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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
____________________
FORM 10-Q
____________________
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended March 31, 2023
OR
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from                       to                      
Commission File No.: 001-16753
https://cdn.kscope.io/8e2d4c974a2f762670299a25ab1286d6-Cover page photo.10Q.jpg
AMN HEALTHCARE SERVICES, INC.
(Exact Name of Registrant as Specified in Its Charter)
Delaware
06-1500476
(State or Other Jurisdiction of
Incorporation or Organization)
(I.R.S. Employer
Identification No.)
8840 Cypress Waters BoulevardSuite 300
DallasTexas75019
(Address of Principal Executive Offices)(Zip Code)

Registrant’s Telephone Number, Including Area Code: (866871-8519
____________________

Securities registered pursuant to Section 12(b) of the Act:
Title of Each ClassTrading SymbolName of each exchange on which registered
Common Stock, $0.01 par valueAMNNew York Stock Exchange
Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.  Yes  x  No  o
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).  Yes  x No  o
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filerAccelerated filer   Non-accelerated filer
Smaller reporting companyEmerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. o
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange
Act).  Yes    No  x
As of May 3, 2023, there were 39,645,292 shares of common stock, $0.01 par value, outstanding.

Auditor Name: KPMG LLP        Auditor Location: San Diego, California        Auditor Firm ID: 185



TABLE OF CONTENTS
 
Item Page
PART I - FINANCIAL INFORMATION
1.
2.
3.
4.
PART II - OTHER INFORMATION
1.
1A.
2.
3.
4.
5.
6.



Table of Contents
PART I - FINANCIAL INFORMATION

Item 1. Condensed Consolidated Financial Statements

AMN HEALTHCARE SERVICES, INC.
 
CONDENSED CONSOLIDATED BALANCE SHEETS
(Unaudited and in thousands, except par value)
March 31, 2023December 31, 2022
ASSETS
Current assets:
Cash and cash equivalents$28,516 $64,524 
Accounts receivable, net of allowances of $37,736 and $31,910 at March 31, 2023 and December 31, 2022, respectively
687,645 675,650 
Accounts receivable, subcontractor276,655 268,726 
Prepaid expenses26,696 18,708 
Other current assets51,552 66,037 
Total current assets1,071,064 1,093,645 
Restricted cash, cash equivalents and investments67,594 61,218 
Fixed assets, net of accumulated depreciation of $233,942 and $227,617 at March 31, 2023 and December 31, 2022, respectively
155,276 149,276 
Other assets197,325 172,016 
Goodwill935,319 935,364 
Intangible assets, net of accumulated amortization of $379,172 and $361,327 at March 31, 2023 and December 31, 2022, respectively
454,485 476,832 
Total assets$2,881,063 $2,888,351 
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Accounts payable and accrued expenses$473,764 $476,452 
Accrued compensation and benefits269,237 333,244 
Other current liabilities60,600 48,237 
Total current liabilities803,601 857,933 
Revolving credit facility140,000  
Notes payable, net of unamortized fees and premium843,801 843,505 
Deferred income taxes, net16,113 22,713 
Other long-term liabilities121,774 120,566 
Total liabilities1,925,289 1,844,717 
Commitments and contingencies
Stockholders’ equity:
Preferred stock, $0.01 par value; 10,000 shares authorized; none issued and outstanding at March 31, 2023 and December 31, 2022
  
Common stock, $0.01 par value; 200,000 shares authorized; 50,236 issued and 40,238 outstanding at March 31, 2023 and 50,109 issued and 41,879 outstanding at December 31, 2022
502 501 
Additional paid-in capital505,857 501,674 
Treasury stock, at cost; 9,998 and 8,230 shares at March 31, 2023 and December 31, 2022, respectively
(874,898)(698,598)
Retained earnings1,325,106 1,240,996 
Accumulated other comprehensive loss(793)(939)
Total stockholders’ equity955,774 1,043,634 
Total liabilities and stockholders’ equity$2,881,063 $2,888,351 

See accompanying notes to unaudited condensed consolidated financial statements.
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AMN HEALTHCARE SERVICES, INC.
 
CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
(Unaudited and in thousands, except per share amounts)
 
 Three Months Ended March 31,
 20232022
Revenue$1,126,223 $1,552,538 
Cost of revenue757,377 1,056,370 
Gross profit368,846 496,168 
Operating expenses:
Selling, general and administrative205,599 257,579 
Depreciation and amortization (exclusive of depreciation included in cost of revenue)37,577 30,656 
Total operating expenses243,176 288,235 
Income from operations125,670 207,933 
Interest expense, net, and other10,259 9,589 
Income before income taxes115,411 198,344 
Income tax expense31,301 52,336 
Net income$84,110 $146,008 
Other comprehensive income (loss):
Unrealized gains (losses) on available-for-sale securities, net, and other146 (907)
Other comprehensive income (loss)146 (907)
Comprehensive income$84,256 $145,101 
Net income per common share:
Basic$2.03 $3.11 
Diluted$2.02 $3.09 
Weighted average common shares outstanding:
Basic41,378 46,913 
Diluted41,570 47,208 
 
See accompanying notes to unaudited condensed consolidated financial statements.

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AMN HEALTHCARE SERVICES, INC.
 
CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY
(Unaudited and in thousands)
 Common StockAdditional
Paid-in
Capital
Treasury StockRetained EarningsAccumulated Other Comprehensive LossTotal
 SharesAmountSharesAmount
Balance, December 31, 202149,849 $498 $486,709 (2,586)$(121,831)$796,946 $(295)$1,162,027 
Repurchase of common stock into treasury— — — (2,298)(228,024)— — (228,024)
Equity awards vested, net of shares withheld for taxes164 2 (9,433)— — — — (9,431)
Share-based compensation— — 11,259 — — — — 11,259 
Comprehensive income (loss)— — — — — 146,008 (907)145,101 
Balance, March 31, 202250,013 $500 $488,535 (4,884)$(349,855)$942,954 $(1,202)$1,080,932 


 Common StockAdditional
Paid-in
Capital
Treasury StockRetained EarningsAccumulated Other Comprehensive LossTotal
 SharesAmountSharesAmount
Balance, December 31, 202250,109 $501 $501,674 (8,230)$(698,598)$1,240,996 $(939)$1,043,634 
Repurchase of common stock into treasury— — — (1,768)(176,300)— — (176,300)
Equity awards vested, net of shares withheld for taxes127 1 (6,135)— — — — (6,134)
Share-based compensation— — 10,318 — — — — 10,318 
Comprehensive income— — — — — 84,110 146 84,256 
Balance, March 31, 202350,236 $502 $505,857 (9,998)$(874,898)$1,325,106 $(793)$955,774 

See accompanying notes to unaudited condensed consolidated financial statements.

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AMN HEALTHCARE SERVICES, INC.
 
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(Unaudited and in thousands)
 
Three Months Ended March 31,
 
20232022
Cash flows from operating activities:
Net income$84,110 $146,008 
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization (inclusive of depreciation included in cost of revenue)38,834 31,510 
Non-cash interest expense and other505 479 
Change in fair value of contingent consideration liabilities80  
Increase in allowance for credit losses and sales credits25,447 3,432 
Provision for deferred income taxes(6,639)18,526 
Share-based compensation10,318 11,259 
Loss on disposal or impairment of long-lived assets1,849 241 
Net loss on investments in available-for-sale securities81 174 
Net loss (gain) on deferred compensation balances41 (570)
Non-cash lease expense(228)2,880 
Changes in assets and liabilities, net of effects from acquisitions:
Accounts receivable(37,376)(194,044)
Accounts receivable, subcontractor(7,929)(50,592)
Income taxes receivable8,875  
Prepaid expenses(7,988)33,373 
Other current assets(115)12,180 
Other assets221 (342)
Accounts payable and accrued expenses(9,557)70,988 
Accrued compensation and benefits(71,038)96,486 
Other liabilities11,903 18,353 
Deferred revenue2,040 (126)
Net cash provided by operating activities43,434 200,215 
Cash flows from investing activities:
Purchase and development of fixed assets(17,487)(13,590)
Purchase of investments (4,018)
Proceeds from sale and maturity of investments2,007 6,885 
Proceeds from sale of equity investment 68 
Payments to fund deferred compensation plan(16,951)(12,584)
Net cash used in investing activities(32,431)(23,239)
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Three Months Ended March 31,
 
20232022
Cash flows from financing activities:
Payments on revolving credit facility(70,000) 
Proceeds from revolving credit facility210,000  
Repurchase of common stock (1)
(174,744)(228,024)
Payment of financing costs(3,579) 
Cash paid for shares withheld for taxes(6,134)(9,431)
Net cash used in financing activities(44,457)(237,455)
Effect of exchange rate changes on cash (183)
Net decrease in cash, cash equivalents and restricted cash(33,454)(60,662)
Cash, cash equivalents and restricted cash at beginning of period137,872 246,714 
Cash, cash equivalents and restricted cash at end of period$104,418 $186,052 
Supplemental disclosures of cash flow information:
Cash paid for amounts included in the measurement of operating lease liabilities$2,610 $4,230 
Cash paid for interest (net of $288 and $121 capitalized for the three months ended March 31, 2023 and 2022, respectively)
$1,053 $196 
Cash paid for income taxes$5,404 $9,824 
Supplemental disclosures of non-cash investing and financing activities:
Purchase of fixed assets recorded in accounts payable and accrued expenses$6,849 $4,771 
Excise tax payable on share repurchases$1,556 $ 
(1) The difference between the amount reported for the three months ended March 31, 2023 and the corresponding amount presented in the condensed consolidated statements of stockholders’ equity is due to accrued excise tax payable on share repurchases recorded within treasury stock.

