AMN Healthcare Services (AMN) 10-Q5 May 232023 Q1 Quarterly reportFinancial data

Company Profile

Cover Page

Cover Page - shares	3 Months Ended
Cover Page - shares	Mar. 31, 2023	May 03, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 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	8840 Cypress Waters Boulevard
Entity Address, Address Line Two	Suite 300
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)		39,645,292
Entity Central Index Key	0001142750
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q1
Amendment Flag	false

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 28,516	$ 64,524
Accounts receivable, net of allowances of $37,736 and $31,910 at March 31, 2023 and December 31, 2022, respectively	687,645	675,650
Accounts receivable, subcontractor	276,655	268,726
Prepaid expenses	26,696	18,708
Other current assets	51,552	66,037
Total current assets	1,071,064	1,093,645
Restricted cash, cash equivalents and investments	67,594	61,218
Fixed assets, net of accumulated depreciation of $233,942 and $227,617 at March 31, 2023 and December 31, 2022, respectively	155,276	149,276
Other assets	197,325	172,016
Goodwill	935,319	935,364
Intangible assets, net of accumulated amortization of $379,172 and $361,327 at March 31, 2023 and December 31, 2022, respectively	454,485	476,832
Total assets	2,881,063	2,888,351
Current liabilities:
Accounts payable and accrued expenses	473,764	476,452
Accrued compensation and benefits	269,237	333,244
Other current liabilities	60,600	48,237
Total current liabilities	803,601	857,933
Revolving credit facility	140,000	0
Notes payable, net of unamortized fees and premium	843,801	843,505
Deferred income taxes, net	16,113	22,713
Other long-term liabilities	121,774	120,566
Total liabilities	1,925,289	1,844,717
Commitments and contingencies
Stockholders’ equity:
Preferred stock, $0.01 par value; 10,000 shares authorized; none issued and outstanding at March 31, 2023 and December 31, 2022	0	0
Common stock, $0.01 par value; 200,000 shares authorized; 50,236 issued and 40,238 outstanding at March 31, 2023 and 50,109 issued and 41,879 outstanding at December 31, 2022	502	501
Additional paid-in capital	505,857	501,674
Treasury stock, at cost; 9,998 and 8,230 shares at March 31, 2023 and December 31, 2022, respectively	(874,898)	(698,598)
Retained earnings	1,325,106	1,240,996
Accumulated other comprehensive loss	(793)	(939)
Total stockholders’ equity	955,774	1,043,634
Total liabilities and stockholders’ equity	$ 2,881,063	$ 2,888,351

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Accounts receivable, allowance	$ 37,736	$ 31,910
Accumulated depreciation	233,942	227,617
Accumulated amortization	$ 379,172	$ 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)	50,236,000	50,109,000
Common stock, shares outstanding (in shares)	40,238,000	41,879,000
Treasury stock (in shares)	9,998,000	8,230,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Comprehensive Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Statement of Comprehensive Income [Abstract]
Revenue	$ 1,126,223	$ 1,552,538
Cost of revenue	757,377	1,056,370
Gross profit	368,846	496,168
Operating expenses:
Selling, general and administrative	205,599	257,579
Depreciation and amortization (exclusive of depreciation included in cost of revenue)	37,577	30,656
Total operating expenses	243,176	288,235
Income from operations	125,670	207,933
Interest expense, net, and other	10,259	9,589
Income before income taxes	115,411	198,344
Income tax expense	31,301	52,336
Net income	84,110	146,008
Other comprehensive income (loss):
Unrealized gains (losses) on available-for-sale securities, net, and other	146	(907)
Other comprehensive income (loss)	146	(907)
Comprehensive income	$ 84,256	$ 145,101
Net income per common share:
Basic (in dollars per share)	$ 2.03	$ 3.11
Diluted (in dollars per share)	$ 2.02	$ 3.09
Weighted average common shares outstanding:
Basic (in shares)	41,378	46,913
Diluted (in shares)	41,570	47,208

Condensed Consolidated Statem_2

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 into treasury (in shares)				(2,298)
Repurchase of common stock into treasury	(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, 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 into treasury (in shares)				(1,768)
Repurchase of common stock into treasury	$ (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	40,238	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)			(9,998)

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2023	Mar. 31, 2022
Cash flows from operating activities:
Net income		$ 84,110	$ 146,008
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization (inclusive of depreciation included in cost of revenue)		38,834	31,510
Non-cash interest expense and other		505	479
Change in fair value of contingent consideration liabilities		80	0
Increase in allowance for credit losses and sales credits		25,447	3,432
Provision for deferred income taxes		(6,639)	18,526
Share-based compensation		10,318	11,259
Loss on disposal or impairment of long-lived assets		1,849	241
Net loss on investments in available-for-sale securities		81	174
Net loss (gain) on deferred compensation balances		41	(570)
Non-cash lease expense		(228)	2,880
Changes in assets and liabilities, net of effects from acquisitions:
Accounts receivable		(37,376)	(194,044)
Accounts receivable, subcontractor		(7,929)	(50,592)
Income taxes receivable		8,875	0
Prepaid expenses		(7,988)	33,373
Other current assets		(115)	12,180
Other assets		221	(342)
Accounts payable and accrued expenses		(9,557)	70,988
Accrued compensation and benefits		(71,038)	96,486
Other liabilities		11,903	18,353
Deferred revenue		2,040	(126)
Net cash provided by operating activities		43,434	200,215
Cash flows from investing activities:
Purchase and development of fixed assets		(17,487)	(13,590)
Purchase of investments		0	(4,018)
Proceeds from sale and maturity of investments		2,007	6,885
Proceeds from sale of equity investment		0	68
Payments to fund deferred compensation plan		(16,951)	(12,584)
Net cash used in investing activities		(32,431)	(23,239)
Cash flows from financing activities:
Payments on revolving credit facility		(70,000)	0
Proceeds from revolving credit facility		210,000	0
Repurchase of common stock	[1]	(174,744)	(228,024)
Payment of financing costs		(3,579)	0
Cash paid for shares withheld for taxes		(6,134)	(9,431)
Net cash used in financing activities		(44,457)	(237,455)
Effect of exchange rate changes on cash		0	(183)
Net decrease in cash, cash equivalents and restricted cash		(33,454)	(60,662)
Cash, cash equivalents and restricted cash at beginning of period		137,872	246,714
Cash, cash equivalents and restricted cash at end of period		104,418	186,052
Supplemental disclosures of cash flow information:
Cash paid for amounts included in the measurement of operating lease liabilities		2,610	4,230
Cash paid for interest (net of $288 and $121 capitalized for the three months ended March 31, 2023 and 2022, respectively)		1,053	196
Cash paid for income taxes		5,404	9,824
Supplemental disclosures of non-cash investing and financing activities:
Purchase of fixed assets recorded in accounts payable and accrued expenses		6,849	4,771
Excise tax payable on share repurchases		$ 1,556	$ 0

