View all news

AMN Healthcare Announces Second Quarter 2021 Results

August 5, 2021

Quarterly revenue of $857 million;

GAAP EPS of $1.39 and adjusted EPS of $1.64

DALLAS--(BUSINESS WIRE)-- AMN Healthcare Services, Inc. (NYSE: AMN), the leader and innovator in total talent solutions for healthcare organizations across the United States, today announced its second quarter 2021 financial results. Financial highlights are as follows:

Dollars in millions, except per share amounts.

 

Q2 2021

% Change Q2
2020

YTD June 30,
2021

% Change YTD
June 30, 2020

Revenue

$857.4

41%

$1,743.4

44%

Gross profit

$280.5

42%

$569.4

42%

Net income

$66.8

199%

$137.1

289%

GAAP diluted EPS

$1.39

196%

$2.86

286%

Adjusted diluted EPS*

$1.64

98%

$3.34

107%

Adjusted EBITDA*

$133.5

66%

$274.5

78%

* See “Non-GAAP Measures” below for a discussion of our use of non-GAAP items and the table entitled “Non-GAAP Reconciliation Tables” for a reconciliation of non-GAAP items.

Business Highlights

  • Second quarter financial performance was better than guidance across our reportable segments driven by a strong demand environment and AMN team execution.
  • Increased healthcare utilization and a tight labor market have created record high demand in many areas of our business.
  • Revenue for the quarter was $857 million, 41% above prior year.
  • Operating cash flow in the first half of 2021 was $211 million, up 64% year over year, and our leverage ratio at quarter end was 1.7 to 1.
  • Our outsourcing and technology solutions continue to be recognized as industry leading. AMN received the highest ranking for a healthcare MSP in HRO Today's customer satisfaction ratings. Our RPO solution was recognized as a Star Performer by Everest.

“As the leader in our industry, the AMN team continues to amplify our impact and make extraordinary contributions as the healthcare labor market enters a new era of heightened demand and tighter supply. Healthcare organizations are partnering with AMN to build more contemporary, flexible and sustainable staffing models for the future, which will also provide greater access to patient care,” said Susan R. Salka, Chief Executive Officer of AMN Healthcare.

“More than ever, we are collaborating and innovating with our clients and healthcare professionals to improve the health and well-being of patients, and the communities we serve. As always, these efforts begin with our strong commitment to diversity, equity, inclusion and social responsibility,” Ms. Salka said. “We have increased investments in our team and technologies to support and expand our ability to provide total talent solutions that empower healthcare workers and organizations, now and far into the future.”

Second Quarter 2021 Results

Consolidated revenue for the quarter was $857 million, a 41% increase over prior year and 3% lower than prior quarter. Net income was $67 million (7.8% of revenue), or $1.39 per diluted share, compared with $22 million (3.7% of revenue), or $0.47 per diluted share, in the same quarter last year. Adjusted diluted EPS in the second quarter was $1.64 compared with $0.83 in the same quarter of the prior year.

Revenue for the Nurse and Allied Solutions segment was $624 million up 41% year over year and down 5% sequentially. Travel nurse staffing revenue grew 37% year over year, and allied division revenue was up 44% year over year. Revenue cycle solutions revenue grew 9% from prior year.

The Physician and Leadership Solutions segment reported revenue of $139 million, up 28% year over year and down 1% sequentially. Locum tenens revenue was $78 million, up 26% year over year and down 10% sequentially. Year-over-year growth in locums was driven by stronger days filled, while the sequential comparison saw a 2% decrease in days filled as most pandemic-related work ended in the first quarter. Interim leadership revenue was higher by 30% year over year and 13% sequentially. Our physician and leadership search businesses had revenue growth of 33% year over year and 12% sequentially.

Technology and Workforce Solutions segment revenue was $94 million, an increase of 70% year over year. Language services produced $46 million revenue in the quarter, up 61% over prior year. Vendor management systems revenue was $31 million growing by 76% year over year.

Consolidated gross margin was 32.7%, 20 basis points higher year over year and up 10 basis points sequentially. Gross margin improved year over year and sequentially due primarily to a higher mix of Technology and Workforce Solutions revenue.

Consolidated SG&A expenses were $157 million, or 18.3% of revenue, compared with $137 million, or 22.5% of revenue, in the same quarter last year. SG&A was $161 million, or 18.2% of revenue, in the previous quarter. The year-over-year increase in SG&A costs was driven primarily by higher employee and related expenses to support strong revenue growth. SG&A margin declined due to operating leverage on increased revenue.

