0001142750-23-000030 | 10-Q | XBRL Viewer | AMN Healthcare Services INC

REVENUE RECOGNITION	9 Months Ended
REVENUE RECOGNITION	Sep. 30, 2023
Revenue from Contract with Customer [Abstract]
REVENUE RECOGNITION	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.

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-9

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 10
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-10

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 15
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-15

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
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-Paragraph 12
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-Paragraph 12
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)(2)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-13

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
-Topic 606
-Publisher FASB
-URI https://asc.fasb.org//606/tableOfContent

+ Details

SEGMENT INFORMATION - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Segment Reporting Information [Line Items]
Revenue	$ 853,463	$ 1,138,586	$ 2,970,985	$ 4,117,731
Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	573,426	828,317	2,086,921	3,157,834
Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	159,554	175,152	501,540	530,355
Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	120,483	135,117	382,524	429,542
Travel nurse staffing
Segment Reporting Information [Line Items]
Revenue	384,102	583,463	1,453,988	2,329,240
Travel nurse staffing \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	384,102	583,463	1,453,988	2,329,240
Travel nurse staffing \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Travel nurse staffing \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Labor disruption services
Segment Reporting Information [Line Items]
Revenue	777	19,479	11,515	102,549
Labor disruption services \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	777	19,479	11,515	102,549
Labor disruption services \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Labor disruption services \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Local staffing
Segment Reporting Information [Line Items]
Revenue	16,991	31,814	61,038	109,265
Local staffing \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	16,991	31,814	61,038	109,265
Local staffing \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Local staffing \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Allied staffing
Segment Reporting Information [Line Items]
Revenue	167,622	190,044	545,959	611,226
Allied staffing \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	167,622	190,044	545,959	611,226
Allied staffing \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Allied staffing \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Locum tenens staffing
Segment Reporting Information [Line Items]
Revenue	112,514	106,055	341,129	324,663
Locum tenens staffing \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Locum tenens staffing \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	112,514	106,055	341,129	324,663
Locum tenens staffing \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Interim leadership staffing
Segment Reporting Information [Line Items]
Revenue	30,910	47,559	107,553	139,519
Interim leadership staffing \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Interim leadership staffing \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	30,910	47,559	107,553	139,519
Interim leadership staffing \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Temporary staffing
Segment Reporting Information [Line Items]
Revenue	712,916	978,414	2,521,182	3,616,462
Temporary staffing \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	569,492	824,800	2,072,500	3,152,280
Temporary staffing \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	143,424	153,614	448,682	464,182
Temporary staffing \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Permanent placement
Segment Reporting Information [Line Items]
Revenue	20,064	25,055	67,279	71,727
Permanent placement \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	3,934	3,517	14,421	5,554
Permanent placement \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	16,130	21,538	52,858	66,173
Permanent placement \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Language services
Segment Reporting Information [Line Items]
Revenue	66,406	55,502	191,732	158,031
Language services \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Language services \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Language services \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	66,406	55,502	191,732	158,031
Vendor management systems
Segment Reporting Information [Line Items]
Revenue	38,116	60,304	138,843	210,470
Vendor management systems \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Vendor management systems \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Vendor management systems \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	38,116	60,304	138,843	210,470
Other technologies
Segment Reporting Information [Line Items]
Revenue	5,052	7,290	18,191	21,787
Other technologies \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Other technologies \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Other technologies \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	5,052	7,290	18,191	21,787
Technology-enabled services
Segment Reporting Information [Line Items]
Revenue	109,574	123,096	348,766	390,288
Technology-enabled services \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Technology-enabled services \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Technology-enabled services \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	109,574	123,096	348,766	390,288
Talent planning and acquisition
Segment Reporting Information [Line Items]
Revenue	10,909	12,021	33,758	39,254
Talent planning and acquisition \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Talent planning and acquisition \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0	0	0
Talent planning and acquisition \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	$ 10,909	$ 12,021	$ 33,758	$ 39,254

SEGMENT INFORMATION

9 Months Ended

Sep. 30, 2023

Segment Reporting [Abstract]

SEGMENT INFORMATION

The Company’s operating segments are identified in the same manner as they are reported internally and used by the Company’s chief operating decision maker for the purpose of evaluating performance and allocating resources. 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:


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Revenue
Nurse and allied solutions	$	573,426	$	828,317	$	2,086,921	$	3,157,834
Physician and leadership solutions	159,554		175,152		501,540		530,355
Technology and workforce solutions	120,483		135,117		382,524		429,542
	$	853,463	$	1,138,586	$	2,970,985	$	4,117,731
Segment operating income
Nurse and allied solutions	$	82,882	$	115,182	$	299,320	$	471,141
Physician and leadership solutions	21,609		23,904		73,165		64,280
Technology and workforce solutions	50,664		71,145		173,297		232,526
	155,155		210,231		545,782		767,947
Unallocated corporate overhead	27,196		34,635		108,286		116,356
Depreciation and amortization	39,175		33,239		113,599		96,169
Depreciation (included in cost of revenue)	1,552		1,091		4,196		2,918
Share-based compensation	306		4,898		15,442		24,670
Interest expense, net, and other	11,541		8,961		33,975		28,630
Income before income taxes	$	75,385	$	127,407	$	270,284	$	499,204

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


	Nurse and Allied Solutions		Physician and Leadership Solutions		Technology and Workforce Solutions		Total
Balance, January 1, 2023	$	382,005	$	152,800	$	400,559	$	935,364


Goodwill adjustment for Connetics acquisition	415		—		—		415

Balance, September 30, 2023	$	382,420	$	152,800	$	400,559	$	935,779
Accumulated impairment loss as of December 31, 2022 and September 30, 2023	$	154,444	$	60,495	$	—	$	214,939

Disaggregation of Revenue

The following tables present the Company’s revenue disaggregated by service type:


	Three Months Ended September 30, 2023
	Nurse and Allied Solutions		Physician and Leadership Solutions		Technology and Workforce Solutions		Total
Travel nurse staffing	$	384,102	$	—	$	—	$	384,102
Labor disruption services	777		—		—		777
Local staffing	16,991		—		—		16,991
Allied staffing	167,622		—		—		167,622
Locum tenens staffing	—		112,514		—		112,514
Interim leadership staffing	—		30,910		—		30,910
Temporary staffing	569,492		143,424		—		712,916
Permanent placement	3,934		16,130		—		20,064
Language services	—		—		66,406		66,406
Vendor management systems	—		—		38,116		38,116
Other technologies	—		—		5,052		5,052
Technology-enabled services	—		—		109,574		109,574
Talent planning and acquisition	—		—		10,909		10,909
Total revenue	$	573,426	$	159,554	$	120,483	$	853,463


	Three Months Ended September 30, 2022
	Nurse and Allied Solutions		Physician and Leadership Solutions		Technology and Workforce Solutions		Total
Travel nurse staffing	$	583,463	$	—	$	—	$	583,463
Labor disruption services	19,479		—		—		19,479
Local staffing	31,814		—		—		31,814
Allied staffing	190,044		—		—		190,044
Locum tenens staffing	—		106,055		—		106,055
Interim leadership staffing	—		47,559		—		47,559
Temporary staffing	824,800		153,614		—		978,414
Permanent placement	3,517		21,538		—		25,055
Language services	—		—		55,502		55,502
Vendor management systems	—		—		60,304		60,304
Other technologies	—		—		7,290		7,290
Technology-enabled services	—		—		123,096		123,096
Talent planning and acquisition	—		—		12,021		12,021
Total revenue	$	828,317	$	175,152	$	135,117	$	1,138,586