[1]The difference between the amount reported for the three months ended March 31, 2023 and the corresponding amount presented in the condensed consolidated statements of stockholders’ equity is due to accrued excise tax payable on share repurchases recorded within treasury stock.

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Statement of Cash Flows [Abstract]
Interest capitalized	$ 288	$ 121

Basis of Presentation

Basis of Presentation	3 Months Ended
Basis of Presentation	Mar. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation	BASIS OF PRESENTATION The condensed consolidated balance sheets and related condensed consolidated statements of comprehensive income, stockholders’ equity and cash flows contained in this Quarterly Report on Form 10-Q (this “Quarterly Report”), which are unaudited, include the accounts of AMN Healthcare Services, Inc. and its wholly-owned subsidiaries (collectively, the “Company”). All significant intercompany balances and transactions have been eliminated in consolidation. In the opinion of management, all entries necessary for a fair presentation of such unaudited condensed consolidated financial statements have been included. These entries consisted of all normal recurring items. The results of operations for the interim period are not necessarily indicative of the results to be expected for any other interim period or for the entire fiscal year or for any future period. The unaudited condensed consolidated financial statements do not include all information and notes necessary for a complete presentation of financial position, results of operations and cash flows in conformity with accounting principles generally accepted in the United States (“U.S. GAAP”). Please refer to the Company’s audited consolidated financial statements and the related notes for the fiscal year ended December 31, 2022, contained in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022, filed with the Securities and Exchange Commission on February 22, 2023 (the “2022 Annual Report”). The preparation of financial statements in conformity with U.S. GAAP requires management to make a number of estimates and assumptions relating to the reporting of assets and liabilities and the disclosure of contingent assets and liabilities at the dates of the financial statements and the reported amounts of revenue and expenses during the reporting periods. On an ongoing basis, the Company evaluates its estimates, including those related to intangible assets purchased in a business combination, asset impairments, accruals for self-insurance, compensation and related benefits, accounts receivable, contingencies and litigation, contingent consideration liabilities associated with acquisitions, and income taxes. Actual results could differ from those estimates under different assumptions or conditions. Recently Adopted Accounting Pronouncements In October 2021, the Financial Accounting Standards Board issued Accounting Standards Update (“ASU”) 2021-08, “Business Combinations (Topic 805): Accounting for Contract Assets and Contract Liabilities from Contracts with Customers.” The new guidance requires companies to apply the definition of a performance obligation under Accounting Standards Codification (“ASC”) Topic 606, Revenue from Contracts with Customers, to recognize and measure contract assets and contract liabilities, such as deferred revenue, relating to contracts with customers that are acquired in a business combination. Under prior guidance, an acquirer generally recognized assets acquired and liabilities assumed in a business combination, including contract assets and contract liabilities arising from revenue contracts with customers, at their acquisition-date fair values in accordance with ASC Subtopic 820-10, Fair Value Measurements—Overall. Generally, this new guidance will result in the acquirer recognizing acquired contract assets and liabilities on the same basis that would have been recorded by the acquiree prior to the acquisition under ASC Topic 606. The Company adopted this standard effective January 1, 2023 on a prospective basis, and the adoption did not have a material effect on the Company’s consolidated financial statements. Cash, Cash Equivalents and Restricted Cash The Company considers all highly liquid investments with an original maturity of three months or less to be cash equivalents. Cash and cash equivalents include currency on hand, deposits with financial institutions, money market funds, commercial paper and other highly liquid investments. Restricted cash and cash equivalents primarily includes cash, corporate bonds and commercial paper that serve as collateral for the Company’s captive insurance subsidiary claim payments. See Note (7), “Fair Value Measurement” for additional information. The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the accompanying condensed consolidated balance sheets and related notes to the amounts presented in the accompanying condensed consolidated statements of cash flows. March 31, 2023 December 31, 2022 Cash and cash equivalents $ 28,516 $ 64,524 Restricted cash and cash equivalents (included in other current assets) 31,500 37,225 Restricted cash, cash equivalents and investments 67,594 61,218 Total cash, cash equivalents and restricted cash and investments 127,610 162,967 Less restricted investments (23,192) (25,095) Total cash, cash equivalents and restricted cash $ 104,418 $ 137,872 The Company maintains its cash and restricted cash in bank deposit accounts primarily at large, national financial institutions, which typically exceed federally insured limits. The Company has not experienced any losses in such accounts. Accounts Receivable The Company records accounts receivable at the invoiced amount. Accounts receivable are non-interest bearing. The Company maintains an allowance for expected credit losses based on the Company’s historical write-off experience, an assessment of its customers’ financial conditions and available information that is relevant to assessing the collectability of cash flows, which includes current conditions and forecasts about future economic conditions. The following table provides a reconciliation of activity in the allowance for credit losses for accounts receivable: 2023 2022 Balance as of January 1, $ 31,910 $ 6,838 Provision for expected credit losses 6,938 1,166 Amounts written off charged against the allowance (1,112) (534) Balance as of March 31, $ 37,736 $ 7,470 The increase in the provision for expected credit losses for the three months ended March 31, 2023 was primarily the result of concern with a specific customer’s ability to meet its financial obligations, and uncertainty regarding the collectability of cash flows from customers due primarily to the current macroeconomic outlook. Reclassifications To conform to the current year presentation, certain reclassifications have been made to prior year balances in the condensed consolidated balance sheets and accompanying Note (10), “Balance Sheet Details.”

