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Document and Entity Information - shares	9 Months Ended
Document and Entity Information - shares	Sep. 30, 2014	Nov. 03, 2014
Document and Entity Information [Abstract]
Entity Registrant Name	AMN HEALTHCARE SERVICES INC
Entity Central Index Key	0001142750
Document Type	10-Q
Document Period End Date	Sep. 30, 2014
Amendment Flag	false
Document Fiscal Year Focus	2014
Document Fiscal Period Focus	Q3
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Entity Common Stock, Shares Outstanding		46,631,739

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2014	Dec. 31, 2013
Current assets:
Cash and cash equivalents	$ 9,663	$ 15,580
Accounts receivable, net of allowances of $4,529 and $5,118 at September 30, 2014 and December 31, 2013, respectively	164,078	147,477
Accounts receivable, subcontractor	21,569	18,271
Deferred income taxes, net	24,970	24,938
Prepaid and other current assets	28,844	26,631
Total current assets	249,124	232,897
Restricted cash, cash equivalents and investments	21,012	23,115
Fixed assets, net of accumulated depreciation of $67,857 and $63,031 at September 30, 2014 and December 31, 2013, respectively	29,202	21,158
Other assets	40,045	32,279
Goodwill	144,937	144,642
Intangible assets, net of accumulated amortization of $40,022 and $42,439 at September 30, 2014 and December 31, 2013, respectively	144,498	150,197
Total assets	628,818	604,288
Current liabilities:
Accounts payable and accrued expenses	66,949	71,081
Accrued compensation and benefits	64,574	55,949
Revolving credit facility	0	10,000
Current portion of notes payable	7,500	0
Other current liabilities	8,746	6,060
Total current liabilities	147,769	143,090
Notes payable, net of discount	138,750	148,672
Other long-term liabilities	96,881	94,784
Total liabilities	383,400	386,546
Commitments and contingencies (Note 9)
Stockholders’ equity:
Preferred stock, $0.01 par value; 10,000 shares authorized; none issued and outstanding at September 30, 2014 and December 31, 2013	0	0
Common stock, $0.01 par value; 200,000 shares authorized; 46,631 and 46,011 shares issued and outstanding at September 30, 2014 and December 31, 2013, respectively	466	460
Additional paid-in capital	433,373	429,055
Accumulated deficit	(187,953)	(211,275)
Accumulated other comprehensive loss	(468)	(498)
Total stockholders’ equity	245,418	217,742
Total liabilities and stockholders’ equity	$ 628,818	$ 604,288

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) shares in Thousands, $ in Thousands	Sep. 30, 2014	Dec. 31, 2013
Accounts receivable, allowance	$ 4,529	$ 5,118
Accumulated depreciation	67,857	63,031
Accumulated amortization	$ 40,022	$ 42,439
Preferred stock, par value	$ 0.01	$ 0.01
Preferred stock, shares authorized	10,000	10,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	200,000	200,000
Common stock, shares issued	46,631	46,011
Common stock, shares outstanding	46,631	46,011

Condensed Consolidated Statements of Comprehensive Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Revenue	$ 264,584	$ 257,095	$ 756,378	$ 763,158
Cost of revenue	184,278	181,428	524,957	540,071
Gross profit	80,306	75,667	231,421	223,087
Operating expenses:
Selling, general and administrative	60,319	55,605	170,553	163,763
Depreciation and amortization	4,086	3,317	11,916	9,847
Total operating expenses	64,405	58,922	182,469	173,610
Income from operations	15,901	16,745	48,952	49,477
Interest expense, net (including loss on debt extinguishment of $3,113 and $434 for the nine months ended September 30, 2014 and 2013, respectively), and other	1,433	1,840	7,908	7,829
Income before income taxes	14,468	14,905	41,044	41,648
Income tax expense	5,969	6,290	17,722	17,071
Net income	8,499	8,615	23,322	24,577
Other comprehensive income (loss) - foreign currency translation	75	(84)	29	(19)
Comprehensive income	$ 8,574	$ 8,531	$ 23,351	$ 24,558
Net income per common share:
Basic (in dollars per share)	$ 0.18	$ 0.19	$ 0.50	$ 0.53
Diluted (in dollars per share)	$ 0.18	$ 0.18	$ 0.49	$ 0.51
Weighted average common shares outstanding:
Basic (shares)	46,546	45,986	46,460	45,947
Diluted (shares)	48,122	47,810	47,959	47,776

Condensed Consolidated Statements of Comprehensive Income (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Loss on debt extinguishment	$ 3,113	$ 434	$ 3,113	$ 434

