AMN Healthcare Announces Third Quarter 2024 Results
AMN Healthcare reported Q3 2024 financial results with revenue of $688 million, representing a 19% decrease year-over-year. The company posted GAAP EPS of $0.18 and adjusted EPS of $0.61. Net income was $7 million, down 87% from Q3 2023. Despite challenging conditions, performance exceeded expectations with strong cash flow from operations at $67 million. The Nurse and Allied Solutions segment revenue decreased 30% to $399 million, while Physician and Leadership Solutions grew 13% to $181 million. The company reduced debt by $60 million during the quarter, with a net leverage ratio of 2.8:1.
AMN Healthcare ha riportato i risultati finanziari del terzo trimestre 2024 con un fatturato di 688 milioni di dollari, rappresentando un calo del 19% rispetto all'anno precedente. L'azienda ha registrato un utile per azione GAAP di $0,18 e un utile per azione rettificato di $0,61. Il reddito netto è stato di $7 milioni, in diminuzione dell'87% rispetto al terzo trimestre 2023. Nonostante le condizioni difficili, le performance hanno superato le aspettative, con un forte flusso di cassa dalle operazioni di $67 milioni. Il fatturato del segmento Nurse and Allied Solutions è diminuito del 30% a $399 milioni, mentre il segmento Physician and Leadership Solutions è cresciuto del 13% a $181 milioni. L'azienda ha ridotto il debito di $60 milioni durante il trimestre, con un rapporto di leva netta di 2,8:1.
AMN Healthcare reportó los resultados financieros del tercer trimestre de 2024 con ingresos de 688 millones de dólares, lo que representa una disminución del 19% en comparación con el año anterior. La compañía publicó un BPA GAAP de $0,18 y un BPA ajustado de $0,61. El ingreso neto fue de $7 millones, un 87% menos que en el tercer trimestre de 2023. A pesar de las condiciones desafiantes, el rendimiento superó las expectativas con un fuerte flujo de caja operativo de $67 millones. Los ingresos del segmento Nurse and Allied Solutions disminuyeron un 30% a $399 millones, mientras que los de Physician and Leadership Solutions crecieron un 13% a $181 millones. La compañía redujo su deuda en $60 millones durante el trimestre, con una relación de apalancamiento neto de 2,8:1.
AMN Healthcare는 2024년 3분기 재무 결과를 발표하며 6억 8800만 달러의 수익을 기록했으며, 이는 전년 대비 19% 감소한 수치입니다. 회사는 GAAP 주당순이익(EPS)으로 $0.18, 조정된 EPS로 $0.61을 발표했습니다. 순이익은 $700만 달러로, 2023년 3분기 대비 87% 감소했습니다. 어려운 환경에도 불구하고 운영에서의 강력한 현금 흐름이 $6700만 달러로 기대치를 웃돌았습니다. Nurse and Allied Solutions 부문의 수익은 30% 감소하여 $3억 9900만 달러에 이르렀고, Physician and Leadership Solutions 부문은 13% 성장하여 $1억 8100만 달러에 달했습니다. 회사는 이번 분기 동안 채무를 $6000만 달러 줄였으며, 순 레버리지 비율은 2.8:1이었습니다.
AMN Healthcare a publié ses résultats financiers du troisième trimestre 2024 avec un chiffre d'affaires de 688 millions de dollars, représentant une baisse de 19% par rapport à l'année précédente. L'entreprise a affiché un bénéfice par action GAAP de 0,18 $ et un bénéfice par action ajusté de 0,61 $. Le revenu net était de 7 millions de dollars, en baisse de 87% par rapport au troisième trimestre 2023. Malgré des conditions difficiles, les performances ont dépassé les attentes grâce à un solide flux de trésorerie provenant des opérations, atteignant 67 millions de dollars. Les revenus du segment Nurse and Allied Solutions ont diminué de 30% pour atteindre 399 millions de dollars, tandis que ceux des Physician and Leadership Solutions ont augmenté de 13% pour atteindre 181 millions de dollars. L'entreprise a réduit sa dette de 60 millions de dollars au cours du trimestre, avec un ratio de levier net de 2,8:1.
