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Document and Entity Information - shares	3 Months Ended
Document and Entity Information - shares	Mar. 31, 2016	May 04, 2016
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	Mar. 31, 2016
Amendment Flag	false
Document Fiscal Year Focus	2016
Document Fiscal Period Focus	Q1
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		48,033,392

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2016	Dec. 31, 2015
Current assets:
Cash and cash equivalents	$ 23,106	$ 9,576
Accounts receivable, net of allowances of $7,791 and $7,691 at March 31, 2016 and December 31, 2015, respectively	302,342	277,996
Accounts receivable, subcontractor	49,858	50,807
Prepaid expenses	16,008	13,526
Other current assets	21,648	23,723
Total current assets	412,962	375,628
Restricted cash and cash equivalents	27,176	27,352
Fixed assets, net of accumulated depreciation of $79,108 and $76,680 at March 31, 2016 and December 31, 2015, respectively	53,731	50,134
Other assets	52,993	47,569
Goodwill	307,161	204,779
Intangible assets, net of accumulated amortization of $58,083 and $53,747 at March 31, 2016 and December 31, 2015, respectively	240,478	174,970
Total assets	1,094,501	880,432
Current liabilities:
Accounts payable and accrued expenses	109,121	118,822
Accrued compensation and benefits	98,049	83,701
Current portion of revolving credit facility	40,000	30,000
Current portion of notes payable	11,250	7,500
Deferred revenue	8,436	5,620
Other current liabilities	23,998	5,374
Total current liabilities	290,854	251,017
Revolving credit facility	127,500	52,500
Notes payable, less unamortized fees	196,746	128,490
Deferred income taxes, net	22,514	22,431
Other long-term liabilities	83,076	78,134
Total liabilities	720,690	532,572
Commitments and contingencies
Stockholders’ equity:
Preferred stock, $0.01 par value; 10,000 shares authorized; none issued and outstanding at March 31, 2016 and December 31, 2015	0	0
Common stock, $0.01 par value; 200,000 shares authorized; 47,998 and 47,709 shares issued and outstanding at March 31, 2016 and December 31, 2015, respectively	480	477
Additional paid-in capital	444,236	443,733
Accumulated deficit	(70,298)	(96,167)
Accumulated other comprehensive loss	(607)	(183)
Total stockholders’ equity	373,811	347,860
Total liabilities and stockholders’ equity	$ 1,094,501	$ 880,432

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2016	Dec. 31, 2015
Statement of Financial Position [Abstract]
Accounts receivable, allowance	$ 7,791	$ 7,691
Accumulated depreciation	79,108	76,680
Accumulated amortization	$ 58,083	$ 53,747
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized	10,000,000	10,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized	200,000,000	200,000,000
Common stock, shares issued	47,998,000	47,709,000
Common stock, shares outstanding	47,998,000	47,709,000

Condensed Consolidated Statements of Comprehensive Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Statement of Comprehensive Income [Abstract]
Revenue	$ 468,002	$ 327,510
Cost of revenue	316,104	226,078
Gross profit	151,898	101,432
Operating expenses:
Selling, general and administrative	97,823	71,552
Depreciation and amortization	6,765	5,095
Total operating expenses	104,588	76,647
Income from operations	47,310	24,785
Interest expense, net, and other	3,249	1,807
Income before income taxes	44,061	22,978
Income tax expense	18,192	10,769
Net income	25,869	12,209
Other Comprehensive Income (Loss), Net of Tax, Portion Attributable to Parent [Abstract]
Foreign currency translation	39	68
Unrealized loss on cash flow hedge, net of income taxes	(463)	0
Other comprehensive income (loss):	(424)	68
Comprehensive income	$ 25,445	$ 12,277
Net income per common share:
Basic (in dollars per share)	$ 0.54	$ 0.26
Diluted (in dollars per share)	$ 0.53	$ 0.25
Weighted average common shares outstanding:
Basic (shares)	47,894	47,146
Diluted (shares)	49,103	48,364

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Cash flows from operating activities:
Net income	$ 25,869	$ 12,209
Adjustments to reconcile net income to net cash provided by operating activities, net of acquisitions:
Depreciation and amortization	6,765	5,095
Non-cash interest expense and other	576	457
Change in fair value of contingent consideration	99	0
Increase in allowances for doubtful accounts and sales credits	2,687	2,192
Provision for deferred income taxes	(1,201)	5,359
Share-based compensation	3,381	2,377
Excess tax benefits from share-based compensation	(2,322)	(5,029)
Loss on disposal or sale of fixed assets	0	(2)
Changes in assets and liabilities, net of effects from acquisitions:
Accounts receivable	(15,219)	(16,443)
Accounts receivable, subcontractor	916	(5,748)
Income taxes receivable	6,006	5,171
Prepaid expenses	(2,469)	(2,742)
Other current assets	(1,477)	(321)
Other assets	(2,471)	(2,150)
Accounts payable and accrued expenses	(10,229)	3,621
Accrued compensation and benefits	9,775	996
Other liabilities	14,079	4,382
Deferred revenue	286	(532)
Restricted cash and cash equivalents balance	176	(205)
Net cash provided by operating activities	35,227	8,687
Cash flows from investing activities:
Purchase and development of fixed assets	(6,618)	(6,370)
Loan to Pipeline Health Holdings LLC	0	(667)
Payments to fund deferred compensation plan	(2,855)	(1,203)
Cash paid for acquisitions, net of cash received	(165,230)	(76,945)
Cash paid for working capital adjustments for prior year acquisition	0	(165)
Net cash used in investing activities	(174,703)	(85,350)
Cash flows from financing activities:
Capital lease repayments	0	(4)
Payments on term loan	(2,813)	(1,875)
Proceeds from term loan	75,000	0
Payments on revolving credit facility	0	(7,000)
Proceeds from revolving credit facility	85,000	84,500
Payment of financing costs	(448)	0
Earn-out payment for prior acquisition	900	0
Proceeds from exercise of equity awards	0	3,199
Cash paid for shares withheld for taxes	(5,194)	(8,694)
Excess tax benefits from share-based compensation	2,322	5,029
Net cash provided by financing activities	152,967	75,155
Effect of exchange rate changes on cash	39	68
Net increase (decrease) in cash and cash equivalents	13,530	(1,440)
Cash and cash equivalents at beginning of period	9,576	13,073
Cash and cash equivalents at end of period	23,106	11,633
Supplemental disclosures of cash flow information:
Cash paid for interest (net of $264 and $43 capitalized for the three months ended March 31, 2016 and 2015, respectively)	2,295	1,330
Cash paid for income taxes	2,418	473
Acquisitions:
Fair value of tangible assets acquired in acquisitions, net of cash received	12,706	25,627
Goodwill	101,531	42,702
Intangible assets	69,844	30,219
Liabilities assumed	(13,139)	(21,603)
Holdback provision	(2,122)	0
Earn-out liabilities	(3,590)	0
Net cash paid for acquisitions	(165,230)	(76,945)
Supplemental disclosures of non-cash investing and financing activities:
Purchase of fixed assets recorded in accounts payable and accrued expenses	$ 2,489	$ 3,607

Condensed Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Statement of Cash Flows [Abstract]
Interest capitalized	$ 264	$ 43