	Nine Months Ended September 30, 2023
	Nurse and Allied Solutions		Physician and Leadership Solutions		Technology and Workforce Solutions		Total
Travel nurse staffing	$	1,453,988	$	—	$	—	$	1,453,988
Labor disruption services	11,515		—		—		11,515
Local staffing	61,038		—		—		61,038
Allied staffing	545,959		—		—		545,959
Locum tenens staffing	—		341,129		—		341,129
Interim leadership staffing	—		107,553		—		107,553
Temporary staffing	2,072,500		448,682		—		2,521,182
Permanent placement	14,421		52,858		—		67,279
Language services	—		—		191,732		191,732
Vendor management systems	—		—		138,843		138,843
Other technologies	—		—		18,191		18,191
Technology-enabled services	—		—		348,766		348,766
Talent planning and acquisition	—		—		33,758		33,758
Total revenue	$	2,086,921	$	501,540	$	382,524	$	2,970,985


	Nine Months Ended September 30, 2022
	Nurse and Allied Solutions		Physician and Leadership Solutions		Technology and Workforce Solutions		Total
Travel nurse staffing	$	2,329,240	$	—	$	—	$	2,329,240
Labor disruption services	102,549		—		—		102,549
Local staffing	109,265		—		—		109,265
Allied staffing	611,226		—		—		611,226
Locum tenens staffing	—		324,663		—		324,663
Interim leadership staffing	—		139,519		—		139,519
Temporary staffing	3,152,280		464,182		—		3,616,462
Permanent placement	5,554		66,173		—		71,727
Language services	—		—		158,031		158,031
Vendor management systems	—		—		210,470		210,470
Other technologies	—		—		21,787		21,787
Technology-enabled services	—		—		390,288		390,288
Talent planning and acquisition	—		—		39,254		39,254
Total revenue	$	3,157,834	$	530,355	$	429,542	$	4,117,731

- Definition

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

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-22

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

ACQUISITIONS

9 Months Ended

Sep. 30, 2023

Business Combination and Asset Acquisition [Abstract]

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. 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, which resulted in a payment of $7,500 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 $42,905 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 Value		Useful Life
				(in years)
Identifiable intangible assets
	Customer relationships	$	32,800	15
	Staffing database	4,200		5
	Tradenames and trademarks	3,200		5
		$	40,200

FAIR VALUE MEASUREMENT - Schedule of Assets and Liabilities at Fair Value (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	$ 47,618	$ 31,536
Level 2 \| Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	47,618	31,536
Level 2 \| Restricted Cash Equivalents
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	47,618	31,536
Level 2 \| Restricted Cash Equivalents \| Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	47,618	31,536
Level 2 \| Restricted Cash Equivalents \| Corporate bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	0	0
Level 2 \| Restricted Investments
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	15,367	25,095
Level 2 \| Restricted Investments \| Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	0	0
Level 2 \| Restricted Investments \| Corporate bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	$ 15,367	$ 25,095

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands

9 Months Ended

Sep. 30, 2023

Sep. 30, 2022

Cash flows from operating activities:

Net income

$ 198,190

$ 362,253

Adjustments to reconcile net income to net cash provided by operating activities:

Depreciation and amortization (inclusive of depreciation included in cost of revenue)

117,795

99,087

Non-cash interest expense and other

1,587

1,427

Change in fair value of contingent consideration liabilities

2,430

(1,190)

Increase in allowance for credit losses and sales credits

31,968

22,199

Provision for deferred income taxes

8,495

(5,364)

Share-based compensation

15,442

24,670

Loss on disposal or impairment of long-lived assets

1,793

571

Net loss on investments in available-for-sale securities

228

652

Net gain on deferred compensation balances

(300)

(1,324)

Non-cash lease expense

1,146

4,818

Changes in assets and liabilities, net of effects from acquisitions:

Accounts receivable

77,572

44,532

Accounts receivable, subcontractor

92,750

(14,235)

Income taxes receivable

8,875

(1,426)

Prepaid expenses

344

55,495

Other current assets

3,793

12,399

Other assets

(1,103)

(608)

Accounts payable and accrued expenses

(122,763)

31,855

Accrued compensation and benefits

(78,290)

2,937

Other liabilities

52,503

(99,534)

Deferred revenue

840

(809)

Net cash provided by operating activities

413,295

538,405

Cash flows from investing activities:

Purchase and development of fixed assets

(73,831)

(51,229)

Purchase of investments

(13,152)

Proceeds from sale and maturity of investments

9,894

12,549

Proceeds from sale of equity investment

Payments to fund deferred compensation plan

(24,902)

(21,411)

Cash paid for acquisitions, net of cash and restricted cash received

(69,801)

Cash paid for other intangibles

(5,091)

Net cash used in investing activities

(88,762)

(148,067)

Cash flows from financing activities:

Payments on revolving credit facility

(330,000)

Proceeds from revolving credit facility

425,000

Repurchase of common stock

^[1]

(424,744)

(401,891)

Payment of financing costs

(3,579)

Earn-out payments to settle contingent consideration liabilities for prior acquisitions

(7,500)

Cash paid for shares withheld for taxes

(11,943)

(13,632)

Net cash used in financing activities

(352,766)

(415,523)

Net decrease in cash, cash equivalents and restricted cash

(28,233)

(25,185)

Cash, cash equivalents and restricted cash at beginning of period

137,872

246,714

Cash, cash equivalents and restricted cash at end of period

109,639

221,529

Supplemental disclosures of cash flow information:

Cash paid for amounts included in the measurement of operating lease liabilities

6,891

10,700

Cash paid for interest (net of $1,026 and $452 capitalized for the nine months ended September 30, 2023 and 2022, respectively)

25,087

18,950

Cash paid for income taxes

10,833

164,757

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

14,841

5,187

Excise tax payable on share repurchases

3,739

Right-of-use assets obtained in exchange for operating lease liabilities

$ 25,794

$ 5,017

[1]	The difference between the amount reported for the nine months ended September 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.

NET INCOME PER COMMON SHARE

9 Months Ended

Sep. 30, 2023

Earnings Per Share [Abstract]

NET INCOME PER COMMON SHARE

Basic net income per common share is calculated by dividing net income by the weighted average number of common shares outstanding during the reporting period. The following table sets forth the computation of basic and diluted net income per common share:


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Net income	$	53,174	$	92,445	$	198,190	$	362,253

Net income per common share - basic	$	1.39	$	2.11	$	5.01	$	8.04
Net income per common share - diluted	$	1.39	$	2.10	$	4.99	$	7.99

Weighted average common shares outstanding - basic	38,147		43,785		39,547		45,056
Plus dilutive effect of potential common shares	178		254		187		276
Weighted average common shares outstanding - diluted	38,325		44,039		39,734		45,332

Share-based awards to purchase 43 and 84 shares of common stock were not included in the above calculation of diluted net income per common share for the three and nine months ended September 30, 2023, respectively, because the effect of these instruments was anti-dilutive. Share-based awards to purchase 14 and 15 shares of common stock were not included in the above calculation of diluted net income per common share for the three and nine months ended September 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. On August 10, 2023, the Company received a final delivery of approximately 261 additional shares of its common stock, representing the remaining 20% of the prepayment amount and final settlement of the ASR agreement. The total number of shares received and average price per share of $98.97 was based on the volume-weighted average price over the term of the ASR agreement, less an agreed upon discount.