AMN Healthcare hat die finanziellen Ergebnisse des dritten Quartals 2024 mit einem Umsatz von 688 Millionen Dollar veröffentlicht, was einem Rückgang von 19% im Vergleich zum Vorjahr entspricht. Das Unternehmen verzeichnete einen GAAP-EPS von $0,18 und einen adjustierten EPS von $0,61. Der Nettogewinn betrug $7 Millionen, ein Rückgang um 87% gegenüber dem dritten Quartal 2023. Trotz herausfordernder Bedingungen übertrafen die Leistungen die Erwartungen mit einem starken operativen Cashflow von $67 Millionen. Die Einnahmen im Segment Nurse and Allied Solutions gingen um 30% auf $399 Millionen zurück, während die Physician and Leadership Solutions um 13% auf $181 Millionen wuchsen. Das Unternehmen reduzierte während des Quartals die Schulden um $60 Millionen, mit einem Netto-Leverage-Verhältnis von 2,8:1.
- Strong cash flow from operations at $67 million
- Physician and Leadership Solutions segment revenue grew 13% YoY
- Debt reduction of $60 million in Q3, total $175 million YTD
- Locum tenens revenue increased 26% year over year
- Language services revenue grew 13% compared to prior year
- Overall revenue declined 19% YoY to $688 million
- Net income dropped 87% YoY to $7 million
- Travel nurse staffing revenue decreased 37% YoY
- Operating margin declined to 3.2% from 10.2% YoY
- Adjusted EBITDA margin decreased 500 basis points YoY
Insights
AMN Healthcare's Q3 2024 results reveal significant challenges, with revenue declining
The company's debt reduction of
The healthcare staffing market dynamics are shifting significantly, as evidenced by AMN's performance. The company's strategic pivot toward total talent solutions and increased adoption of tech-enabled services (with top clients now using approximately 10 services) indicates an evolution in the business model. However, the
The growth in Language services (
Quarterly revenue of
GAAP EPS of
DALLAS, Nov. 07, 2024 (GLOBE NEWSWIRE) -- AMN Healthcare Services, Inc. (NYSE: AMN), the leader and innovator in total talent solutions for healthcare organizations across the United States, today announced its third quarter 2024 financial results. Financial highlights are as follows:
Dollars in millions, except per share amounts.
| Q3 2024 | % Change Q3 2023 | YTD September 30, 2024 | % Change YTD September 30, 2023 | |||
| Revenue | ( | ( | ||||
| Gross profit | ( | ( | ||||
| Net income | ( | ( | ||||
| GAAP diluted EPS | ( | ( | ||||
| Adjusted diluted EPS* | ( | ( | ||||
| Adjusted EBITDA* | ( | ( | ||||
* 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
- Third quarter revenue and earnings were better than expected, driven by core results and several beneficial discrete items.
- We made progress on our market growth strategy with sequential improvements in our overall sales pipeline, MSP net wins, and internal fill rates.
- Our tech-enabled, total talent solutions continue to be well received by clients looking to optimize their workforces, with our average number of services used by top clients increasing to approximately 10.
- Cash flow from operations was strong at
$67 million in the third quarter, which allowed us to reduce debt by$60 million , bringing the year-to-date repayment to$175 million . Our net leverage ratio at quarter end was 2.8:1.
“Our company performed well in difficult competitive conditions to surpass revenue and earnings expectations in the third quarter of 2024,” said Cary Grace, President and Chief Executive Officer of AMN Healthcare. “Current and prospective clients are showing greater interest in total talent solutions, pulling in a diverse set of solutions including predictive workforce tools, temporary and permanent staffing, enabling technology, and our comprehensive range of managed staffing from master-supplier to vendor-neutral. We continue to innovate with clients and healthcare partners to help them optimize their workforce, including adding Locums functionality to extend the market leadership of our ShiftWise Flex VMS platform.”
Third Quarter 2024 Results
Consolidated revenue for the quarter was
Revenue for the Nurse and Allied Solutions segment was
The Physician and Leadership Solutions segment reported revenue of
Technology and Workforce Solutions segment revenue was
Consolidated gross margin was
Consolidated SG&A expenses were
Income from operations was
At September 30, 2024, cash and cash equivalents totaled
Fourth Quarter 2024 Outlook
| Metric | Guidance* |
| Consolidated revenue | |
| Gross margin | |
| SG&A as percentage of revenue | |
| Operating margin | |
| Adjusted EBITDA margin |
*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 fourth quarter of 2024 is expected to be 14
Fourth quarter estimates for certain other financial items include depreciation of
Conference Call on November 7, 2024
AMN Healthcare Services, Inc. (NYSE: AMN) will host a conference call to discuss its third quarter 2024 financial results and fourth quarter 2024 outlook on Thursday, November 7, 2024 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. Interested parties may participate live via telephone by registering at this link. Registrants will receive confirmation and dial-in details. Following the conclusion of the call, a replay of the webcast will be available at the Company’s investor relations website.