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2014	Sep. 30, 2013
Cash flows from operating activities:
Net income	$ 23,322	$ 24,577
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	11,916	9,847
Non-cash interest expense and other	1,104	1,050
Increase in allowances for doubtful accounts and sales credits	2,915	2,679
Provision for deferred income taxes	1,768	1,951
Share-based compensation	5,361	4,667
Excess tax benefits from share-based compensation	(1,780)	(1,529)
Holdback settlement in equity from prior acquisition	0	(3,046)
Loss on disposal or sale of fixed assets	50	13
Loss on debt extinguishment	3,113	434
Changes in assets and liabilities:
Accounts receivable	(19,516)	(5,102)
Accounts receivable, subcontractor	(3,298)	(402)
Prepaid expenses and other current assets	(2,184)	5,181
Other assets	(188)	(2,480)
Accounts payable and accrued expenses	(4,156)	1,573
Accrued compensation and benefits	8,625	4,778
Other liabilities	4,625	3,383
Restricted cash, cash equivalents and investments balance	(9,038)	(3,225)
Net cash provided by operating activities	22,639	44,349
Cash flows from investing activities:
Purchase and development of fixed assets	(14,287)	(6,447)
Proceeds from sales of assets held for sale	0	600
Equity method investment	(5,000)	0
Payments to fund deferred compensation plan	(2,174)	(1,251)
Change in restricted cash, cash equivalents and investments balance	11,141	48
Net cash used in investing activities	(10,320)	(7,050)
Cash flows from financing activities:
Capital lease repayments	(472)	(479)
Payments on term loan	(153,370)	(10,000)
Proceeds from term loan	150,000	0
Payments on revolving credit facility	(39,500)	(1,000)
Proceeds from revolving credit facility	29,500	1,000
Payment of financing costs	(3,488)	(935)
Proceeds from exercise of equity awards	1,792	1,174
Cash paid for shares withheld for taxes	(4,361)	(2,662)
Excess tax benefits from share-based compensation	1,780	1,529
Change in bank overdraft	(146)	65
Net cash used in financing activities	(18,265)	(11,308)
Effect of exchange rate changes on cash	29	(19)
Net (decrease) increase in cash and cash equivalents	(5,917)	25,972
Cash and cash equivalents at beginning of period	15,580	5,681
Cash and cash equivalents at end of period	9,663	31,653
Supplemental disclosures of cash flow information:
Cash paid for interest (net of $83 and $63 capitalized for the nine months ended September 30, 2014 and 2013, respectively)	3,687	4,253
Cash paid for income taxes	12,732	14,708
Supplemental disclosures of non-cash investing and financing activities:
Purchase of fixed assets recorded in accounts payable and accrued expenses	$ 3,751	$ 1,221

Condensed Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2014	Sep. 30, 2013
Interest capitalized	$ 83	$ 63

Basis of Presentation	9 Months Ended
Basis of Presentation	Sep. 30, 2014
Organization, Consolidation and Presentation of Financial Statements [Abstract]
BASIS OF PRESENTATION	BASIS OF PRESENTATION The condensed consolidated balance sheets and related condensed consolidated statements of comprehensive income and cash flows contained in this Quarterly Report on Form 10-Q (this “Quarterly Report”), which are unaudited, include the accounts of AMN Healthcare Services, Inc. and its wholly-owned subsidiaries (collectively, the “Company”). All significant intercompany balances and transactions have been eliminated in consolidation. In the opinion of management, all entries necessary for a fair presentation of such unaudited condensed consolidated financial statements have been included. These entries consisted of all normal recurring items. The results of operations for the interim period are not necessarily indicative of the results to be expected for any other interim period or for the entire fiscal year or for any future period. The unaudited condensed consolidated financial statements do not include all information and notes necessary for a complete presentation of financial position, results of operations and cash flows in conformity with accounting principles generally accepted in the United States. Please refer to the Company’s audited consolidated financial statements and the related notes for the fiscal year ended December 31, 2013, contained in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2013, filed with the Securities and Exchange Commission (“SEC”) on February 21, 2014. The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires management to make a number of estimates and assumptions relating to the reporting of assets and liabilities and the disclosure of contingent assets and liabilities at the dates of the financial statements and the reported amounts of revenue and expenses during the reporting periods. On an ongoing basis, the Company evaluates its estimates, including those related to asset impairments, accruals for self-insurance, compensation and related benefits, accounts receivable, contingencies and litigation, valuation and recognition of share-based payments and income taxes. Actual results could differ from those estimates under different assumptions or conditions. Reclassification Certain reclassifications have been made to the prior year’s consolidated financial statements to conform to the current year presentation. Specifically, payments made into the Company’s life insurance policies to assist in funding the deferred compensation plan were reclassified from cash flows from operating activities to cash flows from investing activities in the unaudited condensed consolidated statement of cash flows for the nine months ended September 30, 2013. In addition, the Company reclassified expected insurance recoveries under its professional liability and workers’ compensation policies in the condensed consolidated balance sheet for the year ended December 31, 2013 to conform to the current year presentation. Professional liability and workers’ compensation liability were previously presented net of insurance recoveries. Commencing June 30, 2014, expected insurance recoveries are presented on a gross basis, with the short-term insurance receivable portion included within “Prepaid and other current assets” and the long-term portion included within “Other assets” on the condensed consolidated balance sheet.