Basis of Presentation	3 Months Ended
Basis of Presentation	Mar. 31, 2016
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, 2015, contained in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2015, filed with the Securities and Exchange Commission on February 24, 2016 (“2015 Annual Report”). 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, earn-out liabilities, and income taxes. Actual results could differ from those estimates under different assumptions or conditions. Recently Adopted Accounting Pronouncements In April 2015, the Financial Accounting Standards Board (“FASB”) issued ASU 2015-05, “Intangibles - Goodwill and Other - Internal-Use Software (Subtopic 350-40), Customer’s Accounting for Fees Paid in a Cloud Computing Arrangement.” This standard provides guidance about whether a cloud computing arrangement includes a software license. If a cloud computing arrangement includes a software license, then the software license element of the arrangement should be accounted for by the customer consistent with the acquisition of other software licenses. If a cloud computing arrangement does not include a software license, the customer should account for the arrangement as a service contract. ASU 2015-05 is effective for fiscal years beginning after December 15, 2015, and interim periods within those years. This standard can be adopted either prospectively to all arrangements entered into or materially modified after the effective date or retrospectively. The Company adopted this pronouncement prospectively beginning January 1, 2016 and the adoption did not have a material effect on the Company’s consolidated financial statements. In September 2015, the FASB issued ASU 2015-16, “Business Combinations - Simplifying the Accounting for Measurement-Period Adjustments.” This standard requires that an acquirer recognize adjustments to provisional amounts that are identified during the measurement period in the reporting period in which the adjustment amounts are determined. The standard requires that the acquirer record, in the same period’s financial statements, the effect on earnings of changes in depreciation, amortization, or other income effects, if any, as a result of the change to the provisional amounts, calculated as if the accounting had been completed at the acquisition date. The standard also requires an entity to present separately on the face of the income statement or disclose in the notes the portion of the amount recorded in current-period earnings by line item that would have been recorded in previous reporting periods if the adjustment to the provisional amounts had been recognized as of the acquisition date. ASU 2015-16 is effective for public business entities for fiscal years beginning after December 15, 2015, and interim periods within those years. The Company adopted this pronouncement prospectively beginning January 1, 2016 and the adoption did not have a material effect on the Company’s consolidated financial statements.

Business Combinations

3 Months Ended

Mar. 31, 2016

Business Combinations [Abstract]

BUSINESS COMBINATIONS

As set forth below, the Company completed five acquisitions from January 1, 2015 through March 31, 2016. The Company accounted for each acquisition using the acquisition method of accounting. Accordingly, it recorded the tangible and intangible assets acquired and liabilities assumed at their estimated fair values as of the applicable date of acquisition. For each acquisition, the Company did not incur any material acquisition-related costs.

HealthSource Global Staffing Acquisition

On January 11, 2016, the Company completed its acquisition of HealthSource Global Staffing (“HSG”), which provides labor disruption and rapid response staffing. The initial purchase price of $9,379 included (1) $2,727 cash consideration paid at acquisition, funded through cash-on-hand, net of cash received, and settlement of the pre-existing relationship between AMN and HSG, (2) $2,122 cash holdback for potential indemnification claims, (3) $940 cash holdback for the income tax payment paid on behalf of the sellers after the acquisition date, and (4) a tiered contingent earn-out payment of up to $4,000 with an estimated fair value of $3,590 as of the acquisition date. The contingent earn-out payment is comprised of (A) up to $2,000 based on the operating results of HSG for the year ending December 31, 2016, and (B) up to $2,000 based on the operating results of HSG for the year ending December 31, 2017. As the acquisition is not considered material, pro forma information is not provided. The results of HSG have been included in the Company’s nurse and allied solutions segment since the date of acquisition.

The preliminary allocation of the $9,379 purchase price consisted of (1) $1,670 of fair value of tangible assets acquired, (2) $5,509 of liabilities assumed, (3) $3,944 of identified intangible assets, and (4) $9,274 of goodwill, none of which is deductible for tax purposes. The intangible assets include the fair value of trademarks, customer relationships, staffing databases, and covenants not to compete with a weighted average useful life of approximately eight years.

B.E. Smith Acquisition

On January 4, 2016, the Company completed its acquisition of B.E. Smith (“BES”), a full-service healthcare interim leadership placement and executive search firm, for $162,232 in cash, net of cash received, and settlement of the pre-existing relationship between AMN and BES. BES places interim leaders and executives across all healthcare settings, including acute care hospitals, academic medical and children’s hospitals, physician practices, and post-acute care providers. The acquisition provides the Company additional access to healthcare executives and enhances its integrated services to hospitals, health systems and other healthcare facilities across the nation. To help finance the acquisition, the Company entered into the First Amendment to the Credit Agreement (the “First Amendment”), which provided $125,000 of additional available borrowings to the Company. The First Amendment is more fully described in Note (7), “Notes Payable and Credit Agreement.” The results of BES have been included in the Company’s other workforce solutions segment since the date of acquisition.

The preliminary allocation of the $162,232 purchase price consisted of (1) $11,704 of fair value of tangible assets acquired, (2) $7,630 of liabilities assumed, (3) $65,900 of identified intangible assets, and (4) $92,258 of goodwill, a portion of which is deductible for tax purposes. The intangible assets acquired have a weighted average useful life of approximately fifteen years. The following table summarizes the fair value and useful life of each intangible asset acquired:



		Fair Value	Useful Life
			(in years)
Identifiable intangible assets
	Tradenames and Trademarks	$26,300	20
	Customer Relationships	25,700	12
	Staffing Database	13,000	10
	Non-Compete Agreements	900	5
		$65,900

Approximately $26,651 of revenue and $3,890 of income before taxes of BES were included in the condensed consolidated statement of comprehensive income for the three months ended March 31, 2016. The following summary presents unaudited pro forma consolidated results of operations of the Company for the three months ended March 31, 2015 as if the BES acquisition had occurred on January 1, 2015, which gives effect to certain adjustments, including the reduction of compensation expense related to non-recurring executive salary expense, acquisition-related costs and the amortization of intangible assets. The pro forma financial information is not necessarily indicative of the operating results that would have occurred had the acquisition been consummated as of the date indicated, nor is it necessarily indicative of our future operating results.



	Three Months Ended March 31, 2015
Revenue	$	346,789
Income from operations	$	25,195
Net income	$	11,677
Net income per common share:
Basic	$	0.25
Diluted	$	0.24

MillicanSolutions Acquisition

On October 5, 2015, the Company acquired MillicanSolutions, Inc. (“Millican”), a physician and executive leadership search firm. The total purchase price of $3,985 included (1) $2,985 cash consideration paid upon acquisition, funded by cash on-hand, (2) $500 to be paid on December 31, 2016, and (3) $500 to be paid on December 31, 2017. The acquisition enhances the Company’s ability to respond to the specialized leadership needs within academic pediatrics and children’s medical centers and expands its expertise in serving academic medical centers and teaching hospitals in physician and leadership search. As the acquisition is not considered material, pro forma information is not provided. The results of operations of Millican have been included in the Company’s other workforce solutions segment since the date of acquisition.

The preliminary allocation of the $3,985 purchase price consisted of (1) $261 of fair value of tangible assets acquired, (2) $287 of liabilities assumed, (3) $645 of identified intangible assets, and (4) $3,366 of goodwill, a portion of which is deductible for tax purposes. The intangible assets include the fair value of tradenames and trademarks, staffing databases, customer relationships, and a covenant not to compete. The weighted average useful life of the acquired intangible assets subject to amortization is approximately five years.

The First String Healthcare Acquisition

On September 15, 2015, the Company completed its acquisition of The First String Healthcare (“TFS”), a leading provider of interim staffing and permanent placement of nurse leaders and executives. The total purchase price of $7,653 included (1) $4,453 cash consideration paid upon acquisition, funded by cash-on-hand, net of cash received, (2) $500 to be paid on the first anniversary of the acquisition date, and (3) a contingent earn-out with a fair value of $2,700 as of the acquisition date. Also, the purchase agreement included an additional $1,000 payment to be paid on the second anniversary of the acquisition date conditioned upon, subject to certain exceptions, continued employment of the selling shareholders, which is being recorded as compensation expense for post-combination services. The acquisition is intended to enhance the Company’s capabilities to provide interim and permanent nursing leadership. As the acquisition is not considered material, pro forma information is not provided. The results of operations of TFS are included in the other workforce solutions segment in the Company’s consolidated financial statements since the date of acquisition.

The acquisition agreement provides for a tiered contingent earn-out payment of up to $4,000, of which (1) $1,000 was paid to the sellers in March 2016 based on the operating results of TFS for the 12-month period ended December 31, 2015, and (2) up to $3,000 may be paid in 2017 based on the operating results of TFS for the 12-month period ending December 31, 2016. The preliminary allocation of the purchase price consisted of (A) $919 of fair value of tangible assets acquired, (B) $867 of liabilities assumed, (C) $3,373 of identified intangible assets, and (D) $4,228 of goodwill, which is deductible for tax purposes. The intangible assets include the fair value of tradenames and trademarks, customer relationships, a staffing database, and covenants not to compete. The weighted average useful life of the acquired intangible assets subject to amortization is approximately seven years.