Acquisitions

Acquisitions	3 Months Ended
Acquisitions	Mar. 31, 2023
Business Combination and Asset Acquisition [Abstract]
Acquisitions	ACQUISITIONS The Company accounted for the acquisition set forth below using the acquisition method of accounting. Accordingly, the Company recorded the tangible and intangible assets acquired and liabilities assumed at their estimated fair values as of the date of acquisition. Since the date of acquisition, the Company has revised the allocation of the purchase price to the tangible and intangible assets acquired and liabilities assumed based on analysis of information that has been made available through March 31, 2023. The allocation will continue to be updated through the measurement period, if necessary. The goodwill recognized for the acquisition is attributable to expected growth as the Company leverages its brand and diversifies its services offered to clients, including potential revenue growth and margin expansion. The Company did not incur any material acquisition-related costs. Connetics Acquisition On May 13, 2022, the Company completed its acquisition of Connetics Communications, LLC (“Connetics”), which specializes in the direct hire recruitment and permanent placement of international nurse and allied health professionals with healthcare facilities in the United States. The initial purchase price of $78,764 included (1) $70,764 cash consideration paid upon acquisition, funded through cash on hand, and (2) contingent consideration (earn-out payment) of up to $12,500 with an estimated fair value of $8,000 as of the acquisition date. The contingent earn-out payment is based on the operating results of Connetics for the twelve months ending May 31, 2023. The results of Connetics have been included in the Company’s nurse and allied solutions segment since the date of acquisition. During the fourth quarter of 2022, $231 was returned to the Company in respect of the final working capital settlement. The preliminary allocation of the $78,533 purchase price, which was reduced by the final working capital settlement during the fourth quarter of 2022, consisted of (1) $3,632 of fair value of tangible assets acquired, which included $963 cash received, (2) $8,244 of liabilities assumed, (3) $40,200 of identified intangible assets, and (4) $42,945 of goodwill, of which $34,944 is deductible for tax purposes. The intangible assets acquired have a weighted average useful life of approximately thirteen years. The following table summarizes the fair value and useful life of each intangible asset acquired as of the acquisition date: Fair 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

Revenue Recognition

Revenue Recognition	3 Months Ended
Revenue Recognition	Mar. 31, 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.

Net Income Per Common Share

Net Income Per Common Share	3 Months Ended
Net Income Per Common Share	Mar. 31, 2023
Earnings Per Share [Abstract]
Net Income Per Common Share	NET INCOME PER COMMON SHARE Basic net income per common share is calculated by dividing net income by the weighted average number of common shares outstanding during the reporting period. The following table sets forth the computation of basic and diluted net income per common share: Three Months Ended March 31, 2023 2022 Net income $ 84,110 $ 146,008 Net income per common share - basic $ 2.03 $ 3.11 Net income per common share - diluted $ 2.02 $ 3.09 Weighted average common shares outstanding - basic 41,378 46,913 Plus dilutive effect of potential common shares 192 295 Weighted average common shares outstanding - diluted 41,570 47,208 Share-based awards to purchase 243 and 160 shares of common stock were not included in the above calculation of diluted net income per common share for the three months ended March 31, 2023 and 2022, respectively, because the effect of these instruments was anti-dilutive. Since March 31, 2023, and through May 5, 2023, the Company repurchased 594 shares of its common stock at an average price of $84.18 per share excluding broker’s fee, resulting in an aggregate purchase price of $50,000 excluding the effect of 1% of excise taxes on the repurchased amount.

Segment Information

Segment Information	3 Months Ended
Segment Information	Mar. 31, 2023
Segment Reporting [Abstract]
Segment Information	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 March 31, 2023 2022 Revenue Nurse and allied solutions $ 824,480 $ 1,228,039 Physician and leadership solutions 165,757 179,506 Technology and workforce solutions 135,986 144,993 $ 1,126,223 $ 1,552,538 Segment operating income Nurse and allied solutions $ 113,445 $ 195,089 Physician and leadership solutions 25,100 20,381 Technology and workforce solutions 67,010 78,880 205,555 294,350 Unallocated corporate overhead 30,733 43,648 Depreciation and amortization 37,577 30,656 Depreciation (included in cost of revenue) 1,257 854 Share-based compensation 10,318 11,259 Interest expense, net, and other 10,259 9,589 Income before income taxes $ 115,411 $ 198,344 The following table summarizes the activity related to the carrying value of goodwill by reportable segment: Nurse and Allied 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 (45) — — (45) Balance, March 31, 2023 $ 381,960 $ 152,800 $ 400,559 $ 935,319 Accumulated impairment loss as of December 31, 2022 and March 31, 2023 $ 154,444 $ 60,495 $ — $ 214,939 Disaggregation of Revenue The following tables present the Company’s revenue disaggregated by service type: Three Months Ended March 31, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 592,677 $ — $ — $ 592,677 Labor disruption services 5,702 — — 5,702 Local staffing 25,272 — — 25,272 Allied staffing 196,125 — — 196,125 Locum tenens staffing — 106,703 — 106,703 Interim leadership staffing — 40,242 — 40,242 Temporary staffing 819,776 146,945 — 966,721 Permanent placement 4,704 18,812 — 23,516 Language services — — 61,676 61,676 Vendor management systems — — 54,173 54,173 Other technologies — — 7,347 7,347 Technology-enabled services — — 123,196 123,196 Talent planning and acquisition — — 12,790 12,790 Total revenue $ 824,480 $ 165,757 $ 135,986 $ 1,126,223 Three Months Ended March 31, 2022 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 970,109 $ — $ — $ 970,109 Local staffing 44,057 — — 44,057 Allied staffing 213,873 — — 213,873 Locum tenens staffing — 112,672 — 112,672 Interim leadership staffing — 44,354 — 44,354 Temporary staffing 1,228,039 157,026 — 1,385,065 Permanent placement — 22,480 — 22,480 Language services — — 49,238 49,238 Vendor management systems — — 75,022 75,022 Other technologies — — 7,658 7,658 Technology-enabled services — — 131,918 131,918 Talent planning and acquisition — — 13,075 13,075 Total revenue $ 1,228,039 $ 179,506 $ 144,993 $ 1,552,538 The Company did not generate material revenue from labor disruption services during the three months ended March 31, 2022.

