Procedures Adopted	true

Cybersecurity Risk Management a

Cybersecurity Risk Management and Strategy Disclosure	12 Months Ended
	Dec. 31, 2024
Cybersecurity Risk Management, Strategy, and Governance [Line Items]
Cybersecurity Risk Management Processes for Assessing, Identifying, and Managing Threats [Text Block]	AMN Healthcare’s board of directors (the “Board”) is responsible for overseeing our enterprise-wide risk management program. The audit committee of the Board (the “Audit Committee”) has primary oversight responsibility for information and cybersecurity, including internal controls designed to mitigate risks related to these topics. This includes regular, and at least quarterly, review by the Audit Committee of reports on topics including, among others, significant cybersecurity risks, results from third-party assessments, training and vulnerability testing, and our incident response plan. Material breaches, if any, and any disclosure obligations arising from any such breach are also discussed separately with the Audit Committee as part of the Board’s risk oversight generally. AMN’s information and cybersecurity program has adopted policies, standards, processes, and practices that follow recognized frameworks established by the National Institute of Standards and Technology (“NIST”), the International Organization for Standardization, and other relevant standards. AMN Healthcare has also implemented certain controls and procedures that allow its management to assess, identify, and manage material risks from cybersecurity threats. Our processes are integrated into the overall enterprise risk management program, which includes financial risk, compliance risk and other strategic and operational risks that affect the Company. These processes complement our enterprise-wide risk assessment architecture, as implemented by the Company’s management and as overseen by the Board through its Audit Committee. To identify and assess material risks from cybersecurity threats, we engage in regular network and endpoint monitoring, vulnerability assessments, penetration testing, and periodic tabletop exercises. We have developed an incident response plan to manage identified vulnerabilities and further improve our cybersecurity preparedness and response infrastructure. The incident response plan sets forth the actions to be taken in responding to and recovering from cybersecurity incidents, which include triage, assessing the severity of incidents, escalation protocols, containment of incidents, investigation of incidents, and remediation. In addition to our in-house capabilities, we engage with key security and technology vendors, industry participants and intelligence communities to assess our program and test our technical capabilities and enhance the effectiveness of our information and cybersecurity policies and procedures. We use a combination of tools and technologies to protect AMN Healthcare’s assets and information. We maintain and operate a proactive threat intelligence program to identify and assess risk. We have implemented processes to identify, monitor and address material risks from cybersecurity threats associated with our use of third-party vendors, including those in our supply chain or who have access to our systems, data or facilities that house such systems or data. Our team members receive annual training to understand the behaviors necessary to protect company and personal information and receive annual training on privacy laws and requirements. We also offer ongoing practice and education for team members to recognize and report suspicious activity, including phishing campaigns. The Company has experienced cyber threats resulting in immaterial cyber incidents and expects cyber threats to continue with varying levels of sophistication.
Cybersecurity Risk Management Processes Integrated [Flag]	true
Cybersecurity Risk Management Processes Integrated [Text Block]	Our processes are integrated into the overall enterprise risk management program, which includes financial risk, compliance risk and other strategic and operational risks that affect the Company.
Cybersecurity Risk Management Third Party Engaged [Flag]	true
Cybersecurity Risk Third Party Oversight and Identification Processes [Flag]	true
Cybersecurity Risk Materially Affected or Reasonably Likely to Materially Affect Registrant [Flag]	true
Cybersecurity Risk Board of Directors Oversight [Text Block]	AMN Healthcare’s board of directors (the “Board”) is responsible for overseeing our enterprise-wide risk management program. AMN’s information and cybersecurity program reports up to our Chief Information & Digital Officer (“CIO”) and is managed by our Vice President, Information & Cyber Security, whose team is responsible for leading our enterprise-wide cybersecurity strategy. Through ongoing communications with the team, the CIO and the Vice President, Information & Cyber Security, are informed about and monitor the prevention, detection, mitigation and remediation of cybersecurity incidents and progress on cybersecurity infrastructure initiatives. In the event of a material cybersecurity incident, the CIO, in coordination with AMN’s Chief Legal Officer, will escalate to the Audit Committee and the Board is made aware as appropriate and in accordance with AMN’s incident response plan. Our CIO and Vice President, Information & Cyber Security have proven experience as technology leaders establishing and overseeing enterprise information security programs in the healthcare industry. Our CIO has over 25 years of experience serving as Chief Information Officer, Senior Vice President of IT, and Director of IT at various healthcare services and technology companies. AMN’s Vice President, Information & Cyber Security has over 20 years of experience in various roles in information technology and information security. He holds a M.Sc. in Computer Information Systems and holds several relevant certifications, including Certified Information Security Manager and Zero Trust Certified Architect. AMN’s Privacy function, which reports up through our Chief Legal Officer, works collaboratively with the Information Security function to create and review policies, standards and processes. In addition to updating the Audit Committee, the CIO and Vice President, Information & Security, and Privacy team provide regular updates to the Corporate Governance and Compliance Committee, as well as our Chief Executive Officer and other members of our senior management as appropriate.
Cybersecurity Risk Board Committee or Subcommittee Responsible for Oversight [Text Block]	The audit committee of the Board (the “Audit Committee”) has primary oversight responsibility for information and cybersecurity, including internal controls designed to mitigate risks related to these topics.
Cybersecurity Risk Process for Informing Board Committee or Subcommittee Responsible for Oversight [Text Block]	This includes regular, and at least quarterly, review by the Audit Committee of reports on topics including, among others, significant cybersecurity risks, results from third-party assessments, training and vulnerability testing, and our incident response plan. Material breaches, if any, and any disclosure obligations arising from any such breach are also discussed separately with the Audit Committee as part of the Board’s risk oversight generally.
Cybersecurity Risk Role of Management [Text Block]	AMN’s information and cybersecurity program reports up to our Chief Information & Digital Officer (“CIO”) and is managed by our Vice President, Information & Cyber Security, whose team is responsible for leading our enterprise-wide cybersecurity strategy. Through ongoing communications with the team, the CIO and the Vice President, Information & Cyber Security, are informed about and monitor the prevention, detection, mitigation and remediation of cybersecurity incidents and progress on cybersecurity infrastructure initiatives. In the event of a material cybersecurity incident, the CIO, in coordination with AMN’s Chief Legal Officer, will escalate to the Audit Committee and the Board is made aware as appropriate and in accordance with AMN’s incident response plan. Our CIO and Vice President, Information & Cyber Security have proven experience as technology leaders establishing and overseeing enterprise information security programs in the healthcare industry. Our CIO has over 25 years of experience serving as Chief Information Officer, Senior Vice President of IT, and Director of IT at various healthcare services and technology companies. AMN’s Vice President, Information & Cyber Security has over 20 years of experience in various roles in information technology and information security. He holds a M.Sc. in Computer Information Systems and holds several relevant certifications, including Certified Information Security Manager and Zero Trust Certified Architect. AMN’s Privacy function, which reports up through our Chief Legal Officer, works collaboratively with the Information Security function to create and review policies, standards and processes. In addition to updating the Audit Committee, the CIO and Vice President, Information & Security, and Privacy team provide regular updates to the Corporate Governance and Compliance Committee, as well as our Chief Executive Officer and other members of our senior management as appropriate.
Cybersecurity Risk Management Positions or Committees Responsible [Flag]	true
Cybersecurity Risk Management Positions or Committees Responsible [Text Block]	AMN’s information and cybersecurity program reports up to our Chief Information & Digital Officer (“CIO”) and is managed by our Vice President, Information & Cyber Security, whose team is responsible for leading our enterprise-wide cybersecurity strategy. Through ongoing communications with the team, the CIO and the Vice President, Information & Cyber Security, are informed about and monitor the prevention, detection, mitigation and remediation of cybersecurity incidents and progress on cybersecurity infrastructure initiatives. In the event of a material cybersecurity incident, the CIO, in coordination with AMN’s Chief Legal Officer, will escalate to the Audit Committee and the Board is made aware as appropriate and in accordance with AMN’s incident response plan.
Cybersecurity Risk Management Expertise of Management Responsible [Text Block]	Our CIO and Vice President, Information & Cyber Security have proven experience as technology leaders establishing and overseeing enterprise information security programs in the healthcare industry. Our CIO has over 25 years of experience serving as Chief Information Officer, Senior Vice President of IT, and Director of IT at various healthcare services and technology companies. AMN’s Vice President, Information & Cyber Security has over 20 years of experience in various roles in information technology and information security. He holds a M.Sc. in Computer Information Systems and holds several relevant certifications, including Certified Information Security Manager and Zero Trust Certified Architect.
Cybersecurity Risk Process for Informing Management or Committees Responsible [Text Block]	Through ongoing communications with the team, the CIO and the Vice President, Information & Cyber Security, are informed about and monitor the prevention, detection, mitigation and remediation of cybersecurity incidents and progress on cybersecurity infrastructure initiatives. In the event of a material cybersecurity incident, the CIO, in coordination with AMN’s Chief Legal Officer, will escalate to the Audit Committee and the Board is made aware as appropriate and in accordance with AMN’s incident response plan.
Cybersecurity Risk Management Positions or Committees Responsible Report to Board [Flag]	true