See accompanying notes to unaudited condensed consolidated financial statements.
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AMN HEALTHCARE SERVICES, INC.
 
NOTES TO UNAUDITED CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(in thousands, except per share amounts)
 
1. BASIS OF PRESENTATION
The condensed consolidated balance sheets and related condensed consolidated statements of comprehensive income, stockholders’ equity and cash flows contained in this Quarterly Report on Form 10-Q (this “Quarterly Report”), which are unaudited, include the accounts of AMN Healthcare Services, Inc. and its wholly-owned subsidiaries (collectively, the “Company”). All significant intercompany balances and transactions have been eliminated in consolidation. In the opinion of management, all entries necessary for a fair presentation of such unaudited condensed consolidated financial statements have been included. These entries consisted of all normal recurring items. The results of operations for the interim period are not necessarily indicative of the results to be expected for any other interim period or for the entire fiscal year or for any future period.
The unaudited condensed consolidated financial statements do not include all information and notes necessary for a complete presentation of financial position, results of operations and cash flows in conformity with accounting principles generally accepted in the United States (“U.S. GAAP”). Please refer to the Company’s audited consolidated financial statements and the related notes for the fiscal year ended December 31, 2022, contained in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022, filed with the Securities and Exchange Commission on February 22, 2023 (the “2022 Annual Report”).
The preparation of financial statements in conformity with U.S. GAAP requires management to make a number of estimates and assumptions relating to the reporting of assets and liabilities and the disclosure of contingent assets and liabilities at the dates of the financial statements and the reported amounts of revenue and expenses during the reporting periods. On an ongoing basis, the Company evaluates its estimates, including those related to intangible assets purchased in a business combination, asset impairments, accruals for self-insurance, compensation and related benefits, accounts receivable, contingencies and litigation, contingent consideration liabilities associated with acquisitions, and income taxes. Actual results could differ from those estimates under different assumptions or conditions.
Recently Adopted Accounting Pronouncements
In October 2021, the Financial Accounting Standards Board issued Accounting Standards Update (“ASU”) 2021-08, “Business Combinations (Topic 805): Accounting for Contract Assets and Contract Liabilities from Contracts with Customers.” The new guidance requires companies to apply the definition of a performance obligation under Accounting Standards Codification (“ASC”) Topic 606, Revenue from Contracts with Customers, to recognize and measure contract assets and contract liabilities, such as deferred revenue, relating to contracts with customers that are acquired in a business combination. Under prior guidance, an acquirer generally recognized assets acquired and liabilities assumed in a business combination, including contract assets and contract liabilities arising from revenue contracts with customers, at their acquisition-date fair values in accordance with ASC Subtopic 820-10, Fair Value Measurements—Overall. Generally, this new guidance will result in the acquirer recognizing acquired contract assets and liabilities on the same basis that would have been recorded by the acquiree prior to the acquisition under ASC Topic 606. The Company adopted this standard effective January 1, 2023 on a prospective basis, and the adoption did not have a material effect on the Company’s consolidated financial statements.
Cash, Cash Equivalents and Restricted Cash
The Company considers all highly liquid investments with an original maturity of three months or less to be cash equivalents. Cash and cash equivalents include currency on hand, deposits with financial institutions, money market funds, commercial paper and other highly liquid investments. Restricted cash and cash equivalents primarily includes cash, corporate bonds and commercial paper that serve as collateral for the Company’s captive insurance subsidiary claim payments. See Note (7), “Fair Value Measurement” for additional information.
The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the accompanying condensed consolidated balance sheets and related notes to the amounts presented in the accompanying condensed consolidated statements of cash flows.
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 March 31, 2023December 31, 2022
Cash and cash equivalents$28,516 $64,524 
Restricted cash and cash equivalents (included in other current assets)31,500 37,225 
Restricted cash, cash equivalents and investments67,594 61,218 
Total cash, cash equivalents and restricted cash and investments127,610 162,967 
Less restricted investments(23,192)(25,095)
Total cash, cash equivalents and restricted cash$104,418 $137,872 
The Company maintains its cash and restricted cash in bank deposit accounts primarily at large, national financial institutions, which typically exceed federally insured limits. The Company has not experienced any losses in such accounts.
Accounts Receivable
The Company records accounts receivable at the invoiced amount. Accounts receivable are non-interest bearing. The Company maintains an allowance for expected credit losses based on the Company’s historical write-off experience, an assessment of its customers’ financial conditions and available information that is relevant to assessing the collectability of cash flows, which includes current conditions and forecasts about future economic conditions.
The following table provides a reconciliation of activity in the allowance for credit losses for accounts receivable:
20232022
Balance as of January 1,$31,910 $6,838 
Provision for expected credit losses6,938 1,166 
Amounts written off charged against the allowance(1,112)(534)
Balance as of March 31,$37,736 $7,470 
The increase in the provision for expected credit losses for the three months ended March 31, 2023 was primarily the result of concern with a specific customer’s ability to meet its financial obligations, and uncertainty regarding the collectability of cash flows from customers due primarily to the current macroeconomic outlook.
Reclassifications
To conform to the current year presentation, certain reclassifications have been made to prior year balances in the condensed consolidated balance sheets and accompanying Note (10), “Balance Sheet Details.”
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2. ACQUISITIONS
The Company accounted for the acquisition set forth below using the acquisition method of accounting. Accordingly, the Company recorded the tangible and intangible assets acquired and liabilities assumed at their estimated fair values as of the date of acquisition. Since the date of acquisition, the Company has revised the allocation of the purchase price to the tangible and intangible assets acquired and liabilities assumed based on analysis of information that has been made available through March 31, 2023. The allocation will continue to be updated through the measurement period, if necessary. The goodwill recognized for the acquisition is attributable to expected growth as the Company leverages its brand and diversifies its services offered to clients, including potential revenue growth and margin expansion. The Company did not incur any material acquisition-related costs.
Connetics Acquisition
On May 13, 2022, the Company completed its acquisition of Connetics Communications, LLC (“Connetics”), which specializes in the direct hire recruitment and permanent placement of international nurse and allied health professionals with healthcare facilities in the United States. The initial purchase price of $78,764 included (1) $70,764 cash consideration paid upon acquisition, funded through cash on hand, and (2) contingent consideration (earn-out payment) of up to $12,500 with an estimated fair value of $8,000 as of the acquisition date. The contingent earn-out payment is based on the operating results of Connetics for the twelve months ending May 31, 2023. The results of Connetics have been included in the Company’s nurse and allied solutions segment since the date of acquisition. During the fourth quarter of 2022, $231 was returned to the Company in respect of the final working capital settlement.
The preliminary allocation of the $78,533 purchase price, which was reduced by the final working capital settlement during the fourth quarter of 2022, consisted of (1) $3,632 of fair value of tangible assets acquired, which included $963 cash received, (2) $8,244 of liabilities assumed, (3) $40,200 of identified intangible assets, and (4) $42,945 of goodwill, of which $34,944 is deductible for tax purposes. The intangible assets acquired have a weighted average useful life of approximately thirteen years. The following table summarizes the fair value and useful life of each intangible asset acquired as of the acquisition date:
Fair ValueUseful Life
(in years)
Identifiable intangible assets
Customer relationships$32,800 15
Staffing database4,200 5
Tradenames and trademarks3,200 5
$40,200 