Business Combination and Equity Investment	9 Months Ended
Business Combination and Equity Investment	Sep. 30, 2014
Business Combinations [Abstract]
BUSINESS COMBINATION AND EQUITY INVESTMENT	ShiftWise Acquisition On November 20, 2013, the Company completed its acquisition of ShiftWise, a leading national provider of web-based healthcare workforce solutions, including its vendor management systems, or “VMS,” utilized by hospitals and other healthcare systems. The acquisition is not considered a material business combination and, accordingly, pro forma information is not provided. The Company accounted for the acquisition using the acquisition method of accounting and recorded the tangible and intangible assets acquired and liabilities assumed at their estimated fair values as of the date of the acquisition. The purchase price of the acquisition totaled $39,500, of which $6,000 was deposited in escrow to satisfy any indemnification claims by the Company with respect to, among other customary items, breaches of representations, warranties and covenants by ShiftWise and post-closing purchase price adjustments. The $6,000 deposited in escrow will be disbursed to the selling shareholders in three years following the closing date at $2,000 per annum minus any indemnification claims. As of the date of filing of this Form 10-Q, the Company is still finalizing the allocation of the purchase price. The provisional items pending finalization are primarily related to tax matters, which the Company expects to complete during 2014. The preliminary allocation of the purchase price consisted of $9,899 of fair value of assets acquired, $11,801 of liabilities assumed (including $2,933 of deferred tax liabilities), $21,612 of goodwill and $19,790 of identified intangible assets. The intangible assets include the fair value of trade names and trademarks, customer relationships, non-compete agreements and acquired technologies. The weighted average useful life of the acquired intangible assets subject to amortization is approximately 8 years. There was no goodwill recognized as part of this acquisition that is deductible for tax purposes. The results of operations of ShiftWise have been included in the nurse and allied healthcare staffing segment in the Company’s condensed consolidated financial statements since the date of acquisition. Pipeline Equity Investment In March 2014, the Company entered into an agreement (the “Pipeline Agreement”) under which it made an initial $2,000 investment in Pipeline Health Holdings LLC (“Pipeline”), a telepharmacy provider. The Company’s ownership percentage in Pipeline at March 31, 2014 was approximately 9%. Under the Pipeline Agreement, the Company committed to invest up to an additional $3,000 contingent upon Pipeline reaching two milestone commitments within a year. In April and September 2014, the Company made the milestone investments of $1,000 and $2,000, respectively, which together with the initial investment represents an ownership percentage in Pipeline of approximately 18% as of September 30, 2014. The investment is accounted for under the equity method of accounting. The Company’s share of Pipeline’s results is included within “Interest expense, net, and other” in the accompanying unaudited condensed consolidated statement of comprehensive income for both the three and nine months ended September 30, 2014.

- Definition

The entire disclosure for a business combination (or series of individually immaterial business combinations) completed during the period, including background, timing, and recognized assets and liabilities. The disclosure may include leverage buyout transactions (as applicable).

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+ Details

Revenue Recognition	9 Months Ended
Revenue Recognition	Sep. 30, 2014
Revenue Recognition [Abstract]
REVENUE RECOGNITION	REVENUE RECOGNITION Revenue consists of fees earned from the permanent and temporary placement of clinicians and physicians. Revenue is recognized when earned and realizable. The Company has entered into certain contracts with healthcare organizations to provide managed services programs. Under these contract arrangements, the Company uses its clinicians and physicians along with those of third party subcontractors to fulfill client orders. If the Company uses subcontractors, it records revenue net of related subcontractors expense. The resulting net revenue represents the administrative fee the Company charges for its vendor management services. The Company records subcontractor accounts receivable from the client in the consolidated balance sheets. The Company generally pays the subcontractor after it has received payment from the client. Payables to subcontractors of $23,613 and $22,051, respectively, were included in accounts payable and accrued expenses in the unaudited condensed consolidated balance sheet as of September 30, 2014 and the audited consolidated balance sheet as of December 31, 2013.

Net Income Per Common Share

9 Months Ended

Sep. 30, 2014

Earnings Per Share [Abstract]

NET INCOME PER COMMON SHARE

Basic net income per common share is calculated by dividing net income by the weighted average number of common shares outstanding during the reporting period. Diluted net income per common share reflects the effects of potentially dilutive share-based equity instruments.

Share-based awards to purchase 286 and 296 shares of common stock were not included in the calculation of diluted net income per common share for the three months ended September 30, 2014 and 2013, respectively, because the effect of these instruments was anti-dilutive. Share-based awards to purchase 344 and 313 shares of common stock were not included in the calculation of diluted net income per common share for the nine months ended September 30, 2014 and 2013, respectively, because the effect of these instruments was anti-dilutive.

The following table sets forth the computation of basic and diluted net income per common share for the three and nine months ended September 30, 2014 and 2013, respectively:



	Three Months Ended September 30,				Nine Months Ended September 30,
	2014		2013		2014		2013
Net income	$	8,499	$	8,615	$	23,322	$	24,577

Net income per common share - basic	$	0.18	$	0.19	$	0.50	$	0.53
Net income per common share - diluted	$	0.18	$	0.18	$	0.49	$	0.51

Weighted average common shares outstanding - basic	46,546		45,986		46,460		45,947
Plus dilutive effect of potential common shares	1,576		1,824		1,499		1,829
Weighted average common shares outstanding - diluted	48,122		47,810		47,959		47,776

Segment Information

9 Months Ended

Sep. 30, 2014

Segment Reporting [Abstract]

SEGMENT INFORMATION

The Company has three reportable segments: nurse and allied healthcare staffing, locum tenens staffing and physician permanent placement services.

The Company’s management relies on internal management reporting processes that provide revenue and operating income by reportable segment for making financial decisions and allocating resources. Segment operating income represents income before income taxes plus depreciation, amortization of intangible assets, share-based compensation expense, interest expense (net) and other, and unallocated corporate overhead. The Company’s management does not evaluate, manage or measure performance of segments using asset information; accordingly, asset information by segment is not prepared or disclosed.