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2024
Accounting Policies [Abstract]
Principles of Consolidation	The accompanying consolidated financial statements include the accounts of AMN Healthcare Services, Inc. and its wholly-owned subsidiaries. All significant intercompany balances and transactions have been eliminated in consolidation.
Use of Estimates	The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America 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 consolidated 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 indefinite-lived intangible assets, professional liability reserve, 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.
Cost of Revenue	Cost of revenue represents costs directly associated with the earnings of revenue and are comprised primarily of compensation, benefits, housing, travel and allowance costs for healthcare professionals and medically qualified interpreters.
Selling, General and Administrative Expenses	Selling, general and administrative expenses consist predominantly of compensation and benefits costs for corporate employees, in additional to professional service fees, legal matter accruals, and other overhead costs. Unallocated corporate overhead is a subset of selling, general and administrative expenses and is comprised of indirect costs related to certain corporate functions that are not allocated to the Company’s reportable segments.
Cash and Cash Equivalents	The Company considers all highly liquid investments with an original maturity of three months or less to be cash equivalents. Cash and cash equivalents include currency on hand, deposits with financial institutions, money market funds, and other highly liquid investments.
Restricted Cash, Cash Equivalents and Investments	Restricted cash, cash equivalents and investments primarily include cash, corporate bonds and commercial paper that serve as collateral for the Company’s captive insurance subsidiary claim payments.
Fixed Assets	The Company records furniture, equipment, leasehold improvements and capitalized software at cost less accumulated amortization and depreciation. The Company records equipment acquired under finance leases at the present value of the future minimum lease payments. The Company capitalizes major additions and improvements, and it expenses maintenance and repairs when incurred. The Company calculates depreciation on furniture, equipment and software using the straight-line method based on the estimated useful lives of the related assets (typically three The Company capitalizes costs it incurs to develop software during the application development stage. Application development stage costs generally include costs associated with software configuration, coding, installation and testing. The Company also capitalizes costs of significant upgrades and enhancements that result in additional functionality, whereas it expenses as incurred costs for maintenance and minor upgrades and enhancements. The Company amortizes capitalized costs using the straight-line method over three The Company assesses long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset group to the future undiscounted net cash flows that are expected to be generated by the asset group. If such asset group is considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the asset group exceeds the fair value of the asset group. The Company reports assets to be disposed of at the lower of the carrying amount or fair value less costs to sell.
Leases	The Company recognizes operating lease right-of-use assets and liabilities at commencement date based on the present value of the future minimum lease payments over the lease term. Leases with an initial term of 12 months or less are not recorded on the balance sheet in accordance with the short-term lease recognition exemption. The Company applies the practical expedient to not separate lease and non-lease components for all leases that qualify. The rates implicit in the Company’s lease arrangements are generally not readily determinable and as such, the Company uses its incremental borrowing rate as the discount rate to measure its lease liabilities. The incremental borrowing rate is determined for each operating lease based on the Company’s borrowing capabilities over a similar term of the lease arrangement, which is estimated by utilizing the Company’s credit rating and the effects of full collateralization. Lease expense is recognized on a straight-line basis over the lease term. Operating lease right-of-use assets are included in other assets, and operating lease liabilities are included in other current liabilities and other long-term liabilities in the consolidated balance sheets.
Goodwill	The Company records as goodwill the portion of the purchase price that exceeds the fair value of net assets of entities acquired. The Company evaluates goodwill annually for impairment at the reporting unit level and whenever circumstances occur indicating that goodwill may be impaired. The Company may first perform an optional qualitative assessment to
Intangible Assets	Intangible assets consist of identifiable intangible assets acquired through acquisitions, which include tradenames and trademarks, customer relationships, staffing databases, developed technology and non-compete agreements. The Company amortizes intangible assets, other than those with an indefinite life, using the straight-line method over their useful lives. The Company amortizes non-compete agreements using the straight-line method over the lives of the related agreements. The Company reviews for impairment intangible assets with estimable useful lives whenever events or changes in circumstances indicate that the carrying amount may not be recoverable. The Company does not amortize indefinite-lived intangible assets and instead reviews them for impairment annually .
Insurance Reserves	The Company maintains an accrual for professional liability that is included in accounts payable and accrued expenses and other long-term liabilities in the consolidated balance sheets. The expense is included in the selling, general and administrative expenses in the consolidated statements of comprehensive income (loss). The Company determines the adequacy of this accrual by evaluating its historical experience and trends, loss reserves established by the Company’s insurance carriers, management and third-party administrators, and independent actuarial studies. The Company obtains actuarial studies on a semi-annual basis that use the Company’s actual claims data and industry data to assist the Company in determining the adequacy of its reserves each year. For periods between the actuarial studies, the Company records its accruals based on loss rates provided in the most recent actuarial study and management’s review of loss history and trends. Liabilities include provisions for estimated incurred but not yet reported (“IBNR”) losses, as well as provisions for known claims. IBNR reserve estimates involve the use of assumptions that are primarily based upon historical loss experience, industry data and other actuarial assumptions. The Company maintains insurance programs through its wholly-owned captive insurance subsidiary, which primarily provides coverage, on an occurrence basis, for professional liability within its nurse and allied solutions segment. In addition, the Company maintains excess insurance coverage through a commercial carrier for losses above the per occurrence retention. Losses covered by excess insurance are included in the accrual for professional liability, as the Company remains liable to the extent commercial carriers do not meet their obligations. The Company maintains an accrual for workers’ compensation, which is included in accrued compensation and benefits and other long-term liabilities in the consolidated balance sheets. The expense relating to healthcare professionals is included in cost of revenue, while the expense relating to corporate employees is included in the selling, general and administrative expenses in the consolidated statements of comprehensive income (loss). The Company determines the adequacy of this accrual by evaluating its historical experience and trends, loss reserves established by the Company’s insurance carriers and third-party administrators, and independent actuarial studies. The Company obtains actuarial studies on a semi-annual basis that use the Company’s payroll and historical claims data, as well as industry data, to determine the appropriate reserve for both reported claims and IBNR claims for each policy year. For periods between the actuarial studies, the Company records its accruals based on loss rates provided in the most recent actuarial study.
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. See additional information below regarding the Company’s revenue disaggregated by service type. 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 recognizes assets from incremental costs to obtain a contract with a customer and costs incurred to fulfill a contract with a customer, which are deferred and amortized using the portfolio approach on a straight line basis over the average period of benefit consistent with the timing of transfer of services to the customer. 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.
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.
Concentration of Credit Risk	The majority of the Company’s business activity is with hospitals located throughout the United States. Credit is extended based on the evaluation of each entity’s financial condition. The Company’s cash and cash equivalents and restricted cash, cash equivalents and investments accounts are financial instruments that are exposed to concentration of credit risk. The Company maintains most of its cash, cash equivalents and
Income Taxes	Income Taxes The Company records income taxes using the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax basis. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in the period the changes are enacted. In assessing the realizability of deferred tax assets, the Company considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. The Company considers the scheduled reversal of deferred tax liabilities (including the impact of available carryback and carryforward periods), projected future taxable income, and tax-planning strategies in making this assessment. The Company recognizes the effect of income tax positions only if it is more likely than not that such positions will be sustained. Recognized income tax positions are measured at the largest amount that is greater than 50% likely of being realized. Changes in recognition or measurement are reflected in the period in which the change in judgment occurs. The Company records interest and penalties related to unrecognized tax benefits in income tax expense.
Fair Value of Financial Instruments	Fair Value of Financial Instruments The carrying amounts of the Company’s cash equivalents and restricted cash equivalents and investments approximate their respective fair values due to the short-term nature and liquidity of these financial instruments. The fair value of the Company’s equity investment is measured using observable prices for identical or similar investments of the same issuer when such transactions are identified, which is more fully described in Note (3) , “Fair Value Measurement.” As it relates to the Company’s 2027 Notes and 2029 Notes (as defined in Note (8) and Note (3) , respectively, below), fair value disclosure is detailed in Note (3) , “Fair Value Measurement.” See Note (8) , “Notes Payable and Credit Agreement,” for additional information. The fair value of the Company’s long-term self-insurance accruals cannot be estimated because the Company cannot reasonably determine the timing of future payments.
Share-Based Compensation	The Company accounts for its share-based employee compensation plans by expensing the estimated fair value of share-based awards on a straight-line basis over the requisite employee service period, which typically is the vesting period, except for awards granted to retirement-eligible employees, which are expensed on an accelerated basis. Restricted stock units (“RSUs”) typically vest over a three-year period. Share-based compensation cost of RSUs is measured by the market value of the Company’s common stock on the date of grant, and the Company records share-based compensation expense only for those awards that are expected to vest. Performance restricted stock units (“PRSUs”) primarily consist of PRSUs that contain performance conditions dependent on defined targets of the Company’s adjusted EBITDA, with a range of 0% to 200% of the target amount granted to be issued under the award. Share-based compensation cost for these PRSUs is measured by the market value of the Company’s common stock on the date of grant, and the amount recognized is adjusted for estimated achievement of the performance conditions. A limited amount of PRSUs contain a market condition dependent upon the Company’s relative and absolute total stockholder return over a three-year period, typically with a range of 0% to 175% (and certain awards with a range of 0% to 200%) of the target amount granted to be issued under the award. Share-based compensation cost for these PRSUs is measured using the Monte-Carlo simulation valuation model and is not adjusted for the achievement, or lack thereof, of the market conditions. Share-based compensation cost for purchase rights granted under the Company’s employee stock purchase plan is measured using the Black-Scholes model and the related employee contributions are included in accrued compensation and benefits in the consolidated balance sheets.
Net Income (Loss) per Common Share	The dilutive effect of potential shares and anti-dilutive potential common shares primarily include outstanding share-based awards, which consists of restricted stock units, performance restricted stock units, and obligations under the Company’s employee stock purchase plan.
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 (“CODM”) for the purpose of evaluating performance and allocating resources. The Company’s Chief Executive Officer and its Chief Financial Officer and Chief Operating Officer serve as the Company’s CODM. 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 (“VMS”), workforce optimization, and outsourced solutions businesses. The Company’s CODM relies on internal management reporting processes that provide revenue, gross profit and operating income by reportable segment. These financial measures are used by the CODM to evaluate segment performance, monitor variances between periods and against projections, make key operating decisions, and allocate resources such as capital and personnel to each segment. The CODM does not evaluate or measure performance of segments using asset information; accordingly, asset information by segment is not prepared or disclosed.
Recently Adopted Accounting Pronouncements	In November 2023, the FASB issued Accounting Standards Update (“ASU”) 2023-07, “Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures,” which expands the breadth and frequency of reportable segment disclosure requirements, primarily through enhanced disclosures about significant segment expenses. The new guidance requires public entities to disclose, on an annual and interim basis, significant segment expenses that are regularly provided to the chief operating decision maker (“CODM”), the amount and composition of other segment items by reportable segment, any additional measures of a segment’s profit or loss used by the CODM when assessing performance and deciding how to allocate resources, and the CODM’s title and position. Additionally, public entities will be required to provide in interim periods all disclosures about a reportable segment’s profit or loss that are currently required annually by Topic 280. This standard is effective on a retrospective basis for fiscal years beginning after December 15, 2023 and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. The Company adopted this standard for the year ending December 31, 2024.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2024
Accounting Policies [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 consolidated balance sheets and related notes to the amounts presented in the accompanying consolidated statements of cash flows. December 31, 2024 December 31, 2023 Cash and cash equivalents $ 10,649 $ 32,935 Restricted cash and cash equivalents (included in other current assets) 14,984 22,056 Restricted cash, cash equivalents and investments 71,840 68,845 Total cash, cash equivalents and restricted cash and investments 97,473 123,836 Less restricted investments (8,168) (15,563) Total cash, cash equivalents and restricted cash $ 89,305 $ 108,273
Schedule of Reconciliation of Activity in the Allowance for Credit Losses	The following table provides a reconciliation of activity in the allowance for expected credit losses for accounts receivable: 2024 2023 Balance as of January 1, $ 32,233 $ 31,910 Provision for expected credit losses 6,549 5,544 Amounts written off charged against the allowance (6,361) (5,221) Balance as of December 31, $ 32,421 $ 32,233
Schedule of Computation of Basic and Diluted Net Income (Loss) Per Common Share	The following table sets forth the computation of basic and diluted net income (loss) per common share for the years ended December 31, 2024, 2023 and 2022, respectively: Years Ended December 31, 2024 2023 2022 Net income (loss) $ (146,979) $ 210,679 $ 444,050 Net income (loss) per common share - basic $ (3.85) $ 5.38 $ 9.96 Net income (loss) per common share - diluted $ (3.85) $ 5.36 $ 9.90 Weighted average common shares outstanding - basic 38,188 39,173 44,591 Plus dilutive effect of potential common shares — 168 279 Weighted average common shares outstanding - diluted 38,188 39,341 44,870 Anti-dilutive potential common shares excluded from diluted weighted average common shares outstanding 85 88 19
Schedule of Reconciliation of Revenue and Segment Operating Income by Reportable Segment to Consolidated Results	The following tables provide reconciliations of revenue, gross profit and operating income by reportable segment to consolidated results and were derived from each segment’s internal financial information as used for corporate management purposes. Segment operating income represents income (loss) before income taxes plus depreciation, amortization of intangible assets, share-based compensation, goodwill impairment losses, interest expense, net, and other, and unallocated corporate overhead. Year Ended December 31, 2024 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Revenue $ 1,815,718 $ 728,608 $ 439,455 $ 2,983,781 Cost of revenue 1,371,660 511,959 180,786 2,064,405 Gross profit 444,058 216,649 258,669 919,376 Segment selling, general and administrative expenses 270,467 137,600 91,590 499,657 Depreciation (included in cost of revenue) — — (6,676) (6,676) Segment operating income $ 173,591 $ 79,049 $ 173,755 426,395 Unallocated corporate overhead 109,515 Depreciation and amortization 167,103 Depreciation (included in cost of revenue) 6,676 Share-based compensation 23,317 Goodwill impairment losses 222,457 Interest expense, net, and other 69,901 Loss before income taxes $ (172,574) Year Ended December 31, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Revenue $ 2,624,509 $ 669,701 $ 495,044 $ 3,789,254 Cost of revenue 1,932,099 440,230 167,344 2,539,673 Gross profit 692,410 229,471 327,700 1,249,581 Segment selling, general and administrative expenses 330,252 134,505 118,977 583,734 Depreciation (included in cost of revenue) — — (6,013) (6,013) Segment operating income $ 362,158 $ 94,966 $ 214,736 671,860 Unallocated corporate overhead 154,484 Depreciation and amortization 154,914 Depreciation (included in cost of revenue) 6,013 Share-based compensation 18,020 Interest expense, net, and other 54,140 Income before income taxes $ 284,289 Year Ended December 31, 2022 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Revenue $ 3,982,453 $ 697,946 $ 562,843 $ 5,243,242 Cost of revenue 2,934,738 456,996 134,824 3,526,558 Gross profit 1,047,715 240,950 428,019 1,716,684 Segment selling, general and administrative expenses 471,489 148,619 132,733 752,841 Depreciation (included in cost of revenue) — — (4,104) (4,104) Segment operating income $ 576,226 $ 92,331 $ 299,390 967,947 Unallocated corporate overhead 153,669 Depreciation and amortization 133,007 Depreciation (included in cost of revenue) 4,104 Share-based compensation 30,066 Interest expense, net, and other 40,398 Income before income taxes $ 606,703
Schedule of Revenue Disaggregated by Service Type	The following tables present the Company’s revenue disaggregated by service type: Year Ended December 31, 2024 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 1,084,398 $ — $ — $ 1,084,398 Labor disruption services 63,316 — — 63,316 Local staffing 45,517 — — 45,517 Allied staffing 610,661 — — 610,661 Locum tenens staffing — 566,351 — 566,351 Interim leadership staffing — 115,672 — 115,672 Temporary staffing 1,803,892 682,023 — 2,485,915 Permanent placement (1) 11,826 46,585 — 58,411 Language services — — 298,241 298,241 Vendor management systems — — 104,277 104,277 Other technologies — — 21,195 21,195 Technology-enabled services — — 423,713 423,713 Talent planning and acquisition — — 15,742 15,742 Total revenue $ 1,815,718 $ 728,608 $ 439,455 $ 2,983,781 Year Ended December 31, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 1,806,653 $ — $ — $ 1,806,653 Labor disruption services 13,303 — — 13,303 Local staffing 76,553 — — 76,553 Allied staffing 709,632 — — 709,632 Locum tenens staffing — 464,797 — 464,797 Interim leadership staffing — 136,953 — 136,953 Temporary staffing 2,606,141 601,750 — 3,207,891 Permanent placement (1) 18,368 67,951 — 86,319 Language services — — 260,121 260,121 Vendor management systems — — 169,370 169,370 Other technologies — — 24,222 24,222 Technology-enabled services — — 453,713 453,713 Talent planning and acquisition — — 41,331 41,331 Total revenue $ 2,624,509 $ 669,701 $ 495,044 $ 3,789,254 Year Ended December 31, 2022 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 2,912,677 $ — $ — $ 2,912,677 Labor disruption services 112,160 — — 112,160 Local staffing 142,724 — — 142,724 Allied staffing 806,491 — — 806,491 Locum tenens staffing — 428,133 — 428,133 Interim leadership staffing — 184,819 — 184,819 Temporary staffing 3,974,052 612,952 — 4,587,004 Permanent placement (1) 8,401 84,994 — 93,395 Language services — — 216,120 216,120 Vendor management systems — — 265,525 265,525 Other technologies — — 29,553 29,553 Technology-enabled services — — 511,198 511,198 Talent planning and acquisition — — 51,645 51,645 Total revenue $ 3,982,453 $ 697,946 $ 562,843 $ 5,243,242 (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: Years Ended December 31, 2024 2023 2022 International nurse staffing (1) $ 165,875 $ 208,132 $ 161,992 International nurse permanent placement (2) 11,826 18,368 8,401 Total international nurse revenue $ 177,701 $ 226,500 $ 170,393 (1) Included in “Travel nurse staffing” as presented in the preceding tables. (2) Included in “Permanent placement” as presented in the preceding tables.

