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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 June 30, 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/4078a272d9b9f47c0e7b6ad8e85a37be-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.)
2999 Olympus BoulevardSuite 500
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 August 2, 2023, there were 37,988,128 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)
June 30, 2023December 31, 2022
ASSETS
Current assets:
Cash and cash equivalents$7,013 $64,524 
Accounts receivable, net of allowances of $36,401 and $31,910 at June 30, 2023 and December 31, 2022, respectively
579,926 675,650 
Accounts receivable, subcontractor168,231 268,726 
Prepaid expenses17,965 18,708 
Other current assets34,101 66,037 
Total current assets807,236 1,093,645 
Restricted cash, cash equivalents and investments71,564 61,218 
Fixed assets, net of accumulated depreciation of $250,150 and $227,617 at June 30, 2023 and December 31, 2022, respectively
177,417 149,276 
Other assets219,781 172,016 
Goodwill935,779 935,364 
Intangible assets, net of accumulated amortization of $401,217 and $361,327 at June 30, 2023 and December 31, 2022, respectively
432,366 476,832 
Total assets$2,644,143 $2,888,351 
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Accounts payable and accrued expenses$327,538 $476,452 
Accrued compensation and benefits261,629 333,244 
Other current liabilities84,548 48,237 
Total current liabilities673,715 857,933 
Revolving credit facility190,000  
Notes payable, net of unamortized fees and premium844,097 843,505 
Deferred income taxes, net6,986 22,713 
Other long-term liabilities163,048 120,566 
Total liabilities1,877,846 1,844,717 
Commitments and contingencies
Stockholders’ equity:
Preferred stock, $0.01 par value; 10,000 shares authorized; none issued and outstanding at June 30, 2023 and December 31, 2022
  
Common stock, $0.01 par value; 200,000 shares authorized; 50,339 issued and 37,987 outstanding at June 30, 2023 and 50,109 issued and 41,879 outstanding at December 31, 2022
503 501 
Additional paid-in capital467,387 501,674 
Treasury stock, at cost; 12,352 and 8,230 shares at June 30, 2023 and December 31, 2022, respectively
(1,086,862)(698,598)
Retained earnings1,386,012 1,240,996 
Accumulated other comprehensive loss(743)(939)
Total stockholders’ equity766,297 1,043,634 
Total liabilities and stockholders’ equity$2,644,143 $2,888,351 

See accompanying notes to unaudited condensed consolidated financial statements.
1

Table of Contents
AMN HEALTHCARE SERVICES, INC.
 
CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
(Unaudited and in thousands, except per share amounts)
 
 Three Months Ended June 30,Six Months Ended June 30,
 2023202220232022
Revenue$991,299 $1,426,607 $2,117,522 $2,979,145 
Cost of revenue661,018 966,370 1,418,395 2,022,740 
Gross profit330,281 460,237 699,127 956,405 
Operating expenses:
Selling, general and administrative201,771 244,430 407,370 502,009 
Depreciation and amortization (exclusive of depreciation included in cost of revenue)36,847 32,274 74,424 62,930 
Total operating expenses238,618 276,704 481,794 564,939 
Income from operations91,663 183,533 217,333 391,466 
Interest expense, net, and other12,175 10,080 22,434 19,669 
Income before income taxes79,488 173,453 194,899 371,797 
Income tax expense18,582 49,653 49,883 101,989 
Net income$60,906 $123,800 $145,016 $269,808 
Other comprehensive income (loss):
Unrealized gains (losses) on available-for-sale securities, net, and other50 332 196 (575)
Other comprehensive income (loss)50 332 196 (575)
Comprehensive income$60,956 $124,132 $145,212 $269,233 
Net income per common share:
Basic$1.56 $2.78 $3.60 $5.90 
Diluted$1.55 $2.77 $3.58 $5.87 
Weighted average common shares outstanding:
Basic39,151 44,504 40,258 45,702 
Diluted39,341 44,740 40,454 45,972 
 
See accompanying notes to unaudited condensed consolidated financial statements.