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 direct staffing, vendor-neutral and managed services programs, clinical and interim healthcare leaders, temporary staffing, permanent placement, executive search, vendor management systems, recruitment process outsourcing, predictive modeling, language services, revenue cycle solutions, 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, 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. 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 future demand and supply for contingent staffing and other services, internal fill rates, the ability of our solutions to meet the needs of our markets and align with our clients, strategies for innovation with clients and healthcare partners, the competitive environment in nurse staffing, our long-term growth opportunities, strategy, and sales pipeline, fourth quarter 2024 financial projections for consolidated and segment revenue, consolidated gross margin, operating margin, SG&A as a percent of revenue, adjusted EBITDA margin, labor disruption revenue, and other revenue not expected to recur after this quarter, depreciation expense, non-cash amortization expense, share-based compensation expense, integration and other expenses, interest expense, adjusted tax rate, and number of diluted shares outstanding. 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 ability of our clients to increase the efficiency and effectiveness of their staffing management and recruiting efforts, through predictive analytics, online recruiting, internal travel agencies and float pools, telemedicine or otherwise and successfully hire and retain permanent staff, (ii) the duration and extent to which hospitals and other healthcare entities adjust their utilization of temporary nurses and allied healthcare professionals, physicians, healthcare leaders and other healthcare professionals and workforce technology applications as a result of the labor market or economic conditions, (iii) the magnitude and duration of the effects of the post-COVID-19 pandemic environment or any future pandemic or health crisis on demand and supply trends, our business, its financial condition and our results of operations, (iv) our ability to effectively address client demand by attracting and placing nurses and other clinicians, (v) our ability to recruit and retain sufficient quality healthcare professionals at reasonable costs, (vi) 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 implementing changes that will make our services more tech-enabled and integrated, (vii) our ability to manage the pricing impact that the labor market or consolidation of healthcare delivery organizations may have on our business, (viii) the effects of economic downturns, inflation or slow recoveries, which could result in less demand for our services, increased client initiatives designed to contain costs, including reevaluating their approach as it pertains to contingent labor and managed services programs, other solutions and providers, pricing pressures and negatively impact payments terms and collectability of accounts receivable, (ix) 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, (x) our ability and the expense 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, (xi) our ability to consummate and effectively incorporate acquisitions into our business, (xii) the negative effects that intermediary organizations may have on our ability to secure new and profitable contracts, (xiii) the extent to which the Great Resignation or a future spike in the COVID-19 pandemic or other pandemic or health crisis may disrupt our operations due to the unavailability of our employees or healthcare professionals due to burnout, illness, risk of illness, quarantines, travel restrictions, mandatory vaccination requirements, or other factors that limit our existing or potential workforce and pool of candidates, (xiv) security breaches and cybersecurity incidents, including ransomware, that could compromise our information and systems, which could adversely affect our business operations and reputation and could subject us to substantial liabilities and (xv) the severity and duration of the impact the labor market, economic downturn or 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, 2023. 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.