Acquisitions (Tables)

Acquisitions (Tables)	12 Months Ended
	Dec. 31, 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 Fair Value Useful Life (in years) Identifiable intangible assets Customer relationships $ 32,800 15 Staffing database 4,200 5 Tradenames and trademarks 3,200 5 $ 40,200

Fair Value Measurement (Tables)

Fair Value Measurement (Tables)	12 Months Ended
	Dec. 31, 2024
Fair Value Disclosures [Abstract]
Schedule of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis	The following table presents the fair value of commercial paper and corporate bonds issued and outstanding: As of December 31, 2024 As of December 31, 2023 Commercial paper $ 64,580 $ 48,206 Total classified as restricted cash equivalents $ 64,580 $ 48,206 Commercial paper $ 1,399 $ — Corporate bonds 6,769 15,563 Total classified as restricted investments $ 8,168 $ 15,563 The following tables present information about the above-referenced assets and liabilities and indicate the fair value hierarchy of the valuation techniques utilized to determine such fair value: Fair Value Measurements as of December 31, 2024 Fair Value Measurements as of December 31, 2023 Assets (Liabilities) Level 1 Level 2 Level 3 Total Level 1 Level 2 Level 3 Total Deferred compensation $ (191,006) $ — $ — $ (191,006) $ (165,574) $ — $ — $ (165,574) Corporate bonds — 6,769 — 6,769 — 15,563 — 15,563 Commercial paper — 65,979 — 65,979 — 48,206 — 48,206
Schedule of Available-for-Sale Securities	The fair value of our available-for-sale securities as of December 31, 2024, by remaining contractual maturities, are presented in the following table: Fair Value Due in one year or less $ 5,770 Due after one year through five years 2,398 $ 8,168
Schedule of Carrying Amounts and Estimated Fair Value of Notes	The carrying amounts and estimated fair value of the 2027 Notes and the 2029 Notes, which are more fully described in Note (8) , “Notes Payable and Credit Agreement,” are presented in the following table: As of December 31, 2024 As of December 31, 2023 Carrying Estimated Carrying Estimated 2027 Notes $ 500,000 $ 473,750 $ 500,000 $ 468,750 2029 Notes 350,000 312,375 350,000 314,125