2

Table of Contents
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— — — (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 
Repurchase of common stock— — — (1,876)(173,867)— — (173,867)
Equity awards vested, net of shares withheld for taxes19 — (366)— — — — (366)
Share-based compensation— — 8,513 — — — — 8,513 
Comprehensive income— — — — — 123,800 332 124,132 
Balance, June 30, 202250,032 $500 $496,682 (6,760)$(523,722)$1,066,754 $(870)$1,039,344 


 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— — — (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 
Repurchase of common stock— — (40,000)(2,354)(211,964)— — (251,964)
Equity awards vested, net of shares withheld for taxes103 1 (3,288)— — — — (3,287)
Share-based compensation— — 4,818 — — — — 4,818 
Comprehensive income— — — — — 60,906 50 60,956 
Balance, June 30, 202350,339 $503 $467,387 (12,352)$(1,086,862)$1,386,012 $(743)$766,297 

See accompanying notes to unaudited condensed consolidated financial statements.

3

Table of Contents
AMN HEALTHCARE SERVICES, INC.
 
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(Unaudited and in thousands)
 
Six Months Ended June 30,
 
20232022
Cash flows from operating activities:
Net income$145,016 $269,808 
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization (inclusive of depreciation included in cost of revenue)77,068 64,757 
Non-cash interest expense and other1,038 953 
Change in fair value of contingent consideration liabilities2,430 580 
Increase in allowance for credit losses and sales credits29,432 13,803 
Provision for deferred income taxes(15,780)3,421 
Share-based compensation15,136 19,772 
Loss on disposal or impairment of long-lived assets1,933 479 
Net loss on investments in available-for-sale securities155 536 
Net gain on deferred compensation balances(577)(39)
Non-cash lease expense(240)3,542 
Changes in assets and liabilities, net of effects from acquisitions:
Accounts receivable65,906 (3,535)
Accounts receivable, subcontractor100,495 (7,988)
Income taxes receivable8,875 (1,022)
Prepaid expenses743 45,083 
Other current assets1,820 15,338 
Other assets894 1,002 
Accounts payable and accrued expenses(159,862)29,461 
Accrued compensation and benefits(84,837)73,349 
Other liabilities50,887 (104,729)
Deferred revenue569 106 
Net cash provided by operating activities241,101 424,677 
Cash flows from investing activities:
Purchase and development of fixed assets(43,936)(30,811)
Purchase of investments (10,659)
Proceeds from sale and maturity of investments6,987 9,085 
Proceeds from sale of equity investment 68 
Payments to fund deferred compensation plan(17,910)(12,584)
Cash paid for acquisitions, net of cash and restricted cash received (69,801)
Cash paid for other intangibles (1,060)
Net cash used in investing activities(54,859)(115,762)
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Six Months Ended June 30,
 