Income from operations was $99 million with an operating margin of 11.6%, compared with $38 million and 6.3%, respectively, in the same quarter last year. Adjusted EBITDA was $134 million, a year-over-year increase of 66%. Adjusted EBITDA margin was 15.6%, representing an increase of 240 basis points year over year.

At June 30, 2021, cash and cash equivalents totaled $139 million. Cash flow from operations was $171 million for the quarter, and capital expenditures were $11 million. The Company ended the quarter with total debt outstanding of $850 million and a leverage ratio of 1.7 to 1 as defined under our credit agreement.

Third Quarter 2021 Outlook

 

Metric

Guidance*

Consolidated revenue

$770 - $790 million

Gross margin

33.4% - 33.9%

SG&A as percentage of revenue

19.8% - 20.2%

Operating margin

10.0% - 10.5%

Adjusted EBITDA margin

14.2% - 14.7%

*Note: Guidance percentage metrics are approximate. For a reconciliation of adjusted EBITDA margin, see the table entitled “Reconciliation of Guidance Operating Margin to Guidance Adjusted EBITDA Margin” below.

Revenue in the third quarter of 2021 is expected to be 40-43% higher than prior year. Nurse and Allied Solutions segment revenue is expected to grow approximately 45% year over year. For the Physician and Leadership Solutions segment, revenue is expected to be 25-27% higher than prior year. Technology and Workforce Solutions segment revenue is expected to grow by 44-48% compared with the year-ago period. Revenue guidance includes approximately $20 million from labor disruption-related activities.

Third quarter estimates for certain other financial items include depreciation of $10 million, non-cash amortization expense of $16 million, stock-based compensation expense of $3.5 million, interest expense of $10 million, integration and other expenses of $3 million, and an adjusted tax rate of 28%.

Conference Call on August 5, 2021

AMN Healthcare Services, Inc. (NYSE: AMN), the leader and innovator in total talent solutions for healthcare, will host a conference call to discuss its second quarter 2021 financial results and outlook on Thursday, August 5, 2021 at 5:00 p.m. Eastern Time. A live webcast of the call can be accessed through AMN Healthcare’s website at http://ir.amnhealthcare.com. Please log in at least 10 minutes prior to the conference call in order to download the applicable audio software. Interested parties may participate live via telephone by dialing (833) 968-2219 in the U.S. or +1 778-560-2894 internationally and using passcode 5688436. Following the conclusion of the call, a replay of the webcast will be available at the Company’s website. Alternatively, a telephonic replay of the call will be available beginning at 8:00 p.m. Eastern Time on August 5, 2021 and can be accessed until 11:59 p.m. Eastern Time on August 19, 2021 by calling (800) 585-8367 in the U.S. or +1 416-621-4642 internationally, with access code 5688436.

About AMN Healthcare

AMN Healthcare is the leader and innovator in total talent solutions for healthcare organizations across the nation. The Company provides access to the most comprehensive network of quality healthcare professionals through its innovative recruitment strategies and breadth of career opportunities. With insights and expertise, AMN Healthcare helps providers optimize their workforce to successfully reduce complexity, increase efficiency and improve patient outcomes. AMN total talent solutions include managed services programs, clinical and interim healthcare leaders, temporary staffing, executive search solutions, vendor management systems, recruitment process outsourcing, predictive modeling, language services, revenue cycle solutions, credentialing, and other services. Clients include acute-care hospitals, community health centers and clinics, physician practice groups, retail and urgent care centers, home health facilities, schools and many other healthcare settings. AMN Healthcare is committed to fostering and maintaining a diverse team that reflects the communities we serve. Our commitment to the inclusion of many different backgrounds, experiences and perspectives enables our innovation and leadership in the healthcare services industry.

The Company’s common stock is listed on the New York Stock Exchange under the symbol “AMN.” For more information about AMN Healthcare, visit www.amnhealthcare.com, where the Company posts news releases, investor presentations, webcasts, SEC filings and other material information. The Company also utilizes email alerts and Really Simple Syndication (“RSS”) as routine channels to supplement distribution of this information. To register for email alerts and RSS, visit http://ir.amnhealthcare.com.