Goodwill and Identifiable Int_2

Goodwill and Identifiable Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Acquired Intangible Assets By Major Class	As of December 31, 2024 and 2023, the Company had the following acquired intangible assets: As of December 31, 2024 As of December 31, 2023 Gross Accumulated Net Gross Accumulated Net Intangible assets subject to amortization: Staffing databases $ 52,336 $ (39,879) $ 12,457 $ 52,336 $ (33,398) $ 18,938 Customer relationships 532,048 (247,550) 284,498 532,048 (210,606) 321,442 Tradenames and trademarks 284,488 (204,159) 80,329 284,488 (161,656) 122,832 Non-compete agreements 9,399 (7,783) 1,616 9,399 (6,727) 2,672 Acquired technology 37,915 (35,451) 2,464 37,915 (29,665) 8,250 $ 916,186 $ (534,822) $ 381,364 $ 916,186 $ (442,052) $ 474,134
Schedule of Estimated Amortization Expense	Based on the net carrying amount of intangible assets subject to amortization, the estimated future amortization expense as of December 31, 2024 is as follows: Amount Year ending December 31, 2025 $ 75,633 Year ending December 31, 2026 67,108 Year ending December 31, 2027 56,069 Year ending December 31, 2028 35,889 Year ending December 31, 2029 27,166 Thereafter 119,499 $ 381,364
Schedule of Goodwill	The following table summarizes the activity related to the carrying value of goodwill by reportable segment: Nurse and Allied Physician and Leadership Technology and Workforce Solutions Total Balance, January 1, 2023 $ 382,005 $ 152,800 $ 400,559 $ 935,364 Goodwill adjustment for Connetics acquisition 415 — — 415 Goodwill from MSDR acquisition — 175,770 — 175,770 Balance, December 31, 2023 382,420 328,570 400,559 1,111,549 Goodwill adjustment for MSDR acquisition — 8,364 — 8,364 Goodwill impairment losses (123,283) (99,174) — (222,457) Balance, December 31, 2024 $ 259,137 $ 237,760 $ 400,559 $ 897,456 Accumulated impairment loss as of December 31, 2023 $ 154,444 $ 60,495 $ — $ 214,939 Accumulated impairment loss as of December 31, 2024 $ 277,727 $ 159,669 $ — $ 437,396

Leases (Tables)

Leases (Tables)	12 Months Ended
	Dec. 31, 2024
Leases [Abstract]
Schedule of Components of Lease Expense	The components of lease expense were as follows: Years Ended December 31, 2024 2023 2022 Operating lease cost $ 9,204 $ 9,610 $ 16,439 Short-term lease cost 2,437 3,738 5,787 Variable and other lease cost 2,469 2,789 3,129 Net lease cost $ 14,110 $ 16,137 $ 25,355
Schedule of Maturities of Lease Liabilities	The maturities of lease liabilities as of December 31, 2024 were as follows: Operating Leases Year ending December 31, 2025 $ 8,715 Year ending December 31, 2026 7,580 Year ending December 31, 2027 7,672 Year ending December 31, 2028 7,866 Year ending December 31, 2029 5,861 Thereafter 12,486 Total lease payments 50,180 Less imputed interest (8,255) Present value of lease liabilities $ 41,925
Schedule of Assumptions used for Operating Leases	The weighted average remaining lease term and discount rate as of December 31, 2024 and 2023 were as follows: December 31, 2024 2023 Weighted average remaining lease term 7 years 7 years Weighted average discount rate 5.6 % 5.3 %

Balance Sheet Details (Tables)

Balance Sheet Details (Tables)	12 Months Ended
	Dec. 31, 2024
Balance Sheet Related Disclosures [Abstract]
Schedule of Supplemental Balance Sheet Disclosures	The consolidated balance sheets detail is as follows: December 31, 2024 2023 Other current assets: Restricted cash and cash equivalents $ 14,984 $ 22,056 Income taxes receivable 11,683 5,350 Other 26,791 18,264 Other current assets $ 53,458 $ 45,670 Fixed assets: Furniture and equipment $ 90,970 $ 71,815 Software 440,034 388,812 Leasehold improvements 16,061 15,839 547,065 476,466 Accumulated depreciation (360,795) (285,081) Fixed assets, net $ 186,270 $ 191,385 Other assets: Life insurance cash surrender value $ 194,350 $ 162,780 Operating lease right-of-use assets 32,115 34,543 Other 31,588 39,473 Other assets $ 258,053 $ 236,796 Accounts payable and accrued expenses: Trade accounts payable $ 31,356 $ 54,128 Subcontractor payable 69,563 122,983 Accrued expenses 57,263 82,257 Loss contingencies 2,999 69,837 Professional liability reserve 8,395 7,761 Other 14,735 6,881 Accounts payable and accrued expenses $ 184,311 $ 343,847 Accrued compensation and benefits: Accrued payroll $ 46,896 $ 53,633 Accrued bonuses and commissions 25,988 31,236 ESPP contributions 812 950 Workers compensation reserve 9,954 12,130 Deferred compensation 191,006 165,574 Other 12,888 15,013 Accrued compensation and benefits $ 287,544 $ 278,536 Other current liabilities: Deferred revenue $ 10,014 $ 11,303 Client deposits 56,341 8,707 Operating lease liabilities 6,200 7,993 Other 1,375 5,735 Other current liabilities $ 73,930 $ 33,738 December 31, 2024 2023 Other long-term liabilities: Workers compensation reserve $ 18,445 $ 21,169 Professional liability reserve 38,307 36,891 Operating lease liabilities 35,725 37,603 Other 14,973 13,316 Other long-term liabilities $ 107,450 $ 108,979

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2024
Income Tax Disclosure [Abstract]
Schedule of Provision For Income Taxes From Continuing Operations	The provision for income taxes from operations for the years ended December 31, 2024, 2023 and 2022 consists of the following: Years Ended December 31, 2024 2023 2022 Current income taxes: Federal $ 20,430 $ 65,877 $ 145,217 State 5,042 20,666 42,051 Total 25,472 86,543 187,268 Deferred income taxes: Federal (36,685) (10,203) (20,173) State (14,382) (2,730) (4,442) Total (51,067) (12,933) (24,615) Provision (benefit) for income taxes from operations $ (25,595) $ 73,610 $ 162,653
Schedule of Income Tax Reconciliation	The Company’s income tax expense differs from the amount that would have resulted from applying the federal statutory rate of 21% for 2024, 2023 and 2022 to pretax income (loss) from operations because of the effect of the following items during the years ended December 31, 2024, 2023 and 2022: Years Ended December 31, 2024 2023 2022 Tax expense at federal statutory rate $ (36,241) $ 59,701 $ 127,390 State taxes, net of federal benefit (7,379) 14,170 29,711 Non-deductible expenses 2,110 3,010 — Share-based compensation 513 (944) (2,383) Unrecognized tax benefit 1,328 1,957 3,245 Company-owned life insurance policies (4,855) (4,428) 4,094 Tax credits (1,289) (3,172) (2,741) Goodwill impairment losses 18,054 — — Other, net 2,164 3,316 3,337 Income tax expense (benefit) from operations $ (25,595) $ 73,610 $ 162,653
Schedule of Deferred Tax Assets and Liabilities	The tax effects of temporary differences that give rise to significant portions of deferred tax assets and liabilities are presented below as of December 31, 2024 and 2023: December 31, 2024 2023 Deferred tax assets: Share-based compensation $ 6,394 $ 5,461 Deferred compensation 48,821 41,976 Accrued bonus 5,546 2,585 Accrued expenses 10,783 11,426 Operating lease liabilities 10,954 11,296 Net operating losses 5,314 4,809 Loss contingencies 563 813 Workers compensation insurance 5,273 5,997 Professional services expenses 179 16,242 Provision for expected credit losses 8,415 9,161 Sales credits 5,960 6,896 Other 3,995 1,516 Total deferred tax assets $ 112,197 $ 118,178 Deferred tax liabilities: Intangible assets $ (65,251) $ (111,590) Fixed assets (8,662) (14,947) Operating lease right-of-use assets (8,395) (8,539) Other (4,060) (6,452) Total deferred tax liabilities $ (86,368) $ (141,528) Net deferred tax asset (liability) $ 25,829 $ (23,350)
Schedule of Unrecognized Tax Benefits	A summary of the changes in the amount of unrecognized tax benefits (excluding interest and penalties) for 2024, 2023 and 2022 is as follows: 2024 2023 2022 Beginning balance of unrecognized tax benefits $ 8,689 $ 6,980 $ 4,067 Additions based on tax positions related to the current year 978 1,873 1,464 Additions based on tax positions of prior years 266 491 1,966 Reductions due to lapse of applicable statute of limitation (484) (655) (517) Ending balance of unrecognized tax benefits $ 9,449 $ 8,689 $ 6,980

Notes Payable and Credit Agre_2

Notes Payable and Credit Agreement (Tables)	12 Months Ended
	Dec. 31, 2024
Debt Disclosure [Abstract]
Schedule of Outstanding Debt	Outstanding debt balances as of December 31, 2024 and 2023 consisted of the following: As of December 31, 2024 2023 Senior Credit Facility $ 210,000 $ 460,000 2027 Notes 500,000 500,000 2029 Notes 350,000 350,000 Total debt outstanding 1,060,000 1,310,000 Less unamortized fees and premium (4,128) (5,312) Long-term portion of notes payable $ 1,055,872 $ 1,304,688