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3. REVENUE RECOGNITION
Revenue primarily consists of fees earned from the temporary staffing and permanent placement of healthcare professionals, executives, and leaders (clinical and operational). The Company also generates revenue from technology-enabled services, including language interpretation and vendor management systems, and talent planning and acquisition services, including recruitment process outsourcing. The Company recognizes revenue when control of its services is transferred to its customers, in an amount that reflects the consideration the Company expects to be entitled to receive in exchange for those services. Revenue from temporary staffing services is recognized as the services are rendered by clinical and non-clinical healthcare professionals. Under the Company’s managed services program (“MSP”) arrangements, the Company manages all or a part of a customer’s supplemental workforce needs utilizing its own network of healthcare professionals along with those of third-party subcontractors. Revenue and the related direct costs under MSP arrangements are recorded in accordance with the accounting guidance on reporting revenue gross as a principal versus net as an agent. When the Company uses subcontractors and acts as an agent, revenue is recorded net of the related subcontractor’s expense. Revenue from permanent placement and recruitment process outsourcing services is recognized as the services are rendered. Depending on the arrangement, the Company’s technology-enabled service revenue is recognized either as the services are rendered or ratably over the applicable arrangement’s service period.
The Company’s customers are primarily billed as services are rendered. Any fees billed in advance of being earned are recorded as deferred revenue. While payment terms vary by the type of customer and the services rendered, the term between invoicing and when payment is due is not significant.
The Company has elected to apply the following practical expedients and optional exemptions related to contract costs and revenue recognition:
Recognize incremental costs of obtaining a contract with amortization periods of one year or less as expense when incurred. These costs are recorded within selling, general and administrative expenses.
Recognize revenue in the amount of consideration that the Company has a right to invoice the customer if that amount corresponds directly with the value to the customer of the Company’s services completed to date.
Exemptions from disclosing the value of unsatisfied performance obligations for (i) contracts with an original expected length of one year or less, (ii) contracts for which revenue is recognized in the amount of consideration that the Company has a right to invoice for services performed and (iii) contracts for which variable consideration is allocated entirely to a wholly unsatisfied performance obligation or to a wholly unsatisfied promise to transfer a distinct service that forms part of a single performance obligation.
See Note (5), “Segment Information,” for additional information regarding the Company’s revenue disaggregated by service type.