Contact:
Randle Reece
Senior Director, Investor Relations & Strategy
866.861.3229
| AMN Healthcare Services, Inc. Condensed Consolidated Statements of Comprehensive Income (in thousands, except per share amounts) (unaudited) | |||||||||||||||||||
| Three Months Ended | Nine Months Ended | ||||||||||||||||||
| September 30, | June 30, | September 30, | |||||||||||||||||
| 2024 | 2023 | 2024 | 2024 | 2023 | |||||||||||||||
| Revenue | $ | 687,509 | $ | 853,463 | $ | 740,685 | $ | 2,249,072 | $ | 2,970,985 | |||||||||
| Cost of revenue | 474,454 | 563,957 | 510,858 | 1,548,684 | 1,982,352 | ||||||||||||||
| Gross profit | 213,055 | 289,506 | 229,827 | 700,388 | 988,633 | ||||||||||||||
| Gross margin | 31.0 | % | 33.9 | % | 31.0 | % | 31.1 | % | 33.3 | % | |||||||||
| Operating expenses: | |||||||||||||||||||
| Selling, general and administrative (SG&A) | 149,681 | 163,405 | 149,044 | 473,567 | 570,775 | ||||||||||||||
| SG&A as a % of revenue | 21.8 | % | 19.1 | % | 20.1 | % | 21.1 | % | 19.2 | % | |||||||||
| Depreciation and amortization (exclusive of depreciation included in cost of revenue) | 41,122 | 39,175 | 43,101 | 126,942 | 113,599 | ||||||||||||||
| Total operating expenses | 190,803 | 202,580 | 192,145 | 600,509 | 684,374 | ||||||||||||||
| Income from operations | 22,252 | 86,926 | 37,682 | 99,879 | 304,259 | ||||||||||||||
| Operating margin (1) | 3.2 | % | 10.2 | % | 5.1 | % | 4.4 | % | 10.2 | % | |||||||||
| Interest expense, net, and other | 14,444 | 11,541 | 15,715 | 46,787 | 33,975 | ||||||||||||||
| Income before income taxes | 7,808 | 75,385 | 21,967 | 53,092 | 270,284 | ||||||||||||||
| Income tax expense | 819 | 22,211 | 5,730 | 12,538 | 72,094 | ||||||||||||||
| Net income | $ | 6,989 | $ | 53,174 | $ | 16,237 | $ | 40,554 | $ | 198,190 | |||||||||
| Net income as a % of revenue | 1.0 | % | 6.2 | % | 2.2 | % | 1.8 | % | 6.7 | % | |||||||||
| Other comprehensive income: | |||||||||||||||||||
| Unrealized gains on available-for-sale securities, net, and other | 101 | 133 | 182 | 367 | 329 | ||||||||||||||
| Other comprehensive income | 101 | 133 | 182 | 367 | 329 | ||||||||||||||
| Comprehensive income | $ | 7,090 | $ | 53,307 | $ | 16,419 | $ | 40,921 | $ | 198,519 | |||||||||
| Net income per common share: | |||||||||||||||||||
| Basic | $ | 0.18 | $ | 1.39 | $ | 0.43 | $ | 1.06 | $ | 5.01 | |||||||||
| Diluted | $ | 0.18 | $ | 1.39 | $ | 0.42 | $ | 1.06 | $ | 4.99 | |||||||||
| Weighted average common shares outstanding: | |||||||||||||||||||
| Basic | 38,200 | 38,147 | 38,173 | 38,163 | 39,547 | ||||||||||||||
| Diluted | 38,287 | 38,325 | 38,234 | 38,247 | 39,734 | ||||||||||||||
| AMN Healthcare Services, Inc. Condensed Consolidated Balance Sheets (dollars in thousands) (unaudited) | ||||||||
| September 30, 2024 | December 31, 2023 | September 30, 2023 | ||||||
| Assets | ||||||||
| Current assets: | ||||||||
| Cash and cash equivalents | $ | 30,550 | $ | 32,935 | $ | 29,377 | ||
| Accounts receivable, net | 451,062 | 623,488 | 565,724 | |||||
| Accounts receivable, subcontractor | 68,566 | 117,703 | 175,976 | |||||
| Prepaid and other current assets | 62,088 | 67,559 | 60,043 | |||||
| Total current assets | 612,266 | 841,685 | 831,120 | |||||
| Restricted cash, cash equivalents and investments | 72,167 | 68,845 | 69,995 | |||||
| Fixed assets, net | 196,902 | 191,385 | 187,557 | |||||
| Other assets | 267,266 | 236,796 | 220,512 | |||||
| Goodwill | 1,116,815 | 1,111,549 | 935,779 | |||||
| Intangible assets, net | 402,400 | 474,134 | 409,803 | |||||
| Total assets | $ | 2,667,816 | $ | 2,924,394 | $ | 2,654,766 | ||
| Liabilities and stockholders’ equity | ||||||||
| Current liabilities: | ||||||||
| Accounts payable and accrued expenses | $ | 213,206 | $ | 343,847 | $ | 362,907 | ||
| Accrued compensation and benefits | 281,683 | 278,536 | 263,697 | |||||
| Other current liabilities | 23,657 | 33,738 | 80,522 | |||||
| Total current liabilities | 518,546 | 656,121 | 707,126 | |||||