Capital Stock (Tables)

Capital Stock (Tables)	12 Months Ended
	Dec. 31, 2024
Equity [Abstract]
Schedule of Share Repurchases	The total number of shares repurchased, average price per share (excluding broker’s fees), and total cost (excluding the effect of excise taxes) for the years ended December 31, 2023 and 2022 were as follows: Years Ended December 31, 2023 2022 Number of shares repurchased 4,383 5,644 Average price per share $ 96.90 $ 102.16 Total cost of share repurchases $ 424,744 $ 576,767

Share-Based Compensation (Table

Share-Based Compensation (Tables)	12 Months Ended
	Dec. 31, 2024
Share-Based Payment Arrangement [Abstract]
Schedule of RSU and PRSU Activity for Non-vested Awards	The following table summarizes RSU and PRSU activity for the years ended December 31, 2024, 2023 and 2022: Number of Shares Weighted Average Unvested at January 1, 2022 755 $ 78.13 Granted—RSUs 200 $ 109.66 Granted—PRSUs (1) 190 $ 92.65 Vested (405) $ 72.43 Canceled/forfeited (75) $ 82.13 Unvested at December 31, 2022 665 $ 94.79 Granted—RSUs 196 $ 95.67 Granted—PRSUs (1) 176 $ 109.74 Vested (349) $ 89.76 Canceled/forfeited (87) $ 104.14 Unvested at December 31, 2023 601 $ 101.01 Granted—RSUs 443 $ 61.30 Granted—PRSUs (1) 259 $ 70.73 Vested (234) $ 89.64 Canceled/forfeited (156) $ 90.66 Unvested at December 31, 2024 913 $ 77.81 (1) PRSUs granted included both the PRSUs granted during the year at the target amount and the additional shares of prior period granted PRSUs vested during the year in excess of the target shares.
Schedule of Share-based Compensation Expense	Total share-based compensation expense for the years ended December 31, 2024, 2023 and 2022 was as follows: Years Ended December 31, 2024 2023 2022 Share-based employee compensation, before tax $ 23,317 $ 18,020 $ 30,066 Related income tax benefits (6,062) (4,685) (7,817) Share-based employee compensation, net of tax $ 17,255 $ 13,335 $ 22,249

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Restricted Cash, Cash Equivalents and Investments (Details) - USD ($) $ in Thousands	Jan. 31, 2025	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Accounting Policies [Abstract]
Cash and cash equivalents		$ 10,649	$ 32,935
Restricted cash and cash equivalents (included in other current assets)		14,984	22,056
Restricted cash, cash equivalents and investments		71,840	68,845
Total cash, cash equivalents and restricted cash and investments		97,473	123,836
Less restricted investments		(8,168)	(15,563)
Total cash, cash equivalents and restricted cash		$ 89,305	$ 108,273	$ 137,872	$ 246,714
Subsequent Event
Subsequent Event [Line Items]
Restricted cash and cash equivalents, released amount	$ 25,000

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Fixed Assets (Details)	Dec. 31, 2024
Furniture, Equipment and Technology and Software | Minimum
Property, Plant and Equipment [Line Items]
Fixed assets, useful life	3 years
Furniture, Equipment and Technology and Software | Maximum
Property, Plant and Equipment [Line Items]
Fixed assets, useful life	10 years
Software Development | Minimum
Property, Plant and Equipment [Line Items]
Fixed assets, useful life	3 years
Software Development | Maximum
Property, Plant and Equipment [Line Items]
Fixed assets, useful life	10 years

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Allowance for Credit Losses (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Accounts Receivable, Allowance for Credit Loss [Roll Forward]
Beginning balance	$ 32,233	$ 31,910
Provision for expected credit losses	6,549	5,544
Amounts written off charged against the allowance	(6,361)	(5,221)
Ending balance	$ 32,421	$ 32,233

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - Concentration of Credit Risk (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Concentration Risk [Line Items]
Total cash, cash equivalents and restricted cash and investments	$ 97,473	$ 123,836
One Customer | Revenue from Contract with Customer Benchmark | Customer Concentration Risk
Concentration Risk [Line Items]
Concentration risk percentage	16%	17%	18%

Summary of Significant Accoun_8

Summary of Significant Accounting Policies - Share-Based Compensation (Details)	12 Months Ended
	Dec. 31, 2024
Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period	3 years
Performance Shares, Shareholder Return-Based
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Period for relative and absolute shareholder return	3 years
Minimum | Performance Shares, EBITDA-Based
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percent of target amount granted to be issued	0%
Minimum | Performance Shares, Shareholder Return-Based
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percent of target amount granted to be issued	0%
Minimum | Performance Shares, Shareholder Return-Based, Certain
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percent of target amount granted to be issued	0%
Maximum | Performance Shares, EBITDA-Based
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percent of target amount granted to be issued	200%
Maximum | Performance Shares, Shareholder Return-Based
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percent of target amount granted to be issued	175%
Maximum | Performance Shares, Shareholder Return-Based, Certain
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percent of target amount granted to be issued	200%

Summary of Significant Accoun_9

Summary of Significant Accounting Policies - Net Income (Loss) per Common Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Computation of Basic and Diluted Net Income Per Common Share [Abstract]
Net income (loss)	$ (146,979)	$ 210,679	$ 444,050
Net income (loss)	$ (146,979)	$ 210,679	$ 444,050
Net income (loss) per common share - basic (in dollars per share)	$ (3.85)	$ 5.38	$ 9.96
Net income (loss) per common share - diluted (in dollars per share)	$ (3.85)	$ 5.36	$ 9.90
Weighted average common shares outstanding - basic (in shares)	38,188	39,173	44,591
Plus dilutive effect of potential common shares (in shares)	0	168	279
Weighted average common shares outstanding - diluted (in shares)	38,188	39,341	44,870
Anti-dilutive potential common shares excluded from diluted weighted average common shares outstanding (in shares)	85	88	19

Summary of Significant Accou_10

Summary of Significant Accounting Policies - Segment Information (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($) segment	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Accounting Policies [Abstract]
Number of reportable segments | segment	3
Segment Reporting Information, Profit (Loss) [Abstract]
Revenue	$ 2,983,781	$ 3,789,254	$ 5,243,242
Cost of revenue	2,064,405	2,539,673	3,526,558
Gross profit	919,376	1,249,581	1,716,684
Segment selling, general and administrative expenses	632,489	756,238	936,576
Income (loss) from operations	(102,673)	338,429	647,101
Depreciation and amortization	167,103	154,914	133,007
Share-based compensation	23,317	18,020	30,066
Goodwill impairment losses	222,457	0	0
Interest expense, net, and other	69,901	54,140	40,398
Nurse and Allied Solutions
Segment Reporting Information, Profit (Loss) [Abstract]
Revenue	1,815,718	2,624,509	3,982,453
Goodwill impairment losses	123,283
Physician and Leadership Solutions
Segment Reporting Information, Profit (Loss) [Abstract]
Revenue	728,608	669,701	697,946
Goodwill impairment losses	99,174
Technology and Workforce Solutions
Segment Reporting Information, Profit (Loss) [Abstract]
Revenue	439,455	495,044	562,843
Goodwill impairment losses	0
Operating Segments
Segment Reporting Information, Profit (Loss) [Abstract]
Revenue	2,983,781	3,789,254	5,243,242
Cost of revenue	2,064,405	2,539,673	3,526,558
Gross profit	919,376	1,249,581	1,716,684
Segment selling, general and administrative expenses	499,657	583,734	752,841
Depreciation (included in cost of revenue)	(6,676)	(6,013)	(4,104)
Income (loss) from operations	426,395	671,860	967,947
Goodwill impairment losses	222,457
Operating Segments | Nurse and Allied Solutions
Segment Reporting Information, Profit (Loss) [Abstract]
Revenue	1,815,718	2,624,509	3,982,453
Cost of revenue	1,371,660	1,932,099	2,934,738
Gross profit	444,058	692,410	1,047,715
Segment selling, general and administrative expenses	270,467	330,252	471,489
Depreciation (included in cost of revenue)	0	0	0
Income (loss) from operations	173,591	362,158	576,226
Operating Segments | Physician and Leadership Solutions
Segment Reporting Information, Profit (Loss) [Abstract]
Revenue	728,608	669,701	697,946
Cost of revenue	511,959	440,230	456,996
Gross profit	216,649	229,471	240,950
Segment selling, general and administrative expenses	137,600	134,505	148,619
Depreciation (included in cost of revenue)	0	0	0
Income (loss) from operations	79,049	94,966	92,331
Operating Segments | Technology and Workforce Solutions
Segment Reporting Information, Profit (Loss) [Abstract]
Revenue	439,455	495,044	562,843
Cost of revenue	180,786	167,344	134,824
Gross profit	258,669	327,700	428,019
Segment selling, general and administrative expenses	91,590	118,977	132,733
Depreciation (included in cost of revenue)	(6,676)	(6,013)	(4,104)
Income (loss) from operations	173,755	214,736	299,390
Non-Segment
Segment Reporting Information, Profit (Loss) [Abstract]
Unallocated corporate overhead	109,515	154,484	153,669
Reconciling Item
Segment Reporting Information, Profit (Loss) [Abstract]
Depreciation and amortization	167,103	154,914	133,007
Depreciation (included in cost of revenue)	(6,676)	(6,013)	(4,104)
Share-based compensation	23,317	18,020	30,066
Interest expense, net, and other	69,901	54,140	40,398
Income (loss) before income taxes	$ (172,574)	$ 284,289	$ 606,703