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4. NET INCOME PER COMMON SHARE
Basic net income per common share is calculated by dividing net income by the weighted average number of common shares outstanding during the reporting period. The following table sets forth the computation of basic and diluted net income per common share:
 Three Months Ended March 31,
 20232022
Net income$84,110 $146,008 
Net income per common share - basic $2.03 $3.11 
Net income per common share - diluted $2.02 $3.09 
Weighted average common shares outstanding - basic41,378 46,913 
Plus dilutive effect of potential common shares192 295 
Weighted average common shares outstanding - diluted41,570 47,208 
Share-based awards to purchase 243 and 160 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, 2023 and 2022, respectively, because the effect of these instruments was anti-dilutive.
Since March 31, 2023, and through May 5, 2023, the Company repurchased 594 shares of its common stock at an average price of $84.18 per share excluding broker’s fee, resulting in an aggregate purchase price of $50,000 excluding the effect of 1% of excise taxes on the repurchased amount.

5. SEGMENT INFORMATION
The Company’s operating segments are identified in the same manner as they are reported internally and used by the Company’s chief operating decision maker for the purpose of evaluating performance and allocating resources. The Company has three reportable segments: (1) nurse and allied solutions, (2) physician and leadership solutions, and (3) technology and workforce solutions. The nurse and allied solutions segment includes the Company’s travel nurse staffing (including international nurse staffing and rapid response nurse staffing), labor disruption staffing, local staffing, international nurse and allied permanent placement, allied staffing and revenue cycle solutions businesses. The physician and leadership solutions segment includes the Company’s locum tenens staffing, healthcare interim leadership staffing, executive search, and physician permanent placement businesses. The technology and workforce solutions segment includes the Company’s language services, vendor management systems, workforce optimization, virtual care, and outsourced solutions businesses.
The Company’s chief operating decision maker relies on internal management reporting processes that provide revenue and operating income by reportable segment for making financial decisions and allocating resources. Segment operating income represents income before income taxes plus depreciation, amortization of intangible assets, share-based compensation, interest expense, net, and other, and unallocated corporate overhead. The Company’s management does not evaluate, manage or measure performance of segments using asset information; accordingly, asset information by segment is not prepared or disclosed.
The following table provides a reconciliation of revenue and operating income by reportable segment to consolidated results and was derived from each segment’s internal financial information as used for corporate management purposes:
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 Three Months Ended March 31,
 20232022
Revenue
Nurse and allied solutions$824,480 $1,228,039 
Physician and leadership solutions165,757 179,506 
Technology and workforce solutions135,986 144,993 
$1,126,223 $1,552,538 
Segment operating income
Nurse and allied solutions$113,445 $195,089 
Physician and leadership solutions25,100 20,381 
Technology and workforce solutions67,010 78,880 
205,555 294,350 
Unallocated corporate overhead30,733 43,648 
Depreciation and amortization37,577 30,656 
Depreciation (included in cost of revenue)1,257 854 
Share-based compensation10,318 11,259 
Interest expense, net, and other10,259 9,589 
Income before income taxes$115,411 $198,344 

The following table summarizes the activity related to the carrying value of goodwill by reportable segment:
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Balance, January 1, 2023$382,005 $152,800 $400,559 $935,364 
Goodwill adjustment for Connetics acquisition(45)  (45)
Balance, March 31, 2023$381,960 $152,800 $400,559 $935,319 
Accumulated impairment loss as of December 31, 2022 and March 31, 2023$154,444 $60,495 $ $214,939 