| Revolving credit facility | 285,000 | 460,000 | 95,000 | |||||
| Notes payable, net | 845,576 | 844,688 | 844,393 | |||||
| Deferred income taxes, net | 17,270 | 23,350 | 31,296 | |||||
| Other long-term liabilities | 110,759 | 108,979 | 159,782 | |||||
| Total liabilities | 1,777,151 | 2,093,138 | 1,837,597 | |||||
| Commitments and contingencies | ||||||||
| Stockholders’ equity: | 890,665 | 831,256 | 817,169 | |||||
| Total liabilities and stockholders’ equity | $ | 2,667,816 | $ | 2,924,394 | $ | 2,654,766 | ||
| AMN Healthcare Services, Inc. Summary Condensed Consolidated Statements of Cash Flows (dollars in thousands) (unaudited) | |||||||||||||||||||
| Three Months Ended | Nine Months Ended | ||||||||||||||||||
| September 30, | June 30, | September 30, | |||||||||||||||||
| 2024 | 2023 | 2024 | 2024 | 2023 | |||||||||||||||
| Net cash provided by operating activities | $ | 66,703 | $ | 172,194 | $ | 99,515 | $ | 247,604 | $ | 413,295 | |||||||||
| Net cash used in investing activities | (22,004 | ) | (33,903 | ) | (22,332 | ) | (65,735 | ) | (88,762 | ) | |||||||||
| Net cash used in financing activities | (60,469 | ) | (105,022 | ) | (80,108 | ) | (179,550 | ) | (352,766 | ) | |||||||||
| Net increase (decrease) in cash, cash equivalents and restricted cash | (15,770 | ) | 33,269 | (2,925 | ) | 2,319 | (28,233 | ) | |||||||||||
| Cash, cash equivalents and restricted cash at beginning of period | 126,362 | 76,370 | 129,287 | 108,273 | 137,872 | ||||||||||||||
| Cash, cash equivalents and restricted cash at end of period | $ | 110,592 | $ | 109,639 | $ | 126,362 | $ | 110,592 | $ | 109,639 | |||||||||
| AMN Healthcare Services, Inc. Non-GAAP Reconciliation Tables (dollars in thousands, except per share data) (unaudited) | |||||||||||||||||||
| Three Months Ended | Nine Months Ended | ||||||||||||||||||
| September 30, | June 30, | September 30, | |||||||||||||||||
| 2024 | 2023 | 2024 | 2024 | 2023 | |||||||||||||||
| Reconciliation of Non-GAAP Items: | |||||||||||||||||||
| Net income | $ | 6,989 | $ | 53,174 | $ | 16,237 | $ | 40,554 | $ | 198,190 | |||||||||
| Income tax expense | 819 | 22,211 | 5,730 | 12,538 | 72,094 | ||||||||||||||
| Income before income taxes | 7,808 | 75,385 | 21,967 | 53,092 | 270,284 | ||||||||||||||
| Interest expense, net, and other | 14,444 | 11,541 | 15,715 | 46,787 | 33,975 | ||||||||||||||
| Income from operations | 22,252 | 86,926 | 37,682 | 99,879 | 304,259 | ||||||||||||||
| Depreciation and amortization | 41,122 | 39,175 | 43,101 | 126,942 | 113,599 | ||||||||||||||
| Depreciation (included in cost of revenue) (2) | 1,928 | 1,552 | 1,637 | 5,363 | 4,196 | ||||||||||||||
| Share-based compensation | 5,555 | 306 | 6,357 | 19,651 | 15,442 | ||||||||||||||
| Acquisition, integration, and other costs (3) | 3,017 | 5,771 | 5,310 | 13,792 | 16,616 | ||||||||||||||
| Legal settlement accrual changes (4) | — | — | — | — | 21,000 | ||||||||||||||
| Adjusted EBITDA (5) | $ | 73,874 | $ | 133,730 | $ | 94,087 | $ | 265,627 | $ | 475,112 | |||||||||
| Adjusted EBITDA margin (6) | 10.7 | % | 15.7 | % | 12.7 | % | 11.8 | % | 16.0 | % | |||||||||
| Net income | $ | 6,989 | $ | 53,174 | $ | 16,237 | $ | 40,554 | $ | 198,190 | |||||||||
| Adjustments: | |||||||||||||||||||
| Amortization of intangible assets | 22,104 | 22,563 | 24,744 | 71,734 | 66,340 | ||||||||||||||
| Acquisition, integration, and other costs (3) | 3,017 | 5,771 | 5,310 | 13,792 | 16,616 | ||||||||||||||
| Legal settlement accrual changes (4) | — | — | — | — | 21,000 | ||||||||||||||
| Cumulative effect of change in accounting principle (7) | — | — | — | — | 2,974 | ||||||||||||||
| Tax effect on above adjustments | (6,532 | ) | (7,367 | ) | (7,814 | ) | (22,237 | ) | (27,802 | ) | |||||||||
| Tax effect of COLI fair value changes (8) | (2,530 | ) | 1,227 | (910 | ) | (6,174 | ) | (2,324 | ) | ||||||||||
| Tax deficiencies (benefits) related to equity awards and ESPP (9) | 206 | 134 | (235 | ) | 145 | (2,346 | ) | ||||||||||||