Summary of Significant Accou_11

Summary of Significant Accounting Policies - Revenue Disaggregated by Service Type (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	$ 2,983,781	$ 3,789,254	$ 5,243,242
Nurse and Allied Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	1,815,718	2,624,509	3,982,453
Physician and Leadership Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	728,608	669,701	697,946
Technology and Workforce Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	439,455	495,044	562,843
Travel nurse staffing
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	1,084,398	1,806,653	2,912,677
Travel nurse staffing | Nurse and Allied Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	1,084,398	1,806,653	2,912,677
Travel nurse staffing | Physician and Leadership Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Travel nurse staffing | Technology and Workforce Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Labor disruption services
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	63,316	13,303	112,160
Labor disruption services | Nurse and Allied Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	63,316	13,303	112,160
Labor disruption services | Physician and Leadership Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Labor disruption services | Technology and Workforce Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Local staffing
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	45,517	76,553	142,724
Local staffing | Nurse and Allied Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	45,517	76,553	142,724
Local staffing | Physician and Leadership Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Local staffing | Technology and Workforce Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Allied staffing
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	610,661	709,632	806,491
Allied staffing | Nurse and Allied Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	610,661	709,632	806,491
Allied staffing | Physician and Leadership Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Allied staffing | Technology and Workforce Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Locum tenens staffing
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	566,351	464,797	428,133
Locum tenens staffing | Nurse and Allied Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Locum tenens staffing | Physician and Leadership Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	566,351	464,797	428,133
Locum tenens staffing | Technology and Workforce Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Interim leadership staffing
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	115,672	136,953	184,819
Interim leadership staffing | Nurse and Allied Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Interim leadership staffing | Physician and Leadership Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	115,672	136,953	184,819
Interim leadership staffing | Technology and Workforce Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Temporary staffing
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	2,485,915	3,207,891	4,587,004
Temporary staffing | Nurse and Allied Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	1,803,892	2,606,141	3,974,052
Temporary staffing | Physician and Leadership Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	682,023	601,750	612,952
Temporary staffing | Technology and Workforce Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Permanent placement
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	58,411	86,319	93,395
Permanent placement | Nurse and Allied Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	11,826	18,368	8,401
Permanent placement | Physician and Leadership Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	46,585	67,951	84,994
Permanent placement | Technology and Workforce Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Language services
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	298,241	260,121	216,120
Language services | Nurse and Allied Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Language services | Physician and Leadership Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Language services | Technology and Workforce Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	298,241	260,121	216,120
Vendor management systems
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	104,277	169,370	265,525
Vendor management systems | Nurse and Allied Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Vendor management systems | Physician and Leadership Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Vendor management systems | Technology and Workforce Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	104,277	169,370	265,525
Other technologies
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	21,195	24,222	29,553
Other technologies | Nurse and Allied Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Other technologies | Physician and Leadership Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Other technologies | Technology and Workforce Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	21,195	24,222	29,553
Technology-enabled services
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	423,713	453,713	511,198
Technology-enabled services | Nurse and Allied Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Technology-enabled services | Physician and Leadership Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Technology-enabled services | Technology and Workforce Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	423,713	453,713	511,198
Talent planning and acquisition
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	15,742	41,331	51,645
Talent planning and acquisition | Nurse and Allied Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Talent planning and acquisition | Physician and Leadership Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	0	0	0
Talent planning and acquisition | Technology and Workforce Solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	15,742	41,331	51,645
International nurse revenue
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	177,701	226,500	170,393
International nurse staffing
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	165,875	208,132	161,992
International nurse permanent placement
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	$ 11,826	$ 18,368	$ 8,401

Acquisitions - MSDR Acquisition

Acquisitions - MSDR Acquisition (Details)		3 Months Ended
	Nov. 30, 2023 USD ($) company	Dec. 31, 2024 USD ($)	Jun. 30, 2024 USD ($)	Dec. 31, 2023 USD ($)	Feb. 10, 2023 USD ($)	Feb. 09, 2023 USD ($)	Dec. 31, 2022 USD ($)
Business Acquisition [Line Items]
Goodwill		$ 897,456,000		$ 1,111,549,000			$ 935,364,000
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 companies acquired | 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		41,406,000
Cash received		562,000
Liabilities assumed		26,371,000
Identified intangible assets	$ 92,000,000	92,000,000
Goodwill		184,134,000
Goodwill expected to be tax deductible		$ 94,762,000
Intangible assets acquired, weighted average useful life		7 years

Acquisitions - Schedule of Inta

Acquisitions - Schedule of Intangible Assets Acquired (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Nov. 30, 2023	Jun. 30, 2023	May 13, 2022
MSDR
Acquired Finite-Lived Intangible Assets [Line Items]
Fair Value	$ 92,000	$ 92,000
MSDR | Customer relationships
Acquired Finite-Lived Intangible Assets [Line Items]
Fair Value		$ 54,300
MSDR | Customer relationships | Minimum
Acquired Finite-Lived Intangible Assets [Line Items]
Useful Life		7 years
MSDR | Customer relationships | Maximum
Acquired Finite-Lived Intangible Assets [Line Items]
Useful Life		10 years
MSDR | Tradenames and trademarks
Acquired Finite-Lived Intangible Assets [Line Items]
Fair Value		$ 26,400
Useful Life		3 years
MSDR | Staffing database
Acquired Finite-Lived Intangible Assets [Line Items]
Fair Value		$ 11,300
Useful Life		5 years
Connetics Communications, LLC
Acquired Finite-Lived Intangible Assets [Line Items]
Fair Value			$ 40,200	$ 40,200
Connetics Communications, LLC | Customer relationships
Acquired Finite-Lived Intangible Assets [Line Items]
Fair Value				$ 32,800
Useful Life				15 years
Connetics Communications, LLC | Tradenames and trademarks
Acquired Finite-Lived Intangible Assets [Line Items]
Fair Value				$ 3,200
Useful Life				5 years
Connetics Communications, LLC | Staffing database
Acquired Finite-Lived Intangible Assets [Line Items]
Fair Value				$ 4,200
Useful Life				5 years

Acquisitions - Connetics Acquis

Acquisitions - Connetics Acquisition (Details) - USD ($) $ in Thousands		3 Months Ended			12 Months Ended
	May 13, 2022	Sep. 30, 2023	Jun. 30, 2023	Dec. 31, 2022	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Payment to settle contingent consideration liabilities					$ 0	$ 7,500	$ 0
Goodwill				$ 935,364	$ 897,456	$ 1,111,549	$ 935,364
Connetics Communications, LLC
Business Acquisition [Line Items]
Purchase price	$ 78,764		$ 78,533
Cash consideration	70,764
Contingent earn-out based on future operating performance (up to)	12,500
Fair value of contingent earn-out	8,000
Payment to settle contingent consideration liabilities		$ 7,500
Cash returned to the company for final working capital settlement				$ 231
Fair value of tangible assets acquired			3,172
Cash received			963
Liabilities assumed			8,244
Identified intangible assets	$ 40,200		40,200
Goodwill			43,405
Goodwill expected to be tax deductible			$ 42,905
Intangible assets acquired, weighted average useful life			13 years

Fair Value Measurement - Schedu

Fair Value Measurement - Schedule of Assets and Liabilities at Fair Value (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
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	$ 64,580	$ 48,206
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	8,168	15,563
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	65,979	48,206
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	65,979	48,206
Commercial paper | 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	64,580	48,206
Commercial paper | 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	1,399	0
Corporate bonds | 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	$ 6,769	$ 15,563

Fair Value Measurement - Sche_2

Fair Value Measurement - Schedule of Available-for-sale Securities (Details) $ in Thousands	Dec. 31, 2024 USD ($)
Debt Securities, Available-for-sale, Maturity, Allocated and Single Maturity Date, Fair Value [Abstract]
Due in one year or less	$ 5,770
Due after one year through five years	2,398
Total	$ 8,168

Fair Value Measurement - Additi

Fair Value Measurement - Additional Information (Details) - USD ($)	Dec. 31, 2024	Dec. 31, 2023	Oct. 20, 2020
2029 Notes | Senior Notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate			4%
Fair Value, Nonrecurring | Level 3 | Acquisition contingent consideration liabilities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liabilities	$ 0	$ 0
Fair Value, 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	19,860,000
Equity investment balance	$ 2,773,000	$ 12,503,000

Fair Value Measurement - Financ

Fair Value Measurement - Financial Assets and Liabilities (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Corporate bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	$ 6,769	$ 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	6,769	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	65,979	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	65,979	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	(191,006)	(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	(191,006)	(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 ($)	Dec. 31, 2024	Dec. 31, 2023	Oct. 20, 2020	Aug. 13, 2020	Oct. 01, 2019
2027 Notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Carrying Amount	$ 500,000,000	$ 500,000,000		$ 200,000,000	$ 300,000,000
Estimated Fair Value	473,750,000	468,750,000
2029 Notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Carrying Amount	350,000,000	350,000,000	$ 350,000,000
Estimated Fair Value	$ 312,375,000	$ 314,125,000

Goodwill and Identifiable Int_3

Goodwill and Identifiable Intangible Assets - Acquired Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 916,186	$ 916,186
Accumulated Amortization	(534,822)	(442,052)
Net Carrying Amount	381,364	474,134
Staffing databases
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	52,336	52,336
Accumulated Amortization	(39,879)	(33,398)
Net Carrying Amount	12,457	18,938
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	532,048	532,048
Accumulated Amortization	(247,550)	(210,606)
Net Carrying Amount	284,498	321,442
Tradenames and trademarks
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	284,488	284,488
Accumulated Amortization	(204,159)	(161,656)
Net Carrying Amount	80,329	122,832
Non-compete agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	9,399	9,399
Accumulated Amortization	(7,783)	(6,727)
Net Carrying Amount	1,616	2,672
Acquired technology
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	37,915	37,915
Accumulated Amortization	(35,451)	(29,665)
Net Carrying Amount	$ 2,464	$ 8,250