During the second quarter of 2023, the prepayment was recognized as a reduction to stockholders’ equity, consisting of (1) an increase in treasury stock, which reflected the fair value of the shares received upon initial delivery, and (2) a reduction in additional paid-in capital, which reflected the pending settlement of the ASR agreement. The reduction in additional paid-in capital was reclassified to treasury stock during the three months ended September 30, 2023 upon final settlement.

NOTES PAYABLE AND CREDIT AGREEMENT	9 Months Ended
NOTES PAYABLE AND CREDIT AGREEMENT	Sep. 30, 2023
Debt Disclosure [Abstract]
NOTES PAYABLE AND CREDIT AGREEMENT	NOTES PAYABLE AND CREDIT AGREEMENTOn 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.

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(c))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 470
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//470/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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-Paragraph 1E
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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-Name Accounting Standards Codification
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-Paragraph 1I
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

+ Details

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Accounts receivable, allowance	$ 34,426	$ 31,910
Accumulated depreciation	268,131	227,617
Accumulated amortization	$ 423,780	$ 361,327
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	10,000,000	10,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	200,000,000	200,000,000
Common stock, shares issued (in shares)	50,387,000	50,109,000
Common stock, shares outstanding (in shares)	37,774,000	41,879,000
Treasury stock (in shares)	12,613,000	8,230,000

ACQUISITIONS - Connetics Acquisition (Details) - USD ($) $ in Thousands		3 Months Ended			9 Months Ended
	May 13, 2022	Sep. 30, 2023	Jun. 30, 2023	Dec. 31, 2022	Sep. 30, 2023	Sep. 30, 2022
Business Acquisition [Line Items]
Fair value of contingent earn-out		$ 0		$ 5,070	$ 0
Payment to settle contingent consideration liabilities					7,500	$ 0
Goodwill		935,779		935,364	$ 935,779
Connetics Communications, LLC
Business Acquisition [Line Items]
Purchase price	$ 78,764		$ 78,533
Cash consideration	70,764
Contingent earn-out based on future operating performance (up to)	12,500
Fair value of contingent earn-out	8,000
Payment to settle contingent consideration liabilities		$ 7,500
Cash returned to the Company for final working capital settlement				$ 231
Fair value of tangible assets acquired			3,172
Cash received			963
Liabilities assumed			8,244
Identifiable intangible assets	$ 40,200		40,200
Goodwill			43,405
Goodwill expected to be deductible for tax purposes			$ 42,905
Intangible assets acquired, weighted average useful life			13 years

NET INCOME PER COMMON SHARE - Narrative (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands			3 Months Ended			9 Months Ended
	Aug. 10, 2023	May 08, 2023	Sep. 30, 2023	Aug. 10, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Common stock excluded from calculation of EPS (in shares)			43		14	84	15
Accelerated Share Repurchase Agreement
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Accelerated share repurchases, prepaid amount		$ 200,000
Accelerated share repurchases, initial delivery, shares (in share)		1,760
Accelerated share repurchases, shares repurchased, prepayment percentage	20.00%	80.00%
Accelerated share repurchases, initial delivery, price paid per share (in dollars per share)		$ 90.89
Accelerated share repurchases, final delivery, shares (in share)	261
Accelerated share repurchases, final price price paid per share (in dollars per share)				$ 98.97

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Parenthetical) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Statement of Cash Flows [Abstract]
Interest capitalized	$ 1,026	$ 452

COMMITMENTS AND CONTINGENCIES	9 Months Ended
COMMITMENTS AND CONTINGENCIES	Sep. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
COMMITMENTS AND CONTINGENCIES	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 September 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.

ACQUISITIONS - Schedule of Intangible Assets Acquired (Details) - Connetics Communications, LLC - USD ($) $ in Thousands	Jun. 30, 2023	May 13, 2022
Acquired Finite-Lived Intangible Assets [Line Items]
Fair Value	$ 40,200	$ 40,200
Customer relationships
Acquired Finite-Lived Intangible Assets [Line Items]
Fair Value		$ 32,800
Useful Life		15 years
Staffing database
Acquired Finite-Lived Intangible Assets [Line Items]
Fair Value		$ 4,200
Useful Life		5 years
Tradenames and trademarks
Acquired Finite-Lived Intangible Assets [Line Items]
Fair Value		$ 3,200
Useful Life		5 years

SEGMENT INFORMATION- Narrative (Details)	9 Months Ended
SEGMENT INFORMATION- Narrative (Details)	Sep. 30, 2023 segment
Segment Reporting [Abstract]
Number of reportable segments	3

COVER - shares	9 Months Ended
COVER - shares	Sep. 30, 2023	Nov. 01, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2023
Document Transition Report	false
Entity File Number	001-16753
Entity Registrant Name	AMN HEALTHCARE SERVICES, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	06-1500476
Entity Address, Address Line One	2999 Olympus Boulevard
Entity Address, Address Line Two	Suite 500
Entity Address, City or Town	Dallas
Entity Address, State or Province	TX
Entity Address, Postal Zip Code	75019
City Area Code	866
Local Phone Number	871-8519
Title of 12(b) Security	Common Stock, $0.01 par value
Trading Symbol	AMN
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding (excluding treasury shares)		37,789,140
Entity Central Index Key	0001142750
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q3
Amendment Flag	false

ACQUISITIONS (Tables)

9 Months Ended

Sep. 30, 2023

Business Combination and Asset Acquisition [Abstract]

Schedule of Finite-Lived and Indefinite-Lived Intangible Assets Acquired as Part of Business Combination

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


		Fair Value		Useful Life
				(in years)
Identifiable intangible assets
	Customer relationships	$	32,800	15
	Staffing database	4,200		5
	Tradenames and trademarks	3,200		5
		$	40,200

NOTES PAYABLE AND CREDIT AGREEMENT (Details)	Feb. 10, 2023 USD ($)
Senior Credit Facility \| Line of Credit
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 750,000,000

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 835
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-Name Accounting Standards Codification
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+ Details

BALANCE SHEET DETAILS

9 Months Ended

Sep. 30, 2023

Balance Sheet Related Disclosures [Abstract]

BALANCE SHEET DETAILS

The consolidated balance sheets detail is as follows:


	September 30, 2023		December 31, 2022
Other current assets:
Restricted cash and cash equivalents	$	25,634	$	37,225
Income taxes receivable	—		8,875
Other	16,045		19,937
Other current assets	$	41,679	$	66,037






Fixed assets:
Furniture and equipment	$	66,108	$	51,408
Software	374,179		323,418
Leasehold improvements	15,401		2,067
	455,688		376,893
Accumulated depreciation	(268,131)		(227,617)
Fixed assets, net	$	187,557	$	149,276

Other assets:
Life insurance cash surrender value	$	149,842	$	117,139
Operating lease right-of-use assets	26,798		16,266
Other	43,872		38,611
Other assets	$	220,512	$	172,016

