AMN HEALTHCARE SERVICES INC
For the period ended Jun 30, 2026. Filed Aug 7, 2026.
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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.
Jun 30, 2026 · Filed Aug 7, 2026
What changed in Management’s Discussion and Analysis?
Read the current filingPrevious report: 10-Q
Period ended 2026-03-31; filed 2026-05-08.
0001628280-26-032419
Item 2. Management’s Discussion and Analysis of Financial Condition and Results of OperationsCurrent report: 10-Q
Period ended 2026-06-30; filed 2026-08-07.
0001628280-26-054507
Item 2. Management’s Discussion and Analysis of Financial Condition and Results of OperationsThe baseline is this issuer’s latest earlier reporting period of the same form that was filed before the current report. A previous 10-Q is a different quarter, not a year-over-year comparison. Amendments are excluded.
Compared 96 previous paragraphs and 113 current paragraphs.
68 unchanged; 28 reworded; 9 added; 0 removed; 0 previous and 8 current paragraphs rearranged.
Tables are not compared: 6 previous and 10 current tables excluded. Dates, whitespace, punctuation and numbering changes are ignored; changes to financial figures remain significant.
A changed paragraph is not evidence that risk increased or decreased. An unchanged paragraph does not establish that risk stayed the same.
Added paragraphs (9)
Current report
Nurse and allied solutions segment revenue increased 11% to $422.0 million for the three months ended June 30, 2026 from $381.9 million for the same period in 2025. The $40.1 million increase was primarily attributable to a $20.3 million increase driven by a 6% increase in the average number of travelers on assignment, a $10.0 million increase in labor disruption revenue related to reserve releases and billing true ups from multiple large scale labor disruption events that we supported in the prior periods, an $8.6 million increase driven by non-volume revenue, and a $3.3 million increase driven by a 1% increase in average billable hours.
Current report
Physician and leadership solutions segment revenue decreased 6% to $164.6 million for the three months ended June 30, 2026 from $174.5 million for the same period in 2025. The $9.9 million decrease was primarily attributable to lower revenue in our locum tenens business, partially offset by higher revenue in our physician permanent placement and executive search business within the segment. Revenue in our locum tenens business declined $11.8 million (or 8%) due to a $12.1 million decline from an 8% decrease in the number of days filled. Our physician permanent placement and executive search business increased $2.5 million (or 26.7%) primarily due to higher new search volume in the quarter.
Current report
Goodwill Impairment Loss. A goodwill impairment loss of $109.5 million was recognized in the physician and leadership solutions segment during the three months ended June 30, 2025.
Current report
Long-Lived Assets Impairment Loss. An impairment loss of $18.3 million was recognized for intangible assets during the three months ended June 30, 2025.
Current report
Revenue. Revenue increased 52% to $2,051.6 million for the six months ended June 30, 2026 from $1,347.7 million for the same period in 2025, attributable to higher revenue in our nurse and allied solutions segment. Revenue broken down among the reportable segments is as follows:
Current report
Cost of Revenue. Cost of revenue increased 55% to $1,476.9 million for the six months ended June 30, 2026 from $953.2 million for the same period in 2025. The $523.7 million increase was primarily attributable to the increase in our nurse and allied solutions segment. Cost of revenue broken down among the reportable segments is as follows:
Current report
Goodwill Impairment Loss. A goodwill impairment loss of $109.5 million was recognized in the physician and leadership solutions segment during the six months ended June 30, 2025.
Current report
Long-Lived Assets Impairment Loss. An impairment loss of $18.3 million was recognized for intangible assets during the six months ended June 30, 2025.
Current report
Income Tax Expense (Benefit). Income tax expense (benefit) was $47 million for the six months ended June 30, 2026 as compared to $(17.6) million for the same period in 2025, reflecting effective income tax rates of 36% and 13% for the six months ended June 30, 2026 and 2025, respectively. The increase in the effective income tax rate was primarily attributable to a significant increase in income (loss) before income taxes year over year, mostly related to the increase in labor disruption revenue in the current year and the goodwill impairment loss recognized in the prior year.