The following table provides a reconciliation of revenue and operating income by reportable segment to consolidated results and was derived from each segment’s internal financial information as used for corporate management purposes:



	Three Months Ended September 30,				Nine Months Ended September 30,
	2014		2013		2014		2013
Revenue
Nurse and allied healthcare staffing	$	174,292	$	170,955	$	503,636	$	517,858
Locum tenens staffing	78,816		75,253		219,996		213,417
Physician permanent placement services	11,476		10,887		32,746		31,883
	$	264,584	$	257,095	$	756,378	$	763,158
Segment Operating Income
Nurse and allied healthcare staffing	$	21,279	$	20,392	$	63,283	$	62,994
Locum tenens staffing	8,139		7,547		22,830		17,347
Physician permanent placement services	2,756		2,205		7,074		6,735
	32,174		30,144		93,187		87,076
Unallocated corporate overhead	10,396		8,595		26,958		23,085
Depreciation and amortization	4,086		3,317		11,916		9,847
Share-based compensation	1,791		1,487		5,361		4,667
Interest expense, net (including loss on debt extinguishment of $3,113 and $434 for the nine months ended September 30, 2014 and 2013, respectively), and other	1,433		1,840		7,908		7,829
Income before income taxes	$	14,468	$	14,905	$	41,044	$	41,648

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

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+ Details

Fair Value Measurement

9 Months Ended

Sep. 30, 2014

Fair Value Disclosures [Abstract]

FAIR VALUE MEASUREMENT

FAIR VALUE MEASUREMENTS

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.

Assets Measured on a Recurring Basis

The Company’s assets that are measured at fair value on a recurring basis include restricted cash equivalents and investments and the Company’s investments associated with its deferred compensation plan. The following tables present information about these assets and indicate the fair value hierarchy of the valuation techniques utilized to determine such fair value:



	Fair Value Measurements as of September 30, 2014
	Total		Quoted Prices in Active Markets for Identical Assets (Level 1)
U.S. Treasury securities	$	6,700	$	6,700
Money market funds	335		335
Total financial assets measured at fair value	$	7,035	$	7,035



	Fair Value Measurements as of December 31, 2013
	Total		Quoted Prices in Active Markets for Identical Assets (Level 1)
U.S. Treasury securities	$	17,817	$	17,817
Money market funds	359		359
Total financial assets measured at fair value	$	18,176	$	18,176

The Company’s restricted cash equivalents and investments typically consist of U.S. Treasury securities and money market funds on deposit with financial institutions that serve as collateral for the Company’s outstanding letters of credit, and the Company’s investments associated with its deferred compensation plan typically consist of money market funds, which fair values are based on quoted prices in active markets for identical assets.

Assets Measured on a Non-Recurring Basis

The Company applies fair value techniques on a non-recurring basis associated with valuing potential impairment losses related to its goodwill, indefinite-lived intangible assets, long-lived assets and equity method investment. There were no triggering events identified and no indication of impairment of the Company’s goodwill, indefinite-lived intangible assets, long-lived assets or equity method investment during the nine months ended September 30, 2014 and 2013.

Fair Value of Financial Instruments

The carrying amount of notes payable approximates its fair value as the instrument’s interest rates are variable and comparable to rates currently offered for similar debt instruments of comparable maturity. 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.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

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Income Taxes	9 Months Ended
Income Taxes	Sep. 30, 2014
Income Tax Disclosure [Abstract]
INCOME TAXES	INCOME TAXES The Company is subject to taxation in the U.S. and various states and foreign jurisdictions. With few exceptions, as of September 30, 2014, the Company is no longer subject to U.S. federal, state, local or foreign examinations by tax authorities for years before 2005. During 2013, the Internal Revenue Service (“IRS”) completed its tax audit of the Company for the years 2007, 2008, 2009 and 2010. The IRS issued a Revenue Agent Report (“RAR”) to the Company related to its completed tax examination. The RAR seeks adjustments to the Company’s taxable income for 2007-2010 and net operating loss carryforwards for 2005-2006. The adjustments to the Company’s taxable income relate to the proposed disallowance of certain per diems paid to our clinicians and locum tenens providers on the Company’s income tax return. Concurrent with the RAR, the Company received an Employment Tax Examination Report (“ETER”) for 2009 and 2010. The ETER adjustments propose additional Company payroll tax liabilities and penalties related to the treatment of certain non-taxable per diem allowances and travel benefits. The positions in the RAR and ETER are mutually exclusive. The RAR and ETER contain multiple tax positions, some of which are contrary to each other. The Company has filed a Protest Letter for both the RAR and ETER and intends to defend its position. The Company has held three meetings with the IRS Appeals office and will continue to meet with the IRS Appeals office throughout the course of the year. The Company cannot predict with certainty the timing of a resolution. The Company believes its reserve for unrecognized tax benefits and contingent tax issues is adequate. Notwithstanding, the Company could adjust its provision for income taxes and contingent tax liability based on future developments. The IRS commenced income and payroll tax audits for the years 2011 and 2012 during November 2013.

Notes Payable and Related Credit Agreement

9 Months Ended

Sep. 30, 2014

Debt Disclosure [Abstract]

NOTES PAYABLE AND RELATED CREDIT AGREEMENT

On April 18, 2014, the Company entered into a Credit Agreement (the “Credit Agreement”) with several lenders to provide for two credit facilities (the “New Credit Facilities”) to replace its prior credit facilities, including (A) a $225,000 secured revolving credit facility (the “Revolver”) that includes a $40,000 sublimit for the issuance of letters of credit and a $20,000 sublimit for swingline loans and (B) a $150,000 secured term loan credit facility (the “Term Loan”). In addition, the Credit Agreement provides that the Company may from time to time obtain an increase in the Revolver or the Term Loan or both in an aggregate principal amount not to exceed $125,000 subject to, among other conditions, the arrangement of additional commitments with financial institutions reasonably acceptable to the Company and the administrative agent. The obligations of the Company under the Credit Agreement and the New Credit Facilities are secured by substantially all of the assets of the Company.