Onward Healthcare Acquisition

On January 7, 2015, the Company completed its acquisition of Onward Healthcare, including its two wholly-owned subsidiaries, Locum Leaders and Medefis (collectively, “OH”), for approximately $76,643 in cash, funded by cash-on-hand and borrowings under the Company’s revolving credit facility. Onward Healthcare is a national nurse and allied healthcare staffing firm, Locum Leaders is a national locum tenens provider, and Medefis is a provider of a software-as-a-service (“SaaS”)-based vendor management system for healthcare facilities. The acquisition helps the Company to expand its service lines and its supply and placement capabilities of healthcare professionals to its clients. The results of Onward Healthcare are included in the Company’s nurse and allied solutions segment, the results of Locum Leaders are included in the Company’s locum tenens solutions segment, and the results of Medefis are included in the Company’s other workforce solutions segment since the date of acquisition.

The allocation of the $76,643 purchase price consisted of (1) $25,216 of fair value of tangible assets acquired (including $21,313 of accounts receivable), (2) $22,275 of liabilities assumed (including $11,113 of accounts payable and accrued expenses), (3) $30,219 of identified intangible assets, and (4) $43,483 of goodwill, a portion of which is deductible for tax purposes. The intangible assets include the fair value of tradenames and trademarks, customer relationships, staffing database, acquired technologies, and non-compete agreements. The weighted average useful life of the acquired intangible assets is approximately eleven years. The following table summarizes the fair value and useful life of each intangible asset acquired:



		Fair Value		Useful Life
				(in years)
Identifiable intangible assets
	Tradenames and Trademarks	$	8,100	3 - 15
	Customer Relationships	17,600		10 - 15
	Staffing Database	2,600		5
	Acquired Technologies	1,700		8
	Non-Compete Agreements	219		2
		$	30,219

Of the $43,483 allocated to goodwill, $23,032, $5,241 and $15,210 were allocated to the Company’s nurse and allied solutions, locum tenens solutions and other workforce solutions segments, respectively.

- 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).

+ References

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+ Details

Revenue Recognition	3 Months Ended
Revenue Recognition	Mar. 31, 2016
Revenue Recognition [Abstract]
REVENUE RECOGNITION	REVENUE RECOGNITION Revenue consists of fees earned from the temporary and permanent placement of healthcare professionals as well as from the Company’s SaaS-based technology, including its vendor management systems and its scheduling software. Revenue from temporary staffing services is recognized as the services are rendered by the healthcare professional. Under the Company’s managed services program arrangements, the Company manages all or a part of a customer’s supplemental workforce needs utilizing its own pool of healthcare professionals along with those of third-party subcontractors. When the Company uses subcontractors, revenue is recorded net of the related subcontractor’s expense. Payables to subcontractors of $50,225 and $56,177 were included in accounts payable and accrued expenses in the unaudited condensed consolidated balance sheet as of March 31, 2016 and the audited consolidated balance sheet as of December 31, 2015, respectively. Revenue from recruitment and permanent placement services is recognized as the services are provided and upon successful placements. The Company’s SaaS-based revenue is recognized ratably over the applicable arrangement’s service period. Fees billed in advance of being earned are recorded as deferred revenue.

Net Income Per Common Share

3 Months Ended

Mar. 31, 2016

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. The following table sets forth the computation of basic and diluted net income per common share for the three months ended March 31, 2016 and 2015, respectively:



	Three Months Ended March 31,
	2016		2015
Net income	$	25,869	$	12,209

Net income per common share - basic	$	0.54	$	0.26
Net income per common share - diluted	$	0.53	$	0.25

Weighted average common shares outstanding - basic	47,894		47,146
Plus dilutive effect of potential common shares	1,209		1,218
Weighted average common shares outstanding - diluted	49,103		48,364

Share-based awards to purchase 43 and 33 shares of common stock were not included in the above calculation of diluted net income per common share for the three months ended March 31, 2016 and 2015, respectively, because the effect of these instruments was anti-dilutive.

Segment Information

3 Months Ended

Mar. 31, 2016

Segment Reporting [Abstract]

SEGMENT INFORMATION

The Company’s operating segments are identified in the same manner as they are reported internally and used by the Company’s chief operating decision maker for the purpose of evaluating performance and allocating resources. Effective as of January 1, 2016, the Company modified its reportable segments. The Company previously utilized three reportable segments, which it identified as follows: (1) nurse and allied healthcare staffing, (2) locum tenens staffing, and (3) physician permanent placement services. In light of the Company’s acquisitions over the past several years as well as its transition to a healthcare workforce solutions company, the Company’s management renamed the Company’s three reportable segments and also placed several of the Company’s business lines that were in the nurse and allied healthcare staffing segment into a different segment to better reflect how the business is evaluated by the chief operating decision maker. As of January 1, 2016, the Company began to disclose the following three reportable segments: (1) nurse and allied solutions, (2) locum tenens solutions, and (3) other workforce solutions. The nurse and allied solutions segment includes the Company’s travel nurse, allied, and local staffing businesses. The locum tenens solutions segment includes its locum tenens staffing business. The other workforce solutions segment includes its healthcare interim leadership staffing and executive search services business, physician permanent placement services business, recruitment process outsourcing business, vendor management systems business, workforce optimization services business, and its education business.

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

The following table, which includes reclassified prior period data to conform to the new segment reporting structure, provides a reconciliation of revenue and operating income by reportable segment to consolidated results and was derived from each segment’s internal financial information as used for corporate management purposes:



	Three Months Ended March 31,
	2016		2015
Revenue
Nurse and allied solutions	$	297,724	$	216,992
Locum tenens solutions	102,738		86,692
Other workforce solutions	67,540		23,826
	$	468,002	$	327,510
Segment operating income
Nurse and allied solutions	$	41,618	$	27,362
Locum tenens solutions	13,291		9,110
Other workforce solutions	17,586		7,810
	72,495		44,282
Unallocated corporate overhead	15,039		12,025
Depreciation and amortization	6,765		5,095
Share-based compensation	3,381		2,377
Interest expense, net, and other	3,249		1,807
Income before income taxes	$	44,061	$	22,978

The following table summarizes the activity related to the carrying value of goodwill by reportable segment:



	Nurse and Allied Solutions		Locum Tenens Solutions		Other Workforce Solutions		Total
Balance, January 1, 2016	$	95,309	$	19,743	$	89,727	$	204,779
Goodwill from BES acquisition	—		—		92,258		92,258
Goodwill from HSG acquisition	9,274		—		—		9,274
Goodwill adjustment for OH acquisition	850		—		—		850
Balance, March 31, 2016	$	105,433	$	19,743	$	181,985	$	307,161
Accumulated impairment loss as of December 31, 2015 and March 31, 2016	$	154,444	$	53,940	$	6,555	$	214,939

- 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

Derivative Instruments	3 Months Ended
Derivative Instruments	Mar. 31, 2016
Derivative Instruments and Hedging Activities Disclosure [Abstract]
DERIVATIVE INSTRUMENTS	DERIVATIVE INSTRUMENTS In April 2015, the Company entered into an interest rate swap agreement to minimize its exposure to interest rate fluctuations on $100,000 of its outstanding variable rate debt under one of its term loans whereby the Company pays a fixed rate of 0.983% per annum and receives a variable rate equal to floating one-month LIBOR. This agreement expires on March 30, 2018, and no initial investment was made to enter into this agreement. At March 31, 2016, the interest rate swap agreement had a fair value of $(592), which is included in other long-term liabilities in the accompanying unaudited condensed consolidated balance sheet as of March 31, 2016. At December 31, 2015, the interest rate swap agreement had a fair value of $165, which was included in other assets in the audited consolidated balance sheet as of December 31, 2015. The Company has formally documented the hedging relationship and accounts for this arrangement as a cash flow hedge. The Company recognizes all derivatives on the balance sheet at fair value based on quotes from an independent pricing service. Gains or losses resulting from changes in the values of the arrangement are recorded in other comprehensive income (loss), net of tax, until the hedged item is recognized in earnings. The Company also formally assesses, both at the hedge’s inception and on an ongoing basis, whether the derivative instrument that is used in the hedging transaction is highly effective in offsetting changes in fair values or cash flows of the hedged item. When it is determined that a derivative instrument is not highly effective as a hedge or that it has ceased to be a highly effective hedge, the Company discontinues hedge accounting prospectively and recognizes subsequent changes in market value in earnings.