Reworded paragraphs (28)
Previous wording
We conduct business through three reportable segments: (1) nurse and allied solutions, (2) physician and leadership solutions, and (3) technology and workforce solutions. For the three months ended March 31, 2026, we recorded revenue of $1,378.4 million, as compared to $689.5 million for the same period last year.
Current wording
We conduct business through three reportable segments: (1) nurse and allied solutions, (2) physician and leadership solutions, and (3) technology and workforce solutions. For the three months ended June 30, 2026, we recorded revenue of $673.2 million, as compared to $658.2 million for the same period last year. For the six months ended June 30, 2026, we recorded revenue of $2,051.6 million, as compared to $1,347.7 million for the same period last year.
Previous wording
Nurse and allied solutions segment revenue comprised 82% and 60%of total consolidated revenue for the three months ended March 31, 2026 and 2025, respectively. Through our nurse and allied solutions segment, we provide hospitals, other healthcare facilities, and schools with a comprehensive set of staffing solutions, including direct, vendor-neutral, and managed services solutions in which we manage and staff all the temporary and permanent nursing and allied staffing needs, as well as the revenue cycle management needs, of a client. A majority of our placements in this segment are under our managed services solution.
Current wording
Nurse and allied solutions segment revenue comprised 76% and 59%of total consolidated revenue for the six months ended June 30, 2026 and 2025, respectively. Through our nurse and allied solutions segment, we provide hospitals, other healthcare facilities, and schools with a comprehensive set of staffing solutions, including direct, vendor-neutral, and managed services solutions in which we manage and staff all the temporary and permanent nursing and allied staffing needs, as well as the revenue cycle management needs, of a client. A majority of our placements in this segment are under our managed services solution.
Previous wording
Physician and leadership solutions segment revenue comprised 12% and 25% of total consolidated revenue for the three months ended March 31, 2026 and 2025, respectively. Through our physician and leadership solutions segment, we place physicians of all specialties, as well as dentists and advanced practice providers, with clients on a temporary basis, generally as independent contractors. We also recruit physicians and healthcare leaders for permanent placement and place interim leaders and executives on variable-length assignments across all healthcare settings.
Current wording
Physician and leadership solutions segment revenue comprised 16% and 26% of total consolidated revenue for the six months ended June 30, 2026 and 2025, respectively. Through our physician and leadership solutions segment, we place physicians of all specialties, as well as dentists and advanced practice providers, with clients on a temporary basis, generally as independent contractors. We also recruit physicians and healthcare leaders for permanent placement and place interim leaders and executives on variable-length assignments across all healthcare settings.
Previous wording
Technology and workforce solutions segment revenue comprised 6%and 15% of total consolidated revenue for the three months ended March 31, 2026 and 2025, respectively. Through our technology and workforce solutions segment, we provide hospitals and other healthcare facilities with a range of workforce solutions, including: (1) language services, (2) software-as-a-service (“SaaS”)-based VMS technologies through which our clients can self-manage the procurement of contingent clinical labor and their internal float pool, (3) workforce optimization services that include advisory, planning, and analytics, and (4) recruitment process outsourcing services in which we recruit, hire and/or onboard permanent clinical and nonclinical positions on behalf of our clients.
Current wording
Technology and workforce solutions segment revenue comprised 8% and 15%of total consolidated revenue for the six months ended June 30, 2026 and 2025, respectively. Through our technology and workforce solutions segment, we provide hospitals and other healthcare facilities with a range of workforce solutions, including: (1) language services, (2) software-as-a-service (“SaaS”)-based VMS technologies through which our clients can self-manage the procurement of contingent clinical labor and their internal float pool, (3) workforce optimization services that include advisory, planning, and analytics, and (4) recruitment process outsourcing services in which we recruit, hire and/or onboard permanent clinical and nonclinical positions on behalf of our clients.