The New Credit Facilities are available for working capital, capital expenditures, permitted acquisitions and general corporate purposes of the Company. The maturity date of the New Credit Facilities is April 18, 2019. At September 30, 2014, the outstanding balance of the Term Loan was $146,250, of which $7,500 is due in the next 12 months, and there was no amount outstanding under the Revolver. At September 30, 2014, with $8,155 of outstanding letters of credit collaterialized by the Revolver, there was $216,845 of available credit under the Revolver.

Annual principal maturities of the outstanding Term Loan are as follows:



Three months ending December 31, 2014	$	1,875
Year ending December 31, 2015	7,500
Year ending December 31, 2016	7,500
Year ending December 31, 2017	7,500
Year ending December 31, 2018	7,500
Thereafter	114,375
	$	146,250

The Revolver carries an unused fee of 0.25% to 0.35% per annum and each standby letter of credit issued under the Revolver is subject to a letter of credit fee ranging from 1.50% to 2.25% per annum of the average daily maximum amount available to be drawn under the standby letter of credit, in each case, depending on the Company’s consolidated leverage ratio, as calculated quarterly in accordance with the Credit Agreement. The Term Loan is subject to amortization of principal of 5.00% per year of the original Term Loan amount, which is $7,500 per annum, and payable in equal quarterly installments. Borrowings under the Term Loan and Revolver bear interest at floating rates, at the Company’s option, based upon either LIBOR plus a spread of 1.50% to 2.25% or a base rate plus a spread of 0.50% to 1.25%. The applicable spread is determined quarterly based upon the Company’s consolidated leverage ratio, as calculated quarterly in accordance with the Credit Agreement. The interest rate for the outstanding Term Loan was 1.9% on a LIBOR basis as of September 30, 2014.

The Company used the proceeds from the New Credit Facilities to repay in full all outstanding indebtedness under its prior credit facilities and to pay related transaction costs. In addition, approximately $9,500 of standby letters of credit issued under the prior credit facilities were rolled into and deemed issued under the Revolver.

In connection with obtaining the New Credit Facilities, the Company incurred $3,488 in fees paid to lenders and other third parties, which were capitalized and are amortized to interest expense over the term of the New Credit Facilities. In addition, the Company wrote off $3,113 of unamortized financing fees and original issue discount, which was recorded as loss on debt extinguishment in the accompanying unaudited condensed consolidated statement of comprehensive income for the nine months ended September 30, 2014.

The Credit Agreement contains various customary affirmative and negative covenants, including restrictions on assumption of additional indebtedness, declaration and payment of dividends, dispositions of assets, consolidation into another entity and allowable investments. It also contains financial covenants that require the Company (1) not to exceed a certain maximum consolidated leverage ratio, as calculated in accordance with the Credit Agreement, which is initially set at 4.00 to 1.00 but ultimately steps down to 3.50 to 1.00 beginning with the fiscal quarter ending June 30, 2016, and (2) to maintain a minimum consolidated interest coverage ratio of 2.50 to 1.00, as calculated in accordance with the Credit Agreement.

Letters of Credit

At September 30, 2014, the Company maintained outstanding standby letters of credit totaling $15,190 as collateral in relation to its professional liability insurance agreements, workers’ compensation insurance agreements, and a corporate office lease agreement. Of the $15,190 of outstanding letters of credit, the Company has collateralized $7,035 in cash, cash equivalents and investments and the remaining amounts are collateralized by the Revolver. Outstanding standby letters of credit at December 31, 2013 totaled $27,691.

Commitments and Contingencies

9 Months Ended

Sep. 30, 2014

Commitments and Contingencies Disclosure [Abstract]

COMMITMENTS AND CONTINGENCIES

(a) Legal

The Company is subject to various claims and legal actions in the ordinary course of its business. Some of these matters relate to professional liability, tax, payroll, contract and employee-related matters and include individual and collective lawsuits, as well as inquiries and investigations by governmental agencies regarding the Company’s employment practices. During the first quarter of 2014, the Company completed the settlement of a wage and hour class action (and a related action) for an immaterial amount. 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 clinicians and physicians. Depending upon the particular facts and circumstances, the Company may be subject to indemnification obligations under its contracts with certain clients relating to these matters.