Accounts payable and accrued expenses:
Trade accounts payable	$	70,685	$	78,057
Subcontractor payable	177,821		295,259
Accrued expenses	87,113		73,885
Loss contingencies	12,320		14,638
Professional liability reserve	7,812		7,756
Other	7,156		6,857
Accounts payable and accrued expenses	$	362,907	$	476,452

Accrued compensation and benefits:
Accrued payroll	$	59,436	$	63,857
Accrued bonuses and commissions	26,487		96,760


Workers compensation reserve	13,914		12,113
Deferred compensation	150,074		128,465
Other	13,786		32,049
Accrued compensation and benefits	$	263,697	$	333,244

Other current liabilities:
Acquisition related liabilities	$	—	$	5,070
Income taxes payable	43,400		—
Client deposits	10,490		21,466
Operating lease liabilities	8,477		8,090
Deferred revenue	12,685		11,825
Other	5,470		1,786
Other current liabilities	$	80,522	$	48,237

Other long-term liabilities:
Workers compensation reserve	$	19,011	$	23,841
Professional liability reserve	38,803		36,214

Operating lease liabilities	28,462		9,360


Other	73,506		51,151
Other long-term liabilities	$	159,782	$	120,566

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Pay vs Performance Disclosure
Net income	$ 53,174	$ 92,445	$ 198,190	$ 362,253

- Definition

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

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+ Details

NET INCOME PER COMMON SHARE - Schedule of Computation of Basic and Diluted Net Income Per Common Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Earnings Per Share [Abstract]
Net income	$ 53,174	$ 92,445	$ 198,190	$ 362,253
Net income per common share - basic (in dollars per share)	$ 1.39	$ 2.11	$ 5.01	$ 8.04
Net income per common share - diluted (in dollars per share)	$ 1.39	$ 2.10	$ 4.99	$ 7.99
Weighted average common shares outstanding - basic (in shares)	38,147	43,785	39,547	45,056
Plus dilutive effect of potential common shares (in shares)	178	254	187	276
Weighted average common shares outstanding - diluted (in shares)	38,325	44,039	39,734	45,332

- Definition

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

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+ Details

- Definition

The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.

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+ Details

- Definition

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

+ References

+ Details

SEGMENT INFORMATION (Tables)

9 Months Ended

Sep. 30, 2023

Segment Reporting [Abstract]

Schedule of Reconciliation of Revenue and Segment Operating Income by Reportable Segment


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Revenue
Nurse and allied solutions	$	573,426	$	828,317	$	2,086,921	$	3,157,834
Physician and leadership solutions	159,554		175,152		501,540		530,355
Technology and workforce solutions	120,483		135,117		382,524		429,542
	$	853,463	$	1,138,586	$	2,970,985	$	4,117,731
Segment operating income
Nurse and allied solutions	$	82,882	$	115,182	$	299,320	$	471,141
Physician and leadership solutions	21,609		23,904		73,165		64,280
Technology and workforce solutions	50,664		71,145		173,297		232,526
	155,155		210,231		545,782		767,947
Unallocated corporate overhead	27,196		34,635		108,286		116,356
Depreciation and amortization	39,175		33,239		113,599		96,169
Depreciation (included in cost of revenue)	1,552		1,091		4,196		2,918
Share-based compensation	306		4,898		15,442		24,670
Interest expense, net, and other	11,541		8,961		33,975		28,630
Income before income taxes	$	75,385	$	127,407	$	270,284	$	499,204

Schedule of Goodwill by Reportable Segment

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


	Nurse and Allied Solutions		Physician and Leadership Solutions		Technology and Workforce Solutions		Total
Balance, January 1, 2023	$	382,005	$	152,800	$	400,559	$	935,364


Goodwill adjustment for Connetics acquisition	415		—		—		415

Balance, September 30, 2023	$	382,420	$	152,800	$	400,559	$	935,779
Accumulated impairment loss as of December 31, 2022 and September 30, 2023	$	154,444	$	60,495	$	—	$	214,939

Schedule of Disaggregation of Revenue

The following tables present the Company’s revenue disaggregated by service type:


	Three Months Ended September 30, 2023
	Nurse and Allied Solutions		Physician and Leadership Solutions		Technology and Workforce Solutions		Total
Travel nurse staffing	$	384,102	$	—	$	—	$	384,102
Labor disruption services	777		—		—		777
Local staffing	16,991		—		—		16,991
Allied staffing	167,622		—		—		167,622
Locum tenens staffing	—		112,514		—		112,514
Interim leadership staffing	—		30,910		—		30,910
Temporary staffing	569,492		143,424		—		712,916
Permanent placement	3,934		16,130		—		20,064
Language services	—		—		66,406		66,406
Vendor management systems	—		—		38,116		38,116
Other technologies	—		—		5,052		5,052
Technology-enabled services	—		—		109,574		109,574
Talent planning and acquisition	—		—		10,909		10,909
Total revenue	$	573,426	$	159,554	$	120,483	$	853,463


	Three Months Ended September 30, 2022
	Nurse and Allied Solutions		Physician and Leadership Solutions		Technology and Workforce Solutions		Total
Travel nurse staffing	$	583,463	$	—	$	—	$	583,463
Labor disruption services	19,479		—		—		19,479
Local staffing	31,814		—		—		31,814
Allied staffing	190,044		—		—		190,044
Locum tenens staffing	—		106,055		—		106,055
Interim leadership staffing	—		47,559		—		47,559
Temporary staffing	824,800		153,614		—		978,414
Permanent placement	3,517		21,538		—		25,055
Language services	—		—		55,502		55,502
Vendor management systems	—		—		60,304		60,304
Other technologies	—		—		7,290		7,290
Technology-enabled services	—		—		123,096		123,096
Talent planning and acquisition	—		—		12,021		12,021
Total revenue	$	828,317	$	175,152	$	135,117	$	1,138,586


	Nine Months Ended September 30, 2023
	Nurse and Allied Solutions		Physician and Leadership Solutions		Technology and Workforce Solutions		Total
Travel nurse staffing	$	1,453,988	$	—	$	—	$	1,453,988
Labor disruption services	11,515		—		—		11,515
Local staffing	61,038		—		—		61,038
Allied staffing	545,959		—		—		545,959
Locum tenens staffing	—		341,129		—		341,129
Interim leadership staffing	—		107,553		—		107,553
Temporary staffing	2,072,500		448,682		—		2,521,182
Permanent placement	14,421		52,858		—		67,279
Language services	—		—		191,732		191,732
Vendor management systems	—		—		138,843		138,843
Other technologies	—		—		18,191		18,191
Technology-enabled services	—		—		348,766		348,766
Talent planning and acquisition	—		—		33,758		33,758
Total revenue	$	2,086,921	$	501,540	$	382,524	$	2,970,985


	Nine Months Ended September 30, 2022
	Nurse and Allied Solutions		Physician and Leadership Solutions		Technology and Workforce Solutions		Total
Travel nurse staffing	$	2,329,240	$	—	$	—	$	2,329,240
Labor disruption services	102,549		—		—		102,549
Local staffing	109,265		—		—		109,265
Allied staffing	611,226		—		—		611,226
Locum tenens staffing	—		324,663		—		324,663
Interim leadership staffing	—		139,519		—		139,519
Temporary staffing	3,152,280		464,182		—		3,616,462
Permanent placement	5,554		66,173		—		71,727
Language services	—		—		158,031		158,031
Vendor management systems	—		—		210,470		210,470
Other technologies	—		—		21,787		21,787
Technology-enabled services	—		—		390,288		390,288
Talent planning and acquisition	—		—		39,254		39,254
Total revenue	$	3,157,834	$	530,355	$	429,542	$	4,117,731

- Definition

Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule.