Non-GAAP Measures

This earnings release and the non-GAAP reconciliation tables included with the earnings release contain certain non-GAAP financial information, which the Company provides as additional information, and not as an alternative, to the Company’s condensed consolidated financial statements presented in accordance with GAAP. These non-GAAP financial measures include (1) adjusted EBITDA, (2) adjusted EBITDA margin, (3) adjusted net income and (4) adjusted diluted EPS. The Company provides such non-GAAP financial measures because management believes that they are useful to both management and investors as a supplement, and not as a substitute, when evaluating the Company’s operating performance. Additionally, management believes that adjusted EBITDA, adjusted EBITDA margin, adjusted net income and adjusted diluted EPS serve as industry-wide financial measures. The Company uses adjusted EBITDA for making financial decisions, allocating resources and for determining certain incentive compensation objectives. The non-GAAP measures in this release are not in accordance with, or an alternative to, GAAP measures and may be different from non-GAAP measures, or may be calculated differently than other similarly titled non-GAAP measures, reported by other companies. They should not be used in isolation to evaluate the Company’s performance. A reconciliation of non-GAAP measures identified in this release, along with further detail about the use and limitations of certain of these non-GAAP measures, may be found below in the table entitled “Non-GAAP Reconciliation Tables” under the caption entitled “Reconciliation of Non-GAAP Items” and the footnotes thereto or on the Company’s website at https://ir.amnhealthcare.com/financials/quarterly-results/default.aspx. Additionally, from time to time, additional information regarding non-GAAP financial measures, including pro forma measures, may be made available on the Company’s website.

Forward-Looking Statements

This press release contains “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements include, among others, statements concerning the impact and contributions of the AMN team, healthcare utilization, the competitive and strained labor market, current demand drivers, healthcare organizations' need for different staffing models, the impact of mandatory vaccination requirements on demand and supply, third quarter 2021 revenue projections for our travel nurse and allied businesses and each of our Nurse and Allied Solutions, Physician and Leadership Solutions and Technology and Workforce Solutions segments, and our third quarter 2021 guidance for consolidated revenue, gross margin, operating margin, SG&A as a percent of revenue, adjusted EBITDA margin, depreciation expense, non-cash amortization expense, stock-based compensation expense, interest expense, integration and other expenses, and adjusted tax rate. The Company bases these forward-looking statements on its current expectations, estimates and projections about future events and the industry in which it operates using information currently available to it. Actual results could differ materially from those discussed in, or implied by, these forward-looking statements. Forward-looking statements are also identified by words such as “believe,” "project," “anticipate,” “expect,” “intend,” “plan,” “will,” “may,” “estimates,” variations of such words and other similar expressions. In addition, any statements that refer to expectations, projections or other characterizations of future events or circumstances are forward-looking statements.

The targets and expectations noted in this release depend upon, among other factors, (i) the magnitude and duration of the effects of the COVID-19 pandemic on demand and supply trends, our business, its financial condition and our results of operations, (ii) our ability to effectively address client demand by attracting and placing nurses and other clinicians, (iii) our ability to recruit and retain sufficient quality healthcare professionals at reasonable costs, (iv) our ability to anticipate and quickly respond to changing marketplace conditions, such as alternative modes of healthcare delivery, reimbursement, or client needs and requirements, including mandatory vaccination, (v) our ability to manage the pricing impact that the COVID-19 pandemic and consolidation of healthcare delivery organizations may have on our business, (vi) the duration of the period that hospitals and other healthcare entities adjust their utilization of temporary employees, physicians, leaders and other workforce technology applications as a result of the suspension of or restrictions placed on non-essential and elective healthcare as a result of the COVID-19 pandemic, (vii) the duration of the period that individuals may continue to forego non-essential and elective healthcare as “safer at home” restrictions and recommendations lift, (viii) our ability to develop and evolve our current technology offerings and capabilities and implement new infrastructure and technology systems to optimize our operating results and manage our business effectively, (ix) our ability to comply with extensive and complex federal and state laws and regulations related to the conduct of our operations, costs and payment for services and payment for referrals as well as laws regarding employment practices, (x) our ability to consummate and effectively incorporate acquisitions into our business, (xi) the extent to which “shelter-in-place” orders, quarantines and restrictions on travel and mass gatherings that were ordered earlier in the year to slow the spread of the COVID-19 virus may be reinstituted as infection rates continue to climb in many parts of the country, (xii) the extent and duration of the period that a significant spike in unemployment that has resulted from the COVID-19 pandemic will cause an increase in under- and uninsured patients and a corresponding reduction in overall healthcare utilization and demand for our services, (xiii) the extent to which the COVID-19 pandemic may disrupt our operations due to the unavailability of our employees or healthcare professionals due to illness, risk of illness, quarantines, travel restrictions, mandatory vaccination requirements, or other factors that limit our existing or potential workforce and pool of candidates, and (xiv) the severity and duration of the impact the COVID-19 pandemic has on the financial condition and cash flow of many hospitals and healthcare systems such that it impairs their ability to make payments to us, timely or otherwise, for services rendered.