(b) Leases

During the nine months ended September 30, 2014, the Company entered into a third amendment (the “Third Amendment”) to its office lease (as amended to date, the “Lease”) with Kilroy Realty, L.P. for its corporate headquarters in San Diego. Among other things, the Third Amendment extended the term under the Lease nine additional years from its original termination date of August 1, 2018 through July 31, 2027 and also reduced the rental payment from January 1, 2015 through the original termination date in 2018. The Company recognizes rent expense on a straight-line basis over the lease term. Future minimum lease payments under the Third Amendment as of September 30, 2014 are as follows:



Three months ending December 31, 2014	$	2,311
Year ending December 31, 2015	6,500
Year ending December 31, 2016	8,073
Year ending December 31, 2017	8,355
Year ending December 31, 2018	8,648
Thereafter	87,892
Total minimum lease payments	$	121,779

Basis of Presentation (Policies)	9 Months Ended
Basis of Presentation (Policies)	Sep. 30, 2014
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Use of Estimates	The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires management to make a number of estimates and assumptions relating to the reporting of assets and liabilities and the disclosure of contingent assets and liabilities at the dates of the financial statements and the reported amounts of revenue and expenses during the reporting periods. On an ongoing basis, the Company evaluates its estimates, including those related to asset impairments, accruals for self-insurance, compensation and related benefits, accounts receivable, contingencies and litigation, valuation and recognition of share-based payments and income taxes. Actual results could differ from those estimates under different assumptions or conditions.
Revenue Recognition	Revenue consists of fees earned from the permanent and temporary placement of clinicians and physicians. Revenue is recognized when earned and realizable. The Company has entered into certain contracts with healthcare organizations to provide managed services programs. Under these contract arrangements, the Company uses its clinicians and physicians along with those of third party subcontractors to fulfill client orders. If the Company uses subcontractors, it records revenue net of related subcontractors expense. The resulting net revenue represents the administrative fee the Company charges for its vendor management services. The Company records subcontractor accounts receivable from the client in the consolidated balance sheets. The Company generally pays the subcontractor after it has received payment from the client.
Net Income per Common Share	Basic net income per common share is calculated by dividing net income by the weighted average number of common shares outstanding during the reporting period. Diluted net income per common share reflects the effects of potentially dilutive share-based equity instruments.
Segment Information	The Company’s management relies on internal management reporting processes that provide revenue and operating income by reportable segment for making financial decisions and allocating resources. Segment operating income represents income before income taxes plus depreciation, amortization of intangible assets, share-based compensation expense, interest expense (net) and other, and unallocated corporate overhead. The Company’s management does not evaluate, manage or measure performance of segments using asset information; accordingly, asset information by segment is not prepared or disclosed.
Fair Value Measurement	Fair Value of Financial Instruments The carrying amount of notes payable approximates its fair value as the instrument’s interest rates are variable and comparable to rates currently offered for similar debt instruments of comparable maturity. 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. Assets Measured on a Non-Recurring Basis The Company applies fair value techniques on a non-recurring basis associated with valuing potential impairment losses related to its goodwill, indefinite-lived intangible assets, long-lived assets and equity method investment. 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. Assets Measured on a Recurring Basis The Company’s assets that are measured at fair value on a recurring basis include restricted cash equivalents and investments and the Company’s investments associated with its deferred compensation plan.

- Definition

Disclosure of accounting policy for revenue recognition. If the entity has different policies for different types of revenue transactions, the policy for each material type of transaction is generally disclosed. If a sales transaction has multiple element arrangements (for example, delivery of multiple products, services or the rights to use assets) the disclosure may indicate the accounting policy for each unit of accounting as well as how units of accounting are determined and valued. The disclosure may encompass important judgment as to appropriateness of principles related to recognition of revenue. The disclosure also may indicate the entity's treatment of any unearned or deferred revenue that arises from the transaction.

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Net Income Per Common Share (Tables)

9 Months Ended

Sep. 30, 2014

Earnings Per Share [Abstract]

Computation of basic and diluted net income per common share

The following table sets forth the computation of basic and diluted net income per common share for the three and nine months ended September 30, 2014 and 2013, respectively:



	Three Months Ended September 30,				Nine Months Ended September 30,
	2014		2013		2014		2013
Net income	$	8,499	$	8,615	$	23,322	$	24,577

Net income per common share - basic	$	0.18	$	0.19	$	0.50	$	0.53
Net income per common share - diluted	$	0.18	$	0.18	$	0.49	$	0.51

Weighted average common shares outstanding - basic	46,546		45,986		46,460		45,947
Plus dilutive effect of potential common shares	1,576		1,824		1,499		1,829
Weighted average common shares outstanding - diluted	48,122		47,810		47,959		47,776

Segment Information (Tables)

9 Months Ended

Sep. 30, 2014

Segment Reporting [Abstract]

Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results



	Three Months Ended September 30,				Nine Months Ended September 30,
	2014		2013		2014		2013
Revenue
Nurse and allied healthcare staffing	$	174,292	$	170,955	$	503,636	$	517,858
Locum tenens staffing	78,816		75,253		219,996		213,417
Physician permanent placement services	11,476		10,887		32,746		31,883
	$	264,584	$	257,095	$	756,378	$	763,158
Segment Operating Income
Nurse and allied healthcare staffing	$	21,279	$	20,392	$	63,283	$	62,994
Locum tenens staffing	8,139		7,547		22,830		17,347
Physician permanent placement services	2,756		2,205		7,074		6,735
	32,174		30,144		93,187		87,076
Unallocated corporate overhead	10,396		8,595		26,958		23,085
Depreciation and amortization	4,086		3,317		11,916		9,847
Share-based compensation	1,791		1,487		5,361		4,667
Interest expense, net (including loss on debt extinguishment of $3,113 and $434 for the nine months ended September 30, 2014 and 2013, respectively), and other	1,433		1,840		7,908		7,829
Income before income taxes	$	14,468	$	14,905	$	41,044	$	41,648

Fair Value Measurement (Tables)