Notes Payable and Credit Agreem

Notes Payable and Credit Agreement	3 Months Ended
Notes Payable and Credit Agreement	Mar. 31, 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.

Fair Value Measurement

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

Income Taxes

Income Taxes	3 Months Ended
Income Taxes	Mar. 31, 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 March 31, 2023, the Company is no longer subject to state, local or foreign examinations by tax authorities for tax years before 2011, and the Company is no longer subject to U.S. federal income or payroll tax examinations for tax years before 2019. 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.

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
Commitments and Contingencies	Mar. 31, 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. This case is proceeding in the United States District Court. On May 2, 2019, former travel nurse Sara Woehrle filed a complaint against AMN Services, LLC, and Providence Health System – Southern California in California Superior Court in Los Angeles County. The Company removed the case to the United States District Court for the Central District of California (Case No. 2:19-cv-05282 DSF-KS). The complaint asserts that, due to the Company’s per diem adjustment practices, traveling nurses’ per diem benefits should be included in their regular rate of pay for the purposes of calculating their overtime compensation. The complaint also alleges that the putative class members were denied required meal periods, denied proper overtime compensation, were not compensated for all time worked, including reporting time and training time, and received non-compliant wage statements. The Company reached an agreement to settle this matter in its entirety and received court approval of the settlement. Payment is expected to be made in the second quarter of 2023. Because of the inherent uncertainty of litigation, the Company is not able to reasonably predict if any matter will be resolved in a manner that is materially adverse to the Company. The Company has recorded accruals in connection with the two matters described above amounting to $46,225. The Company is currently unable to estimate the possible loss or range of loss beyond amounts already accrued. Loss contingencies accrued as of both March 31, 2023 and December 31, 2022 are included in accounts payable and accrued expenses and other long-term liabilities in the consolidated balance sheets. Operating Leases In the first quarter of 2022, the Company entered into a lease agreement for an office building located in Dallas, Texas, with future undiscounted lease payments of approximately $29,514, excluding lease incentives. Because the Company does not control the underlying asset during the construction period, the Company is not considered the owner of the asset under construction for accounting purposes. The lease will commence upon completion of the construction of the office building which is expected be in the second quarter of 2023. The initial term of the lease is approximately eleven years with options to renew the lease during the lease term. A right-of-use asset and lease liability will be recognized in the consolidated balance sheet in the period the lease commences.

Balance Sheet Details

Balance Sheet Details	3 Months Ended
Balance Sheet Details	Mar. 31, 2023
Balance Sheet Related Disclosures [Abstract]
Balance Sheet Details	BALANCE SHEET DETAILS The consolidated balance sheets detail is as follows: March 31, 2023 December 31, 2022 Other current assets: Restricted cash and cash equivalents $ 31,500 $ 37,225 Income taxes receivable — 8,875 Other 20,052 19,937 Other current assets $ 51,552 $ 66,037 Fixed assets: Furniture and equipment $ 54,978 $ 51,408 Software 333,302 323,418 Leasehold improvements 938 2,067 389,218 376,893 Accumulated depreciation (233,942) (227,617) Fixed assets, net $ 155,276 $ 149,276 Other assets: Life insurance cash surrender value $ 140,731 $ 117,139 Operating lease right-of-use assets $ 14,484 16,266 Other 42,110 38,611 Other assets $ 197,325 $ 172,016 Accounts payable and accrued expenses: Trade accounts payable $ 81,447 $ 78,057 Subcontractor payable 278,432 295,259 Accrued expenses 82,337 73,885 Loss contingencies 15,874 14,638 Professional liability reserve 8,091 7,756 Other 7,583 6,857 Accounts payable and accrued expenses $ 473,764 $ 476,452 Accrued compensation and benefits: Accrued payroll $ 72,113 $ 63,857 Accrued bonuses and commissions 28,032 96,760 Workers compensation reserve 12,394 12,113 Deferred compensation 144,349 128,465 Other 12,349 32,049 Accrued compensation and benefits $ 269,237 $ 333,244 Other current liabilities: Acquisition related liabilities $ 5,150 $ 5,070 Income taxes payable 23,395 — Client deposits 7,463 21,466 Operating lease liabilities 7,789 8,090 Deferred revenue 13,876 11,825 Other 2,927 1,786 Other current liabilities $ 60,600 $ 48,237 Other long-term liabilities: Workers compensation reserve $ 22,756 $ 23,841 Professional liability reserve 38,153 36,214 Operating lease liabilities 7,652 9,360 Other 53,213 51,151 Other long-term liabilities $ 121,774 $ 120,566