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+ Details

FAIR VALUE MEASUREMENT (Tables)

9 Months Ended

Sep. 30, 2023

Fair Value Disclosures [Abstract]

Schedule of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis

The following table presents the fair value of commercial paper and corporate bonds issued and outstanding:


	As of September 30, 2023		As of December 31, 2022
Commercial paper	$	47,618	$	31,536
Corporate bonds	—		—
Total classified as restricted cash equivalents	$	47,618	$	31,536
Commercial paper	$	—	$	—
Corporate bonds	15,367		25,095
Total classified as restricted investments	$	15,367	$	25,095

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:


	Fair Value Measurements as of September 30, 2023								Fair Value Measurements as of December 31, 2022
Assets (Liabilities)	Level 1		Level 2		Level 3		Total		Level 1		Level 2		Level 3		Total
Money market funds	$	657	$	—	$	—	$	657	$	36,895	$	—	$	—	$	36,895
Deferred compensation	(150,074)		—		—		(150,074)		(128,465)		—		—		(128,465)
Corporate bonds	—		15,367		—		15,367		—		25,095		—		25,095
Commercial paper	—		47,618		—		47,618		—		31,536		—		31,536
Acquisition contingent consideration liabilities	—		—		—		—		—		—		(5,070)		(5,070)

Schedule of Fair Value of Financial Instruments

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 September 30, 2023				As of December 31, 2022
	Carrying Amount		Estimated Fair Value		Carrying Amount		Estimated Fair Value
2027 Notes	$	500,000	$	453,125	$	500,000	$	460,000
2029 Notes	350,000		297,500		350,000		300,125

INCOME TAXES	9 Months Ended
INCOME TAXES	Sep. 30, 2023
Income Tax Disclosure [Abstract]
INCOME TAXES	INCOME TAXESThe Company is subject to taxation in the U.S. and various states and foreign jurisdictions. With few exceptions, as of September 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. 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.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

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+ Details

BASIS OF PRESENTATION

9 Months Ended

Sep. 30, 2023

Organization, Consolidation and Presentation of Financial Statements [Abstract]

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.


	September 30, 2023		December 31, 2022
Cash and cash equivalents	$	29,377	$	64,524
Restricted cash and cash equivalents (included in other current assets)	25,634		37,225
Restricted cash, cash equivalents and investments	69,995		61,218
Total cash, cash equivalents and restricted cash and investments	125,006		162,967
Less restricted investments	(15,367)		(25,095)
Total cash, cash equivalents and restricted cash	$	109,639	$	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:


	2023		2022
Balance as of January 1,	$	31,910	$	6,838

Provision for expected credit losses	5,464		10,129
Amounts written off charged against the allowance	(2,948)		(1,773)

Balance as of September 30,	$	34,426	$	15,194

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.”

COMMITMENTS AND CONTINGENCIES (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Jun. 30, 2023	Dec. 31, 2022	Mar. 31, 2022
Commitments and Contingencies [Line Items]
Operating lease right-of-use assets	$ 26,798		$ 16,266
Office Building
Commitments and Contingencies [Line Items]
Future undiscounted lease payments				$ 29,514
Lease term		11 years
Operating lease right-of-use assets		$ 15,782
Operating lease, liability		22,713
Lease incentive		$ 6,931
Wage and Hour claims \| Pending Litigation
Commitments and Contingencies [Line Items]
Litigation matters accrual	$ 62,000

FAIR VALUE MEASUREMENT - Financial Assets and Liabilities (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Deferred compensation
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	$ (150,074)	$ (128,465)
Deferred compensation \| Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	(150,074)	(128,465)
Deferred compensation \| Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	0	0
Deferred compensation \| Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	0	0
Acquisition contingent consideration liabilities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	0	(5,070)
Acquisition contingent consideration liabilities \| Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	0	0
Acquisition contingent consideration liabilities \| Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	0	0
Acquisition contingent consideration liabilities \| Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	0	(5,070)
Money market funds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	657	36,895
Money market funds \| Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	657	36,895
Money market funds \| Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	0	0
Money market funds \| Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	0	0
Corporate bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	15,367	25,095
Corporate bonds \| Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	0	0
Corporate bonds \| Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	15,367	25,095
Corporate bonds \| Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	0	0
Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	47,618	31,536
Commercial paper \| Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	0	0
Commercial paper \| Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	47,618	31,536
Commercial paper \| Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	$ 0	$ 0

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 29,377	$ 64,524
Accounts receivable, net of allowances of $34,426 and $31,910 at September 30, 2023 and December 31, 2022, respectively	565,724	675,650
Accounts receivable, subcontractor	175,976	268,726
Prepaid expenses	18,364	18,708
Other current assets	41,679	66,037
Total current assets	831,120	1,093,645
Restricted cash, cash equivalents and investments	69,995	61,218
Fixed assets, net of accumulated depreciation of $268,131 and $227,617 at September 30, 2023 and December 31, 2022, respectively	187,557	149,276
Other assets	220,512	172,016
Goodwill	935,779	935,364
Intangible assets, net of accumulated amortization of $423,780 and $361,327 at September 30, 2023 and December 31, 2022, respectively	409,803	476,832
Total assets	2,654,766	2,888,351
Current liabilities:
Accounts payable and accrued expenses	362,907	476,452
Accrued compensation and benefits	263,697	333,244
Other current liabilities	80,522	48,237
Total current liabilities	707,126	857,933
Revolving credit facility	95,000	0
Notes payable, net of unamortized fees and premium	844,393	843,505
Deferred income taxes, net	31,296	22,713
Other long-term liabilities	159,782	120,566
Total liabilities	1,837,597	1,844,717
Commitments and contingencies
Stockholders’ equity:
Preferred stock, $0.01 par value; 10,000 shares authorized; none issued and outstanding at September 30, 2023 and December 31, 2022	0	0
Common stock, $0.01 par value; 200,000 shares authorized; 50,387 issued and 37,774 outstanding at September 30, 2023 and 50,109 issued and 41,879 outstanding at December 31, 2022	504	501
Additional paid-in capital	505,170	501,674
Treasury stock, at cost; 12,613 and 8,230 shares at September 30, 2023 and December 31, 2022, respectively	(1,127,081)	(698,598)
Retained earnings	1,439,186	1,240,996
Accumulated other comprehensive loss	(610)	(939)
Total stockholders’ equity	817,169	1,043,634
Total liabilities and stockholders’ equity	$ 2,654,766	$ 2,888,351

FAIR VALUE MEASUREMENT - Fair Value of Financial Instruments (Details) - Senior Notes - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
2027 Notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Carrying Amount	$ 500,000	$ 500,000
Estimated Fair Value	453,125	460,000
2029 Notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Carrying Amount	350,000	350,000
Estimated Fair Value	$ 297,500	$ 300,125

BASIS OF PRESENTATION (Policies)

9 Months Ended

Sep. 30, 2023

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Use of Estimates

Recently Adopted Accounting Pronouncements

Cash, Cash Equivalents and Restricted Cash

Accounts Receivable

Reclassification

Reclassifications

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.