| Adjusted net income (10) | $ | 23,254 | $ | 75,502 | $ | 37,332 | $ | 97,814 | $ | 272,648 | |||||||||
| GAAP diluted net income per share (EPS) | $ | 0.18 | $ | 1.39 | $ | 0.42 | $ | 1.06 | $ | 4.99 | |||||||||
| Adjustments | 0.43 | 0.58 | 0.56 | 1.50 | 1.87 | ||||||||||||||
| Adjusted diluted EPS (11) | $ | 0.61 | $ | 1.97 | $ | 0.98 | $ | 2.56 | $ | 6.86 | |||||||||
| AMN Healthcare Services, Inc. Supplemental Segment Financial and Operating Data (dollars in thousands, except operating data) (unaudited) | |||||||||||||||||||
| Three Months Ended | Nine Months Ended | ||||||||||||||||||
| September 30, | June 30, | September 30, | |||||||||||||||||
| 2024 | 2023 | 2024 | 2024 | 2023 | |||||||||||||||
| Revenue | |||||||||||||||||||
| Nurse and allied solutions | $ | 399,368 | $ | 573,426 | $ | 442,399 | $ | 1,361,064 | $ | 2,086,921 | |||||||||
| Physician and leadership solutions | 180,605 | 159,554 | 186,065 | 555,467 | 501,540 | ||||||||||||||
| Technology and workforce solutions | 107,536 | 120,483 | 112,221 | 332,541 | 382,524 | ||||||||||||||
| $ | 687,509 | $ | 853,463 | $ | 740,685 | $ | 2,249,072 | $ | 2,970,985 | ||||||||||
| Segment operating income (12) | |||||||||||||||||||
| Nurse and allied solutions | $ | 35,110 | $ | 82,882 | $ | 46,207 | $ | 134,659 | $ | 299,320 | |||||||||
| Physician and leadership solutions | 18,134 | 21,609 | 21,661 | 62,017 | 73,165 | ||||||||||||||
| Technology and workforce solutions | 41,948 | 50,664 | 47,259 | 133,477 | 173,297 | ||||||||||||||
| 95,192 | 155,155 | 115,127 | 330,153 | 545,782 | |||||||||||||||
| Unallocated corporate overhead (13) | 21,318 | 21,425 | 21,040 | 64,526 | 70,670 | ||||||||||||||
| Adjusted EBITDA (5) | $ | 73,874 | $ | 133,730 | $ | 94,087 | $ | 265,627 | $ | 475,112 | |||||||||
| Gross Margin | |||||||||||||||||||
| Nurse and allied solutions | 25.0 | % | 27.5 | % | 23.8 | % | 24.7 | % | 26.6 | % | |||||||||
| Physician and leadership solutions | 28.3 | % | 33.4 | % | 30.5 | % | 30.1 | % | 34.6 | % | |||||||||
| Technology and workforce solutions | 57.9 | % | 65.0 | % | 60.2 | % | 59.4 | % | 67.9 | % | |||||||||
| Operating Data: | |||||||||||||||||||
| Nurse and allied solutions | |||||||||||||||||||
| Average travelers on assignment (14) | 9,151 | 11,990 | 10,302 | 10,326 | 13,570 | ||||||||||||||
| Physician and leadership solutions | |||||||||||||||||||
| Days filled (15) | 55,315 | 45,981 | 56,244 | 168,404 | 142,857 | ||||||||||||||
| Revenue per day filled (16) | $ | 2,562 | $ | 2,447 | $ | 2,538 | $ | 2,552 | $ | 2,388 | |||||||||
| As of September 30, | As of December 31, | ||||
| 2024 | 2023 | 2023 | |||
| Leverage ratio (17) | 2.8 | 1.4 | 2.2 | ||
| AMN Healthcare Services, Inc. Additional Supplemental Non-GAAP Disclosure Reconciliation of Guidance Operating Margin to Guidance Adjusted EBITDA Margin (unaudited) | |||||
| Three Months Ended | |||||
| December 31, 2024 | |||||
| Low(18) | High(18) | ||||
| Operating margin | 1.8 | % | 2.5 | % | |
| Depreciation and amortization (total) | 6.3 | % | 6.1 | % | |
| EBITDA margin | 8.1 | % | 8.6 | % | |
| Share-based compensation | 0.6 | % | 0.6 | % | |
| Acquisition, integration, and other costs | 0.5 | % | 0.5 | % | |
| Adjusted EBITDA margin | 9.2 | % | 9.7 | % | |
| (1) | Operating margin represents income from operations divided by revenue. |
| (2) | A portion of depreciation expense for AMN Language Services is included in cost of revenue. We exclude the impact of depreciation included in cost of revenue from the calculation of adjusted EBITDA. |
| (3) | Acquisition, integration, and other costs include acquisition and integration costs, net changes in the fair value of contingent consideration liabilities for recently acquired companies, certain legal expenses, restructuring expenses and other costs associated with exit or disposal activities, and certain nonrecurring 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. For the three and nine months ended September 30, 2024, acquisition and integration costs were approximately |