Basis of Presentation (Policies

Basis of Presentation (Policies)	3 Months Ended
Basis of Presentation (Policies)	Mar. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Use of Estimates	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	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	Cash, Cash Equivalents and Restricted Cash The Company considers all highly liquid investments with an original maturity of three months or less to be cash equivalents. Cash and cash equivalents include currency on hand, deposits with financial institutions, money market funds, commercial paper and other highly liquid investments. Restricted cash and cash equivalents primarily includes cash, corporate bonds and commercial paper that serve as collateral for the Company’s captive insurance subsidiary claim payments. See Note (7), “Fair Value Measurement” for additional information.
Accounts Receivable	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.
Reclassification	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.”
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	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.
Fair Value of Assets and Liabilities	Assets and Liabilities Measured on a Recurring Basis The Company invests a portion of its cash and cash equivalents in non-federally insured money market funds that are measured at fair value based on quoted prices, which are Level 1 inputs. The Company has a deferred compensation plan for certain executives and employees, which is composed of deferred compensation and all related income and losses attributable thereto. The Company’s obligation under its deferred compensation plan is measured at fair value based on quoted market prices of the participants’ elected investments, which are Level 1 inputs. The Company’s restricted cash equivalents and investments that serve as collateral for the Company’s captive insurance company include commercial paper that is measured at observable market prices for identical securities that are traded in less active markets, which are Level 2 inputs. The Company’s cash equivalents also include commercial paper classified as Level 2 in the fair value hierarchy. Of the $37,600 commercial paper issued and outstanding as of March 31, 2023, none had original maturities greater than three months. Of the $31,536 commercial paper issued and outstanding as of December 31, 2022, none had original maturities greater than three months. The Company’s restricted cash equivalents and investments that serve as collateral for the Company’s captive insurance company also include corporate bonds that are measured using readily available pricing sources that utilize observable market data, including the current interest rate for comparable instruments, which are Level 2 inputs. As of March 31, 2023, the Company had $23,192 corporate bonds issued and outstanding, all of which had original maturities greater than three months and were considered available-for-sale securities. As of December 31, 2022, the Company had $25,095 corporate bonds issued and outstanding, all of which had original maturities greater than three months and were considered available-for-sale securities. The Company’s contingent consideration liabilities associated with acquisitions are measured at fair value using a probability-weighted discounted cash flow analysis or a simulation-based methodology for the acquired companies, which are Level 3 inputs. The Company recognizes changes to the fair value of its contingent consideration liabilities in selling, general and administrative expenses in the condensed consolidated statements of comprehensive income. 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. Fair Value of Financial Instruments The Company is required to disclose the fair value of financial instruments for which it is practicable to estimate the value, even though these instruments are not recognized at fair value in the consolidated balance sheets. The fair value of the Company’s 4.625% senior notes due 2027 (the “2027 Notes”) and 4.000% senior notes due 2029 (the “2029 Notes”) was estimated using quoted market prices in active markets for identical liabilities, which are Level 1 inputs. The carrying amounts and estimated fair value of the 2027 Notes and the 2029 Notes are presented in the following table. See additional information regarding the 2027 Notes and the 2029 Notes in Part II, Item 8, “Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note (8), Notes Payable and Credit Agreement” of the 2022 Annual Report. As of March 31, 2023 As of December 31, 2022 Carrying Estimated Carrying Estimated 2027 Notes $ 500,000 $ 463,125 $ 500,000 $ 460,000 2029 Notes 350,000 308,875 350,000 300,125

Basis of Presentation (Tables)

Basis of Presentation (Tables)	3 Months Ended
Basis of Presentation (Tables)	Mar. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of Reconciliation of Cash, Cash Equivalents and Restricted Cash	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. March 31, 2023 December 31, 2022 Cash and cash equivalents $ 28,516 $ 64,524 Restricted cash and cash equivalents (included in other current assets) 31,500 37,225 Restricted cash, cash equivalents and investments 67,594 61,218 Total cash, cash equivalents and restricted cash and investments 127,610 162,967 Less restricted investments (23,192) (25,095) Total cash, cash equivalents and restricted cash $ 104,418 $ 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 6,938 1,166 Amounts written off charged against the allowance (1,112) (534) Balance as of March 31, $ 37,736 $ 7,470

Acquisitions (Tables)

Acquisitions (Tables)	3 Months Ended
Acquisitions (Tables)	Mar. 31, 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

Net Income Per Common Share (Ta

Net Income Per Common Share (Tables)	3 Months Ended
Net Income Per Common Share (Tables)	Mar. 31, 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 March 31, 2023 2022 Net income $ 84,110 $ 146,008 Net income per common share - basic $ 2.03 $ 3.11 Net income per common share - diluted $ 2.02 $ 3.09 Weighted average common shares outstanding - basic 41,378 46,913 Plus dilutive effect of potential common shares 192 295 Weighted average common shares outstanding - diluted 41,570 47,208

Segment Information (Tables)