For a discussion of additional risk factors and a more complete discussion of some of the cautionary statements noted above that could cause actual results to differ from those implied by the forward-looking statements contained in this press release, please refer to our most recent Annual Report on Form 10-K for the year ended December 31, 2020. Be advised that developments subsequent to this press release are likely to cause these statements to become outdated and the Company is under no obligation (and expressly disclaims any such obligation) to update or revise any forward-looking statements whether as a result of new information, future events, or otherwise.

AMN Healthcare Services, Inc.

Condensed Consolidated Statements of Comprehensive Income

(in thousands, except per share amounts)

(unaudited)

 

 

 

 

 

Three Months Ended

 

Six Months Ended

 

June 30,

 

March 31,

 

June 30,

 

2021

 

2020

 

 

2021

 

 

2021

 

 

2020

 

Revenue

$

857,445

 

 

$

608,351

 

 

 

$

885,945

 

 

 

$

1,743,390

 

 

 

$

1,210,812

 

 

Cost of revenue

576,902

 

 

410,811

 

 

 

597,077

 

 

 

1,173,979

 

 

 

811,206

 

 

Gross profit

280,543

 

 

197,540

 

 

 

288,868

 

 

 

569,411

 

 

 

399,606

 

 

Gross margin

32.7

%

 

32.5

 

%

 

32.6

 

%

 

32.7

 

%

 

33.0

 

%

Operating expenses:

 

 

 

 

 

 

 

 

 

Selling, general and administrative (SG&A)

156,629

 

 

137,068

 

 

 

161,212

 

 

 

317,841

 

 

 

283,302

 

 

SG&A as a % of revenue

18.3

%

 

22.5

 

%

 

18.2

 

%

 

18.2

 

%

 

23.4

 

%

 

 

 

 

 

 

 

 

 

 

Depreciation and amortization

24,740

 

 

22,071

 

 

 

23,254

 

 

 

47,994

 

 

 

42,160

 

 

Total operating expenses

181,369

 

 

159,139

 

 

 

184,466

 

 

 

365,835

 

 

 

325,462

 

 

Income from operations

99,174

 

 

38,401

 

 

 

104,402

 

 

 

203,576

 

 

 

74,144

 

 

Operating margin (1)

11.6

%

 

6.3

 

%

 

11.8

 

%

 

11.7

 

%

 

6.1

 

%

 

 

 

 

 

 

 

 

 

 

Interest expense, net, and other (2)

10,111

 

 

11,443

 

 

 

8,944

 

 

 

19,055

 

 

 

22,497

 

 

 

 

 

 

 

 

 

 

 

 

Income before income taxes

89,063

 

 

26,958

 

 

 

95,458

 

 

 

184,521

 

 

 

51,647

 

 

 

 

 

 

 

 

 

 

 

 

Income tax expense

22,293

 

 

4,633

 

 

 

25,080

 

 

 

47,373

 

 

 

16,357

 

 

Net income

$

66,770

 

 

$

22,325

 

 

 

$

70,378

 

 

 

$

137,148

 

 

 

$

35,290

 

 

Net income as a % of revenue

7.8

%

 

3.7

 

%

 

7.9

 

%

 

7.9

 

%

 

2.9

 

%

 

 

 

 

 

 

 

 

 

 

Other comprehensive income (loss):

 

 

 

 

 

 

 

 

 

Foreign currency translation and other

3

 

 

(58

)

 

 

(24

)

 

 

(21

)

 

 

(105

)

 

Other comprehensive income (loss)

3

 

 

(58

)

 

 

(24

)

 

 

(21

)

 

 

(105

)

 

 

 

 

 

 

 

 

 

 

 

Comprehensive income

$

66,773

 

 

$

22,267

 

 

 

$

70,354

 

 

 

$

137,127

 

 

 

$

35,185

 

 

 

 

 

 

 

 

 

 

 

 

Net income per common share:

 

 

 

 

 

 

 

 

 

Basic

$

1.40

 

 

$

0.47

 

 

 

$

1.48

 

 

 

$

2.88

 

 

 

$

0.74

 

 

Diluted

$

1.39

 

 

$

0.47

 

 

 

$

1.47

 

 

 

$

2.86

 

 

 

$

0.74

 

 

Weighted average common shares outstanding:

 

 

 

 

 

 

 

 

 

Basic

47,659

 

 

47,383

 

 

 

47,600

 

 

 

47,629

 

 

 

47,371

 

 

Diluted

48,019

 

 

47,562

 

 

 

47,916

 

 

 

47,976

 

 

 

47,623

 

 

 

 

 

 

 

 

 

 

 

 

AMN Healthcare Services, Inc.

