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AMN HEALTHCARE SERVICES INC

For the period ended Sep 30, 2025. Filed Nov 7, 2025.

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About this filing

A company's report for each of its first three quarters. The financial statements are not audited. It shows how the business has moved since the last annual report, and what management says changed.

Sep 30, 2025 · Filed Nov 7, 2025

AMN$37.81+0.3%Stored close · as of Nov 10, 2026

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Notes to Unaudited Condensed Consolidated Financial Statements

(in thousands, except per share amounts)

  1. BASIS OF PRESENTATION

The condensed consolidated balance sheets and related condensed consolidated statements of comprehensive income (loss), 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, 2024, contained in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2024, filed with the Securities and Exchange Commission on February 21, 2025 (the “2024 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 goodwill and intangible assets purchased in a business combination, asset impairments, accruals for self-insurance, contingent liabilities such as legal accruals, and income taxes. The Company bases these estimates on the information that is currently available and on various other assumptions that it believes are reasonable under the circumstances. Actual results could differ from those estimates under different assumptions or conditions.

Recently Adopted Accounting Pronouncements

In November 2023, the FASB issued Accounting Standards Update (“ASU”) 2023-07, “Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures,” which expands the breadth and frequency of reportable segment disclosure requirements, primarily through enhanced disclosures about significant segment expenses. The new guidance requires public entities to disclose, on an annual and interim basis, significant segment expenses that are regularly provided to the chief operating decision maker (“CODM”), the amount and composition of other segment items by reportable segment, any additional measures of a segment’s profit or loss used by the CODM when assessing performance and deciding how to allocate resources, and the CODM’s title and position. Additionally, public entities will be required to provide in interim periods all disclosures about a reportable segment’s profit or loss that are currently required annually by Topic 280. This standard is effective on a retrospective basis for fiscal years beginning after December 15, 2023 and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. The Company adopted this standard for the year ended December 31, 2024. See Note (5), “Segment Information” for additional information.

Cash, Cash Equivalents and Restricted Cash

The Company considers all highly liquid investments and restricted investments with an original maturity of three months or less to be cash equivalents and restricted cash equivalents, respectively. Cash and cash equivalents include currency on hand, deposits with financial institutions, money market funds and other highly liquid investments. Restricted cash and cash equivalents primarily include cash, corporate bonds and commercial paper that serve as collateral for the Company’s captive insurance subsidiary claim payments. See Note (7), “Fair Value Measurement” for additional information.

The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the accompanying condensed consolidated balance sheets and related notes to the amounts presented in the accompanying condensed consolidated statements of cash flows.

September 30, 2025December 31, 2024
Cash and cash equivalents$52,636$10,649
Restricted cash and cash equivalents (included in other current assets)19,80114,984
Restricted cash, cash equivalents and investments44,36271,840
Total cash, cash equivalents and restricted cash and investments116,79997,473
Less restricted investments(33,905)(8,168)
Total cash, cash equivalents and restricted cash$82,894$89,305

The Company released $25,000 of restricted cash held at its captive insurance subsidiary in January 2025, which was used to repay a portion of the outstanding borrowings under the Company’s $750,000 secured revolving credit facility (the “Senior Credit Facility”). As the restriction was in effect as of December 31, 2024 and the entire outstanding debt balance is classified as a noncurrent liability in the consolidated balance sheet, the noncurrent classification of the restricted cash was maintained as of December 31, 2024. Additional information regarding the Senior Credit Facility and the amended credit agreement is disclosed in Note (11), “Subsequent Event” and in Part II, Item 8, “Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note (8), Notes Payable and Credit Agreement” of the 2024 Annual Report.

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:

20252024
Balance as of January 1,$32,421$32,233
Provision for expected credit losses2,1805,664
Amounts written off charged against the allowance(17,131)(6,698)
Allowance for credit losses in sale of disposal group (1)(91)—
Balance as of September 30,$17,379$31,199

(1) See Note (2), “Sale of disposal group” for additional information regarding the assets disposed of by sale.