9 Months Ended

Sep. 30, 2014

Fair Value Disclosures [Abstract]

Schedule of financial assets and liabilities measured at fair value on recurring basis



	Fair Value Measurements as of September 30, 2014
	Total		Quoted Prices in Active Markets for Identical Assets (Level 1)
U.S. Treasury securities	$	6,700	$	6,700
Money market funds	335		335
Total financial assets measured at fair value	$	7,035	$	7,035



	Fair Value Measurements as of December 31, 2013
	Total		Quoted Prices in Active Markets for Identical Assets (Level 1)
U.S. Treasury securities	$	17,817	$	17,817
Money market funds	359		359
Total financial assets measured at fair value	$	18,176	$	18,176

Notes Payable and Related Credit Agreement (Tables)

9 Months Ended

Sep. 30, 2014

Debt Disclosure [Abstract]

Schedule of Maturities of Long-term Debt

Annual principal maturities of the outstanding Term Loan are as follows:



Three months ending December 31, 2014	$	1,875
Year ending December 31, 2015	7,500
Year ending December 31, 2016	7,500
Year ending December 31, 2017	7,500
Year ending December 31, 2018	7,500
Thereafter	114,375
	$	146,250

Commitments and Contingencies Leases (Tables)

9 Months Ended

Sep. 30, 2014

Leases [Abstract]

Schedule of Future Minimum Rental Payments for Operating Leases

Future minimum lease payments under the Third Amendment as of September 30, 2014 are as follows:



Three months ending December 31, 2014	$	2,311
Year ending December 31, 2015	6,500
Year ending December 31, 2016	8,073
Year ending December 31, 2017	8,355
Year ending December 31, 2018	8,648
Thereafter	87,892
Total minimum lease payments	$	121,779

Business Combination and Equity Investment (Details) $ in Thousands		9 Months Ended
	Nov. 20, 2013 USD ($)	Sep. 30, 2014 USD ($)	Apr. 30, 2014 USD ($)	Mar. 31, 2014 USD ($)
Pipeline Equity Investment [Member]
Equity Method Investments and Joint Ventures [Abstract]
Equity method investment		$ 2,000	$ 1,000	$ 2,000
Ownership percentage		18.00%		9.00%
Investment commitment				$ 3,000
Number of milestone commitments		2
Shiftwise Acquisition
Business Combination, Description
Total purchase price of the acquisition	$ 39,500
Amount deposited into escrow	6,000
Escrow Deposit Disbursements	$ 2,000
Allocation of Purchase Price
Fair Value of Assets Acquired		$ 9,899
Liabilities Assumed		11,801
Deferred tax liability		2,933
Goodwill		21,612
Intangible assets		$ 19,790
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Weighted average useful life of intangible assets		8 years

Revenue Recognition (Details) - USD ($) $ in Thousands	Sep. 30, 2014	Dec. 31, 2013
Revenue Recognition [Abstract]
Accounts Payable to Subcontractor	$ 23,613	$ 22,051

Net Income Per Common Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Earnings Per Share [Abstract]
Common stock excluded from calculation of EPS	286	296	344	313
Computation of basic and diluted net income per common share
Net income	$ 8,499	$ 8,615	$ 23,322	$ 24,577
Basic (in dollars per share)	$ 0.18	$ 0.19	$ 0.50	$ 0.53
Diluted (in dollars per share)	$ 0.18	$ 0.18	$ 0.49	$ 0.51
Weighted average common shares outstanding - basic	46,546	45,986	46,460	45,947
Plus dilutive effect of potential common shares	1,576	1,824	1,499	1,829
Weighted average common shares outstanding - diluted	48,122	47,810	47,959	47,776

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

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- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

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Segment Information (Details) $ in Thousands	3 Months Ended		9 Months Ended
Segment Information (Details) $ in Thousands	Sep. 30, 2014 USD ($)	Sep. 30, 2013 USD ($)	Sep. 30, 2014 USD ($) segment	Sep. 30, 2013 USD ($)
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Revenue	$ 264,584	$ 257,095	$ 756,378	$ 763,158
Operating Income	15,901	16,745	48,952	49,477
Depreciation and amortization	4,086	3,317	11,916	9,847
Share-based compensation	1,791	1,487	5,361	4,667
Interest expense, net (including loss on debt extinguishment of $3,113 and $434 for the nine months ended September 30, 2014 and 2013, respectively), and other	1,433	1,840	7,908	7,829
Income before income taxes	14,468	14,905	41,044	41,648
Loss on debt extinguishment	3,113	434	$ 3,113	434
Segment Information (Textual) [Abstract]
Reportable business segments \| segment			3
Operating segments [Member]
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Revenue	264,584	257,095	$ 756,378	763,158
Operating Income	32,174	30,144	93,187	87,076
Operating segments [Member] \| Nurse and allied healthcare staffing [Member]
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Revenue	174,292	170,955	503,636	517,858
Operating Income	21,279	20,392	63,283	62,994
Operating segments [Member] \| Locum tenens staffing [Member]
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Revenue	78,816	75,253	219,996	213,417
Operating Income	8,139	7,547	22,830	17,347
Operating segments [Member] \| Physician permanent placement services [Member]
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Revenue	11,476	10,887	32,746	31,883
Operating Income	2,756	2,205	7,074	6,735
Corporate, non-segment [Member]
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Unallocated corporate overhead	$ 10,396	$ 8,595	$ 26,958	$ 23,085