Previous wording
During the first quarter, the nurse and allied solutions segment experienced substantial labor disruption staffing activity. We supplied thousands of clinicians to enable clients to maintain continuity of care amid multiple simultaneous large scale labor disruption events. Investments in technology and processes over several years enabled the Company to effectively meet client needs throughout extended events during the quarter. The travel nurse division was also affected by these labor disruptions, resulting in heightened demand for rapid response nurses at elevated bill rates. While demand for travel nurses decreased compared to the prior year, the percentage of orders filled increased, and traveler volume was higher than prior year. The international nurse business continued its sequential growth in the first quarter with recent visa bulletins increasing our number of visa-eligible candidates to be placed. Allied staffing experienced sequential increases in demand during the first quarter, consistent with the previous year, with volume demonstrating growth both sequentially and year over year.
Current wording
The nurse and allied solutions segment included substantial labor disruption staffing revenue in the first quarter. The travel nurse division also was impacted by the labor disruption events, with heightened demand for rapid response nurses at elevated bill rates in the first quarter. While labor disruption and travel nurse revenue was lower sequentially in the second quarter, we are seeing positive trends in our base travel nurse business. Demand for travel nurses increased compared to the prior quarter and prior year along with increases in the percentage of orders filled, and as a result, traveler volume was higher than prior year. The international nurse business continued its sequential growth and year-over-year growth in the second quarter with strong traveler and direct placement growth. Allied staffing continued to experience sequential increases in demand during the second quarter, with volume demonstrating strong year-over-year growth.
Previous wording
In our physician and leadership solutions segment, demand for our locum tenens staffing business in the first quarter increased slightly from prior year but decreased sequentially. Certified registered nurse anesthetists (CRNAs) continue to be the largest specialty for our locum tenens staffing business. Revenue per day filled increased in the first quarter as compared to the prior year but was down sequentially. Days filled were lower compared to both prior year and prior quarter. Demand for our search business in the first quarter was lower compared to prior year and prior quarter, although search revenue increased from the prior year. Demand for interim leadership was higher compared to prior year but lower sequentially. Both businesses have been impacted by healthcare organizations deferring hiring decisions or increasing insourcing.
Current wording
In our physician and leadership solutions segment, demand for our locum tenens staffing business in the second quarter increased from prior year and prior quarter. Days filled were lower compared to prior year but up slightly sequentially. Revenue per day filled was in line with prior year but was down sequentially. Certified registered nurse anesthetists (CRNAs) continue to be the largest specialty for our locum tenens staffing business. Volume for our search business in the second quarter was higher compared to prior year and prior quarter, with particular strength in physician permanent placement and executive search. Demand for interim leadership was lower compared to prior year but higher sequentially.
Previous wording
In our technology and workforce solutions segment, first quarter minutes in our language services business were slightly down as compared to prior year and slightly up as compared to prior quarter. Ongoing pricing pressure for language services is expected due to increased market competition. Volumes in our VMS business declined both sequentially and compared to prior year.
Current wording
In our technology and workforce solutions segment, second quarter minutes in our language services business were in line with prior year and higher compared to prior quarter. Ongoing pricing pressure for language services continues to be a headwind due to increased market competition. Volume in our VMS business declined compared to prior year and prior quarter.