Condensed Consolidated Balance Sheets

(dollars in thousands)

(unaudited)

 

 

 

 

 

 

 

June 30, 2021

 

December 31,

2020

 

June 30, 2020

Assets

 

 

 

 

 

Current assets:

 

 

 

 

 

Cash and cash equivalents

$

139,494

 

 

$

29,213

 

 

$

43,067

 

Accounts receivable, net

468,299

 

 

376,099

 

 

366,574

 

Accounts receivable, subcontractor

130,409

 

 

73,985

 

 

58,469

 

Prepaid and other current assets

51,901

 

 

54,438

 

 

50,529

 

Total current assets

790,103

 

 

533,735

 

 

518,639

 

Restricted cash, cash equivalents and investments

63,441

 

 

61,347

 

 

56,362

 

Fixed assets, net

121,487

 

 

116,174

 

 

113,975

 

Operating lease right-of-use assets

72,641

 

 

77,735

 

 

85,119

 

Other assets

145,463

 

 

135,120

 

 

120,910

 

Goodwill

892,874

 

 

864,485

 

 

870,074

 

Intangible assets, net

546,434

 

 

564,911

 

 

599,737

 

Total assets

$

2,632,443

 

 

$

2,353,507

 

 

$

2,364,816

 

 

 

 

 

 

 

Liabilities and stockholders’ equity

 

 

 

 

 

Current liabilities:

 

 

 

 

 

Accounts payable and accrued expenses

$

260,894

 

 

$

167,881

 

 

144,824

 

Accrued compensation and benefits

288,195

 

 

213,414

 

 

171,007

 

Current portion of notes payable

 

 

4,688

 

 

7,813

 

Current portion of operating lease liabilities

15,783

 

 

15,032

 

 

15,480

 

Deferred revenue

15,065

 

 

11,004

 

 

11,759

 

Other current liabilities

2,626

 

 

10,938

 

 

33,653

 

Total current liabilities

582,563

 

 

422,957

 

 

384,536

 

Revolving credit facility

 

 

 

 

100,000

 

Notes payable, net of unamortized fees and premium

841,731

 

 

857,961

 

 

856,106

 

Deferred income taxes, net

63,748

 

 

67,205

 

 

87,649

 

Operating lease liabilities

71,161

 

 

77,800

 

 

85,504

 

Other long-term liabilities

106,858

 

 

107,907

 

 

73,615

 

Total liabilities

1,666,061

 

 

1,533,830

 

 

1,587,410

 

 

 

 

 

 

 

Commitments and contingencies

 

 

 

 

 

 

 

 

 

 

 

Stockholders’ equity:

966,382

 

 

819,677

 

 

777,406

 

 

 

 

 

 

 

Total liabilities and stockholders’ equity

$

2,632,443

 

 

$

2,353,507

 

 

$

2,364,816

 

 

 

 

 

 

 

AMN Healthcare Services, Inc.

Summary Condensed Consolidated Statements of Cash Flows

(dollars in thousands)

(unaudited)

 

 

 

 

 

Three Months Ended

 

Six Months Ended

 

June 30,

 

March 31,

 

June 30,

 

2021

 

2020

 

2021

 

2021

 

2020

 

 

 

 

 

 

 

 

 

 

Net cash provided by operating activities

$

171,494

 

 

 

$

76,906

 

 

 

$

39,131

 

 

 

$

210,625

 

 

 

$

128,271

 

 

Net cash provided by (used in) investing activities

(56,403

)

 

 

(21,125

)

 

 

2,794

 

 

 

(53,609

)

 

 

(513,262

)

 

Net cash provided by (used in) financing activities

(55,470

)

 

 

(127,132

)

 

 

24,767

 

 

 

(30,703

)

 

 

328,994

 

 

Effect of exchange rates on cash

3

 

 

 

(58

)

 

 

(24

)

 

 

(21

)

 

 

(105

)

 

Net increase (decrease) in cash, cash equivalents and restricted cash

59,624

 

 

 

(71,409

)

 

 

66,668

 

 

 

126,292

 

 

 

(56,102

)

 

Cash, cash equivalents and restricted cash at beginning of period

150,658

 

 

 

169,269

 

 

 

83,990

 

 

 

83,990

 

 

 

153,962

 

 

Cash, cash equivalents and restricted cash at end of period

$

210,282

 

 

 

$

97,860

 

 

 

$

150,658

 

 

 

$

210,282

 

 

 

$

97,860

 

 

 

AMN Healthcare Services, Inc.

