![]() BMO Capital Markets Healthcare Staffing Forum June 5, 2008 Exhibit 99.1 |
![]() 1 This presentation contains forward-looking statements, including those regarding Medical Staffing Network Holdings, Inc. and the services it provides. Investors are cautioned not to place an undue reliance on these forward-looking statements, which will speak only as of the date of this presentation. These statements involve known and unknown risks, uncertainties and other factors that may cause actual results and performance to materially differ from any future results or performance expressed or implied by these forward-looking statements. A description of these factors can be found in our Form 10-K for the year ended December 30, 2007, a copy of which is available on our website. Medical Staffing Network Holdings, Inc. undertakes no obligation to publicly revise these forward-looking statements. This presentation does not serve as an update to any previous comments or statements made by management. The Company will not provide any such updates except in the form of a press release or Form 8-K filing. Safe Harbor Statement |
![]() 2 Company Overview Founded in 1998 by members of the current management team Largest provider of per diem nurse staffing in the country • Branch network of over 110 offices across the US Broad and diversified base of clients and professionals • Over 7,000 client facilities served • Over 28,000 active professionals in database Diversified service lines Sophisticated information systems platform First national provider of per diem services to achieve Joint Commission Health Care Staffing Services Certification |
![]() 3 Industry Overview Source: Staffing Industry Analysts ($ in billions) Y/Y Growth (8.5)% (3.0)% 2.5% 6.0% 7.0% 8.0% 7.9% |
![]() 4 Nurse Staffing Industry Overview Per Diem Nursing Largely Fragmented Travel Nursing Highly Consolidated Top 2 Companies (est.) Top 7 Companies (est.) Market Size: Estimated $4.2 billion Approximately 66% of nurse staffing industry Estimated $2.1 billion Approximately 34% of nurse staffing industry Market Concentration: 25% 70% “It’s estimated that 70% of nurses are married & have or will switch from full-time to part-time employment” Peter Buerhaus, Ph.D., RN, FAAN Large pool of available nurses Limited pool – generally young and/or unmarried Nurse Availability: Source: Staffing Industry Analysts |
![]() 5 Long-Term Industry Growth Drivers Long-term imbalance between supply and demand Significant increase in utilization of healthcare services as population ages Hospitals require a variable labor pool to deal with fluctuations in admissions levels Significant burnout of full-time nursing professionals drives turnover and increases utilization of temporary staff Increased staffing levels due to new staffing ratio and overtime legislation in a number of states |
![]() 6 Recent Market Trends Hospitals are overutilizing their full-time staff • Patient loads and overtime are higher than normal • Legislation in some states is already addressing the issue Currently, demand has also been impacted by lower than anticipated hospital admissions The healthcare industry is consolidating its vendor base • 75% of per diem staffing services are provided by thousands of independent, inefficient and geographically limited vendors • Consolidation reduces administrative costs and improves consistency and quality of service • Projected that more than half of facilities will be in a vendor managed services or preferred-staffing relationship in the next five years |
![]() 7 Recent Market Trends (continued) More favorable pricing environment Independent study supports high quality of supplemental staffing Facilities are raising service-level expectations of staffing companies o In 2005, the Joint Commission launched a certification program for healthcare staffing organizations. In 2006, MSN’s national branch network completed the Joint Commission’s comprehensive review process in order to earn its Gold Seal of Approval™ for a second consecutive year. The Company is one of the largest national providers of diversified healthcare staffing services, which includes per diem nursing, travel and allied health, to achieve Joint Commission certification for all of its locations. |