Previous wording
Revenue. Revenue increased 100% to $1,378.4 million for the three months ended March 31, 2026 from $689.5 million for the same period in 2025, attributable to higher revenue in our nurse and allied solutions segment. Revenue broken down among the reportable segments is as follows:
Current wording
Revenue. Revenue increased 2% to $673.2 million for the three months ended June 30, 2026 from $658.2 million for the same period in 2025, attributable to higher revenue in our nurse and allied solutions segment. Revenue broken down among the reportable segments is as follows:
Previous wording
Technology and workforce solutions segment revenue decreased 15% to $87.1 million for the three months ended March 31, 2026 from $102.2 million for the same period in 2025. The $15.1 million decrease was primarily attributable to declines in our ongoing businesses and a service line divestiture. Revenue for our VMS business declined $3.5 million (or 18%) due to lower staffing utilization on the platforms along with several client losses. Our language services business declined $6.0 million (or 8%) primarily due to lower pricing, and our other technology business declined $4.4 million (or 100%) primarily due to the sale of our Smart Square scheduling software in the third quarter of 2025.
Current wording
Technology and workforce solutions segment revenue decreased 15% to $86.7 million for the three months ended June 30, 2026 from $101.8 million for the same period in 2025. The $15.1 million decrease was primarily attributable to declines in our ongoing businesses and a service line divestiture. Revenue for our language services business declined $6.1 million (or 8%) primarily due to lower pricing, our other technology business declined $4.3 million (or 100%) due to the sale of our Smart Square scheduling software in the third quarter of 2025, and our VMS business declined $3.9 million (or 20%) due to lower staffing utilization on the platforms along with several client losses.
Previous wording
For the three months ended March 31, 2026 and 2025, revenue under our MSP arrangements comprised approximately 74% and 44% of consolidated revenue, 88% and 65% of nurse and allied solutions segment revenue, 18% and 18% of physician and leadership solutions segment revenue, and 1% and 3% of technology and workforce solutions segment revenue, respectively.
Current wording
For the three months ended June 30, 2026 and 2025, revenue under our MSP arrangements comprised approximately 46% and 44% of consolidated revenue, 66% and 68% of nurse and allied solutions segment revenue, 19% and 17% of physician and leadership solutions segment revenue, and 1% and 3% of technology and workforce solutions segment revenue, respectively.
Previous wording
Cost of Revenue. Cost of revenue, which consists predominantly of compensation, benefits, housing, travel and allowance costs for healthcare professionals and medically qualified interpreters, increased 105% to $1,009.5 million for the three months ended March 31, 2026 from $491.4 million for the same period in 2025. The $518.1 million increase was primarily attributable to the increase in our nurse and allied solutions segment. Cost of revenue broken down among the reportable segments is as follows:
Current wording
Cost of Revenue. Cost of revenue, which consists predominantly of compensation, benefits, housing, travel and allowance costs for healthcare professionals and medically qualified interpreters, increased 1% to $467.4 million for the three months ended June 30, 2026 from $461.8 million for the same period in 2025. The $5.6 million increase was primarily attributable to the increase in our nurse and allied solutions segment. Cost of revenue broken down among the reportable segments is as follows:
Previous wording
Selling, General and Administrative Expenses. Selling, general and administrative (“SG&A”) expenses consist predominantly of compensation and benefits costs for corporate employees, in addition to professional service fees, legal matter accruals and other overhead costs. SG&A expenses were $218.4 million, representing 15.8% of revenue, for the three months ended March 31, 2026, as compared to $147.7 million, representing 21.4% of revenue, for the same period in 2025. The increase in SG&A expenses was primarily due to a $45.4 million increase in employee compensation and benefits (inclusive of share-based compensation) and a $17.0 million increase in other expenses primarily in support of the large labor disruption events in the quarter. SG&A expenses broken down among the reportable segments, unallocated corporate overhead, and share-based compensation are as follows:
Current wording
Selling, General and Administrative Expenses. Selling, general and administrative (“SG&A”) expenses consist predominantly of compensation and benefits costs for corporate employees, in addition to professional service fees, legal matter accruals and other overhead costs. SG&A expenses were $147.4 million, representing 21.9% of revenue, for the three months ended June 30, 2026, as compared to $154.6 million, representing 23.5% of revenue, for the same period in 2025. The decrease in SG&A expenses was primarily due to a $5.8 million decrease in the provision for expected credit losses. SG&A expenses broken down among the reportable segments, unallocated corporate overhead, and share-based compensation are as follows:
Previous wording
Depreciation and Amortization Expenses. Amortization expense decreased 8% to $17.9 million for the three months ended March 31, 2026 from $19.4 million for the same period in 2025, primarily attributable to having more intangible assets fully amortized during the three months ended March 31, 2026. Depreciation expense (exclusive of depreciation included in cost of revenue) decreased 17% to $15.3 million for the three months ended March 31, 2026 from $18.5 million for the same period in 2025, primarily attributable to the mix of depreciable assets and their useful lives. Additionally, $2.4 million and $2.0 million of depreciation expense for our language services business is included in cost of revenue for the three months ended March 31, 2026 and 2025, respectively.