Non-GAAP Reconciliation Tables

(dollars in thousands, except per share data)

(unaudited)

 

 

 

 

 

Three Months Ended

 

Six Months Ended

 

June 30,

 

March 31,

 

June 30,

 

2021

 

 

2020

 

 

2021

 

 

2021

 

 

2020

 

Reconciliation of Non-GAAP Items:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income

$

66,770

 

 

 

$

22,325

 

 

 

$

70,378

 

 

 

$

137,148

 

 

 

$

35,290

 

 

Income tax expense

22,293

 

 

 

4,633

 

 

 

25,080

 

 

 

47,373

 

 

 

16,357

 

 

Income before income taxes

89,063

 

 

 

26,958

 

 

 

95,458

 

 

 

184,521

 

 

 

51,647

 

 

Interest expense, net, and other (2)

10,111

 

 

 

11,443

 

 

 

8,944

 

 

 

19,055

 

 

 

22,497

 

 

Income from operations

99,174

 

 

 

38,401

 

 

 

104,402

 

 

 

203,576

 

 

 

74,144

 

 

Depreciation and amortization

24,740

 

 

 

22,071

 

 

 

23,254

 

 

 

47,994

 

 

 

42,160

 

 

Depreciation (included in cost of revenue) (3)

616

 

 

 

355

 

 

 

471

 

 

 

1,087

 

 

 

500

 

 

Share-based compensation

6,019

 

 

 

6,347

 

 

 

9,287

 

 

 

15,306

 

 

 

11,274

 

 

Acquisition, integration, and other costs (4)

2,999

 

 

 

13,364

 

 

 

3,502

 

 

 

6,501

 

 

 

26,441

 

 

Adjusted EBITDA (5)

$

133,548

 

 

 

$

80,538

 

 

 

$

140,916

 

 

 

$

274,464

 

 

 

$

154,519

 

 

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA margin (6)

15.6

 

%

 

13.2

 

%

 

15.9

 

%

 

15.7

 

%

 

12.8

 

%

 

 

 

 

 

 

 

 

 

 

Net income

$

66,770

 

 

 

$

22,325

 

 

 

$

70,378

 

 

 

$

137,148

 

 

 

$

35,290

 

 

Adjustments:

 

 

 

 

 

 

 

 

 

Amortization of intangible assets

15,806

 

 

 

15,068

 

 

 

15,201

 

 

 

31,007

 

 

 

28,499

 

 

Acquisition, integration, and other costs (4)

2,999

 

 

 

13,364

 

 

 

3,502

 

 

 

6,501

 

 

 

26,441

 

 

Fair value changes of equity investments and instruments (2)

 

 

 

593

 

 

 

(1,271

)

 

 

(1,271

)

 

 

1,891

 

 

Debt financing related costs

 

 

 

 

 

 

158

 

 

 

158

 

 

 

 

 

Tax effect on above adjustments

(4,889

)

 

 

(7,546

)

 

 

(4,574

)

 

 

(9,463

)

 

 

(14,776

)

 

Tax effect of COLI fair value changes (7)

(1,093

)

 

 

(4,316

)

 

 

(1,086

)

 

 

(2,179

)

 

 

939

 

 

Excess tax benefits related to equity awards (8)

(877

)

 

 

(15

)

 

 

(676

)

 

 

(1,553

)

 

 

(1,236

)

 

Adjusted net income (9)

$

78,716

 

 

 

$

39,473

 

 

 

$

81,632

 

 

 

$

160,348

 

 

 

$

77,048

 

 

 

 

 

 

 

 

 

 

 

 

GAAP diluted net income per share (EPS)

$

1.39

 

 

 

$

0.47

 

 

 

$

1.47

 

 

 

$

2.86

 

 

 

$

0.74

 

 

Adjustments

0.25

 

 

 

0.36

 

 

 

0.23

 

 

 

0.48

 

 

 

0.88

 

 

Adjusted diluted EPS (10)

$

1.64

 

 

 

$

0.83

 

 

 

$

1.70

 

 

 

$

3.34

 

 

 

$

1.62

 

 

 

AMN Healthcare Services, Inc.

Supplemental Segment Financial and Operating Data

(dollars in thousands, except operating data)

(unaudited)

 

 

 

 

 

Three Months Ended

 

Six Months Ended

 

June 30,

 

March 31,

 

June 30,

 

2021

 

2020

 

2021

 

2021

 

2020

Revenue

 

 

 

 

 

 

 

 

 

Nurse and allied solutions

$

624,485

 

 

$

444,464

 

 

$

656,661

 

 

$

1,281,146

 

 

$

868,810

 

Physician and leadership solutions

139,104

 

 

108,622

 

 

140,756

 

 

279,860

 

 

246,464

 

Technology and workforce solutions

93,856

 

 

55,265

 

 

88,528

 

 

182,384

 

 

95,538

 

 

$

857,445

 

 

$

608,351

 

 

$

885,945

 

 

$

1,743,390

 

 

$

1,210,812

 

 

 

 

 

 

 