- Definition

The entire disclosure for derivative instruments and hedging activities including, but not limited to, risk management strategies, non-hedging derivative instruments, assets, liabilities, revenue and expenses, and methodologies and assumptions used in determining the amounts.

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+ Details

Notes Payable and Credit Agreement	3 Months Ended
Notes Payable and Credit Agreement	Mar. 31, 2016
Debt Disclosure [Abstract]
NOTES PAYABLE AND CREDIT AGREEMENT	NOTES PAYABLE AND 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 to replace its prior credit facilities, including (1) 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 (2) a $150,000 secured term loan credit facility (the “Term Loan”). On January 4, 2016, the Company entered into the First Amendment (together with the Credit Agreement, the “Amended Credit Agreement”) with several lenders to provide for, among other things, (A) a $50,000 increase to the Revolver to $275,000, and (B) an additional $75,000 secured term loan (the “Additional Term Loan”). Additionally, the Amended Credit Agreement no longer requires the Company to make mandatory prepayments under any of the credit facilities provided thereunder with the proceeds of extraordinary receipts and excess cash flow. The Amended 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 Amended Credit Agreement are secured by substantially all of the assets of the Company and the common stock or equity interests of its domestic subsidiaries. The payment obligations under the Amended Credit Agreement may be accelerated upon the occurrence of defined events of default. The Company used the proceeds from the Additional Term Loan, together with a drawdown of a portion of the Revolver, to complete its acquisition of BES, as more fully described in Note (2), “Business Combinations.” The Additional Term Loan is subject to amortization of principal of 5.00% per year of the original Additional Term Loan amount, payable in equal quarterly installments. The maturity date of the Additional Term Loan is January 4, 2021. The Amended Credit Agreement contains various customary affirmative and negative covenants, including restrictions on incurrence of additional indebtedness, declaration and payment of dividends, dispositions of assets, consolidation into another entity, and allowable investments. Additionally, there are financial covenants based on the Company’s consolidated leverage ratio and interest coverage ratio as calculated in accordance with the Amended Credit Agreement. In connection with the First Amendment, the Company incurred $632 in fees paid to lenders and other third parties, of which $448 was capitalized and amortized to interest expense over the remaining term of the Amended Credit Agreement and the remaining amount was recorded as interest expense during the three months ended March 31, 2016.

Fair Value Measurement

3 Months Ended

Mar. 31, 2016

Fair Value Disclosures [Abstract]

FAIR VALUE MEASUREMENT

The Company’s valuation techniques and inputs used to measure fair value and the definition of the three levels (Level 1, Level 2 and Level 3) of the fair value hierarchy are disclosed in Part II, Item 8, “Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note 4—Fair Value Measurement” of the 2015 Annual Report. The Company has not changed the valuation techniques or inputs it uses for its fair value measurement during the three months ended March 31, 2016.

Assets and Liabilities Measured on a Recurring Basis

The Company’s restricted cash equivalents that serve as collateral for the Company’s outstanding letters of credit

typically consist of money market funds that are measured at fair value based on quoted prices, which are Level 1 inputs.

The Company’s interest rate swap is measured at fair value using a discounted cash flow analysis that includes the contractual terms, including the period to maturity, and Level 2 observable market-based inputs, including interest rate curves. The fair value of the swap is determined by netting the discounted future fixed cash receipts payments and the discounted expected variable cash receipts. The variable cash receipts are based on an expectation of future interest rates (forward curves) derived from observable market interest rate yield curves. The valuation also considers credit risk adjustments that are necessary to reflect the probability of default by the counterparty or the Company, which are considered Level 3 inputs; however, as of March 31, 2016, the credit risk adjustments, including nonperformance risk, were considered insignificant to the total fair value of the interest rate swap.

The Company’s contingent consideration liabilities are measured at fair value using probability-weighted discounted cash flow analysis for the acquired companies, which are Level 3 inputs.

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 March 31, 2016
	Total			Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)			Significant Unobservable Inputs (Level 3)
Money market funds	$	5,627		$	5,627	$	—		$	—
Interest rate swap liability	(592		)	—		(592		)	—
Acquisition contingent consideration earn-out liabilities	(6,459		)	—		—			(6,459		)



	Fair Value Measurements as of December 31, 2015
	Total			Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
Money market funds	$	5,627		$	5,627	$	—	$	—
Interest rate swap asset	165			—		165		—
Acquisition contingent consideration earn-out liabilities	(3,770		)	—		—		(3,770		)

Level 3 Information

The following table sets forth reconciliations of changes in the fair value of contingent consideration liabilities classified as Level 3 in the fair value hierarchy:



	Three Months Ended March 31,
	2016			2015
Balance as of January 1,	$	(3,770	)	$	(1,400	)
Settlement of TFS earn-out for year ended 12/31/15	1,000			—
Additional contingent consideration earn-out liability from HSG acquisition on 1/11/16	(3,590		)	—
Change in fair value of contingent consideration earn-out liability from Avantas acquisition	660			—
Change in fair value of contingent consideration earn-out liability from TFS acquisition	(697		)	—
Change in fair value of contingent consideration earn-out liability from HSG acquisition	(62		)	—
Balance as of March 31,	$	(6,459	)	$	(1,400	)

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.

The Company evaluates goodwill and indefinite-lived intangible assets annually for impairment and whenever circumstances occur indicating that goodwill might be impaired. The Company determines the fair value of its reporting units based on a combination of inputs including the market capitalization of the Company as well as Level 3 inputs such as discounted cash flows, which are not observable from the market, directly or indirectly. The Company determines the fair value of its indefinite-lived intangible assets using the income approach (relief-from-royalty method) based on Level 3 inputs.

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 three months ended March 31, 2016 and 2015.

Fair Value of Financial Instruments

The carrying amount of the Company’s notes payable and revolving credit facility approximate their fair value as the instruments’ 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.

+ References + Details

Income Taxes	3 Months Ended
Income Taxes	Mar. 31, 2016
Income Tax Disclosure [Abstract]
INCOME TAXES	INCOME TAXES The Company is subject to taxation in the U.S. and various states and foreign jurisdictions. With few exceptions, as of March 31, 2016, the Company is no longer subject to state, local or foreign examinations by tax authorities for years before 2006, and the Company is no longer subject to U.S. federal income or payroll tax examinations for years before 2011. The Company’s tax years 2007, 2008, 2009 and 2010 had been under audit by the Internal Revenue Service (“IRS”) for several years and in 2014, the IRS issued the Company its Revenue Agent Report (“RAR”) and an Employment Tax Examination Report (“ETER”). The RAR proposed adjustments to the Company’s taxable income for 2007-2010 and net operating loss carryforwards from 2005-2006, resulting from the proposed disallowance of certain per diems paid to the Company’s healthcare professionals, and the ETER proposed assessments for additional payroll tax liabilities and penalties for 2009 and 2010 related to the Company’s treatment of certain non-taxable per diem allowances and travel benefits. The positions in the RAR and ETER were mutually exclusive, and contained multiple tax positions, some of which were contrary to each other. The Company filed a Protest Letter for both the RAR and ETER positions in 2014 and the Company received a final determination from the IRS in July 2015 on both the RAR adjustments and ETER assessments, effectively settling these audits with the IRS for $7,200 (including interest) during the third quarter of 2015. As a result of the settlement, the Company recorded federal income tax benefits of approximately $12,200 during the quarter ended September 30, 2015 and expects to record the state income tax benefits of approximately $1,500 by fiscal year 2019, when the various state statutes are projected to lapse. The IRS has been conducting a separate audit of the Company’s 2011 and 2012 tax years that is focused on income and employment tax issues similar to those raised in the 2007 through 2010 examination. During the quarter ended March 31, 2015, the IRS completed its 2011 and 2012 examination and issued its RAR and ETER to the Company with proposed adjustments to the Company’s taxable income for 2011 and 2012 and net operating loss carryforwards from 2010 and assessments for additional payroll tax liabilities and penalties for 2011 and 2012 related to the Company’s treatment of certain non-taxable per diem allowances and travel benefits. The positions in the RAR and ETER for the 2011 and 2012 years are mutually exclusive and contain multiple tax positions, some of which are contrary to each other. The Company filed a Protest Letter for both the RAR and ETER in April 2015 and expects the 2011 and 2012 years to be at IRS Appeals in 2016. The IRS began an audit of the Company’s 2013 tax year in the quarter ended June 30, 2015. The Company believes its reserves are adequate with respect to all open years.