Current wording
Depreciation and Amortization Expenses. Amortization expense decreased 11% to $17.5 million for the three months ended June 30, 2026 from $19.6 million for the same period in 2025, primarily attributable to having more intangible assets fully amortized during the three months ended June 30, 2026. Depreciation expense (exclusive of depreciation included in cost of revenue) decreased 23% to $14.1 million for the three months ended June 30, 2026 from $18.1 million for the same period in 2025, primarily attributable to the mix of depreciable assets and their useful lives. Additionally, $2.5 million and $2.1 million of depreciation expense for our language services business is included in cost of revenue for the three months ended June 30, 2026 and 2025, respectively.
Previous wording
Interest Expense, Net, and Other. Interest expense, net, and other was $6.7 million during the three months ended March 31, 2026 as compared to $12.3 million for the same period in 2025. The decrease was primarily due to a lower average debt outstanding balance, as well as interest income earned on excess cash during the three months ended March 31, 2026.
Current wording
Interest Expense, Net, and Other. Interest expense, net, and other was $7.0 million during the three months ended June 30, 2026 as compared to $11.4 million for the same period in 2025. The decrease was primarily due to a lower average debt outstanding balance, as well as interest income earned on excess cash during the three months ended June 30, 2026.
Previous wording
Income Tax Expense. Income tax expense was $48.3 million for the three months ended March 31, 2026 as compared to $1.3 million for the same period in 2025, reflecting effective income tax rates of 44% and 697% for these periods, respectively. The decrease in the effective income tax rate wasprimarily attributable to the recognition of$2.6 million of net discrete tax expense during the three months ended March 31, 2026 compared to a $1.3 million net discrete tax expense during the same period in 2025, in relation to income before income taxes of $110.5 million and $0.2 million for the three months ended March 31, 2026 and 2025, respectively. We currently estimate our annual effective tax rate to be approximately 46% for 2026. The 44% effective tax rate for the three months ended March 31, 2026 differs from our estimated annual effective tax rate of 46% primarily due to certain discrete tax expenses recognized during the three months ended March 31, 2026, in relation toincome before income taxes.
Current wording
Income Tax Benefit. Income tax benefit was $(1.3) million for the three months ended June 30, 2026 as compared to $(18.9) million for the same period in 2025, reflecting effective income tax rates of (6)% and 14% for these periods, respectively. The decrease in the effective income tax rate wasprimarily attributable to the recognition of$0.6 million of net discrete tax expense during the three months ended June 30, 2026 compared to a $0.9 million net discrete tax expense during the same period in 2025, along with a goodwill impairment loss recognized in the prior year, in relation to income (loss) before income taxes of $19.9 million and $(135) million for the three months ended June 30, 2026 and 2025, respectively. We currently estimate our annual effective tax rate to be approximately 36% for 2026. The (6)% effective tax rate for the three months ended June 30, 2026 differs from our estimated annual effective tax rate of 36% primarily due to certain tax benefits recognized during the three months ended June 30, 2026, in relation toincome before income taxes.