Segment Information (Tables)	3 Months Ended
Segment Information (Tables)	Mar. 31, 2023
Segment Reporting [Abstract]
Schedule of Reconciliation of Revenue and Segment Operating Income by Reportable Segment	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 March 31, 2023 2022 Revenue Nurse and allied solutions $ 824,480 $ 1,228,039 Physician and leadership solutions 165,757 179,506 Technology and workforce solutions 135,986 144,993 $ 1,126,223 $ 1,552,538 Segment operating income Nurse and allied solutions $ 113,445 $ 195,089 Physician and leadership solutions 25,100 20,381 Technology and workforce solutions 67,010 78,880 205,555 294,350 Unallocated corporate overhead 30,733 43,648 Depreciation and amortization 37,577 30,656 Depreciation (included in cost of revenue) 1,257 854 Share-based compensation 10,318 11,259 Interest expense, net, and other 10,259 9,589 Income before income taxes $ 115,411 $ 198,344
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 (45) — — (45) Balance, March 31, 2023 $ 381,960 $ 152,800 $ 400,559 $ 935,319 Accumulated impairment loss as of December 31, 2022 and March 31, 2023 $ 154,444 $ 60,495 $ — $ 214,939
Schedule of Disaggregation of Revenue	The following tables present the Company’s revenue disaggregated by service type: Three Months Ended March 31, 2023 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 592,677 $ — $ — $ 592,677 Labor disruption services 5,702 — — 5,702 Local staffing 25,272 — — 25,272 Allied staffing 196,125 — — 196,125 Locum tenens staffing — 106,703 — 106,703 Interim leadership staffing — 40,242 — 40,242 Temporary staffing 819,776 146,945 — 966,721 Permanent placement 4,704 18,812 — 23,516 Language services — — 61,676 61,676 Vendor management systems — — 54,173 54,173 Other technologies — — 7,347 7,347 Technology-enabled services — — 123,196 123,196 Talent planning and acquisition — — 12,790 12,790 Total revenue $ 824,480 $ 165,757 $ 135,986 $ 1,126,223 Three Months Ended March 31, 2022 Nurse and Allied Solutions Physician and Leadership Solutions Technology and Workforce Solutions Total Travel nurse staffing $ 970,109 $ — $ — $ 970,109 Local staffing 44,057 — — 44,057 Allied staffing 213,873 — — 213,873 Locum tenens staffing — 112,672 — 112,672 Interim leadership staffing — 44,354 — 44,354 Temporary staffing 1,228,039 157,026 — 1,385,065 Permanent placement — 22,480 — 22,480 Language services — — 49,238 49,238 Vendor management systems — — 75,022 75,022 Other technologies — — 7,658 7,658 Technology-enabled services — — 131,918 131,918 Talent planning and acquisition — — 13,075 13,075 Total revenue $ 1,228,039 $ 179,506 $ 144,993 $ 1,552,538

Fair Value Measurement (Tables)

Fair Value Measurement (Tables)	3 Months Ended
Fair Value Measurement (Tables)	Mar. 31, 2023
Fair Value Disclosures [Abstract]
Schedule of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis	The following tables present information about the above-referenced assets and liabilities and indicate the fair value hierarchy of the valuation techniques utilized to determine such fair value: Fair Value Measurements as of March 31, 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 $ 641 $ — $ — $ 641 $ 36,895 $ — $ — $ 36,895 Deferred compensation (144,349) — — (144,349) (128,465) — — (128,465) Corporate bonds — 23,192 — 23,192 — 25,095 — 25,095 Commercial paper — 37,600 — 37,600 — 31,536 — 31,536 Acquisition contingent consideration liabilities — — (5,150) (5,150) — — (5,070) (5,070)
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 March 31, 2023 As of December 31, 2022 Carrying Estimated Carrying Estimated 2027 Notes $ 500,000 $ 463,125 $ 500,000 $ 460,000 2029 Notes 350,000 308,875 350,000 300,125

Balance Sheet Details (Tables)

Balance Sheet Details (Tables)	3 Months Ended
Balance Sheet Details (Tables)	Mar. 31, 2023
Balance Sheet Related Disclosures [Abstract]
Schedule of Supplemental Balance Sheet Disclosures	The consolidated balance sheets detail is as follows: March 31, 2023 December 31, 2022 Other current assets: Restricted cash and cash equivalents $ 31,500 $ 37,225 Income taxes receivable — 8,875 Other 20,052 19,937 Other current assets $ 51,552 $ 66,037 Fixed assets: Furniture and equipment $ 54,978 $ 51,408 Software 333,302 323,418 Leasehold improvements 938 2,067 389,218 376,893 Accumulated depreciation (233,942) (227,617) Fixed assets, net $ 155,276 $ 149,276 Other assets: Life insurance cash surrender value $ 140,731 $ 117,139 Operating lease right-of-use assets $ 14,484 16,266 Other 42,110 38,611 Other assets $ 197,325 $ 172,016 Accounts payable and accrued expenses: Trade accounts payable $ 81,447 $ 78,057 Subcontractor payable 278,432 295,259 Accrued expenses 82,337 73,885 Loss contingencies 15,874 14,638 Professional liability reserve 8,091 7,756 Other 7,583 6,857 Accounts payable and accrued expenses $ 473,764 $ 476,452 Accrued compensation and benefits: Accrued payroll $ 72,113 $ 63,857 Accrued bonuses and commissions 28,032 96,760 Workers compensation reserve 12,394 12,113 Deferred compensation 144,349 128,465 Other 12,349 32,049 Accrued compensation and benefits $ 269,237 $ 333,244 Other current liabilities: Acquisition related liabilities $ 5,150 $ 5,070 Income taxes payable 23,395 — Client deposits 7,463 21,466 Operating lease liabilities 7,789 8,090 Deferred revenue 13,876 11,825 Other 2,927 1,786 Other current liabilities $ 60,600 $ 48,237 Other long-term liabilities: Workers compensation reserve $ 22,756 $ 23,841 Professional liability reserve 38,153 36,214 Operating lease liabilities 7,652 9,360 Other 53,213 51,151 Other long-term liabilities $ 121,774 $ 120,566

Basis of Presentation - Reconci

Basis of Presentation - Reconciliation of Cash, Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022	Mar. 31, 2022	Dec. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Cash and cash equivalents	$ 28,516	$ 64,524
Restricted cash and cash equivalents (included in other current assets)	31,500	37,225
Restricted cash, cash equivalents and investments	67,594	61,218
Total cash, cash equivalents and restricted cash and investments	127,610	162,967
Less restricted investments	(23,192)	(25,095)
Total cash, cash equivalents and restricted cash	$ 104,418	$ 137,872	$ 186,052	$ 246,714