![]() 8 1.0 1.5 2.0 2.5 3.0 2000 2005 2010 2015 2020 Supply – Demand Imbalance 35.1 36.7 40.2 46.8 54.6 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 2000 2005 2010 2015 2020 Source: U.S. Census Bureau, Population Projections Bureau, March, 2004 Source: U.S. Department of Health and Human Services, Health Resources and Services Administration, 2004 National Sample of Registered Nurses American Population Over 65 (in millions) Registered Nurse Shortage Projection (in millions) DEMAND of FTE RNs SUPPLY of FTE RNs |
![]() 9 Who are the Nurses? 0 100,000 200,000 300,000 400,000 500,000 600,000 <25 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 >65 1980 1992 2004 Source: U.S. Department of Health and Human Services, Health Resources and Services Administration, 2004 National Sample of Registered Nurses Age Distribution of Registered Nurses |
![]() 10 25% 50% 25% <30 31-49 >50 Who are the Nurses? (continued) 2004: average age 46.8 Aging of the Registered Nurse Workforce 1980: average age 41 8% 51% 41% <30 31-49 >50 Source: U.S. Department of Health and Human Services, Health Resources and Services Administration, 2004 National Sample of Registered Nurses |
![]() 11 Who is MSN to the Nurses? Travel nurses – typically less than 30 years of age Nurses looking to settle down – between 30-50 years of age Nurses working full or part time at facilities – over 50 years of age Through our InteliStaf Travel division we can place the younger nurse at facilities throughout the country; potential per diem employee Transfer file from Travel division to one of our 110+ per diem locations and begin per diem and/or short-term local contract staffing Ensure the nurse does not leave bedside patient care by providing flexible work schedule through our vast per diem network / Some “empty nest” travel assignments |
![]() 12 Full-Service Healthcare Staffing Provider Per Diem Nursing • 68% of Q1 2008 revenues; #1 market share Travel Nursing • 18% of Q1 2008 revenues Allied Health Staffing • 14% of Q1 2008 revenues Leading Provider of Vendor Managed Services (VMS) |
![]() 13 Division Overview – Per Diem Assignments range from one shift to 13 weeks Over 110 branch locations nationwide Primarily serve acute care hospitals Largest provider of per diem nurse staffing services in United States, as measured by revenues More than 15% of per diem division revenue staffed through short-term contracts in Q1 2008 Q1 2008 revenue breakdown by division Travel, 18% Allied, 14% Per Diem, 68% |
![]() 14 Division Overview – Travel Assignment length is typically 13 weeks Nationwide placement of healthcare professionals Synergistic opportunity to capture travel nurses into per diem pool at end of travel assignment Q1 2008 revenue breakdown by division Travel, 18% Allied, 14% Per Diem, 68% |
![]() 15 Division Overview – Allied Leading provider of Allied Health Services Core Allied Health Specialties o Radiology o Laboratory and Surgical Technicians o Respiratory Therapy o Pharmacy o Physical and Occupational Therapy Significant opportunity for additional future diversification Q1 2008 revenue breakdown by division Travel, 18% Allied, 14% Per Diem, 68% |
![]() 16 Vendor Managed Services (VMS) Complete solution • Vendor management service and experience • Technology • Per Diem, Travel, Allied Health capabilities Local delivery & local accountability: makes ALL the difference 10 years of experience – creating hospital specific VMS best practices • Process improvements Staffing process: ordering and scheduling Credentialing compliance Usable business intelligence • Rationalized bill rates Balance the need to fill and cost management Agency utilization and vendor review |
![]() 17 Competitive Strengths Only national-scale healthcare staffing provider of per diem, travel and allied health services Established quality-driven operating standards, as evidenced by being awarded the Gold Seal of Approval™ under Joint Commission’s certification program Largest per diem network and leading brand name • Largest provider of per diem nurse staffing in the country • Uniquely able to service regional and national hospital groups as they continue their vendor consolidation • Widely recognized by healthcare organizations and professionals as a leader in providing high quality service |