Previous wording
Nurse and allied solutions segment revenue increased 173% to $1,127.3 million for the three months ended March 31, 2026 from $413.3 million for the same period in 2025. The $714.0 million increase was primarily attributable to a $683.0 million increase in labor disruption revenue from multiple large scale labor disruption events that we supported in the current quarter, a $21.0 million increase driven by a 6% increase in the average bill rate and an $10.0 million increase driven by a 3% increase in the average number of travelers on assignment.
Current wording
Nurse and allied solutions segment revenue increased 95% to $1,549.3 million for the six months ended June 30, 2026 from $795.1 million for the same period in 2025. The $754.2 million increase was primarily attributable to a $693.0 million increase in labor disruption revenue from multiple large scale labor disruption events that we supported in the current year, a $30.4 million increase driven by a 4% increase in the average number of travelers on assignment, a $19.1 million increase driven by an approximately 3% increase in the average bill rate, and a $6.4 million increase driven by an approximately 1% increase in average billable hours.
Previous wording
Physician and leadership solutions segment revenue decreased 6% to $163.9 million for the three months ended March 31, 2026 from $174.1 million for the same period in 2025. The $10.2 million decrease was primarily attributable to a decline in revenue in our locum tenens business of $9.7 million (or 7%) due to a $12.9 million decline driven by a 9% decrease in the number of days filled, partially offset by a $3.2 million increase driven by a 3% increase in the revenue per day filled.
Current wording
Physician and leadership solutions segment revenue decreased 6% to $328.5 million for the six months ended June 30, 2026 from $348.6 million for the same period in 2025. The $20.1 million decrease in the segment revenue was primarily attributable to a decline in revenue in our locum tenens business due to a $25.0 million decline driven by a 9% decrease in the number of days filled, partially offset by a $3.5 million increase driven by a 1% increase in the revenue per day filled.
Previous wording
The increase in our nurse and allied solutions segment was primarily attributable to a $520.2 million increase in clinician pay package costs, including housing, travel and allowances, primarily due to the increase in labor disruption activities.
Current wording
The increase in our nurse and allied solutions segment was primarily attributable to a $529.6 million increase in clinician pay package costs, including housing, travel and allowances, primarily due to the increase in labor disruption activities.
Previous wording
Gross Profit. Gross profit increased 86% to $368.8 million for the three months ended March 31, 2026 from $198.1 million for the same period in 2025, representing gross margins of 26.8% and 28.7%, respectively. The decline in consolidated gross margin for the three months ended March 31, 2026, as compared to the same period in 2025, was primarily due to (1) a lower margin in our physician and leadership solutions segment driven by increases in sales reserve and allowances and (2) a lower margin in our technology and workforce solutions segment primarily due to lower bill rates in our language services business due to increased market competition, a shift in sales mix resulting from reduced revenue in our higher-margin VMS business, and the sale of our Smart Square scheduling software. The overall decrease was partially offset by a revenue mix shift to higher margin labor disruption business in our nurse and allied solutions segment. Gross margin by reportable segment for the three months ended March 31, 2026 and 2025 was 25.1% and 22.7% for nurse and allied solutions, 26.1% and 27.3% for physician and leadership solutions, and 50.0% and 55.5% for technology and workforce solutions, respectively. Gross profit broken down among the reportable segments is as follows:
Current wording
Gross Profit. Gross profit increased 46% to $574.7 million for the six months ended June 30, 2026 from $394.5 million for the same period in 2025, representing gross margins of 28.0% and 29.3%, respectively. The decline in consolidated gross margin for the six months ended June 30, 2026, as compared to the same period in 2025, was primarily due to (1) lower margins in our physician and leadership solutions segments driven by increases in sales reserve and allowances, compression in provider rates, including housing and travel, and increased market competition and (2) a lower margin in our technology and workforce solutions segment primarily due to pricing pressure for our language services business due to increased market competition and a shift in sales mix resulting from reduced revenue in our higher-margin VMS business and the sale of our Smart Square scheduling software. The overall decline was partially offset by a revenue mix shift to higher margin labor disruption business in our nurse and allied solutions segment. Gross margin by reportable segment for the six months ended June 30, 2026 and 2025 was 26.0% and 23.3% for nurse and allied solutions, 26.3% and 27.7% for physician and leadership solutions, and 49.3% and 55.3% for technology and workforce solutions, respectively. Gross profit broken down among the reportable segments is as follows:
Previous wording
As of March 31, 2026, (1) no amount was drawn with $429.8 million of available credit under our $450.0 million secured revolving credit facility (the “Senior Credit Facility”), (2) the aggregate principal amount of our 4.000% senior notes due 2029 (the “2029 Notes”) outstanding was $350.0 million, and (3) the aggregate principal amount of our 6.500% senior notes due 2031 (the “2031 Notes”) outstanding was $400.0 million. We describe in further detail our Amended Credit Agreement (as defined below), under which the Senior Credit Facility is governed, the 2029 Notes, and the 2031 Notes in Part II, Item 8, “Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note (9), Notes Payable and Credit Agreement” of our 2025 Annual Report.