20232022
Cash flows from financing activities:
Payments on revolving credit facility(220,000) 
Proceeds from revolving credit facility410,000  
Repurchase of common stock (1)
(424,744)(401,891)
Payment of financing costs(3,579) 
Cash paid for shares withheld for taxes(9,421)(9,797)
Net cash used in financing activities(247,744)(411,688)
Net decrease in cash, cash equivalents and restricted cash(61,502)(102,773)
Cash, cash equivalents and restricted cash at beginning of period137,872 246,714 
Cash, cash equivalents and restricted cash at end of period$76,370 $143,941 
Supplemental disclosures of cash flow information:
Cash paid for amounts included in the measurement of operating lease liabilities$4,929 $7,922 
Cash paid for interest (net of $658 and $254 capitalized for the six months ended June 30, 2023 and 2022, respectively)
$22,652 $18,887 
Cash paid for income taxes$9,736 $120,660 
Acquisitions:
Fair value of tangible assets acquired in acquisitions, net of cash and restricted cash received$ $2,731 
Goodwill 43,301 
Intangible assets 40,200 
Liabilities assumed (8,431)
Contingent consideration liabilities (8,000)
Net cash paid for acquisitions$ $69,801 
Supplemental disclosures of non-cash investing and financing activities:
Purchase of fixed assets recorded in accounts payable and accrued expenses$10,928 $7,562 
Excise tax payable on share repurchases$3,520 $ 
Right-of-use assets obtained in exchange for operating lease liabilities$26,214 $3,590 
(1) The difference between the amount reported for the six months ended June 30, 2023 and the corresponding amounts 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 and restricted investments with an original maturity of three months or less to be cash equivalents and restricted cash equivalents, respectively. Cash and cash equivalents include currency on hand, deposits with financial institutions, money market funds 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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 June 30, 2023December 31, 2022
Cash and cash equivalents$7,013 $64,524 
Restricted cash and cash equivalents (included in other current assets)15,992 37,225 
Restricted cash, cash equivalents and investments71,564 61,218 
Total cash, cash equivalents and restricted cash and investments94,569 162,967 
Less restricted investments(18,199)(25,095)
Total cash, cash equivalents and restricted cash$76,370 $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 losses7,007 1,280 
Amounts written off charged against the allowance(2,516)(596)
Balance as of June 30,$36,401 $7,522 
The increase in the provision for expected credit losses for the six months ended June 30, 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 June 30, 2023. 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 and expected to be paid in the third quarter of 2023. The results of Connetics have been included in the Company’s nurse and allied solutions segment since the date of acquisition. During the fourth quarter of 2022, $231 was returned to the Company in respect of the final working capital settlement.
The allocation of the $78,533 purchase price, which was reduced by the final working capital settlement and was finalized during the second quarter of 2023, consisted of (1) $3,172 of fair value of tangible assets acquired, which included $963 cash received, (2) $8,244 of liabilities assumed, (3) $40,200 of identified intangible assets, and (4) $43,405 of goodwill, of which $35,405 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 June 30,Six Months Ended June 30,
 2023202220232022
Net income$60,906 $123,800 $145,016 $269,808 
Net income per common share - basic $1.56 $2.78 $3.60 $5.90 
Net income per common share - diluted $1.55 $2.77 $3.58 $5.87 
Weighted average common shares outstanding - basic39,151 44,504 40,258 45,702 
Plus dilutive effect of potential common shares190 236 196 270 
Weighted average common shares outstanding - diluted39,341 44,740 40,454 45,972 
Share-based awards to purchase 78 and 227 shares of common stock were not included in the above calculation of diluted net income per common share for the three and six months ended June 30, 2023, respectively, because the effect of these instruments was anti-dilutive. Share-based awards to purchase 60 and 48 shares of common stock were not included in the above calculation of diluted net income per common share for the three and six months ended June 30, 2022, respectively, because the effect of these instruments was anti-dilutive.
Accelerated Share Repurchase
On May 8, 2023, the Company entered into an accelerated share repurchase (“ASR”) agreement with a counterparty whereupon the Company prepaid $200,000 and received an initial delivery of 1,760 shares of its common stock, which was 80% of the prepayment amount based on a price of $90.89 per share. Under the terms of the ASR, the total number of shares delivered and average price per share will be determined upon settlement based on the volume weighted average price over the term of the ASR agreement, less an agreed upon discount and subject to customary acceleration adjustments. At settlement, the Company may receive additional shares of its common stock or, under certain circumstances, the Company may be required to make a cash payment or deliver shares of its common stock to the counterparty, with the method of settlement at the Company’s election. The final settlement of the ASR will be completed no later than the fourth quarter of 2023, subject to acceleration at the counterparty’s discretion, which could be completed as early as the third quarter of 2023.
During the three months ended June 30, 2023, the prepayment was recognized as a reduction to stockholders’ equity, consisting of (1) an increase in treasury stock, which reflects the fair value of the shares received upon initial delivery, and (2) a reduction in additional paid-in capital, which reflects the pending settlement of the ASR agreement. The effect of the potential share settlement of the ASR agreement was not included in the calculation of diluted net income per common share for the three and six months ended June 30, 2023 because the effect was anti-dilutive.