 

 

 

 

Segment operating income (11)

 

 

 

 

 

 

 

 

 

Nurse and allied solutions

$

89,674

 

 

$

61,175

 

 

$

101,530

 

 

$

191,204

 

 

$

120,783

 

Physician and leadership solutions

21,849

 

 

15,325

 

 

21,216

 

 

43,065

 

 

29,894

 

Technology and workforce solutions

42,653

 

 

21,839

 

 

42,089

 

 

84,742

 

 

37,134

 

 

154,176

 

 

98,339

 

 

164,835

 

 

319,011

 

 

187,811

 

Unallocated corporate overhead (12)

20,628

 

 

17,801

 

 

23,919

 

 

44,547

 

 

33,292

 

Adjusted EBITDA (5)

$

133,548

 

 

$

80,538

 

 

$

140,916

 

 

$

274,464

 

 

$

154,519

 

 

 

 

 

 

 

 

 

 

 

Gross Margin

 

 

 

 

 

 

 

 

 

Nurse and allied solutions

26.6

%

 

27.0

%

 

26.9

%

 

26.8

%

 

27.7

%

Physician and leadership solutions

36.6

%

 

36.4

%

 

37.0

%

 

36.8

%

 

36.6

%

Technology and workforce solutions

67.7

%

 

68.7

%

 

67.7

%

 

67.7

%

 

71.7

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Operating Data:

 

 

 

 

 

 

 

 

 

Nurse and allied solutions

 

 

 

 

 

 

 

 

 

Average travelers on assignment (13)

12,555

 

 

9,815

 

 

12,091

 

 

12,323

 

 

10,613

 

 

 

 

 

 

 

 

 

 

 

Physician and leadership solutions

 

 

 

 

 

 

 

 

 

Days filled (14)

39,368

 

 

32,615

 

 

40,105

 

 

79,472

 

 

72,899

 

Revenue per day filled (15)

$

1,977

 

 

$

1,899

 

 

$

2,153

 

 

$

2,066

 

 

$

1,937

 

 

 

 

 

 

 

 

 

 

 

 

As of June 30,

 

As of December 31,

 

2021

 

2020

 

2020

Leverage ratio (16)

1.7

 

2.7

 

2.6

 

 

 

 

 

 

AMN Healthcare Services, Inc.

Additional Supplemental Non-GAAP Disclosure

Reconciliation of Guidance Operating Margin to Guidance

Adjusted EBITDA Margin

(unaudited)

 

 

 

Three Months Ended

 

September 30, 2021

 

Low(17)

 

High(17)

 

 

 

 

Operating margin

10.0%

 

10.5%

Depreciation and amortization

3.4%

 

3.4%

EBITDA margin

13.4%

 

13.9%

Share-based compensation

0.4%

 

0.4%

Acquisition, integration, and other costs

0.4%

 

0.4%

Adjusted EBITDA margin

14.2%

 

14.7%

(1)

Operating margin represents income from operations divided by revenue.

(2)

Changes in the fair value of equity investments and instruments are recognized in interest expense, net, and other. Since the changes in fair value are unrelated to the Company’s operating performance, we exclude the impact from the calculation of adjusted net income and adjusted diluted EPS.

(3)

A portion of depreciation expense for AMN Language Services (formerly known as Stratus Video, which was acquired in February 2020 and has since been rebranded) is included in cost of revenue. We exclude the impact of depreciation included in cost of revenue from the calculation of adjusted EBITDA.

(4)

Acquisition, integration, and other costs include acquisition and integration costs, net changes in the fair value of contingent consideration liabilities for recently acquired companies, extraordinary legal expenses, and restructuring expenses, which we exclude from the calculation of adjusted EBITDA, adjusted net income, and adjusted diluted EPS because we believe that these expenses are not indicative of the Company’s operating performance. Acquisition, integration, and other costs for the three and six months ended June 30, 2020 include $3,568,000 of restructuring expenses associated with cost reduction actions that were initiated during the three months ended June 30, 2020, acquisition-related costs of the Stratus Video acquisition of $1,713,000 and $9,525,000, respectively, and increases in contingent consideration liabilities for recently acquired companies of $4,800,000 and $5,000,000, respectively.

(5)

Adjusted EBITDA represents net income plus interest expense (net of interest income) and other, income tax expense (benefit), depreciation and amortization, depreciation (included in cost of revenue), acquisition, integration, and other costs, restructuring expenses, extraordinary legal expenses, and share-based compensation. Management believes that adjusted EBITDA provides an effective measure of the Company’s results, as it excludes certain items that management believes are not indicative of the Company’s operating performance. Adjusted EBITDA is not intended to represent cash flows for the period, nor has it been presented as an alternative to income from operations or net income as an indicator of operating performance. Although management believes that some of the items excluded from adjusted EBITDA are not indicative of the Company’s operating performance, these items do impact the statement of comprehensive income, and management therefore utilizes adjusted EBITDA as an operating performance measure in conjunction with GAAP measures such as net income.