Reclassifications

To conform to the current year presentation, certain reclassifications have been made to prior year balances in the accompanying Note (10), “Balance Sheet Details.”

  1. SALE OF DISPOSAL GROUP

On July 1, 2025, the Company completed the sale of its Smart Square healthcare scheduling software, a service offering of the Company’s workforce optimization business within its technology and workforce solutions segment. As a result of the sale, the Company received cash consideration of $65,320 and is owed a 9.000% promissory note of $10,000 (the “2027 Note Receivable”) payable on January 1, 2027. The sale resulted in a preliminary gain of $39,180 recognized during the three months ended September 30, 2025, subject to the final working capital settlement expected to settle in the fourth quarter of 2025.

Assets sold and the related liabilities transferred as part of those transactions (“disposal groups”) were measured at the lower of their carrying amount or fair value less costs to sell. Goodwill was allocated based on the relative fair values of the disposal group and the technology and workforce solutions reporting unit.

The following table presents the assets disposed of and the liabilities transferred as a result of the sale:

September 30, 2025
Assets:
Accounts receivable, net$3,643
Fixed assets, net5,250
Intangible assets, net1,549
Goodwill32,132
Other assets97
Total assets disposed$42,671
Liabilities:
Accounts payable and accrued expenses$92
Deferred revenue6,540
Total liabilities transferred$6,632

The Company determined that the sale of Smart Square does not represent a strategic shift that will have a major effect on the Company’s operations and financial results. As such, the disposal group does not meet the criteria for reporting in discontinued operations.

  1. 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 are recorded in accordance with the accounting guidance on reporting revenue gross as a principal versus net as an agent. Revenue is recorded on a gross basis when the Company utilizes its own network of healthcare professionals (including nurses, allied healthcare professionals, locum tenens, and executive and leadership interim staff). Conversely, when the Company uses subcontractors under an MSP arrangement 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. Revenue for the language services business is recorded on a gross basis. Under vendor management systems arrangements, revenue is recorded on a net basis as an agent because other companies are primarily responsible for providing the staffing services, for which the Company is entitled a percentage fee.

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 customer type and service, the time between invoicing and when payment is due is not significant.

The Company recognizes assets from incremental costs to obtain a contract with a customer and costs incurred to fulfill a contract with a customer, which are deferred and amortized using the portfolio approach on a straight line basis over the average period of benefit consistent with the timing of transfer of services to the customer.

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.

  1. NET INCOME (LOSS) PER COMMON SHARE

Basic net income (loss) per common share is calculated by dividing net income (loss) 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 (loss) per common share:

Three Months Ended September 30,Nine Months Ended September 30,
2025202420252024
Net income (loss)$29,288$6,989$(88,006)$40,554
Net income (loss) per common share - basic$0.76$0.18$(2.29)$1.06
Net income (loss) per common share - diluted$0.76$0.18$(2.29)$1.06
Weighted average common shares outstanding - basic38,61938,20038,44938,163
Plus dilutive effect of potential common shares7487—84
Weighted average common shares outstanding - diluted38,69338,28738,44938,247
Anti-dilutive potential common shares excluded from diluted weighted average common shares outstanding1,42441193392

The dilutive effect of potential shares and anti-dilutive potential common shares primarily includes outstanding share-based awards, which consists of restricted stock units, performance restricted stock units, and obligations under the Company’s employee stock purchase plan (the “ESPP”).

  1. 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 (“CODM”) for the purpose of evaluating performance and allocating resources. The Company hasthree 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 permanent placement, and allied staffing (including 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 (“VMS”), workforce optimization, and outsourced solutions businesses.