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.
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The following table provides a reconciliation of revenue and operating income by reportable segment to consolidated results and was derived from each segment’s internal financial information as used for corporate management purposes:
 Three Months Ended June 30,Six Months Ended June 30,
 2023202220232022
Revenue
Nurse and allied solutions$689,015 $1,101,478 $1,513,495 $2,329,517 
Physician and leadership solutions176,229 175,697 341,986 355,203 
Technology and workforce solutions126,055 149,432 262,041 294,425 
$991,299 $1,426,607 $2,117,522 $2,979,145 
Segment operating income
Nurse and allied solutions$102,993 $160,870 $216,438 $355,959 
Physician and leadership solutions26,456 19,995 51,556 40,376 
Technology and workforce solutions55,623 82,501 122,633 161,381 
185,072 263,366 390,627 557,716 
Unallocated corporate overhead50,357 38,073 81,090 81,721 
Depreciation and amortization36,847 32,274 74,424 62,930 
Depreciation (included in cost of revenue)1,387 973 2,644 1,827 
Share-based compensation4,818 8,513 15,136 19,772 
Interest expense, net, and other12,175 10,080 22,434 19,669 
Income before income taxes$79,488 $173,453 $194,899 $371,797 

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 acquisition415   415 
Balance, June 30, 2023$382,420 $152,800 $400,559 $935,779 
Accumulated impairment loss as of December 31, 2022 and June 30, 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 June 30, 2023
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Travel nurse staffing$477,209 $ $ $477,209 
Labor disruption services5,036   5,036 
Local staffing18,775   18,775 
Allied staffing182,212   182,212 
Locum tenens staffing 121,912  121,912 
Interim leadership staffing 36,401  36,401 
Temporary staffing683,232 158,313  841,545 
Permanent placement5,783 17,916  23,699 
Language services  63,650 63,650 
Vendor management systems  46,554 46,554 
Other technologies  5,792 5,792 
Technology-enabled services  115,996 115,996 
Talent planning and acquisition  10,059 10,059 
Total revenue$689,015 $176,229 $126,055 $991,299 
Three Months Ended June 30, 2022
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Travel nurse staffing$775,668 $ $ $775,668 
Labor disruption services83,070   83,070 
Local staffing33,394   33,394 
Allied staffing207,309   207,309 
Locum tenens staffing 105,936  105,936 
Interim leadership staffing 47,606  47,606 
Temporary staffing1,099,441 153,542  1,252,983 
Permanent placement2,037 22,155  24,192 
Language services  53,291 53,291 
Vendor management systems  75,144 75,144 
Other technologies  6,839 6,839 
Technology-enabled services  135,274 135,274 
Talent planning and acquisition  14,158 14,158 
Total revenue$1,101,478 $175,697 $149,432 $1,426,607 
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Six Months Ended June 30, 2023
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Travel nurse staffing$1,069,886 $ $ $1,069,886 
Labor disruption services10,738   10,738 
Local staffing44,047   44,047 
Allied staffing378,337   378,337 
Locum tenens staffing 228,615  228,615 
Interim leadership staffing 76,643  76,643 
Temporary staffing1,503,008 305,258  1,808,266 
Permanent placement10,487 36,728  47,215 
Language services  125,326 125,326 
Vendor management systems  100,727 100,727 
Other technologies  13,139 13,139 
Technology-enabled services  239,192 239,192 
Talent planning and acquisition  22,849 22,849 
Total revenue$1,513,495 $341,986 $262,041 $2,117,522 
Six Months Ended June 30, 2022
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Travel nurse staffing$1,745,777 $ $ $1,745,777 
Labor disruption services83,070   83,070 
Local staffing77,451   77,451 
Allied staffing421,182   421,182 
Locum tenens staffing 218,608  218,608 
Interim leadership staffing 91,960  91,960 
Temporary staffing2,327,480 310,568  2,638,048 
Permanent placement2,037 44,635  46,672 
Language services  102,529 102,529 
Vendor management systems  150,166 150,166 
Other technologies  14,497 14,497 
Technology-enabled services  267,192 267,192 
Talent planning and acquisition  27,233 27,233 
Total revenue$2,329,517 $355,203 $294,425 $2,979,145 
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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 six months ended June 30, 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 and corporate bonds. The commercial paper is measured at observable market prices for identical securities that are traded in less active markets, which are Level 2 inputs. The corporate bonds are measured using readily available pricing sources that utilize observable market data, including the current interest rate for comparable instruments, which are Level 2 inputs. The following table presents the fair value of commercial paper and corporate bonds issued and outstanding:
 As of June 30, 2023As of December 31, 2022
Commercial paper$40,495 $31,536 
Corporate bonds  
Total classified as restricted cash equivalents$40,495 $31,536 
Commercial paper$ $ 
Corporate bonds18,199 25,095 
Total classified as restricted investments$18,199 $25,095 
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 table presents 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 June 30, 2023Fair Value Measurements as of December 31, 2022
Assets (Liabilities)Level 1Level 2Level 3TotalLevel 1Level 2Level 3Total
Money market funds$649 $ $ $649 $36,895 $ $ $36,895 
Deferred compensation(150,339)  (150,339)(128,465)  (128,465)
Corporate bonds 18,199  18,199  25,095  25,095 
Commercial paper 40,495  40,495  31,536  31,536 
Acquisition contingent consideration liabilities  (7,500)(7,500)  (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 June 30, 2023 and December 31, 2022.
There were no material impairment charges recorded during the six months ended June 30, 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 June 30, 2023As of December 31, 2022
Carrying
Amount
Estimated
Fair Value
Carrying
Amount
Estimated
Fair Value
2027 Notes$500,000 $461,250 $500,000 $460,000 
2029 Notes350,000 305,375 350,000 300,125 
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 June 30, 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. The Company has reached an agreement to settle this matter in its entirety and is awaiting court approval. Accordingly, the Company has recorded an accrual for this matter amounting to $62,000.
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 was made in the second quarter of 2023.
Loss contingencies accrued as of both June 30, 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. The lease commenced upon substantial completion of the construction of the office building in June 2023. The initial term of the lease is approximately eleven years with options to renew during the lease term. The Company recognized a right-of-use asset and operating lease liability of $15,782 and $22,713, respectively, at lease commencement, which reflects the utilization of a tenant improvement allowance of $6,931 accounted for as a lease incentive.
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10. BALANCE SHEET DETAILS