Goodwill and Identifiable Int_4

Goodwill and Identifiable Intangible Assets - Additional Information (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($) unit	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Goodwill [Line Items]
Aggregate amortization expense, intangible assets	$ 92,770	$ 89,756
Number of reporting units | unit	3
Impairment	$ 0
Goodwill impairment losses	222,457	$ 0	$ 0
Nurse and Allied Solutions
Goodwill [Line Items]
Goodwill, impairment loss, gross	104,777
Deferred tax assets, goodwill	18,506
Goodwill impairment losses	123,283
Physician and Leadership Solutions
Goodwill [Line Items]
Goodwill, impairment loss, gross	81,946
Deferred tax assets, goodwill	17,228
Goodwill impairment losses	$ 99,174

Goodwill and Identifiable Int_5

Goodwill and Identifiable Intangible Assets - Estimated Future Amortization (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]
Year ending December 31, 2025	$ 75,633
Year ending December 31, 2026	67,108
Year ending December 31, 2027	56,069
Year ending December 31, 2028	35,889
Year ending December 31, 2029	27,166
Thereafter	119,499
Net Carrying Amount	$ 381,364	$ 474,134

Goodwill and Identifiable Int_6

Goodwill and Identifiable Intangible Assets - Changes in the Carrying Amount of Goodwill (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Goodwill [Roll Forward]
Beginning balance	$ 1,111,549	$ 935,364
Goodwill impairment losses	(222,457)	0	$ 0
Ending balance	897,456	1,111,549	935,364
Accumulated impairment loss	437,396	214,939
Nurse and Allied Solutions
Goodwill [Roll Forward]
Beginning balance	382,420	382,005
Goodwill impairment losses	(123,283)
Ending balance	259,137	382,420	382,005
Accumulated impairment loss	277,727	154,444
Physician and Leadership Solutions
Goodwill [Roll Forward]
Beginning balance	328,570	152,800
Goodwill impairment losses	(99,174)
Ending balance	237,760	328,570	152,800
Accumulated impairment loss	159,669	60,495
Technology and Workforce Solutions
Goodwill [Roll Forward]
Beginning balance	400,559	400,559
Goodwill impairment losses	0
Ending balance	400,559	400,559	$ 400,559
Accumulated impairment loss	0	0
Connetics Communications, LLC
Goodwill [Roll Forward]
Goodwill adjustment for acquisition		415
Connetics Communications, LLC | Nurse and Allied Solutions
Goodwill [Roll Forward]
Goodwill adjustment for acquisition		415
Connetics Communications, LLC | Physician and Leadership Solutions
Goodwill [Roll Forward]
Goodwill adjustment for acquisition		0
Connetics Communications, LLC | Technology and Workforce Solutions
Goodwill [Roll Forward]
Goodwill adjustment for acquisition		0
MSDR
Goodwill [Roll Forward]
Goodwill adjustment for acquisition	8,364
Goodwill from acquisition		175,770
Ending balance	184,134
MSDR | Nurse and Allied Solutions
Goodwill [Roll Forward]
Goodwill adjustment for acquisition	0
Goodwill from acquisition		0
MSDR | Physician and Leadership Solutions
Goodwill [Roll Forward]
Goodwill adjustment for acquisition	8,364
Goodwill from acquisition		175,770
MSDR | Technology and Workforce Solutions
Goodwill [Roll Forward]
Goodwill adjustment for acquisition	$ 0
Goodwill from acquisition		$ 0

Leases - Additional Information

Leases - Additional Information (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($) option	Dec. 31, 2023 USD ($)	Jun. 30, 2023 USD ($)	Mar. 31, 2022 USD ($)
Operating Leased Assets [Line Items]
Option to renew (or more) | option	1
Option to extend, term (up to)	10 years
Option to terminate, term (within)	2 years
Operating lease right-of-use assets	$ 32,115	$ 34,543
Operating lease, liability	$ 41,925
Office Building
Operating Leased Assets [Line Items]
Lease term			11 years
Operating lease right-of-use assets			$ 15,782
Operating lease, liability			22,713
Lease incentive			$ 6,931
Office Building | Operating Lease, Lease Not yet Commenced
Operating Leased Assets [Line Items]
Future undiscounted lease payments				$ 29,514

Leases - Components of Lease Ex

Leases - Components of Lease Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Leases [Abstract]
Operating lease cost	$ 9,204	$ 9,610	$ 16,439
Short-term lease cost	2,437	3,738	5,787
Variable and other lease cost	2,469	2,789	3,129
Net lease cost	$ 14,110	$ 16,137	$ 25,355

Leases - Maturity of Lease Liab

Leases - Maturity of Lease Liabilities (Details) $ in Thousands	Dec. 31, 2024 USD ($)
Lessee, Operating Lease, Liability, to be Paid [Abstract]
2025	$ 8,715
2026	7,580
2027	7,672
2028	7,866
2029	5,861
Thereafter	12,486
Total lease payments	50,180
Less imputed interest	(8,255)
Present value of lease liabilities	$ 41,925

Leases - Assumptions Used for O

Leases - Assumptions Used for Operating Leases (Details)	Dec. 31, 2024	Dec. 31, 2023
Leases [Abstract]
Weighted average remaining lease term	7 years	7 years
Weighted average discount rate	5.60%	5.30%

Balance Sheet Details (Details)

Balance Sheet Details (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Other current assets:
Restricted cash and cash equivalents	$ 14,984	$ 22,056
Income taxes receivable	11,683	5,350
Other	26,791	18,264
Other current assets	53,458	45,670
Fixed assets:
Furniture and equipment	90,970	71,815
Software	440,034	388,812
Leasehold improvements	16,061	15,839
Fixed assets, gross	547,065	476,466
Accumulated depreciation	(360,795)	(285,081)
Fixed assets, net	186,270	191,385
Other assets:
Life insurance cash surrender value	194,350	162,780
Operating lease right-of-use assets	$ 32,115	$ 34,543
Operating lease right-of-use asset [Extensible Enumeration]	Other assets	Other assets
Other	$ 31,588	$ 39,473
Other assets	258,053	236,796
Accounts payable and accrued expenses:
Trade accounts payable	31,356	54,128
Subcontractor payable	69,563	122,983
Accrued expenses	57,263	82,257
Loss contingencies	2,999	69,837
Professional liability reserve	8,395	7,761
Other	14,735	6,881
Accounts payable and accrued expenses	184,311	343,847
Accrued compensation and benefits:
Accrued payroll	46,896	53,633
Accrued bonuses and commissions	25,988	31,236
ESPP contributions	812	950
Workers compensation reserve	9,954	12,130
Deferred compensation	191,006	165,574
Other	12,888	15,013
Accrued compensation and benefits	287,544	278,536
Other current liabilities:
Deferred revenue	10,014	11,303
Client deposits	56,341	8,707
Operating lease liabilities	$ 6,200	$ 7,993
Operating lease liabilities [Extensible Enumeration]	Other current liabilities	Other current liabilities
Other	$ 1,375	$ 5,735
Other current liabilities	73,930	33,738
Other long-term liabilities:
Workers compensation reserve	18,445	21,169
Professional liability reserve	38,307	36,891
Operating lease liabilities	$ 35,725	$ 37,603
Operating lease liabilities [Extensible Enumeration]	Other long-term liabilities	Other long-term liabilities
Other	$ 14,973	$ 13,316
Other long-term liabilities	$ 107,450	$ 108,979

Income Taxes - Provision for In

Income Taxes - Provision for Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Current income taxes:
Federal	$ 20,430	$ 65,877	$ 145,217
State	5,042	20,666	42,051
Total	25,472	86,543	187,268
Deferred income taxes:
Federal	(36,685)	(10,203)	(20,173)
State	(14,382)	(2,730)	(4,442)
Total	(51,067)	(12,933)	(24,615)
Income tax expense (benefit) from operations	$ (25,595)	$ 73,610	$ 162,653

Income Taxes - Income Tax Recon

Income Taxes - Income Tax Reconciliation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income tax reconciliation
Tax expense at federal statutory rate	$ (36,241)	$ 59,701	$ 127,390
State taxes, net of federal benefit	(7,379)	14,170	29,711
Non-deductible expenses	2,110	3,010	0
Share-based compensation	513	(944)	(2,383)
Unrecognized tax benefit	1,328	1,957	3,245
Company-owned life insurance policies	(4,855)	(4,428)	4,094
Tax credits	(1,289)	(3,172)	(2,741)
Goodwill impairment losses	18,054	0	0
Other, net	2,164	3,316	3,337
Income tax expense (benefit) from operations	$ (25,595)	$ 73,610	$ 162,653

Income Taxes - Deferred Tax Ass

Income Taxes - Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Deferred tax assets:
Share-based compensation	$ 6,394	$ 5,461
Deferred compensation	48,821	41,976
Accrued bonus	5,546	2,585
Accrued expenses	10,783	11,426
Operating lease liabilities	10,954	11,296
Net operating losses	5,314	4,809
Loss contingencies	563	813
Workers compensation insurance	5,273	5,997
Professional services expenses	179	16,242
Provision for expected credit losses	8,415	9,161
Sales credits	5,960	6,896
Other	3,995	1,516
Total deferred tax assets	112,197	118,178
Deferred tax liabilities:
Intangible assets	(65,251)	(111,590)
Fixed assets	(8,662)	(14,947)
Operating lease right-of-use assets	(8,395)	(8,539)
Other	(4,060)	(6,452)
Total deferred tax liabilities	(86,368)	(141,528)
Net deferred tax asset (liability)	$ 25,829
Net deferred tax asset (liability)		$ (23,350)

Income Taxes - Operating Loss C

Income Taxes - Operating Loss Carryforwards (Details) $ in Thousands	Dec. 31, 2024 USD ($)
Federal
Operating Loss Carryforwards
Operating loss carryforwards	$ 18,700
State
Operating Loss Carryforwards
Operating loss carryforwards	$ 27,000