(6)

Adjusted EBITDA margin represents adjusted EBITDA divided by revenue.

(7)

The Company records net tax expense (benefit) related to the income tax treatment of the fair value changes in the cash surrender value of its company owned life insurance. Since this change in fair value is unrelated to the Company’s operating performance, we excluded the impact on adjusted net income and adjusted diluted EPS.

(8)

The consolidated effective tax rate is affected by the recording of excess tax benefits and tax deficiencies relating to equity awards vested and exercised during the period. As a result of the adoption of a new accounting pronouncement on January 1, 2017, the Company no longer records excess tax benefits and tax deficiencies to additional paid-in capital, but such excess tax benefits and tax deficiencies are now recognized in income tax expense. The magnitude of the impact of excess tax benefits and tax deficiencies generated in the future, which may be favorable or unfavorable, is dependent upon the Company’s future grants of share-based compensation, the Company’s future stock price on the date awards vest or exercise in relation to the fair value of the awards on the grant date or the exercise behavior of the Company’s stock appreciation rights holders. Since these excess tax benefits and tax deficiencies are largely unrelated to our income before taxes and are unrepresentative of our normal effective tax rate, we excluded their impact in the calculation of adjusted net income and adjusted diluted EPS.

(9)

Adjusted net income represents GAAP net income excluding the impact of the (A) amortization of intangible assets, (B) acquisition, integration, and other costs, (C) extraordinary legal expenses, (D) changes in fair value of equity investments and instruments, (E) deferred financing related costs, (F) tax effect, if any, of the foregoing adjustments, (G) excess tax benefits and tax deficiencies relating to equity awards vested and exercised since January 1, 2017, and (H) net tax expense (benefit) related to the income tax treatment of fair value changes in the cash surrender value of its company owned life insurance, and (I) restructuring tax benefits. Management included this non-GAAP measure to provide investors and prospective investors with an alternative method for assessing the Company’s operating results in a manner that is focused on its operating performance and to provide a more consistent basis for comparison between periods. However, investors and prospective investors should note that this non-GAAP measure involves judgment by management (in particular, judgment as to what is classified as a special item to be excluded in the calculation of adjusted net income). Although management believes the items in the calculation of adjusted net income are not indicative of the Company’s operating performance, these items do impact the statement of comprehensive income, and management therefore utilizes adjusted net income as an operating performance measure in conjunction with GAAP measures such as GAAP net income.

(10)

Adjusted diluted EPS represents adjusted net income divided by diluted weighted average common shares outstanding. Management included this non-GAAP measure to provide investors and prospective investors with an alternative method for assessing the Company’s operating results in a manner that is focused on its operating performance and to provide a more consistent basis for comparison between periods. However, investors and prospective investors should note that this non-GAAP measure involves judgment by management (in particular, judgment as to what is classified as a special item to be excluded in the calculation of adjusted net income). Although management believes the items in the calculation of adjusted net income are not indicative of the Company’s operating performance, these items do impact the statement of comprehensive income, and management therefore utilizes adjusted diluted EPS as an operating performance measure in conjunction with GAAP measures such as GAAP diluted EPS.

(11)

Segment operating income represents net income plus interest expense (net of interest income) and other, income tax expense (benefit), depreciation and amortization, depreciation (included in cost of revenue), unallocated corporate overhead, acquisition, integration, and other costs, and share-based compensation.

(12)

Unallocated corporate overhead (as presented in the tables above) consists of unallocated corporate overhead (as reflected in our quarterly and annual financial statements filed with the SEC) less acquisition, integration, and other costs.

(13)

Average travelers on assignment represents the average number of nurse and allied healthcare professionals on assignment during the period presented.

(14)

Days filled is calculated by dividing the locum tenens hours filled during the period by eight hours.

(15)

Revenue per day filled represents revenue of the Company’s locum tenens business divided by days filled for the period presented.

(16)

Leverage ratio represents the ratio of the consolidated funded indebtedness (as calculated per the Company’s credit agreement) at the end of the subject period to the consolidated adjusted EBITDA (as calculated per the Company’s credit agreement) for the twelve-month period ended at the end of the subject period.

(17)

Guidance percentage metrics are approximate.

 

Randle Reece
Director, Investor Relations
866.861.3229

Source: AMN Healthcare Services, Inc.

Multimedia Files:

View all news