Commitments and Contingencies: Legal	3 Months Ended
Commitments and Contingencies: Legal	Mar. 31, 2016
Commitments and Contingencies Disclosure [Abstract]
COMMITMENTS AND CONTINGENCIES: LEGAL	COMMITMENTS AND CONTINGENCIES: LEGAL From time to time, the Company is involved in various lawsuits, claims, investigations, and proceedings that arise in the ordinary course of business. Additionally, some of its 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 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. With regards to outstanding loss contingencies as of March 31, 2016, the Company believes that such matters will not, either individually or in the aggregate, have a material adverse effect on its business, consolidated financial position, results of operations or cash flows.

Balance Sheet Details

3 Months Ended

Mar. 31, 2016

Balance Sheet Related Disclosures [Abstract]

BALANCE SHEET DETAILS

The consolidated balance sheets detail is as follows as of March 31, 2016 and December 31, 2015:



	March 31, 2016			December 31, 2015
Other current assets:
Restricted cash	$	11,577		$	11,995
Income taxes receivable	—			3,687
Other	10,071			8,041
Other current assets	$	21,648		$	23,723

Fixed assets:
Furniture and equipment	$	25,345		$	23,380
Software	101,895			97,962
Leasehold improvements	5,599			5,472
	132,839			126,814
Accumulated depreciation and amortization	(79,108		)	(76,680		)
Fixed assets, net	$	53,731		$	50,134

Accounts payable and accrued expenses:
Trade accounts payable	$	47,419		$	53,261
Subcontractor payable	50,225			56,177
Professional liability reserve	8,075			7,962
Overdraft	2,191			124
Other	1,211			1,298
Accounts payable and accrued expenses	$	109,121		$	118,822

Accrued compensation and benefits:
Accrued payroll	$	42,602		$	21,058
Accrued bonuses	14,213			24,476
Accrued travel expense	2,969			2,740
Accrued health insurance reserve	3,299			3,225
Accrued workers compensation reserve	8,242			7,701
Deferred compensation	25,933			23,044
Other	791			1,457
Accrued compensation and benefits	$	98,049		$	83,701

Other current liabilities:
Income taxes payable	$	13,269		$	—
Earn-out liabilities	4,712			1,660
Holdback liabilities	2,297			825
Other	3,720			2,889
Other current liabilities	$	23,998		$	5,374

Other long-term liabilities:
Workers’ compensation reserve	$	18,140		$	16,899
Professional liability reserve	40,168			37,369
Deferred rent	12,050			11,826
Unrecognized tax benefits	8,166			8,081
Other	4,552			3,959
Other long-term liabilities	$	83,076		$	78,134

Basis of Presentation (Policies)	3 Months Ended
Basis of Presentation (Policies)	Mar. 31, 2016
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, earn-out liabilities, and income taxes. Actual results could differ from those estimates under different assumptions or conditions.
Recently Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements In April 2015, the Financial Accounting Standards Board (“FASB”) issued ASU 2015-05, “Intangibles - Goodwill and Other - Internal-Use Software (Subtopic 350-40), Customer’s Accounting for Fees Paid in a Cloud Computing Arrangement.” This standard provides guidance about whether a cloud computing arrangement includes a software license. If a cloud computing arrangement includes a software license, then the software license element of the arrangement should be accounted for by the customer consistent with the acquisition of other software licenses. If a cloud computing arrangement does not include a software license, the customer should account for the arrangement as a service contract. ASU 2015-05 is effective for fiscal years beginning after December 15, 2015, and interim periods within those years. This standard can be adopted either prospectively to all arrangements entered into or materially modified after the effective date or retrospectively. The Company adopted this pronouncement prospectively beginning January 1, 2016 and the adoption did not have a material effect on the Company’s consolidated financial statements. In September 2015, the FASB issued ASU 2015-16, “Business Combinations - Simplifying the Accounting for Measurement-Period Adjustments.” This standard requires that an acquirer recognize adjustments to provisional amounts that are identified during the measurement period in the reporting period in which the adjustment amounts are determined. The standard requires that the acquirer record, in the same period’s financial statements, the effect on earnings of changes in depreciation, amortization, or other income effects, if any, as a result of the change to the provisional amounts, calculated as if the accounting had been completed at the acquisition date. The standard also requires an entity to present separately on the face of the income statement or disclose in the notes the portion of the amount recorded in current-period earnings by line item that would have been recorded in previous reporting periods if the adjustment to the provisional amounts had been recognized as of the acquisition date. ASU 2015-16 is effective for public business entities for fiscal years beginning after December 15, 2015, and interim periods within those years. The Company adopted this pronouncement prospectively beginning January 1, 2016 and the adoption did not have a material effect on the Company’s consolidated financial statements.
Revenue Recognition	Revenue consists of fees earned from the temporary and permanent placement of healthcare professionals as well as from the Company’s SaaS-based technology, including its vendor management systems and its scheduling software. Revenue from temporary staffing services is recognized as the services are rendered by the healthcare professional. Under the Company’s managed services program arrangements, the Company manages all or a part of a customer’s supplemental workforce needs utilizing its own pool of healthcare professionals along with those of third-party subcontractors. When the Company uses subcontractors, revenue is recorded net of the related subcontractor’s expense.
Net Income per Common Share	Basic net income per common share is calculated by dividing net income by the weighted average number of common shares outstanding during the reporting period.
Segment Information	The Company’s chief operating decision maker relies on internal management reporting processes that provide revenue and operating income by reportable segment for making financial decisions and allocating resources. Segment operating income represents income before income taxes plus depreciation, amortization of intangible assets, share-based compensation, interest expense (net) and other, and unallocated corporate overhead. The Company’s management does not evaluate, manage or measure performance of segments using asset information; accordingly, asset information by segment is not prepared or disclosed.
Derivative Instruments	The Company recognizes all derivatives on the balance sheet at fair value based on quotes from an independent pricing service. Gains or losses resulting from changes in the values of the arrangement are recorded in other comprehensive income (loss), net of tax, until the hedged item is recognized in earnings. The Company also formally assesses, both at the hedge’s inception and on an ongoing basis, whether the derivative instrument that is used in the hedging transaction is highly effective in offsetting changes in fair values or cash flows of the hedged item. When it is determined that a derivative instrument is not highly effective as a hedge or that it has ceased to be a highly effective hedge, the Company discontinues hedge accounting prospectively and recognizes subsequent changes in market value in earnings.
Fair Value of Financial Instruments	Assets and Liabilities Measured on a Recurring Basis The Company’s restricted cash equivalents that serve as collateral for the Company’s outstanding letters of credit typically consist of money market funds that are measured at fair value based on quoted prices, which are Level 1 inputs. The Company’s interest rate swap is measured at fair value using a discounted cash flow analysis that includes the contractual terms, including the period to maturity, and Level 2 observable market-based inputs, including interest rate curves. The fair value of the swap is determined by netting the discounted future fixed cash receipts payments and the discounted expected variable cash receipts. The variable cash receipts are based on an expectation of future interest rates (forward curves) derived from observable market interest rate yield curves. The valuation also considers credit risk adjustments that are necessary to reflect the probability of default by the counterparty or the Company, which are considered Level 3 inputs Fair Value of Financial Instruments The carrying amount of the Company’s notes payable and revolving credit facility approximate their fair value as the instruments’ 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. The Company evaluates goodwill and indefinite-lived intangible assets annually for impairment and whenever circumstances occur indicating that goodwill might be impaired. The Company determines the fair value of its reporting units based on a combination of inputs including the market capitalization of the Company as well as Level 3 inputs such as discounted cash flows, which are not observable from the market, directly or indirectly. The Company determines the fair value of its indefinite-lived intangible assets using the income approach (relief-from-royalty method) based on Level 3 inputs.