Basis of Presentation - Recon_2

Basis of Presentation - Reconciliation of Activity in Allowance for Credit Losses for Accounts Receivable (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Accounts Receivable, Allowance for Credit Loss [Roll Forward]
Beginning balance	$ 31,910	$ 6,838
Provision for expected credit losses	6,938	1,166
Amounts written off charged against the allowance	(1,112)	(534)
Ending balance	$ 37,736	$ 7,470

Acquisitions - Connetics Acquis

Acquisitions - Connetics Acquisition (Details) - USD ($) $ in Thousands		3 Months Ended
	May 13, 2022	Mar. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Fair value of contingent earn-out		$ 5,150	$ 5,070
Goodwill		935,319	935,364
Connetics Communications, LLC
Business Acquisition [Line Items]
Initial purchase price	$ 78,764
Cash consideration	70,764
Contingent earn-out based on future operating performance (up to)	12,500
Fair value of contingent earn-out	8,000
Cash returned to the Company for final working capital settlement			231
Purchase price, net of working capital adjustment			$ 78,533
Fair value of tangible assets acquired		3,632
Cash received		963
Liabilities assumed		8,244
Identifiable intangible assets	40,200	40,200
Goodwill		42,945
Goodwill expected to be deductible for tax purposes		$ 34,944
Intangible assets acquired, weighted average useful life		13 years
Connetics Communications, LLC \| Customer relationships
Business Acquisition [Line Items]
Identifiable intangible assets	$ 32,800
Useful Life	15 years
Connetics Communications, LLC \| Staffing database
Business Acquisition [Line Items]
Identifiable intangible assets	$ 4,200
Useful Life	5 years
Connetics Communications, LLC \| Tradenames and trademarks
Business Acquisition [Line Items]
Identifiable intangible assets	$ 3,200
Useful Life	5 years

Net Income Per Common Share (De

Net Income Per Common Share (Details) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended	3 Months Ended
	May 05, 2023	Mar. 31, 2023	Mar. 31, 2022
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Net income		$ 84,110	$ 146,008
Net income per common share - basic (in dollars per share)		$ 2.03	$ 3.11
Net income per common share - diluted (in dollars per share)		$ 2.02	$ 3.09
Weighted average common shares outstanding - basic (in shares)		41,378,000	46,913,000
Plus dilutive effect of potential common shares (in shares)		192,000	295,000
Weighted average common shares outstanding - diluted (in shares)		41,570,000	47,208,000
Common stock excluded from calculation of EPS (in shares)		243,000	160,000
Aggregate purchase price of treasury stock		$ 176,300	$ 228,024
Subsequent Event
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Treasury stock acquired (in shares)	594,000
Treasury stock acquired (in dollars per share)	$ 84.18
Aggregate purchase price of treasury stock	$ 50,000
Treasury stock, excise tax effect on repurchase, percentage	1%

Segment Information - Narrative

Segment Information - Narrative (Details)	3 Months Ended
Segment Information - Narrative (Details)	Mar. 31, 2023 segment
Segment Reporting [Abstract]
Number of reportable segments	3

Segment Information - Reconcili

Segment Information - Reconciliation of Revenue and Segment Operating Income by Reportable Segment (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	$ 1,126,223	$ 1,552,538
Segment operating income	125,670	207,933
Depreciation and amortization	37,577	30,656
Depreciation (included in cost of revenue)	1,257	854
Share-based compensation	10,318	11,259
Interest expense, net, and other	10,259	9,589
Income before income taxes	115,411	198,344
Nurse and allied solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	824,480	1,228,039
Physician and leadership solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	165,757	179,506
Technology and workforce solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	135,986	144,993
Operating segments
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	1,126,223	1,552,538
Segment operating income	205,555	294,350
Operating segments \| Nurse and allied solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	824,480	1,228,039
Segment operating income	113,445	195,089
Operating segments \| Physician and leadership solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	165,757	179,506
Segment operating income	25,100	20,381
Operating segments \| Technology and workforce solutions
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	135,986	144,993
Segment operating income	67,010	78,880
Unallocated corporate overhead
Segment Reporting, Revenue Reconciling Item [Line Items]
Unallocated corporate overhead	$ 30,733	$ 43,648

Segment Information - Summary o

Segment Information - Summary of Goodwill by Reportable Segment (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Dec. 31, 2022
Goodwill [Roll Forward]
Goodwill, beginning balance	$ 935,364
Goodwill, ending balance	935,319
Accumulated impairment loss	214,939	$ 214,939
Connetics Communications, LLC
Goodwill [Roll Forward]
Goodwill adjustment	(45)
Goodwill, ending balance	42,945
Nurse and Allied Solutions
Goodwill [Roll Forward]
Goodwill, beginning balance	382,005
Goodwill, ending balance	381,960
Accumulated impairment loss	154,444	154,444
Nurse and Allied Solutions \| Connetics Communications, LLC
Goodwill [Roll Forward]
Goodwill adjustment	(45)
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