Net Income per Common Share

Basic net income per common share is calculated by dividing net income by the weighted average number of common shares outstanding during the reporting period.

Segment Information

Fair Value of Assets and Liabilities

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 nine months ended September 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 September 30, 2023		As of December 31, 2022
Commercial paper	$	47,618	$	31,536
Corporate bonds	—		—
Total classified as restricted cash equivalents	$	47,618	$	31,536
Commercial paper	$	—	$	—
Corporate bonds	15,367		25,095
Total classified as restricted investments	$	15,367	$	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:


	Fair Value Measurements as of September 30, 2023								Fair Value Measurements as of December 31, 2022
Assets (Liabilities)	Level 1		Level 2		Level 3		Total		Level 1		Level 2		Level 3		Total
Money market funds	$	657	$	—	$	—	$	657	$	36,895	$	—	$	—	$	36,895
Deferred compensation	(150,074)		—		—		(150,074)		(128,465)		—		—		(128,465)
Corporate bonds	—		15,367		—		15,367		—		25,095		—		25,095
Commercial paper	—		47,618		—		47,618		—		31,536		—		31,536
Acquisition contingent consideration liabilities	—		—		—		—		—		—		(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.

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 September 30, 2023				As of December 31, 2022
	Carrying Amount		Estimated Fair Value		Carrying Amount		Estimated Fair Value
2027 Notes	$	500,000	$	453,125	$	500,000	$	460,000
2029 Notes	350,000		297,500		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.

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Treasury Stock	Retained Earnings	Accumulated Other Comprehensive Loss
Beginning balance (in shares) at Dec. 31, 2021		49,849
Beginning balance at Dec. 31, 2021	$ 1,162,027	$ 498	$ 486,709	$ (121,831)	$ 796,946	$ (295)
Beginning balance (in shares) at Dec. 31, 2021				(2,586)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Repurchase of common stock (in shares)				(2,298)
Repurchase of common stock	(228,024)			$ (228,024)
Equity awards vested, net of shares withheld for taxes (in shares)		164
Equity awards vested, net of shares withheld for taxes	(9,431)	$ 2	(9,433)
Share-based compensation	11,259		11,259
Comprehensive income (loss)	145,101				146,008	(907)
Ending balance (in shares) at Mar. 31, 2022		50,013
Ending balance at Mar. 31, 2022	1,080,932	$ 500	488,535	$ (349,855)	942,954	(1,202)
Ending balance (in shares) at Mar. 31, 2022				(4,884)
Beginning balance (in shares) at Dec. 31, 2021		49,849
Beginning balance at Dec. 31, 2021	1,162,027	$ 498	486,709	$ (121,831)	796,946	(295)
Beginning balance (in shares) at Dec. 31, 2021				(2,586)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Comprehensive income (loss)	361,459
Ending balance (in shares) at Sep. 30, 2022		50,087
Ending balance at Sep. 30, 2022	1,132,633	$ 501	497,744	$ (523,722)	1,159,199	(1,089)
Ending balance (in shares) at Sep. 30, 2022				(6,760)
Beginning balance (in shares) at Mar. 31, 2022		50,013
Beginning balance at Mar. 31, 2022	1,080,932	$ 500	488,535	$ (349,855)	942,954	(1,202)
Beginning balance (in shares) at Mar. 31, 2022				(4,884)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Repurchase of common stock (in shares)				(1,876)
Repurchase of common stock	(173,867)			$ (173,867)
Equity awards vested, net of shares withheld for taxes (in shares)		19
Equity awards vested, net of shares withheld for taxes	(366)		(366)
Share-based compensation	8,513		8,513
Comprehensive income (loss)	124,132				123,800	332
Ending balance (in shares) at Jun. 30, 2022		50,032
Ending balance at Jun. 30, 2022	1,039,344	$ 500	496,682	$ (523,722)	1,066,754	(870)
Ending balance (in shares) at Jun. 30, 2022				(6,760)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Equity awards vested, net of shares withheld for taxes (in shares)		55
Equity awards vested, net of shares withheld for taxes	(3,835)	$ 1	(3,836)
Share-based compensation	4,898		4,898
Comprehensive income (loss)	92,226				92,445	(219)
Ending balance (in shares) at Sep. 30, 2022		50,087
Ending balance at Sep. 30, 2022	$ 1,132,633	$ 501	497,744	$ (523,722)	1,159,199	(1,089)
Ending balance (in shares) at Sep. 30, 2022				(6,760)
Beginning balance (in shares) at Dec. 31, 2022	41,879	50,109
Beginning balance at Dec. 31, 2022	$ 1,043,634	$ 501	501,674	$ (698,598)	1,240,996	(939)
Beginning balance (in shares) at Dec. 31, 2022	(8,230)			(8,230)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Repurchase of common stock (in shares)				(1,768)
Repurchase of common stock	$ (176,300)			$ (176,300)
Equity awards vested, net of shares withheld for taxes (in shares)		127
Equity awards vested, net of shares withheld for taxes	(6,134)	$ 1	(6,135)
Share-based compensation	10,318		10,318
Comprehensive income (loss)	84,256				84,110	146
Ending balance (in shares) at Mar. 31, 2023		50,236
Ending balance at Mar. 31, 2023	$ 955,774	$ 502	505,857	$ (874,898)	1,325,106	(793)
Ending balance (in shares) at Mar. 31, 2023				(9,998)
Beginning balance (in shares) at Dec. 31, 2022	41,879	50,109
Beginning balance at Dec. 31, 2022	$ 1,043,634	$ 501	501,674	$ (698,598)	1,240,996	(939)
Beginning balance (in shares) at Dec. 31, 2022	(8,230)			(8,230)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Comprehensive income (loss)	$ 198,519
Ending balance (in shares) at Sep. 30, 2023	37,774	50,387
Ending balance at Sep. 30, 2023	$ 817,169	$ 504	505,170	$ (1,127,081)	1,439,186	(610)
Ending balance (in shares) at Sep. 30, 2023	(12,613)			(12,613)
Beginning balance (in shares) at Mar. 31, 2023		50,236
Beginning balance at Mar. 31, 2023	$ 955,774	$ 502	505,857	$ (874,898)	1,325,106	(793)
Beginning balance (in shares) at Mar. 31, 2023				(9,998)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Repurchase of common stock (in shares)				(2,354)
Repurchase of common stock	(251,964)		(40,000)	$ (211,964)
Equity awards vested, net of shares withheld for taxes (in shares)		103
Equity awards vested, net of shares withheld for taxes	(3,287)	$ 1	(3,288)
Share-based compensation	4,818		4,818
Comprehensive income (loss)	60,956				60,906	50
Ending balance (in shares) at Jun. 30, 2023		50,339
Ending balance at Jun. 30, 2023	766,297	$ 503	467,387	$ (1,086,862)	1,386,012	(743)
Ending balance (in shares) at Jun. 30, 2023				(12,352)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Repurchase of common stock (in shares)				(261)
Repurchase of common stock	(219)		40,000	$ (40,219)
Equity awards vested, net of shares withheld for taxes (in shares)		48
Equity awards vested, net of shares withheld for taxes	(2,522)	$ 1	(2,523)
Share-based compensation	306		306
Comprehensive income (loss)	$ 53,307				53,174	133
Ending balance (in shares) at Sep. 30, 2023	37,774	50,387
Ending balance at Sep. 30, 2023	$ 817,169	$ 504	$ 505,170	$ (1,127,081)	$ 1,439,186	$ (610)
Ending balance (in shares) at Sep. 30, 2023	(12,613)			(12,613)