The Company’s CODM relies on internal management reporting processes that provide revenue, gross profit and operating income by reportable segment. These financial measures are used by the CODM to evaluate segment performance, monitor variances between periods and against projections, make key operating decisions, and allocate resources such as capital and personnel to each segment. The CODM does not evaluate or measure performance of segments using asset information; accordingly, asset information by segment is not prepared or disclosed. Beginning this year, the Company revised its corporate resource allocation methodology to better match actual consumption by reportable segments.

The following tables provide reconciliations of revenue, gross profit and operating income by reportable segment to consolidated results and were derived from each segment’s internal financial information as used for corporate management purposes. Segment operating income represents income (loss) before income taxes plus depreciation, amortization of intangible assets, share-based compensation, impairment losses for goodwill and long-lived assets, gain on sale of disposal group, interest expense, net, and other, and unallocated corporate overhead.

Three Months Ended September 30, 2025
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Revenue$361,476$178,214$94,806$634,496
Cost of revenue274,420129,69045,974450,084
Gross profit87,05648,52448,832184,412
Segment selling, general and administrative expenses58,29532,79420,191111,280
Depreciation (included in cost of revenue)——(2,248)(2,248)
Segment operating income$28,761$15,730$30,88975,380
Unallocated corporate overhead20,601
Depreciation and amortization37,380
Depreciation (included in cost of revenue)2,248
Share-based compensation6,713
Gain on sale of disposal group(39,180)
Interest expense, net, and other9,627
Income before income taxes$37,991
Three Months Ended September 30, 2024
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Revenue$399,368$180,605$107,536$687,509
Cost of revenue299,617129,57045,267474,454
Gross profit99,75151,03562,269213,055
Segment selling, general and administrative expenses64,64132,90122,249119,791
Depreciation (included in cost of revenue)——(1,928)(1,928)
Segment operating income$35,110$18,134$41,94895,192
Unallocated corporate overhead24,335
Depreciation and amortization41,122
Depreciation (included in cost of revenue)1,928
Share-based compensation5,555
Interest expense, net, and other14,444
Income before income taxes$7,808
Nine Months Ended September 30, 2025
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Revenue$1,156,608$526,810$298,786$1,982,204
Cost of revenue884,554381,573137,1461,403,273
Gross profit272,054145,237161,640578,931
Segment selling, general and administrative expenses182,572101,55966,647350,778
Depreciation (included in cost of revenue)——(6,355)(6,355)
Segment operating income$89,482$43,678$101,348234,508
Unallocated corporate overhead65,210
Depreciation and amortization113,015
Depreciation (included in cost of revenue)6,355
Share-based compensation24,921
Gain on sale of disposal group(39,180)
Goodwill impairment loss109,515
Long-lived assets impairment loss18,262
Interest expense, net, and other33,311
Loss before income taxes$(96,901)
Nine Months Ended September 30, 2024
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Revenue$1,361,064$555,467$332,541$2,249,072
Cost of revenue1,025,384388,141135,1591,548,684
Gross profit335,680167,326197,382700,388
Segment selling, general and administrative expenses201,021105,30969,268375,598
Depreciation (included in cost of revenue)——(5,363)(5,363)
Segment operating income$134,659$62,017$133,477330,153
Unallocated corporate overhead78,318
Depreciation and amortization126,942
Depreciation (included in cost of revenue)5,363
Share-based compensation19,651
Interest expense, net, and other46,787
Income before income taxes$53,092