| (4) | During the nine months ended September 30, 2023, the Company recorded an increase to its legal accrual for a wage and hour claim in connection with reaching an agreement to settle the matter in its entirety. Since the settlement is largely unrelated to the Company’s operating performance, we excluded its impact in the calculations of adjusted EBITDA, adjusted net income, and adjusted diluted EPS. |
| (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, certain 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) | As a result of a change in accounting principle on January 1, 2023 related to forfeitures of share-based awards, the Company recognized the cumulative effect of the change in share-based compensation expense during the nine months ended September 30, 2023. The cumulative effect of the change in accounting principle is immaterial to prior periods and, therefore, was recognized in the period of the change. Since the cumulative effect is unrelated to the Company’s operating performance for the nine months ended September 30, 2023, we excluded its impact in the calculation of adjusted net income and adjusted diluted EPS. |
| (8) | 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. |
| (9) | The consolidated effective tax rate is affected by the recording of tax benefits and tax deficiencies relating to equity awards vested during the period and tax benefits recognized for disqualifying dispositions related to our employee stock purchase plan (“ESPP”). The magnitude of the impact of tax benefits and tax deficiencies generated in the future related to equity awards and ESPP is dependent upon the Company’s future grants of share-based compensation, the Company’s future stock price on the date equity awards vest in relation to the fair value of the awards on the grant date, the Company’s future stock price on either the ESPP’s offering date or purchase date, whichever is lower, and the length of time the shares issued under the ESPP are held by employees. Since these tax benefits and tax deficiencies related to equity awards and ESPP 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. |
| (10) | Adjusted net income represents GAAP net income excluding the impact of the (A) amortization of intangible assets, (B) acquisition, integration, and other costs, (C) certain legal expenses, (D) changes in fair value of equity investments and instruments, (E) deferred financing related costs, (F) cumulative effect of change in accounting principle, (G) tax effect, if any, of the foregoing adjustments, (H) excess tax benefits and tax deficiencies relating to equity awards vested and ESPP, (I) 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 (J) 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. |
| (11) | 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. |
| (12) | 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, legal settlement accrual changes, and share-based compensation. |
| (13) | 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 and legal settlement accrual changes. |
| (14) | Average travelers on assignment represents the average number of nurse and allied healthcare professionals on assignment during the period presented. |
| (15) | Days filled is calculated by dividing the locum tenens hours filled during the period by eight hours. |
| (16) | Revenue per day filled represents revenue of the Company’s locum tenens business divided by days filled for the period presented. |
| (17) | 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 12-month period ended at the end of the subject period. |
| (18) | Guidance percentage metrics are approximate. |
FAQ
What was AMN Healthcare's revenue in Q3 2024?
How much did AMN's net income decline in Q3 2024?
What is AMN Healthcare's Q4 2024 revenue guidance?
How much debt did AMN Healthcare reduce in Q3 2024?