The consolidated balance sheets detail is as follows:
June 30, 2023December 31, 2022
Other current assets:
Restricted cash and cash equivalents$15,992 $37,225 
Income taxes receivable 8,875 
Other18,109 19,937 
Other current assets$34,101 $66,037 
Fixed assets:
Furniture and equipment$61,042 $51,408 
Software353,379 323,418 
Leasehold improvements13,146 2,067 
427,567 376,893 
Accumulated depreciation(250,150)(227,617)
Fixed assets, net$177,417 $149,276 
Other assets:
Life insurance cash surrender value$148,089 $117,139 
Operating lease right-of-use assets30,080 16,266 
Other41,612 38,611 
Other assets$219,781 $172,016 
Accounts payable and accrued expenses:
Trade accounts payable$54,531 $78,057 
Subcontractor payable168,090 295,259 
Accrued expenses78,332 73,885 
Loss contingencies10,976 14,638 
Professional liability reserve7,652 7,756 
Other7,957 6,857 
Accounts payable and accrued expenses$327,538 $476,452 
Accrued compensation and benefits:
Accrued payroll$55,662 $63,857 
Accrued bonuses and commissions28,113 96,760 
Workers compensation reserve12,294 12,113 
Deferred compensation150,339 128,465 
Other15,221 32,049 
Accrued compensation and benefits$261,629 $333,244 
Other current liabilities:
Acquisition related liabilities$7,500 $5,070 
Income taxes payable