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Disaggregation of Revenue
The following tables present the Company’s revenue disaggregated by service type:
Three Months Ended March 31, 2023
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Travel nurse staffing$592,677 $ $ $592,677 
Labor disruption services5,702   5,702 
Local staffing25,272   25,272 
Allied staffing196,125   196,125 
Locum tenens staffing 106,703  106,703 
Interim leadership staffing 40,242  40,242 
Temporary staffing819,776 146,945  966,721 
Permanent placement4,704 18,812  23,516 
Language services  61,676 61,676 
Vendor management systems  54,173 54,173 
Other technologies  7,347 7,347 
Technology-enabled services  123,196 123,196 
Talent planning and acquisition  12,790 12,790 
Total revenue$824,480 $165,757 $135,986 $1,126,223 
Three Months Ended March 31, 2022
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Travel nurse staffing$970,109 $ $ $970,109 
Local staffing44,057   44,057 
Allied staffing213,873   213,873 
Locum tenens staffing 112,672  112,672 
Interim leadership staffing 44,354  44,354 
Temporary staffing1,228,039 157,026  1,385,065 
Permanent placement 22,480  22,480 
Language services  49,238 49,238 
Vendor management systems  75,022 75,022 
Other technologies  7,658 7,658 
Technology-enabled services  131,918 131,918 
Talent planning and acquisition  13,075 13,075 
Total revenue$1,228,039 $179,506 $144,993 $1,552,538 
The Company did not generate material revenue from labor disruption services during the three months ended March 31, 2022.
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6. NOTES PAYABLE AND CREDIT AGREEMENT
On February 10, 2023, the Company entered into the third amendment to its credit agreement (the “Third Amendment”). The Third Amendment provides for, among other things, the following: (i) an extension of the maturity date of the secured revolving credit facility (the “Senior Credit Facility”) to February 10, 2028, (ii) an increase of the revolving commitments to $750,000, and (iii) a transition from LIBOR to a SOFR-based interest rate. The obligations of the Company under the amended credit agreement are secured by substantially all of the assets of the Company. Additional information regarding the credit agreement, Senior Credit Facility and Third Amendment is disclosed in Part II, Item 8, “Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note (8), Notes Payable and Credit Agreement” of the 2022 Annual Report.