Income Taxes - Unrecognized Tax

Income Taxes - Unrecognized Tax Benefits (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Unrecognized Tax Benefits [Roll Forward]
Beginning balance of unrecognized tax benefits	$ 8,689	$ 6,980	$ 4,067
Additions based on tax positions related to the current year	978	1,873	1,464
Additions based on tax positions of prior years	266	491	1,966
Reductions due to lapse of applicable statute of limitation	(484)	(655)	(517)
Ending balance of unrecognized tax benefits	9,449	8,689	6,980
Unrecognized tax benefits that would affect the effective tax rate, net of temporary differences	10,467
Temporary differences that would affect the effective tax rate	1,848
Accrued interest and penalties related to uncertain tax positions	2,861	1,942	1,390
Interest and penalties recognized	$ 920	$ 552	$ 826

Income Taxes - CARES Act (Detai

Income Taxes - CARES Act (Details) $ in Thousands	Dec. 31, 2022 USD ($)
Income Tax Disclosure [Abstract]
Deferred payroll taxes, CARES Act	$ 48,452

Notes Payable and Credit Agre_3

Notes Payable and Credit Agreement - The Company’s Credit Agreement and Related Credit Facilities (Details) - Line of Credit - USD ($)	Feb. 10, 2023	Nov. 30, 2023	Feb. 09, 2023
Revolving Credit Facility
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 750,000,000	$ 750,000,000	$ 400,000,000
Revolving Credit Facility | Minimum | SOFR
Debt Instrument [Line Items]
Basis spread on variable rate	1%
Revolving Credit Facility | Minimum | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate	0%
Revolving Credit Facility | Maximum | SOFR
Debt Instrument [Line Items]
Basis spread on variable rate	1.75%
Revolving Credit Facility | Maximum | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate	0.75%
Revolving Credit Facility, Sublimit
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 125,000,000
Revolving Credit Facility, Swing Line Loan
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 75,000,000

Notes Payable and Credit Agre_4

Notes Payable and Credit Agreement - Senior Notes (Details) - Senior Notes - USD ($)	Aug. 13, 2020	Dec. 31, 2024	Dec. 31, 2023	Oct. 20, 2020	Oct. 01, 2019
2027 Notes
Debt Instrument [Line Items]
Interest rate	4.625%				4.625%
Aggregate principal amount	$ 200,000,000	$ 500,000,000	$ 500,000,000		$ 300,000,000
Issuance price, percentage of principal amount	101%
2029 Notes
Debt Instrument [Line Items]
Interest rate				4%
Aggregate principal amount		$ 350,000,000	$ 350,000,000	$ 350,000,000

Notes Payable and Credit Agre_5

Notes Payable and Credit Agreement - Schedule of Outstanding Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Total debt outstanding	$ 1,060,000	$ 1,310,000
Less unamortized fees and premium	(4,128)	(5,312)
Long-term portion of notes payable	1,055,872	1,304,688
Senior Notes | 2027 Notes
Debt Instrument [Line Items]
Total debt outstanding	500,000	500,000
Senior Notes | 2029 Notes
Debt Instrument [Line Items]
Total debt outstanding	350,000	350,000
Revolving Credit Facility | Line of Credit
Debt Instrument [Line Items]
Total debt outstanding	$ 210,000	$ 460,000

Notes Payable and Credit Agre_6

Notes Payable and Credit Agreement - Debt Balances (Details) - Line of Credit - Revolving Credit Facility $ in Thousands	Dec. 31, 2024 USD ($)
Debt Instrument [Line Items]
Debt collateral	$ 20,358
Available credit	$ 519,642
Interest rate	6%

Notes Payable and Credit Agre_7

Notes Payable and Credit Agreement - Letters of Credit (Details) - Standby Letters of Credit - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Line of Credit Facility [Line Items]
Letters of credit, amount outstanding	$ 20,912	$ 21,312
Debt collateral	$ 554

Retirement Plans - 401(k) Retir

Retirement Plans - 401(k) Retirement Savings Plan (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Retirement Benefits [Abstract]
Employer contributions, net of forfeitures	$ 4,004	$ 5,673	$ 31,409

Retirement Plans - Deferred Com

Retirement Plans - Deferred Compensation Plan (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Deferred Compensation Arrangement with Individual, Postretirement Benefits [Line Items]
Life insurance cash surrender value	$ 194,350	$ 162,780
Key Executives and Key Employees
Deferred Compensation Arrangement with Individual, Postretirement Benefits [Line Items]
Service vesting period	5 years
Maximum percent of base salary deferrable	80%
Maximum percent of bonus deferrable	90%
Maximum percent of vested RSUs and PRSUs deferrable	100%
Employer contributions	$ 6,849	$ 10,822	$ 18,023

Capital Stock - Additional Info

Capital Stock - Additional Information (Details) - USD ($)			3 Months Ended	12 Months Ended			16 Months Ended
	Aug. 10, 2023	May 08, 2023	Aug. 10, 2023	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Feb. 26, 2023	Nov. 01, 2016
Preferred Stock, Number of Shares, Par Value and Other Disclosures [Abstract]
Preferred stock, shares authorized (in shares)				10,000,000	10,000,000
Preferred stock, par value (in dollars per share)				$ 0.01	$ 0.01
Preferred stock, shares outstanding (in shares)				0	0
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Stock repurchase program, authorized amount (up to)				$ 1,350,000,000				$ 150,000,000
Stock repurchase program, authorized cumulative amount							$ 1,200,000,000
Stock repurchase program, remaining authorized repurchase amount				$ 226,658,000
Number of shares repurchased (in shares)				0	4,383,000	5,644,000
Treasury stock, shares, acquired excluding accelerated share repurchases (in shares)					2,362,000
Treasury stock, shares acquired, average cost per share excluding accelerated share repurchases (in dollars per share)					$ 95.13
Aggregate purchase price excluding accelerated share repurchases					$ 224,744,000
Accelerated Share Repurchase Agreement
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Accelerated share repurchases, prepaid amount		$ 200,000,000
Accelerated share repurchases, initial delivery, shares (in shares)		1,760,000
Accelerated share repurchases, shares repurchased, percentage	20%	80%
Accelerated share repurchases, initial price paid per share (in dollars per share)		$ 90.89
Accelerated share repurchases, final delivery, shares (in shares)	261,000
Accelerated share repurchases, final price paid per share (in dollars per share)			$ 98.97

Capital Stock - Schedule of Sha

Capital Stock - Schedule of Share Repurchases (Details) - USD ($) $ / shares in Units, $ in Thousands		12 Months Ended
		Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Equity [Abstract]
Number of shares repurchased (in shares)		0	4,383,000	5,644,000
Average price per share (in dollars per share)			$ 96.90	$ 102.16
Total cost of share repurchases	[1]	$ 0	$ 424,744	$ 576,767
[1]The difference between the amount reported for the year ended December 31, 2023 and the corresponding amount presented in the consolidated statements of stockholders’ equity is due to accrued excise tax payable on share repurchases which was recorded within treasury stock. The excise tax was paid during the year ended December 31, 2024.

Share-Based Compensation - Addi

Share-Based Compensation - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
RSUs and Performance Shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total unrecognized compensation cost	$ 32,003
Unrecognized compensation cost, weighted average remaining period	1 year 10 months 24 days
Aggregate intrinsic value	$ 21,834	$ 44,979
RSUs and Performance Shares | Equity Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of equity awards reserved for future issuance (in shares)	1,668,000	2,264,000
Employee Stock | Employee Stock Purchase Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares authorized for issuance (in shares)		1,000,000
Share-based compensation arrangement by share-based payment award, purchase period		6 months
Share-based compensation arrangement by share-based payment award, purchase price of common stock, percent		85%
Employee contributions	$ 3,250	$ 950
Shares purchased and issued under employee stock purchase plan (in shares)	78,000	0
Number of shares of common stock available for future grants (in shares)	922,000
Shares purchased under employee stock purchase plan (in shares)		0

Share-Based Compensation - Summ

Share-Based Compensation - Summary of Restricted Stock Units (Details) - $ / shares shares in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Number of Shares
Unvested, beginning balance (in shares)	601	665	755
Vested (in shares)	(234)	(349)	(405)
Canceled/forfeited (in shares)	(156)	(87)	(75)
Unvested, ending balance (in shares)	913	601	665
Weighted Average Grant Date Fair Value per Share
Unvested, beginning balance (in dollars per share)	$ 101.01	$ 94.79	$ 78.13
Vested (in dollars per share)	89.64	89.76	72.43
Canceled/forfeited (in dollars per share)	90.66	104.14	82.13
Unvested, ending balance (in dollars per share)	$ 77.81	$ 101.01	$ 94.79
Restricted Stock Units (RSUs)
Number of Shares
Granted (in shares)	443	196	200
Weighted Average Grant Date Fair Value per Share
Granted (in dollars per share)	$ 61.30	$ 95.67	$ 109.66
Performance Restricted Stock Units (PRSUs)
Number of Shares
Granted (in shares)	259	176	190
Weighted Average Grant Date Fair Value per Share
Granted (in dollars per share)	$ 70.73	$ 109.74	$ 92.65

Share-Based Compensation - Shar

Share-Based Compensation - Share Based Compensation Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Share-Based Payment Arrangement [Abstract]
Share-based employee compensation, before tax	$ 23,317	$ 18,020	$ 30,066
Related income tax benefits	(6,062)	(4,685)	(7,817)
Share-based employee compensation, net of tax	$ 17,255	$ 13,335	$ 22,249

Commitments and Contingencies (

Commitments and Contingencies (Details) $ in Thousands	May 26, 2016 USD ($)
Settled Litigation | Wage and Hour Claims
Loss Contingencies [Line Items]
Litigation matters accrual	$ 62,000