Segment Information - Disaggreg

Segment Information - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Segment Reporting Information [Line Items]
Revenue	$ 1,126,223	$ 1,552,538
Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	824,480	1,228,039
Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	165,757	179,506
Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	135,986	144,993
Travel nurse staffing
Segment Reporting Information [Line Items]
Revenue	592,677	970,109
Travel nurse staffing \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	592,677	970,109
Travel nurse staffing \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Travel nurse staffing \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Labor disruption services
Segment Reporting Information [Line Items]
Revenue	5,702
Labor disruption services \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	5,702
Labor disruption services \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0
Labor disruption services \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0
Local staffing
Segment Reporting Information [Line Items]
Revenue	25,272	44,057
Local staffing \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	25,272	44,057
Local staffing \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Local staffing \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Allied staffing
Segment Reporting Information [Line Items]
Revenue	196,125	213,873
Allied staffing \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	196,125	213,873
Allied staffing \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Allied staffing \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Locum tenens staffing
Segment Reporting Information [Line Items]
Revenue	106,703	112,672
Locum tenens staffing \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Locum tenens staffing \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	106,703	112,672
Locum tenens staffing \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Interim leadership staffing
Segment Reporting Information [Line Items]
Revenue	40,242	44,354
Interim leadership staffing \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Interim leadership staffing \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	40,242	44,354
Interim leadership staffing \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Temporary staffing
Segment Reporting Information [Line Items]
Revenue	966,721	1,385,065
Temporary staffing \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	819,776	1,228,039
Temporary staffing \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	146,945	157,026
Temporary staffing \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Permanent placement
Segment Reporting Information [Line Items]
Revenue	23,516	22,480
Permanent placement \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	4,704	0
Permanent placement \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	18,812	22,480
Permanent placement \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Language services
Segment Reporting Information [Line Items]
Revenue	61,676	49,238
Language services \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Language services \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Language services \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	61,676	49,238
Vendor management systems
Segment Reporting Information [Line Items]
Revenue	54,173	75,022
Vendor management systems \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Vendor management systems \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Vendor management systems \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	54,173	75,022
Other technologies
Segment Reporting Information [Line Items]
Revenue	7,347	7,658
Other technologies \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Other technologies \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Other technologies \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	7,347	7,658
Technology-enabled services
Segment Reporting Information [Line Items]
Revenue	123,196	131,918
Technology-enabled services \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Technology-enabled services \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Technology-enabled services \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	123,196	131,918
Talent planning and acquisition
Segment Reporting Information [Line Items]
Revenue	12,790	13,075
Talent planning and acquisition \| Nurse and Allied Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Talent planning and acquisition \| Physician and Leadership Solutions
Segment Reporting Information [Line Items]
Revenue	0	0
Talent planning and acquisition \| Technology and Workforce Solutions
Segment Reporting Information [Line Items]
Revenue	$ 12,790	$ 13,075

Notes Payable and Credit Agre_2

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

Fair Value Measurement - Narrat

Fair Value Measurement - Narrative (Details) - USD ($)	3 Months Ended
Fair Value Measurement - Narrative (Details) - USD ($)	Mar. 31, 2023	Mar. 31, 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%
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
Commercial paper \| Fair Value, Measurements, Recurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets (liabilities) measured at fair value on a recurring basis	37,600,000		31,536,000
Commercial paper \| Fair Value, Measurements, Recurring \| 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	37,600,000		31,536,000
Securities classified as available-for-sale	0		0
Corporate bonds \| Fair Value, Measurements, Recurring \| 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	23,192,000		25,095,000
Securities classified as available-for-sale	$ 23,192,000		$ 25,095,000

Fair Value Measurement - Financ

Fair Value Measurement - Financial Assets and Liabilities (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Thousands	Mar. 31, 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	$ (144,349)	$ (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	(144,349)	(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	(5,150)	(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	(5,150)	(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	641	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	641	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	23,192	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	23,192	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	37,600	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	37,600	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

Fair Value Measurement - Fair V

Fair Value Measurement - Fair Value of Financial Instruments (Details) - Senior Notes - USD ($) $ in Thousands	Mar. 31, 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	463,125	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	$ 308,875	$ 300,125

Commitments and Contingencies (

Commitments and Contingencies (Details) $ in Thousands	Mar. 31, 2023 USD ($) matter	Mar. 31, 2022 USD ($)
Commitments and Contingencies [Line Items]
Future undiscounted lease payments		$ 29,514
Lease term		11 years
Wage and Hour claims \| Pending Litigation
Commitments and Contingencies [Line Items]
Litigation matters accrual	$ 46,225
Number of legal matters \| matter	2

Balance Sheet Details (Details)

Balance Sheet Details (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Other current assets:
Restricted cash and cash equivalents	$ 31,500	$ 37,225
Income taxes receivable	0	8,875
Other	20,052	19,937
Other current assets	51,552	66,037
Fixed assets:
Furniture and equipment	54,978	51,408
Software	333,302	323,418
Leasehold improvements	938	2,067
Fixed assets, gross	389,218	376,893
Accumulated depreciation	(233,942)	(227,617)
Fixed assets, net	155,276	149,276
Other assets:
Life insurance cash surrender value	140,731	117,139
Operating lease right-of-use assets	14,484	16,266
Other	42,110	38,611
Other assets	197,325	172,016
Accounts payable and accrued expenses:
Trade accounts payable	81,447	78,057
Subcontractor payable	278,432	295,259
Accrued expenses	82,337	73,885
Loss contingencies	15,874	14,638
Professional liability reserve	8,091	7,756
Other	7,583	6,857
Accounts payable and accrued expenses	473,764	476,452
Accrued compensation and benefits:
Accrued payroll	72,113	63,857
Accrued bonuses and commissions	28,032	96,760
Workers compensation reserve	12,394	12,113
Deferred compensation	144,349	128,465
Other	12,349	32,049
Accrued compensation and benefits	269,237	333,244
Other current liabilities:
Acquisition related liabilities	5,150	5,070
Income taxes payable	23,395	0
Client deposits	7,463	21,466
Operating lease liabilities	7,789	8,090
Deferred revenue	13,876	11,825
Other	2,927	1,786
Other current liabilities	60,600	48,237
Other long-term liabilities:
Workers compensation reserve	22,756	23,841
Professional liability reserve	38,153	36,214
Operating lease liabilities	7,652	9,360
Other	53,213	51,151
Other long-term liabilities	$ 121,774	$ 120,566