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Sep. 30, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

BASIS OF PRESENTATION (Tables)

9 Months Ended

Sep. 30, 2023

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Schedule of Reconciliation of Cash, Cash Equivalents and Restricted Cash


	September 30, 2023		December 31, 2022
Cash and cash equivalents	$	29,377	$	64,524
Restricted cash and cash equivalents (included in other current assets)	25,634		37,225
Restricted cash, cash equivalents and investments	69,995		61,218
Total cash, cash equivalents and restricted cash and investments	125,006		162,967
Less restricted investments	(15,367)		(25,095)
Total cash, cash equivalents and restricted cash	$	109,639	$	137,872

Schedule of Reconciliation of Activity in Allowance for Credit Losses for Accounts Receivable

The following table provides a reconciliation of activity in the allowance for credit losses for accounts receivable:


	2023		2022
Balance as of January 1,	$	31,910	$	6,838

Provision for expected credit losses	5,464		10,129
Amounts written off charged against the allowance	(2,948)		(1,773)

Balance as of September 30,	$	34,426	$	15,194

BASIS OF PRESENTATION - Reconciliation of Activity in Allowance for Credit Losses for Accounts Receivable (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Accounts Receivable, Allowance for Credit Loss [Roll Forward]
Beginning balance	$ 31,910	$ 6,838
Provision for expected credit losses	5,464	10,129
Amounts written off charged against the allowance	(2,948)	(1,773)
Ending balance	$ 34,426	$ 15,194

SUBSEQUENT EVENTS	9 Months Ended
SUBSEQUENT EVENTS	Sep. 30, 2023
Subsequent Events [Abstract]
Subsequent Events	SUBSEQUENT EVENTSOn October 23, 2023, the Company announced an agreement to acquire Medical Search International and Dr. Wanted Healthcare Staffing (together, “MSDR”), two healthcare staffing companies that specialize in locum tenens and advanced practice, for approximately $300,000 of cash consideration. The closing of the acquisition is contingent upon certain customary conditions and approval by regulatory authorities.

BALANCE SHEET DETAILS (Tables)

9 Months Ended

Sep. 30, 2023

Balance Sheet Related Disclosures [Abstract]

Schedule of Supplemental Balance Sheet Disclosures

The consolidated balance sheets detail is as follows:


	September 30, 2023		December 31, 2022
Other current assets:
Restricted cash and cash equivalents	$	25,634	$	37,225
Income taxes receivable	—		8,875
Other	16,045		19,937
Other current assets	$	41,679	$	66,037






Fixed assets:
Furniture and equipment	$	66,108	$	51,408
Software	374,179		323,418
Leasehold improvements	15,401		2,067
	455,688		376,893
Accumulated depreciation	(268,131)		(227,617)
Fixed assets, net	$	187,557	$	149,276

Other assets:
Life insurance cash surrender value	$	149,842	$	117,139
Operating lease right-of-use assets	26,798		16,266
Other	43,872		38,611
Other assets	$	220,512	$	172,016

Accounts payable and accrued expenses:
Trade accounts payable	$	70,685	$	78,057
Subcontractor payable	177,821		295,259
Accrued expenses	87,113		73,885
Loss contingencies	12,320		14,638
Professional liability reserve	7,812		7,756
Other	7,156		6,857
Accounts payable and accrued expenses	$	362,907	$	476,452

Accrued compensation and benefits:
Accrued payroll	$	59,436	$	63,857
Accrued bonuses and commissions	26,487		96,760


Workers compensation reserve	13,914		12,113
Deferred compensation	150,074		128,465
Other	13,786		32,049
Accrued compensation and benefits	$	263,697	$	333,244

Other current liabilities:
Acquisition related liabilities	$	—	$	5,070
Income taxes payable	43,400		—
Client deposits	10,490		21,466
Operating lease liabilities	8,477		8,090
Deferred revenue	12,685		11,825
Other	5,470		1,786
Other current liabilities	$	80,522	$	48,237

Other long-term liabilities:
Workers compensation reserve	$	19,011	$	23,841
Professional liability reserve	38,803		36,214

Operating lease liabilities	28,462		9,360


Other	73,506		51,151
Other long-term liabilities	$	159,782	$	120,566

SUBSEQUENT EVENTS (Details) - Medical Search International and Dr.Wanted Healthcare Staffing (MSDR) - Subsequent Event $ in Thousands	Oct. 23, 2023 USD ($) company
Subsequent Event [Line Items]
Number of healthcare staffing companies \| company	2
Cash consideration \| $	$ 300,000

BASIS OF PRESENTATION - Reconciliation of Cash, Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022	Sep. 30, 2022	Dec. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Cash and cash equivalents	$ 29,377	$ 64,524
Restricted cash and cash equivalents (included in other current assets)	25,634	37,225
Restricted cash, cash equivalents and investments	69,995	61,218
Total cash, cash equivalents and restricted cash and investments	125,006	162,967
Less restricted investments	(15,367)	(25,095)
Total cash, cash equivalents and restricted cash	$ 109,639	$ 137,872	$ 221,529	$ 246,714

SEGMENT INFORMATION - Summary of Goodwill by Reportable Segment (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2023	Dec. 31, 2022
Goodwill [Roll Forward]
Goodwill, beginning balance	$ 935,364
Goodwill, ending balance	935,779
Accumulated impairment loss	214,939	$ 214,939
Connetics Communications, LLC
Goodwill [Roll Forward]
Goodwill adjustment	415
Nurse and Allied Solutions
Goodwill [Roll Forward]
Goodwill, beginning balance	382,005
Goodwill, ending balance	382,420
Accumulated impairment loss	154,444	154,444
Nurse and Allied Solutions \| Connetics Communications, LLC
Goodwill [Roll Forward]
Goodwill adjustment	415
Physician and Leadership Solutions
Goodwill [Roll Forward]
Goodwill, beginning balance	152,800
Goodwill, ending balance	152,800
Accumulated impairment loss	60,495	60,495
Physician and Leadership Solutions \| Connetics Communications, LLC
Goodwill [Roll Forward]
Goodwill adjustment	0
Technology and Workforce Solutions
Goodwill [Roll Forward]
Goodwill, beginning balance	400,559
Goodwill, ending balance	400,559
Accumulated impairment loss	0	$ 0
Technology and Workforce Solutions \| Connetics Communications, LLC
Goodwill [Roll Forward]
Goodwill adjustment	$ 0