Disaggregation of Revenue

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

Three Months Ended September 30, 2025
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Travel nurse staffing$195,895$—$—$195,895
Labor disruption services12,465——12,465
Local staffing8,778——8,778
Allied staffing142,291——142,291
Locum tenens staffing—145,710—145,710
Interim leadership staffing—23,225—23,225
Temporary staffing359,429168,935—528,364
Permanent placement (1)2,0479,279—11,326
Language services——75,00575,005
Vendor management systems——16,95116,951
Technology-enabled services——91,95691,956
Talent planning and acquisition——2,8502,850
Total revenue$361,476$178,214$94,806$634,496
Three Months Ended September 30, 2024
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Travel nurse staffing$243,745$—$—$243,745
Labor disruption services486——486
Local staffing10,494——10,494
Allied staffing140,872——140,872
Locum tenens staffing—141,716—141,716
Interim leadership staffing—28,862—28,862
Temporary staffing395,597170,578—566,175
Permanent placement (1)3,77110,027—13,798
Language services——75,00975,009
Vendor management systems——25,01825,018
Other solutions——5,0445,044
Technology-enabled services——105,071105,071
Talent planning and acquisition——2,4652,465
Total revenue$399,368$180,605$107,536$687,509
Nine Months Ended September 30, 2025
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Travel nurse staffing$619,360$—$—$619,360
Labor disruption services66,847——66,847
Local staffing28,207——28,207
Allied staffing435,424——435,424
Locum tenens staffing—429,107—429,107
Interim leadership staffing—69,784—69,784
Temporary staffing1,149,838498,891—1,648,729
Permanent placement (1)6,77027,919—34,689
Language services——225,621225,621
Vendor management systems——55,38555,385
Other solutions——9,7349,734
Technology-enabled services——290,740290,740
Talent planning and acquisition——8,0468,046
Total revenue$1,156,608$526,810$298,786$1,982,204
Nine Months Ended September 30, 2024
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Travel nurse staffing$854,746$—$—$854,746
Labor disruption services886——886
Local staffing33,786——33,786
Allied staffing462,001——462,001
Locum tenens staffing—429,700—429,700
Interim leadership staffing—89,373—89,373
Temporary staffing1,351,419519,073—1,870,492
Permanent placement (1)9,64536,394—46,039
Language services——221,749221,749
Vendor management systems——81,67181,671
Other solutions——15,99315,993
Technology-enabled services——319,413319,413
Talent planning and acquisition——13,12813,128
Total revenue$1,361,064$555,467$332,541$2,249,072

(1) Includes revenue from international nurse permanent placement, physician permanent placement and executive search.

The following table presents the Company’s international nurse revenue by service type:

Three Months Ended September 30,Nine Months Ended September 30,
2025202420252024
International nurse staffing (1)$28,644$41,376$90,169$129,668
International nurse permanent placement (2)2,0473,7716,7709,645
Total international nurse revenue$30,691$45,147$96,939$139,313

(1) Included in “Travel nurse staffing” as presented in the preceding tables.

(2) Included in “Permanent placement” as presented in the preceding tables.

  1. GOODWILL AND IDENTIFIABLE INTANGIBLE ASSETS

Impairment of Goodwill

Due to recent declines in forecasted revenue and earnings of the physician and leadership solutions reporting unit, the Company performed a quantitative goodwill impairment test for the reporting unit in the second quarter of 2025. The Company engaged a third-party valuation specialist to assist with determining the fair value of the reporting unit, which was estimated using an equal weighting of the income and market approaches. The discounted cash flow method (within the income approach) requires the use of Level 3 inputs, including (i) estimated future cash flows based on internally-developed forecasts of revenue, expenses and profit margins, (ii) estimated long-term growth rates, and (iii) determination of the Company’s weighted average cost of capital that reflects the relative risk of the cash flows for each reporting unit. The guideline public company method (within the market approach) derives valuation multiples based on the market capitalization of similar publicly traded companies to apply to the forecasted financial metrics of the reporting unit. The market multiples used are revenue and earnings before interest, taxes, depreciation, and amortization (EBITDA). In addition, as fair value determined under the guideline public company method represents a noncontrolling interest, a control premium was applied to arrive at the estimated fair value of the reporting unit on a controlling basis.