7. FAIR VALUE MEASUREMENT
The Company’s valuation techniques and inputs used to measure fair value and the definition of the three levels (Level 1, Level 2, and Level 3) of the fair value hierarchy are disclosed in Part II, Item 8, “Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note (3), Fair Value Measurement” of the 2022 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, 2023.
Assets and Liabilities Measured on a Recurring Basis
The Company invests a portion of its cash and cash equivalents in non-federally insured money market funds that are measured at fair value based on quoted prices, which are Level 1 inputs.
The Company has a deferred compensation plan for certain executives and employees, which is composed of deferred compensation and all related income and losses attributable thereto. The Company’s obligation under its deferred compensation plan is measured at fair value based on quoted market prices of the participants’ elected investments, which are Level 1 inputs.
The Company’s restricted cash equivalents and investments that serve as collateral for the Company’s captive insurance company include commercial paper that is measured at observable market prices for identical securities that are traded in less active markets, which are Level 2 inputs. The Company’s cash equivalents also include commercial paper classified as Level 2 in the fair value hierarchy. Of the $37,600 commercial paper issued and outstanding as of March 31, 2023, none had original maturities greater than three months. Of the $31,536 commercial paper issued and outstanding as of December 31, 2022, none had original maturities greater than three months.
The Company’s restricted cash equivalents and investments that serve as collateral for the Company’s captive insurance company also include corporate bonds that are measured using readily available pricing sources that utilize observable market data, including the current interest rate for comparable instruments, which are Level 2 inputs. As of March 31, 2023, the Company had $23,192 corporate bonds issued and outstanding, all of which had original maturities greater than three months and were considered available-for-sale securities. As of December 31, 2022, the Company had $25,095 corporate bonds issued and outstanding, all of which had original maturities greater than three months and were considered available-for-sale securities.
The Company’s contingent consideration liabilities associated with acquisitions are measured at fair value using a probability-weighted discounted cash flow analysis or a simulation-based methodology for the acquired companies, which are Level 3 inputs. The Company recognizes changes to the fair value of its contingent consideration liabilities in selling, general and administrative expenses in the condensed consolidated statements of comprehensive income.
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:
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 Fair Value Measurements as of March 31, 2023Fair Value Measurements as of December 31, 2022
Assets (Liabilities)Level 1Level 2Level 3TotalLevel 1Level 2Level 3Total
Money market funds$641 $ $ $641 $36,895 $ $ $36,895 
Deferred compensation(144,349)  (144,349)(128,465)  (128,465)
Corporate bonds 23,192  23,192  25,095  25,095 
Commercial paper 37,600  37,600  31,536  31,536 
Acquisition contingent consideration liabilities  (5,150)(5,150)  (5,070)(5,070)
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, long-lived assets, and equity investments.
The Company evaluates goodwill and indefinite-lived intangible assets annually for impairment and whenever events or changes in circumstances indicate that it is more likely than not that an impairment exists. The Company determines the fair value of its reporting units based on a combination of inputs, including the market capitalization of the Company, as well as Level 3 inputs such as discounted cash flows, which are not observable from the market, directly or indirectly. The Company determines the fair value of its indefinite-lived intangible assets using the income approach (relief-from-royalty method) based on Level 3 inputs.
The Company’s equity investment represents an investment in a non-controlled corporation without a readily determinable market value. The Company has elected to measure the investment at cost minus impairment, if any, plus or minus changes resulting from observable price changes. The fair value is determined by using quoted prices for identical or similar investments of the same issuer, which are Level 2 inputs, and other information available to the Company such as the rights and obligations of the securities. The Company recognizes changes to the fair value of its equity investment in interest expense, net, and other in the condensed consolidated statements of comprehensive income. The balance of the equity investment was $19,204 as of both March 31, 2023 and December 31, 2022.
There were no material impairment charges recorded during the three months ended March 31, 2023 and 2022.
Fair Value of Financial Instruments
The Company is required to disclose the fair value of financial instruments for which it is practicable to estimate the value, even though these instruments are not recognized at fair value in the consolidated balance sheets. The fair value of the Company’s 4.625% senior notes due 2027 (the “2027 Notes”) and 4.000% senior notes due 2029 (the “2029 Notes”) was estimated using quoted market prices in active markets for identical liabilities, which are Level 1 inputs. The carrying amounts and estimated fair value of the 2027 Notes and the 2029 Notes are presented in the following table. See additional information regarding the 2027 Notes and the 2029 Notes in Part II, Item 8, “Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note (8), Notes Payable and Credit Agreement” of the 2022 Annual Report.
As of March 31, 2023As of December 31, 2022
Carrying
Amount
Estimated
Fair Value
Carrying
Amount
Estimated
Fair Value
2027 Notes$500,000 $463,125 $500,000 $460,000 
2029 Notes350,000 308,875 350,000 300,125 
The fair value of the Company’s long-term self-insurance accruals cannot be estimated as the Company cannot reasonably determine the timing of future payments.

8. 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, 2023, the Company is no longer subject to state, local or foreign examinations by tax authorities for tax years before 2011, and the Company is no longer subject to U.S. federal income or payroll tax examinations for tax years before 2019.
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The Company believes its liability for unrecognized tax benefits and contingent tax issues is adequate with respect to all open years. Notwithstanding the foregoing, the Company could adjust its provision for income taxes and contingent tax liability based on future developments.