- Definition

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

+ References + Details

BALANCE SHEET DETAILS (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Other current assets:
Restricted cash and cash equivalents	$ 25,634	$ 37,225
Income taxes receivable	0	8,875
Other	16,045	19,937
Other current assets	41,679	66,037
Fixed assets:
Furniture and equipment	66,108	51,408
Software	374,179	323,418
Leasehold improvements	15,401	2,067
Fixed assets, gross	455,688	376,893
Accumulated depreciation	(268,131)	(227,617)
Fixed assets, net	187,557	149,276
Other assets:
Life insurance cash surrender value	149,842	117,139
Operating lease right-of-use assets	26,798	16,266
Other	43,872	38,611
Other assets	220,512	172,016
Accounts payable and accrued expenses:
Trade accounts payable	70,685	78,057
Subcontractor payable	177,821	295,259
Accrued expenses	87,113	73,885
Loss contingencies	12,320	14,638
Professional liability reserve	7,812	7,756
Other	7,156	6,857
Accounts payable and accrued expenses	362,907	476,452
Accrued compensation and benefits:
Accrued payroll	59,436	63,857
Accrued bonuses and commissions	26,487	96,760
Workers compensation reserve	13,914	12,113
Deferred compensation	150,074	128,465
Other	13,786	32,049
Accrued compensation and benefits	263,697	333,244
Other current liabilities:
Acquisition related liabilities	0	5,070
Income taxes payable	43,400	0
Client deposits	10,490	21,466
Operating lease liabilities	8,477	8,090
Deferred revenue	12,685	11,825
Other	5,470	1,786
Other current liabilities	80,522	48,237
Other long-term liabilities:
Workers compensation reserve	19,011	23,841
Professional liability reserve	38,803	36,214
Operating lease liabilities	28,462	9,360
Other	73,506	51,151
Other long-term liabilities	$ 159,782	$ 120,566

NET INCOME PER COMMON SHARE (Tables)

9 Months Ended

Sep. 30, 2023

Earnings Per Share [Abstract]

Schedule of Computation of Basic and Diluted Net Income Per Common Share

The following table sets forth the computation of basic and diluted net income per common share:


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Net income	$	53,174	$	92,445	$	198,190	$	362,253

Net income per common share - basic	$	1.39	$	2.11	$	5.01	$	8.04
Net income per common share - diluted	$	1.39	$	2.10	$	4.99	$	7.99

Weighted average common shares outstanding - basic	38,147		43,785		39,547		45,056
Plus dilutive effect of potential common shares	178		254		187		276
Weighted average common shares outstanding - diluted	38,325		44,039		39,734		45,332

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Statement of Comprehensive Income [Abstract]
Revenue	$ 853,463	$ 1,138,586	$ 2,970,985	$ 4,117,731
Cost of revenue	563,957	753,560	1,982,352	2,776,300
Gross profit	289,506	385,026	988,633	1,341,431
Operating expenses:
Selling, general and administrative	163,405	215,419	570,775	717,428
Depreciation and amortization (exclusive of depreciation included in cost of revenue)	39,175	33,239	113,599	96,169
Total operating expenses	202,580	248,658	684,374	813,597
Income from operations	86,926	136,368	304,259	527,834
Interest expense, net, and other	11,541	8,961	33,975	28,630
Income before income taxes	75,385	127,407	270,284	499,204
Income tax expense	22,211	34,962	72,094	136,951
Net income	53,174	92,445	198,190	362,253
Other comprehensive income (loss):
Unrealized gains (losses) on available-for-sale securities, net, and other	133	(219)	329	(794)
Other comprehensive income (loss)	133	(219)	329	(794)
Comprehensive income	$ 53,307	$ 92,226	$ 198,519	$ 361,459
Net income per common share:
Basic (in dollars per share)	$ 1.39	$ 2.11	$ 5.01	$ 8.04
Diluted (in dollars per share)	$ 1.39	$ 2.10	$ 4.99	$ 7.99
Weighted average common shares outstanding:
Basic (in shares)	38,147	43,785	39,547	45,056
Diluted (in shares)	38,325	44,039	39,734	45,332

FAIR VALUE MEASUREMENT - Narrative (Details) - USD ($)	9 Months Ended
FAIR VALUE MEASUREMENT - Narrative (Details) - USD ($)	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022	Oct. 20, 2020	Aug. 13, 2020
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Asset impairment charges	$ 0	$ 0
2027 Notes \| Senior Notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate					4.625%
2029 Notes \| Senior Notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate				4.00%
Fair Value, Measurements, Nonrecurring \| Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Equity investment balance	$ 19,204,000		$ 19,204,000

FAIR VALUE MEASUREMENT

9 Months Ended

Sep. 30, 2023

Fair Value Disclosures [Abstract]

FAIR VALUE MEASUREMENT

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.


	As of September 30, 2023		As of December 31, 2022
Commercial paper	$	47,618	$	31,536
Corporate bonds	—		—
Total classified as restricted cash equivalents	$	47,618	$	31,536
Commercial paper	$	—	$	—
Corporate bonds	15,367		25,095
Total classified as restricted investments	$	15,367	$	25,095

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:


	Fair Value Measurements as of September 30, 2023								Fair Value Measurements as of December 31, 2022
Assets (Liabilities)	Level 1		Level 2		Level 3		Total		Level 1		Level 2		Level 3		Total
Money market funds	$	657	$	—	$	—	$	657	$	36,895	$	—	$	—	$	36,895
Deferred compensation	(150,074)		—		—		(150,074)		(128,465)		—		—		(128,465)
Corporate bonds	—		15,367		—		15,367		—		25,095		—		25,095
Commercial paper	—		47,618		—		47,618		—		31,536		—		31,536
Acquisition contingent consideration liabilities	—		—		—		—		—		—		(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.

There were no material impairment charges recorded during the nine months ended September 30, 2023 and 2022.

Fair Value of Financial Instruments


	As of September 30, 2023				As of December 31, 2022
	Carrying Amount		Estimated Fair Value		Carrying Amount		Estimated Fair Value
2027 Notes	$	500,000	$	453,125	$	500,000	$	460,000
2029 Notes	350,000		297,500		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.

- Definition

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

+ References + Details

SEGMENT INFORMATION - Reconciliation of Revenue and Segment Operating Income by Reportable Segment (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	$ 853,463	$ 1,138,586	$ 2,970,985	$ 4,117,731
Segment operating income	86,926	136,368	304,259	527,834
Depreciation and amortization	39,175	33,239	113,599	96,169
Depreciation (included in cost of revenue)	1,552	1,091	4,196	2,918
Share-based compensation	306	4,898	15,442	24,670
Interest expense, net, and other	11,541	8,961	33,975	28,630
Income before income taxes	75,385	127,407	270,284	499,204
Nurse and allied solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	573,426	828,317	2,086,921	3,157,834
Physician and leadership solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	159,554	175,152	501,540	530,355
Technology and workforce solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	120,483	135,117	382,524	429,542
Operating segments
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	853,463	1,138,586	2,970,985	4,117,731
Segment operating income	155,155	210,231	545,782	767,947
Operating segments \| Nurse and allied solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	573,426	828,317	2,086,921	3,157,834
Segment operating income	82,882	115,182	299,320	471,141
Operating segments \| Physician and leadership solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	159,554	175,152	501,540	530,355
Segment operating income	21,609	23,904	73,165	64,280
Operating segments \| Technology and workforce solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	120,483	135,117	382,524	429,542
Segment operating income	50,664	71,145	173,297	232,526
Unallocated corporate overhead
Segment Reporting, Revenue Reconciling Item [Line Items]
Unallocated corporate overhead	$ 27,196	$ 34,635	$ 108,286	$ 116,356