Fair Value Measurement - Financial Assets and Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2014	Dec. 31, 2013
Schedule of financial assets and liabilities measured at fair value on recurring basis
Total financial assets measured at fair value	$ 7,035	$ 18,176
US Treasury securities [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Total financial assets measured at fair value	6,700	17,817
Money Market Funds [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Total financial assets measured at fair value	335	359
Quoted Prices in Active Markets for Identical Assets (Level 1) [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Total financial assets measured at fair value	7,035	18,176
Quoted Prices in Active Markets for Identical Assets (Level 1) [Member] \| US Treasury securities [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Total financial assets measured at fair value	6,700	17,817
Quoted Prices in Active Markets for Identical Assets (Level 1) [Member] \| Money Market Funds [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Total financial assets measured at fair value	$ 335	$ 359

Notes Payable and Related Credit Agreement (Details)		9 Months Ended
Notes Payable and Related Credit Agreement (Details)	Apr. 18, 2014 USD ($) credit_facility	Sep. 30, 2014 USD ($)	Dec. 31, 2013 USD ($)
Line of Credit Facility [Line Items]
Deferred financing fees		$ 3,488,000
Write off of Deferred Debt Issuance Cost		3,113,000
Standby Letters of Credit [Member]
Line of Credit Facility [Line Items]
Letters of Credit Outstanding, Amount		15,190,000	$ 27,691,000
Secured Debt [Member]
Line of Credit Facility [Line Items]
Letters of Credit Outstanding, Amount		7,035,000
Line of Credit [Member]
Line of Credit Facility [Line Items]
Number of credit facilities \| credit_facility	2
Credit facility, available	$ 125,000,000
Line of Credit [Member] \| Letter of Credit [Member]
Line of Credit Facility [Line Items]
Credit facility, available	40,000,000
Line of Credit Facility, Amount Outstanding	9,500,000	0
Letters of Credit Outstanding, Amount		8,155,000
Line of Credit Facility, Remaining Borrowing Capacity		216,845,000
Line of Credit [Member] \| Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Credit facility, available	225,000,000
Line of Credit [Member] \| Term Loan [Member]
Line of Credit Facility [Line Items]
Credit facility, available	$ 150,000,000
Long-term Debt		146,250,000
Long-term Debt, Maturities, Repayments of Principal in Next Twelve Months		$ 7,500,000
Amortization of principal, rate	5.00%
Debt Instrument, Annual Principal Payment	$ 7,500,000
Term loan interest rate		1.90%
Line of Credit [Member] \| Revolving Credit Facility, Swing Line Loan [Member]
Line of Credit Facility [Line Items]
Credit facility, available	$ 20,000,000
Minimum [Member] \| Line of Credit [Member] \| Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Unused fee	0.25%
Letter of Credit Fee	1.50%
Maximum [Member] \| Line of Credit [Member] \| Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Unused fee	0.35%
Letter of Credit Fee	2.25%
London Interbank Offered Rate (LIBOR) [Member] \| Minimum [Member] \| Line of Credit [Member] \| Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Basis spread	1.50%
London Interbank Offered Rate (LIBOR) [Member] \| Minimum [Member] \| Line of Credit [Member] \| Term Loan [Member]
Line of Credit Facility [Line Items]
Basis spread	1.50%
London Interbank Offered Rate (LIBOR) [Member] \| Maximum [Member] \| Line of Credit [Member] \| Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Basis spread	2.25%
London Interbank Offered Rate (LIBOR) [Member] \| Maximum [Member] \| Line of Credit [Member] \| Term Loan [Member]
Line of Credit Facility [Line Items]
Basis spread	2.25%
Base Rate [Member] \| Minimum [Member] \| Line of Credit [Member] \| Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Basis spread	0.50%
Base Rate [Member] \| Minimum [Member] \| Line of Credit [Member] \| Term Loan [Member]
Line of Credit Facility [Line Items]
Basis spread	0.50%
Base Rate [Member] \| Maximum [Member] \| Line of Credit [Member] \| Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Basis spread	1.25%
Base Rate [Member] \| Maximum [Member] \| Line of Credit [Member] \| Term Loan [Member]
Line of Credit Facility [Line Items]
Basis spread	1.25%
Credit Agreement [Member]
Line of Credit Facility [Line Items]
Initial maximum consolidated leverage ratio		4.00
Maximum consolidated leverage ratio beginning June 30, 2016		3.50
Minimum consolidated interest coverage ratio		2.50

Notes Payable and Related Credit Agreement Maturities (Details) - Line of Credit [Member] - Term Loan [Member] $ in Thousands	Sep. 30, 2014 USD ($)
Debt Instrument [Line Items]
Three months ending December 31, 2014	$ 1,875
Year ending December 31, 2015	7,500
Year ending December 31, 2016	7,500
Year ending December 31, 2017	7,500
Year ending December 31, 2018	7,500
Thereafter	114,375
Long-term Debt	$ 146,250

Commitments and Contingencies Commitments and contingencies leases (Details) $ in Thousands	Sep. 30, 2014 USD ($)
Commitments and Contingencies Disclosure [Abstract]
Three months ending December 31, 2014	$ 2,311
Year ending December 31, 2015	6,500
Year ending December 31, 2016	8,073
Year ending December 31, 2017	8,355
Year ending December 31, 2018	8,648
Thereafter	87,892
Total minimum lease payments	$ 121,779