Business Combinations (Tables)

3 Months Ended

Mar. 31, 2016

Business Combinations [Abstract]

Summary of Fair Value and Useful Life of Each Intangible Asset Acquired

The following table summarizes the fair value and useful life of each intangible asset acquired:



		Fair Value		Useful Life
				(in years)
Identifiable intangible assets
	Tradenames and Trademarks	$	8,100	3 - 15
	Customer Relationships	17,600		10 - 15
	Staffing Database	2,600		5
	Acquired Technologies	1,700		8
	Non-Compete Agreements	219		2
		$	30,219

The following table summarizes the fair value and useful life of each intangible asset acquired:



		Fair Value	Useful Life
			(in years)
Identifiable intangible assets
	Tradenames and Trademarks	$26,300	20
	Customer Relationships	25,700	12
	Staffing Database	13,000	10
	Non-Compete Agreements	900	5
		$65,900

Business Acquisition, Pro Forma Information

The following summary presents unaudited pro forma consolidated results of operations of the Company for the three months ended March 31, 2015 as if the BES acquisition had occurred on January 1, 2015, which gives effect to certain adjustments, including the reduction of compensation expense related to non-recurring executive salary expense, acquisition-related costs and the amortization of intangible assets. The pro forma financial information is not necessarily indicative of the operating results that would have occurred had the acquisition been consummated as of the date indicated, nor is it necessarily indicative of our future operating results.



	Three Months Ended March 31, 2015
Revenue	$	346,789
Income from operations	$	25,195
Net income	$	11,677
Net income per common share:
Basic	$	0.25
Diluted	$	0.24

Net Income Per Common Share (Tables)

3 Months Ended

Mar. 31, 2016

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 months ended March 31, 2016 and 2015, respectively:



	Three Months Ended March 31,
	2016		2015
Net income	$	25,869	$	12,209

Net income per common share - basic	$	0.54	$	0.26
Net income per common share - diluted	$	0.53	$	0.25

Weighted average common shares outstanding - basic	47,894		47,146
Plus dilutive effect of potential common shares	1,209		1,218
Weighted average common shares outstanding - diluted	49,103		48,364

Segment Information (Tables)

3 Months Ended

Mar. 31, 2016

Segment Reporting [Abstract]

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



	Three Months Ended March 31,
	2016		2015
Revenue
Nurse and allied solutions	$	297,724	$	216,992
Locum tenens solutions	102,738		86,692
Other workforce solutions	67,540		23,826
	$	468,002	$	327,510
Segment operating income
Nurse and allied solutions	$	41,618	$	27,362
Locum tenens solutions	13,291		9,110
Other workforce solutions	17,586		7,810
	72,495		44,282
Unallocated corporate overhead	15,039		12,025
Depreciation and amortization	6,765		5,095
Share-based compensation	3,381		2,377
Interest expense, net, and other	3,249		1,807
Income before income taxes	$	44,061	$	22,978

Schedule of goodwill

The following table summarizes the activity related to the carrying value of goodwill by reportable segment:



	Nurse and Allied Solutions		Locum Tenens Solutions		Other Workforce Solutions		Total
Balance, January 1, 2016	$	95,309	$	19,743	$	89,727	$	204,779
Goodwill from BES acquisition	—		—		92,258		92,258
Goodwill from HSG acquisition	9,274		—		—		9,274
Goodwill adjustment for OH acquisition	850		—		—		850
Balance, March 31, 2016	$	105,433	$	19,743	$	181,985	$	307,161
Accumulated impairment loss as of December 31, 2015 and March 31, 2016	$	154,444	$	53,940	$	6,555	$	214,939

Fair Value Measurement (Tables)

3 Months Ended

Mar. 31, 2016

Fair Value Disclosures [Abstract]

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

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 March 31, 2016
	Total			Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)			Significant Unobservable Inputs (Level 3)
Money market funds	$	5,627		$	5,627	$	—		$	—
Interest rate swap liability	(592		)	—		(592		)	—
Acquisition contingent consideration earn-out liabilities	(6,459		)	—		—			(6,459		)



	Fair Value Measurements as of December 31, 2015
	Total			Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
Money market funds	$	5,627		$	5,627	$	—	$	—
Interest rate swap asset	165			—		165		—
Acquisition contingent consideration earn-out liabilities	(3,770		)	—		—		(3,770		)

Reconciliations of changes in the fair value of contingent consideration liabilities

The following table sets forth reconciliations of changes in the fair value of contingent consideration liabilities classified as Level 3 in the fair value hierarchy:



	Three Months Ended March 31,
	2016			2015
Balance as of January 1,	$	(3,770	)	$	(1,400	)
Settlement of TFS earn-out for year ended 12/31/15	1,000			—
Additional contingent consideration earn-out liability from HSG acquisition on 1/11/16	(3,590		)	—
Change in fair value of contingent consideration earn-out liability from Avantas acquisition	660			—
Change in fair value of contingent consideration earn-out liability from TFS acquisition	(697		)	—
Change in fair value of contingent consideration earn-out liability from HSG acquisition	(62		)	—
Balance as of March 31,	$	(6,459	)	$	(1,400	)

Balance Sheet Details (Tables)

3 Months Ended

Mar. 31, 2016

Balance Sheet Related Disclosures [Abstract]

Schedule of Supplemental Balance Sheet Disclosures

The consolidated balance sheets detail is as follows as of March 31, 2016 and December 31, 2015:



	March 31, 2016			December 31, 2015
Other current assets:
Restricted cash	$	11,577		$	11,995
Income taxes receivable	—			3,687
Other	10,071			8,041
Other current assets	$	21,648		$	23,723

Fixed assets:
Furniture and equipment	$	25,345		$	23,380
Software	101,895			97,962
Leasehold improvements	5,599			5,472
	132,839			126,814
Accumulated depreciation and amortization	(79,108		)	(76,680		)
Fixed assets, net	$	53,731		$	50,134

Accounts payable and accrued expenses:
Trade accounts payable	$	47,419		$	53,261
Subcontractor payable	50,225			56,177
Professional liability reserve	8,075			7,962
Overdraft	2,191			124
Other	1,211			1,298
Accounts payable and accrued expenses	$	109,121		$	118,822

Accrued compensation and benefits:
Accrued payroll	$	42,602		$	21,058
Accrued bonuses	14,213			24,476
Accrued travel expense	2,969			2,740
Accrued health insurance reserve	3,299			3,225
Accrued workers compensation reserve	8,242			7,701
Deferred compensation	25,933			23,044
Other	791			1,457
Accrued compensation and benefits	$	98,049		$	83,701

Other current liabilities:
Income taxes payable	$	13,269		$	—
Earn-out liabilities	4,712			1,660
Holdback liabilities	2,297			825
Other	3,720			2,889
Other current liabilities	$	23,998		$	5,374

Other long-term liabilities:
Workers’ compensation reserve	$	18,140		$	16,899
Professional liability reserve	40,168			37,369
Deferred rent	12,050			11,826
Unrecognized tax benefits	8,166			8,081
Other	4,552			3,959
Other long-term liabilities	$	83,076		$	78,134