The quantitative test resulted in a goodwill impairment loss for the physician and leadership solutions reporting unit. Consideration was first given to long-lived assets within the reporting unit, and no impairment was recognized on such assets as the future undiscounted cash flows were in excess of the carrying amount of each asset group tested for impairment. The decline in the fair value of the physician and leadership solutions reporting unit below its carrying amount resulted from changes in estimated future cash flows primarily due to lower-than-expected volume for the locum tenens staffing business, continued gross margin pressures in the locum tenens staffing business driven by higher provider pay packages, and a continued decline in demand for the healthcare interim leadership and permanent placement solutions. As a result, an impairment loss of $91,221 was recorded to goodwill of the physician and leadership solutions reporting unit.

Recognition of the non-cash goodwill impairment loss resulted in income tax benefits that reduced the deferred tax liability associated with goodwill by $18,294, which increased the carrying amount of the physician and leadership solutions reporting unit. An incremental impairment loss of the same amount was recognized to reduce the reporting unit’s carrying amount to its previously determined fair value. After recognition of the incremental charge, the goodwill impairment loss amounted to $109,515 in total.

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

Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Balance, January 1, 2025$259,137$237,760$400,559$897,456
Goodwill impairment loss—(109,515)—(109,515)
Goodwill included in sale of disposal group——(32,132)(32,132)
Balance, September 30, 2025$259,137$128,245$368,427$755,809
Accumulated impairment loss as of December 31, 2024$277,727$159,669$—$437,396
Accumulated impairment loss as of September 30, 2025$277,727$269,184$—$546,911

Impairment of Intangible Assets

During the second quarter of 2025, the Company determined that recent declines in forecasted revenue and earnings of the revenue cycle solutions business (within the nurse and allied solutions segment) indicated that the carrying amounts of its customer relationships intangible assets may not be recoverable. Accordingly, the Company tested the recoverability of the asset group based on undiscounted estimated future cash flows and concluded that its carrying amount was not recoverable. The Company engaged a third-party valuation specialist to assist with determining the fair value of the asset group, which was estimated using the discounted cash flow method (within the income approach), and concluded that the asset group’s carrying amount exceeded its fair value. As a result, Company recognized an impairment loss on the customer relationships intangible assets of $18,262, which is included within long-lived assets impairment loss in the condensed consolidated statements of comprehensive income (loss). See Note (7), “Fair Value Measurement,” for additional information regarding the measurement of the asset group’s fair value.

The Company had the following acquired intangible assets as of September 30, 2025 and December 31, 2024:

As of September 30, 2025As of December 31, 2024
GrossCarryingAmountAccumulatedAmortizationNetCarryingAmountGrossCarryingAmountAccumulatedAmortizationNetCarryingAmount
Intangible assets subject to amortization:
Staffing databases$52,336(42,569)$9,767$52,336$(39,879)$12,457
Customer relationships467,321(231,074)236,247532,048(247,550)284,498
Tradenames and trademarks282,168(228,515)53,653284,488(204,159)80,329
Non-compete agreements9,399(8,471)9289,399(7,783)1,616
Acquired technology36,285(34,803)1,48237,915(35,451)2,464
$847,509$(545,432)$302,077$916,186$(534,822)$381,364
  1. 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 2024 Annual Report. The Company has not changed the valuation techniques or inputs it uses for its fair value measurement during the nine months ended September 30, 2025.

Assets and Liabilities Measured on a Recurring Basis

From time to time, the Company invests a portion of its cash and cash equivalents in non-federally insured money market funds that are measured at fair value based on quoted prices, which are Level 1 inputs.

The Company has a deferred compensation plan for certain executives and employees, which is composed of deferred compensation and all related income and losses attributable thereto. The Company’s obligation under its deferred compensation plan is measured at fair value based on quoted market prices of the participants’ elected investments, which are Level 1 inputs.