9. COMMITMENTS AND CONTINGENCIES
Legal Proceedings
From time to time, the Company is involved in various lawsuits, claims, investigations, and proceedings that arise in the ordinary course of business. These matters typically relate to professional liability, tax, compensation, contract, competitor disputes and employee-related matters and include individual and class action lawsuits, as well as inquiries and investigations by governmental agencies regarding the Company’s employment and compensation practices. Additionally, some of the Company’s clients may also become subject to claims, governmental inquiries and investigations, and legal actions relating to services provided by the Company’s healthcare professionals. Depending upon the particular facts and circumstances, the Company may also be subject to indemnification obligations under its contracts with such clients relating to these matters. The Company accrues for contingencies and records a liability when management believes an adverse outcome from a loss contingency is both probable and the amount, or a range, can be reasonably estimated. Significant judgment is required to determine both probability of loss and the estimated amount. The Company reviews its loss contingencies at least quarterly and adjusts its accruals and/or disclosures to reflect the impact of negotiations, settlements, rulings, advice of legal counsel, or other new information, as deemed necessary. The most significant matters for which the Company has established loss contingencies are class actions related to wage and hour claims under California and Federal law. Specifically, among other claims in these lawsuits, it is alleged that certain expense reimbursements should be considered wages and included in the regular rate of pay for purposes of calculating overtime rates.
On May 26, 2016, former travel nurse Verna Maxwell Clarke filed a complaint against AMN Services, LLC, in California Superior Court in Los Angeles County. The Company removed the case to the United States District Court for the Central District of California (Case No. 2:16-cv-04132-DSF-KS) (the “Clarke Matter”). The complaint asserts that, due to the Company’s per diem adjustment practices, traveling nurses’ per diem benefits should be included in their regular rate of pay for the purposes of calculating their overtime compensation. On June 26, 2018, the district court denied the plaintiffs’ Motion for Summary Judgment in its entirety, and granted the Company’s Motion for Summary Judgment with respect to the plaintiffs’ per diem and overtime claims. The plaintiffs filed an appeal of the judgment relating to the per diem claims with the Ninth Circuit Court of Appeals (the “Ninth Circuit”). On February 8, 2021, the Ninth Circuit issued an opinion that reversed the district court’s granting of the Company’s Motion for Summary Judgment and remanded the matter to the district court instructing the district to enter partial summary judgment in favor of the plaintiffs. On August 26, 2021, the Company filed a Petition for Writ of Certiorari in the United States Supreme Court seeking review of the Ninth Circuit’s decision, which was denied on December 13, 2021. This case is proceeding in the United States District Court.
On May 2, 2019, former travel nurse Sara Woehrle filed a complaint against AMN Services, LLC, and Providence Health System – Southern California in California Superior Court in Los Angeles County. The Company removed the case to the United States District Court for the Central District of California (Case No. 2:19-cv-05282 DSF-KS). The complaint asserts that, due to the Company’s per diem adjustment practices, traveling nurses’ per diem benefits should be included in their regular rate of pay for the purposes of calculating their overtime compensation. The complaint also alleges that the putative class members were denied required meal periods, denied proper overtime compensation, were not compensated for all time worked, including reporting time and training time, and received non-compliant wage statements. The Company reached an agreement to settle this matter in its entirety and received court approval of the settlement. Payment is expected to be made in the second quarter of 2023.
Because of the inherent uncertainty of litigation, the Company is not able to reasonably predict if any matter will be resolved in a manner that is materially adverse to the Company. The Company has recorded accruals in connection with the two matters described above amounting to $46,225. The Company is currently unable to estimate the possible loss or range of loss beyond amounts already accrued. Loss contingencies accrued as of both March 31, 2023 and December 31, 2022 are included in accounts payable and accrued expenses and other long-term liabilities in the consolidated balance sheets.
Operating Leases
In the first quarter of 2022, the Company entered into a lease agreement for an office building located in Dallas, Texas, with future undiscounted lease payments of approximately $29,514, excluding lease incentives. Because the Company does not control the underlying asset during the construction period, the Company is not considered the owner of the asset under construction for accounting purposes. The lease will commence upon completion of the construction of the office building which is expected be in the second quarter of 2023. The initial term of the lease is approximately eleven years with options to renew the lease during the lease term. A right-of-use asset and lease liability will be recognized in the consolidated balance sheet in the period the lease commences.
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10. BALANCE SHEET DETAILS

The consolidated balance sheets detail is as follows:
March 31, 2023December 31, 2022
Other current assets:
Restricted cash and cash equivalents$31,500 $37,225 
Income taxes receivable 8,875 
Other20,052 19,937 
Other current assets$51,552 $66,037 
Fixed assets:
Furniture and equipment$54,978 $51,408 
Software333,302 323,418 
Leasehold improvements938 2,067 
389,218 376,893 
Accumulated depreciation(233,942)(227,617)
Fixed assets, net$155,276 $149,276 
Other assets:
Life insurance cash surrender value$140,731 $117,139 
Operating lease right-of-use assets$14,484 16,266 
Other42,110 38,611 
Other assets$197,325 $172,016 
Accounts payable and accrued expenses:
Trade accounts payable$81,447 $78,057 
Subcontractor payable278,432 295,259 
Accrued expenses82,337 73,885 
Loss contingencies15,874 14,638 
Professional liability reserve8,091 7,756 
Other7,583 6,857 
Accounts payable and accrued expenses$473,764 $476,452 
Accrued compensation and benefits:
Accrued payroll$72,113 $63,857 
Accrued bonuses and commissions28,032 96,760 
Workers compensation reserve12,394 12,113 
Deferred compensation144,349 128,465 
Other12,349 32,049 
Accrued compensation and benefits$269,237 $333,244 
Other current liabilities:
Acquisition related liabilities$5,150 $5,070 
Income taxes payable23,395  
Client deposits7,463 21,466 
Operating lease liabilities7,789 8,090 
Deferred revenue13,876 11,825 
Other2,927 1,786 
Other current liabilities$60,600 $48,237 
Other long-term liabilities:
Workers compensation reserve$22,756 $23,841 
Professional liability reserve38,153 36,214 
Operating lease liabilities7,652 9,360 
Other53,213