Business Combinations (Details)										3 Months Ended	15 Months Ended
Business Combinations (Details)	Dec. 31, 2017 USD ($)	Sep. 15, 2017 USD ($)	Dec. 31, 2016 USD ($)	Sep. 15, 2016 USD ($)	Jan. 11, 2016 USD ($)	Jan. 04, 2016 USD ($)	Oct. 05, 2015 USD ($)	Sep. 15, 2015 USD ($)	Jan. 07, 2015 USD ($) subsidiary	Mar. 31, 2015 USD ($) $ / shares	Mar. 31, 2016 USD ($) aquisition	Dec. 31, 2015 USD ($)
Business Acquisition [Line Items]
Number of acquisitions \| aquisition											5
Allocation of Purchase Price
Goodwill											$ 307,161,000	$ 204,779,000
Nurse and allied healthcare staffing [Member]
Allocation of Purchase Price
Goodwill											105,433,000	95,309,000
Locum tenens staffing [Member]
Allocation of Purchase Price
Goodwill											19,743,000	19,743,000
Other workforce solutions [Member]
Allocation of Purchase Price
Goodwill											181,985,000	$ 89,727,000
Line of Credit [Member]
Business Combination, Description
Maximum borrowing capacity						$ 125,000,000
HSG [Member]
Business Combination, Description
Total purchase price of the acquisition					$ 9,379,000
Cash consideration					2,727,000
Cash holdback for potential claims					2,122,000
Cash holdback for income taxes payable on behalf of seller					940,000
Fair value of contingent earn-out					3,590,000
Contingent earn-out based on future operating performance					4,000,000
Allocation of Purchase Price
Fair value of assets acquired					1,670,000
Liabilities assumed					5,509,000
Identified intangible assets					3,944,000
Goodwill					$ 9,274,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Weighted average useful life of intangible assets					8 years
HSG [Member] \| Earn-Out Payment, Based on HSG Operating Results for 2016 [Member]
Business Combination, Description
Contingent earn-out based on future operating performance					$ 2,000,000
HSG [Member] \| Earn-Out Payment, Based on HSG Operating Results for 2017 [Member]
Business Combination, Description
Contingent earn-out based on future operating performance					$ 2,000,000
BES [Member]
Business Combination, Description
Cash consideration						162,232,000
Allocation of Purchase Price
Fair value of assets acquired						11,704,000
Liabilities assumed						7,630,000
Identified intangible assets						65,900,000
Goodwill						$ 92,258,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Weighted average useful life of intangible assets						15 years
Business Acquisition, Pro Forma Information [Abstract]
Actual acquiree revenue since date of acquisition										$ 26,651,000
Actual acquiree income before income taxes since date of acquisition										3,890,000
Pro forma revenue										346,789,000
Pro forma income from operations										25,195,000
Pro forma net income										$ 11,677,000
Net income per common share, basic (in dollars per share) \| $ / shares										$ 0.25
Net income per common share, diluted (in dollars per share) \| $ / shares										$ 0.24
BES [Member] \| Tradenames and trademarks [Member]
Allocation of Purchase Price
Identified intangible assets						$ 26,300,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life						20 years
BES [Member] \| Customer relationships [Member]
Allocation of Purchase Price
Identified intangible assets						$ 25,700,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life						12 years
BES [Member] \| Staffing database [Member]
Allocation of Purchase Price
Identified intangible assets						$ 13,000,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life						10 years
BES [Member] \| Noncompete agreements [Member]
Allocation of Purchase Price
Identified intangible assets						$ 900,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life						5 years
Millican Solutions, Inc. [Member]
Business Combination, Description
Total purchase price of the acquisition							$ 3,985,000
Cash consideration							2,985,000
Allocation of Purchase Price
Fair value of assets acquired							261,000
Liabilities assumed							287,000
Identified intangible assets							645,000
Goodwill							$ 3,366,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Weighted average useful life of intangible assets							5 years
Millican Solutions, Inc. [Member] \| Scenario, Forecast [Member]
Business Combination, Description
Cash consideration	$ 500,000		$ 500,000
TFS [Member]
Business Combination, Description
Total purchase price of the acquisition								$ 7,653,000
Cash consideration								4,453,000
Fair value of contingent earn-out								2,700,000
Contingent earn-out based on future operating performance								4,000,000
Allocation of Purchase Price
Fair value of assets acquired								919,000
Liabilities assumed								867,000
Identified intangible assets								3,373,000
Goodwill								$ 4,228,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Weighted average useful life of intangible assets								7 years
TFS [Member] \| Scenario, Forecast [Member]
Business Combination, Description
Cash consideration				$ 500,000
Contingent earn-out future payments		$ 1,000,000
TFS [Member] \| Earn-Out Payment, Based on HSG Operating Results for 2016 [Member]
Business Combination, Description
Contingent earn-out based on future operating performance											$ 1,000,000
TFS [Member] \| Earn-Out Payment, Based on HSG Operating Results for 2017 [Member] \| Scenario, Forecast [Member]
Business Combination, Description
Contingent earn-out based on future operating performance	$ 3,000,000
Onward Healthcare Acquisition [Member]
Business Combination, Description
Cash consideration									$ 76,643,000
Number of subsidiaries acquired with parent \| subsidiary									2
Allocation of Purchase Price
Fair value of assets acquired									$ 25,216,000
Liabilities assumed									22,275,000
Identified intangible assets									30,219,000
Goodwill									43,483,000
Accounts receivable acquired									21,313,000
Accounts payable assumed									$ 11,113,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Weighted average useful life of intangible assets									11 years
Onward Healthcare Acquisition [Member] \| Nurse and allied healthcare staffing [Member]
Allocation of Purchase Price
Goodwill									$ 23,032,000
Onward Healthcare Acquisition [Member] \| Locum tenens staffing [Member]
Allocation of Purchase Price
Goodwill									5,241,000
Onward Healthcare Acquisition [Member] \| Other workforce solutions [Member]
Allocation of Purchase Price
Goodwill									15,210,000
Onward Healthcare Acquisition [Member] \| Tradenames and trademarks [Member]
Allocation of Purchase Price
Identified intangible assets									8,100,000
Onward Healthcare Acquisition [Member] \| Customer relationships [Member]
Allocation of Purchase Price
Identified intangible assets									17,600,000
Onward Healthcare Acquisition [Member] \| Staffing database [Member]
Allocation of Purchase Price
Identified intangible assets									$ 2,600,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life									5 years
Onward Healthcare Acquisition [Member] \| Technologies [Member]
Allocation of Purchase Price
Identified intangible assets									$ 1,700,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life									8 years
Onward Healthcare Acquisition [Member] \| Noncompete agreements [Member]
Allocation of Purchase Price
Identified intangible assets									$ 219,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life									2 years
Onward Healthcare Acquisition [Member] \| Minimum [Member] \| Tradenames and trademarks [Member]
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life									3 years
Onward Healthcare Acquisition [Member] \| Minimum [Member] \| Customer relationships [Member]
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life									10 years
Onward Healthcare Acquisition [Member] \| Maximum [Member] \| Tradenames and trademarks [Member]
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life									15 years
Onward Healthcare Acquisition [Member] \| Maximum [Member] \| Customer relationships [Member]
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Useful life									15 years

Revenue Recognition (Details) - USD ($) $ in Thousands	Mar. 31, 2016	Dec. 31, 2015
Revenue Recognition [Abstract]
Payables to subcontractor	$ 50,225	$ 56,177

Net Income Per Common Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Computation of basic and diluted net income per common share
Net income	$ 25,869	$ 12,209
Net income per common share - basic (in dollars per share)	$ 0.54	$ 0.26
Net income per common share - diluted (in dollars per share)	$ 0.53	$ 0.25
Weighted average common shares outstanding - basic	47,894	47,146
Plus dilutive effect of potential common shares	1,209	1,218
Weighted average common shares outstanding - diluted	49,103	48,364
Common stock excluded from calculation of EPS	43	33

Segment Information (Details) $ in Thousands	3 Months Ended
Segment Information (Details) $ in Thousands	Mar. 31, 2016 USD ($) segment	Mar. 31, 2015 USD ($)
Segment Reporting [Abstract]
Reportable business segments \| segment	3
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Revenue	$ 468,002	$ 327,510
Operating Income	47,310	24,785
Depreciation and amortization	6,765	5,095
Share-based compensation	3,381	2,377
Interest expense, net, and other	3,249	1,807
Income before income taxes	44,061	22,978
Operating segments [Member]
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Revenue	468,002	327,510
Operating Income	72,495	44,282
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	297,724	216,992
Operating Income	41,618	27,362
Operating segments [Member] \| Locum tenens staffing [Member]
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Revenue	102,738	86,692
Operating Income	13,291	9,110
Operating segments [Member] \| Other workforce solutions [Member]
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Revenue	67,540	23,826
Operating Income	17,586	7,810
Corporate, non-segment [Member]
Schedule of reconciliation of revenue and segment operating income by reportable segment to consolidated results
Unallocated corporate overhead	$ 15,039	$ 12,025