![]() 18 Competitive Strengths (continued) Advanced information systems capability • System allows for: Same day pay to healthcare staff MSN DirectPay Visa ® Debit Card Automatic matches of qualified staff with client orders Ability to network together individual branch databases to address needs of regional clients • Far surpasses the technology of our typical “mom and pop” competitor Management expertise and well-developed, scalable infrastructure Diversified service lines allow clients “one-stop” shopping and easier implementation of vendor consolidation initiatives Proven ability to enter new markets through well developed de novo program Capacity to continue to add new product offerings within Allied division |
![]() 19 Current Strategic Initiatives Per Diem Market Share Growth • Take advantage of leverage opportunity at branch level • Increased visibility via contract staffing • Capitalize on Joint Commission certification as a differentiator in the marketplace Travel Nurse Division synergies • Capture travelers coming off assignment into per diem pool • Offer per diem shifts to existing travelers Further expand Allied footprint and service offerings • Branch-in-Branch (BiB) Offer certain allied services at a local level through our per diem branch network • New service offerings Vendor Management Services • Use expertise acquired in AMR acquisition to: Improve profitability of contracts acquired in InteliStaf acquisition Add new agreements |
![]() Financial Performance |
![]() 21 $0.0 $100.0 $200.0 $300.0 $400.0 $500.0 $600.0 $700.0 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 $33.1 $96.5 $178.4 $338.2 $478.8 $513.0 $417.1 $402.5 $385.5 $584.0 (1) Revenue ($ in millions) (1) Reported fiscal year 2007 revenue was $482.3 million. Annualized fiscal year 2007 revenue of $584.0 million is an estimate derived from annualizing 2H 2007 results that excludes revenues from locations closed in the third quarter 2007 InteliStaf acquisition implementation and restructuring plan. $482.3 |
![]() 22 Q1 2006 Q1 2007 Q1 2008 $19.7 $21.0 $35.1 Gross Profit ($ in millions) 20.7% 23.2% 24.1% |
![]() 23 2005 2007 $402.5 $584.0(1) Revenue and AEBITDA (2) Margin ($ in millions) 1.9% 5.3% AEBITDA % (1) 2007 revenue is an estimate derived from annualized 2H 2007 results (see note 1 on slide 21 for more information). (2) AEBITDA consists of net income (loss) and excludes the effects of income taxes, interest, loss on early extinguishment of debt, depreciation and amortization, restructuring and other similar charges, non-cash impairment of goodwill and recapitalization expenses. For 2005 AEBITDA margin is AEBTIDA of $7.6 million divided by actual revenue of $402.5 million and 2007 AEBITDA margin is annualized 2H 2007 AEBITDA of $31.0 million divided by annualized revenue of $584.0 million. |
![]() 24 $402.5 $181.5 $584.0 $7.6 $23.4 $31.0 2005 Incremental 2007 Future Leverage Potential AEBITDA (2) Revenue (1) Leverage of Fixed Costs ($ in millions) (1) 2007 revenue is an estimate derived from annualized 2H 2007 results (see note 1 on slide 21 for more information). (2) AEBITDA consists of net income (loss) and excludes the effects of income taxes, interest, loss on early extinguishment of debt, depreciation and amortization, restructuring and other similar charges, non-cash impairment of goodwill and recapitalization expenses. For 2005 AEBITDA margin is AEBTIDA of $7.6 million divided by actual revenue of $402.5 million and 2007 AEBITDA margin is annualized 2H 2007 AEBITDA of $31.0 million divided by annualized revenue of $584.0 million. AEBITDA %: 1.9% 13.2% 5.3% |
![]() 25 MSN – Temporary Staffing Leader Experienced management team Recent volume growth through organic initiatives and acquisition provides the opportunity to better leverage a high fixed-cost infrastructure Flexibility under senior credit facility – more than $18 million available at the end of Q1 2008 Scalable staffing model provides the potential for strong operating cash flow: • Efficient billing and collection process • Nominal capital investment requirements • Direct reimbursement from client facilities/minimal exposure to third-party reimbursement National footprint with over 110 per diem offices across the country and centralized travel and allied staffing hubs |