The Company’s restricted cash equivalents and investments that serve as collateral for the Company’s captive insurance company include commercial paper and corporate bonds. The commercial paper is measured at observable market prices for identical securities that are traded in less active markets, which are Level 2 inputs. The corporate bonds are measured using readily available pricing sources that utilize observable market data, including the current interest rate for comparable instruments, which are Level 2 inputs. The following table presents the fair value of commercial paper and corporate bonds issued and outstanding:

As of September 30, 2025As of December 31, 2024
Commercial paper$12,904$64,580
Total classified as restricted cash equivalents$12,904$64,580
Commercial paper$969$1,399
Corporate bonds32,9366,769
Total classified as restricted investments$33,905$8,168

There wereno assets or liabilities measured on a recurring basis with level 3 inputs outstanding as of September 30, 2025 and December 31, 2024.

The following table presents information about the above-referenced assets and liabilities and indicates the fair value hierarchy of the valuation techniques utilized to determine such fair value:

Fair Value Measurements as of September 30, 2025Fair Value Measurements as of December 31, 2024
Assets (Liabilities)Level 1Level 2TotalLevel 1Level 2Total
Deferred compensation$(200,771)$—$(200,771)$(191,006)$—$(191,006)
Commercial paper—13,87313,873—65,97965,979
Corporate bonds—32,93632,936—6,7696,769

Assets Measured on a Non-Recurring Basis

The Company applies fair value techniques on a non-recurring basis associated with identifiable intangible assets acquired through acquisitions and valuing potential impairment losses related to its goodwill, indefinite-lived intangible assets, long-lived assets, and equity investments.

The fair value of identifiable intangible assets is determined using either the income approach (the relief-from-royalty method, multi-period excess earnings method or with-and-without method) or the cost approach (replacement cost method). These valuation approaches use a combination of assumptions, including Level 3 inputs, such as (i) forecasted revenue, growth rates and customer attrition rates, (ii) forecasted operating expenses and profit margins, and (iii) royalty rates and discount rates used to present value the forecasted cash flows.

The Company assesses long-lived assets (including definite-lived intangible assets, fixed assets, and right-of-use assets) for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of long-lived assets to be held and used is measured by a comparison of the carrying amount of an asset group to the future undiscounted net cash flows that are expected to be generated by the asset group. If such asset group is considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the asset group exceeds its fair value. The Company determines the fair value of its asset groups based on a combination of inputs, including Level 3 inputs such as discounted cash flows, which are not observable from the market, directly or indirectly. In connection with the impairment loss on the customer relationships intangible assets recognized during the three months ended June 30, 2025, the following unobservable inputs were used in discounted cash flow method (within the income approach) to measure the fair value of the revenue cycle solutions asset group:

RangeAverage
Revenue growth rates(2.1)% - 6.1%3.3%
Long-term growth rate3.5%N/A
Weighted-average cost of capital14.0%N/A

The Company maintains goodwill on its balance sheet, which represents the excess of the total purchase price of acquisitions over the fair value of the net assets and intangible assets acquired. 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. When the Company identifies price changes in orderly transactions for identical or similar investments of the same issuer, the investment is measured at fair value. To determine whether a security of the same issuer is similar to the Company’s equity investment, the Company considers other information available 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 (loss). As of September 30, 2025, the Company has recognized cumulative upward adjustments and cumulative downward adjustments (including impairments) of$14,033 and $19,860, respectively. The balance of the equity investment was$2,773 as of September 30, 2025 and December 31, 2024.

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 2024 Annual Report.

As of September 30, 2025As of December 31, 2024
CarryingAmountEstimatedFair ValueCarryingAmountEstimatedFair Value
2027 Notes$500,000$500,000$500,000$473,750
2029 Notes350,000329,000350,000312,375

The Company initially recognized the 2027 Note Receivableat its estimated fair value of $9,899 in connection with thesale of its Smart Square healthcare scheduling software on July 1, 2025. The fair valuewas determined using Level 2 inputs, including observable market interest rates and pricing for similar credit facilities. The fair value of the 2027 Note Receivable was not re-measured as of September 30, 2025 as there were no material changes in contractual terms, counterparty credit risk, or other relevant factors. The carrying amount of$9,914 as of September 30, 2025 approximates its fair valueand is classified as a noncurrent asset in the consolidated balance sheet. See Note (2), “Sale of Disposal Group” for additional information.