Segment Information - Goodwill (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Dec. 31, 2015
Goodwill [Roll Forward]
Beginning balance	$ 204,779
Goodwill adjustment for OH acquisition	850
Ending balance	307,161
Accumulated impairment loss	214,939	$ 214,939
Nurse and allied healthcare staffing [Member]
Goodwill [Roll Forward]
Beginning balance	95,309
Goodwill adjustment for OH acquisition	850
Ending balance	105,433
Accumulated impairment loss	154,444	154,444
Locum tenens staffing [Member]
Goodwill [Roll Forward]
Beginning balance	19,743
Goodwill adjustment for OH acquisition	0
Ending balance	19,743
Accumulated impairment loss	53,940	53,940
Other workforce solutions [Member]
Goodwill [Roll Forward]
Beginning balance	89,727
Goodwill adjustment for OH acquisition	0
Ending balance	181,985
Accumulated impairment loss	6,555	$ 6,555
BES [Member]
Goodwill [Roll Forward]
Goodwill from acquisition	92,258
BES [Member] \| Nurse and allied healthcare staffing [Member]
Goodwill [Roll Forward]
Goodwill from acquisition	0
BES [Member] \| Locum tenens staffing [Member]
Goodwill [Roll Forward]
Goodwill from acquisition	0
BES [Member] \| Other workforce solutions [Member]
Goodwill [Roll Forward]
Goodwill from acquisition	92,258
HSG [Member]
Goodwill [Roll Forward]
Goodwill from acquisition	9,274
HSG [Member] \| Nurse and allied healthcare staffing [Member]
Goodwill [Roll Forward]
Goodwill from acquisition	9,274
HSG [Member] \| Locum tenens staffing [Member]
Goodwill [Roll Forward]
Goodwill from acquisition	0
HSG [Member] \| Other workforce solutions [Member]
Goodwill [Roll Forward]
Goodwill from acquisition	$ 0

Derivative Instruments (Details) - Interest Rate Swap [Member] - Designated as Hedging Instrument [Member] - USD ($)	Mar. 31, 2016	Dec. 31, 2015	Apr. 30, 2015
Derivative [Line Items]
Interest rate swap, face amount			$ 100,000,000
Fixed rate on interest rate swap, percent			0.983%
Other Long-time Liabilities [Member]
Derivative [Line Items]
Fair value of interest rate swap liability	$ (592,000)
Other Assets [Member]
Derivative [Line Items]
Fair value of interest rate swap asset		$ 165,000

Notes Payable and Credit Agreement (Details) - Line of Credit [Member]	Apr. 18, 2014 USD ($) credit_facility	Jan. 04, 2016 USD ($)
Debt Instrument [Line Items]
Number of credit facilities \| credit_facility	2
Maximum borrowing capacity		$ 125,000,000
Potential increase to maximum borrowing capacity		125,000,000
Debt issuance fees incurred		632,000
Debt issuance fees capitalized		448,000
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 225,000,000	275,000,000
Increase to maximum borrowing capacity		50,000,000
Letter of Credit [Member]
Debt Instrument [Line Items]
Maximum borrowing capacity	40,000,000
Revolving Credit Facility, Swing Line Loan [Member]
Debt Instrument [Line Items]
Maximum borrowing capacity	20,000,000
Notes Payable to Banks [Member]
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 150,000,000	$ 75,000,000
Amortization rate as a percent of principal	5.00%

Fair Value Measurement - Financial Assets and Liabilities (Details) - Fair Value, Measurements, Recurring [Member] - USD ($) $ in Thousands	Mar. 31, 2016	Dec. 31, 2015
Money Market Funds [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	$ 5,627	$ 5,627
Money Market Funds [Member] \| Significant Other Observable Inputs (Level 2) [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Money Market Funds [Member] \| Significant Unobservable Inputs (Level 3) [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Contingent Consideration [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	(6,459)	(3,770)
Contingent Consideration [Member] \| Quoted Prices in Active Markets for Identical Assets (Level 1) [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Contingent Consideration [Member] \| Significant Other Observable Inputs (Level 2) [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Contingent Consideration [Member] \| Significant Unobservable Inputs (Level 3) [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	(6,459)	(3,770)
Interest Rate Swap [Member] \| Derivative Financial Instruments, Assets [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	(592)	165
Interest Rate Swap [Member] \| Derivative Financial Instruments, Assets [Member] \| Quoted Prices in Active Markets for Identical Assets (Level 1) [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	0	0
Interest Rate Swap [Member] \| Derivative Financial Instruments, Assets [Member] \| Significant Other Observable Inputs (Level 2) [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	(592)	165
Interest Rate Swap [Member] \| Derivative Financial Instruments, Assets [Member] \| Significant Unobservable Inputs (Level 3) [Member]
Schedule of financial assets and liabilities measured at fair value on recurring basis
Financial assets and liabilities measured at fair value	$ 0	$ 0

Fair Value Measurement - Reconciliation of Changes in Contingent Consideration Liabilities (Details) - Fair Value, Inputs, Level 3 [Member] - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015	Dec. 31, 2015	Dec. 31, 2014
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Additional contingent consideration earn-out liability from HSG acquisition on 1/11/16	$ 1,000	$ 0
Contingent Consideration [Member]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance	(6,459)	(1,400)	$ (3,770)	$ (1,400)
Additional contingent consideration earn-out liability from HSG acquisition on 1/11/16	(3,590)	0
Change in fair value of contingent consideration earn-out liability from HSG acquisition	(62)	0
Ending balance	(6,459)	(1,400)	$ (3,770)	$ (1,400)
Contingent Consideration [Member] \| Avantas [Member]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Change in fair value of contingent consideration earn-out liability from acquisition	660	0
Contingent Consideration [Member] \| TFS [Member]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Change in fair value of contingent consideration earn-out liability from acquisition	$ (697)	$ 0

Income Taxes (Details) - USD ($) $ in Thousands	1 Months Ended
Income Taxes (Details) - USD ($) $ in Thousands	Jul. 31, 2015	Dec. 31, 2016	Mar. 31, 2016
Federal Tax Authority [Member]
Income Tax Examination [Line Items]
Income tax benefits to be recorded in connection with settlement			$ 12,200
Federal Tax Authority [Member] \| Internal Revenue Service (IRS) [Member]
Income Tax Examination [Line Items]
Tax settlement amount	$ 7,200
Scenario, Forecast [Member] \| State Jurisdiction [Member]
Income Tax Examination [Line Items]
Income tax benefits to be recorded in connection with settlement		$ 1,500

Balance Sheet Details (Details) - USD ($) $ in Thousands	Mar. 31, 2016	Dec. 31, 2015
Other current assets:
Restricted cash	$ 11,577	$ 11,995
Income taxes receivable	0	3,687
Other	10,071	8,041
Other current assets	21,648	23,723
Fixed assets:
Furniture and equipment	25,345	23,380
Software	101,895	97,962
Leasehold improvements	5,599	5,472
Fixed assets, gross	132,839	126,814
Accumulated depreciation and amortization	(79,108)	(76,680)
Fixed assets, net	53,731	50,134
Accounts payable and accrued expenses:
Trade accounts payable	47,419	53,261
Subcontractor payable	50,225	56,177
Professional liability reserve	8,075	7,962
Overdraft	2,191	124
Other	1,211	1,298
Accounts payable and accrued expenses	109,121	118,822
Accrued compensation and benefits:
Accrued payroll	42,602	21,058
Accrued bonuses	14,213	24,476
Accrued travel expense	2,969	2,740
Accrued health insurance reserve	3,299	3,225
Accrued workers compensation reserve	8,242	7,701
Deferred compensation	25,933	23,044
Other	791	1,457
Accrued compensation and benefits	98,049	83,701
Other current liabilities:
Income taxes payable	13,269	0
Earn-out liabilities	4,712	1,660
Holdback liabilities	2,297	825
Other	3,720	2,889
Other current liabilities	23,998	5,374
Other long-term liabilities:
Workers’ compensation reserve	18,140	16,899
Professional liability reserve	40,168	37,369
Deferred rent	12,050	11,826
Unrecognized tax benefits	8,166	8,081
Other	4,552	3,959
Other long-term liabilities	$ 83,076	$ 78,134