The fair value of the Company’s long-term self-insurance accruals cannot be estimated as the Company cannot reasonably determine the timing of future payments.

  1. INCOME TAXES

The Company is subject to taxation in the U.S. and various states, and foreign jurisdictions. With few exceptions, as of September 30, 2025, 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 2021.

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.

On July 4, 2025, the One Big Beautiful Bill Act (“OBBBA”) was enacted in the U.S. The OBBBA includes significant provisions, such as the permanent extension of certain expiring provisions of the Tax Cuts and Jobs Act, modifications to the international tax framework and the restoration of favorable tax treatment for certain business provisions. The legislation has multiple effective dates, with certain provisions effective in 2025 and others implemented in subsequent years. The Company has assessed its impact on the consolidated financial statements and determined there was no material impact to income tax expense or the effective tax rate as of September 30, 2025.

  1. 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, representative, 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 and representative actions related to wage and hour claims under California and Federal law.

  1. BALANCE SHEET DETAILS

The consolidated balance sheets detail is as follows:

September 30, 2025December 31, 2024
Other current assets:
Restricted cash and cash equivalents$19,801$14,984
Income taxes receivable16,22511,683
Subcontractor deposits3,68111,190
Other17,18215,601
Other current assets$56,889$53,458
Fixed assets:
Furniture and equipment$96,200$90,970
Software431,925440,034
Leasehold improvements16,05816,061
544,183547,065
Accumulated depreciation(397,204)(360,795)
Fixed assets, net$146,979$186,270
Other assets:
Life insurance cash surrender value$209,512$194,350
Operating lease right-of-use assets28,65232,115
Other38,60031,588
Other assets$276,764$258,053
Accounts payable and accrued expenses:
Trade accounts payable$36,218$31,356
Subcontractor payable55,31669,563
Accrued expenses56,67257,263
Loss contingencies7,5502,999
Professional liability reserve8,6648,395
Other6,71514,735
Accounts payable and accrued expenses$171,135$184,311
Accrued compensation and benefits:
Accrued payroll$52,562$46,896
Accrued bonuses and commissions21,26525,988
ESPP contributions75812
Workers compensation reserve8,7939,954
Deferred compensation200,771191,006
Other9,71612,888
Accrued compensation and benefits$293,182$287,544
Other current liabilities:
Client deposits$60,944$56,341
Operating lease liabilities6,1396,200
Deferred revenue5,94810,014
Other4,8141,375
Other current liabilities$77,845$73,930
Other long-term liabilities:
Workers compensation reserve$16,241$18,445
Professional liability reserve39,35638,307
Operating lease liabilities31,99935,725
Other18,02514,973
Other long-term liabilities$105,621$107,450
  1. SUBSEQUENT EVENTS

On October 6, 2025, the Company completed the issuance of $400,000 aggregate principal amount of 6.500% senior notes due 2031 (the “2031 Notes”), which mature on January 15, 2031. Interest on the 2031 Notes is payable semi-annually in arrears on January 15 and July 15 of each year, commencing July 15, 2026.

On October 6, 2025, the Company entered into the fifth amendment to its credit agreement (the “Fifth Amendment”). The Fifth Amendment provides for, among other things, the following: (i) an extension of the maturity date of Senior Credit Facility to October 6, 2030, (ii) a decrease of the revolving commitments to $450,000, and (iii) the revision of the Consolidated Net Leverage Ratio (as calculated in accordance with the amended credit agreement) to be no greater than 5.25 to 1.00 through March 31, 2027.

With the proceeds from the 2031 Notes, together with borrowings under the Senior Credit Facility and cash generated from operations, the Company (1) redeemed the entire outstanding $500,000 aggregate principal amount of the 2027 Notes on October 22, 2025, including all accrued and unpaid interest on the 2027 Notes and (2) paid fees and expenses related to the transactions.

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