Current wording
As of June 30, 2026, (1) no amount was drawn with $430.0 million of available credit under our $450.0 million secured revolving credit facility (the “Senior Credit Facility”), (2) the aggregate principal amount of our 4.000% senior notes due 2029 (the “2029 Notes”) outstanding was $350.0 million, and (3) the aggregate principal amount of our 6.500% senior notes due 2031 (the “2031 Notes”) outstanding was $400.0 million. We describe in further detail our Amended Credit Agreement (as defined below), under which the Senior Credit Facility is governed, the 2029 Notes, and the 2031 Notes in Part II, Item 8, “Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note (9), Notes Payable and Credit Agreement” of our 2025 Annual Report.
Previous wording
As of March 31, 2026, the total of our contractual obligations under operating leases with initial terms in excess of one year was $40.1 million. We describe in further detail our operating lease arrangements in Part II, Item 8, “Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note (6), Leases” of our 2025 Annual Report. We also have various obligations and working capital requirements, such as certain tax and legal matters, contingent consideration and other liabilities, that are recorded on our consolidated balance sheets. See additional information in the accompanying Note (6), “Fair Value Measurement,” Note (7), “Income Taxes,” Note (8), “Commitments and Contingencies,” and Note (9), “Balance Sheet Details.”
Current wording
As of June 30, 2026, the total of our contractual obligations under operating leases with initial terms in excess of one year was $38.0 million. We describe in further detail our operating lease arrangements in Part II, Item 8, “Financial Statements and Supplementary Data—Notes to Consolidated Financial Statements—Note (6), Leases” of our 2025 Annual Report. We also have various obligations and working capital requirements, such as certain tax and legal matters, contingent consideration and other liabilities, that are recorded on our consolidated balance sheets. See additional information in the accompanying Note (6), “Fair Value Measurement,” Note (7), “Income Taxes,” Note (8), “Commitments and Contingencies,” and Note (9), “Balance Sheet Details.”
Previous wording
Net cash provided by operating activities for the three months ended March 31, 2026 was $562.5 million, compared to $92.7 million for the same period in 2025. The increase in net cash provided by operations was primarily attributable to (1) an increase in other liabilities between periods of $380.5 million primarily related to receipts of client deposits and related reserves, (2) a year-over-year increase in net income (loss) excluding non-cash items of $107.4 million primarily due to higher segment operating income in our nurse and allied solutions segment, (3) an increase in accrued compensation and benefits between periods of $41.0 million primarily related to our labor disruption services, and (4) an increase in accounts payable and accrued expenses between periods of $25.8 million primarily due to the timing of payments.
Current wording
Net cash provided by operating activities for the six months ended June 30, 2026 was $372.5 million, compared to $171.2 million for the same period in 2025. The increase in net cash provided by operations was primarily attributable to (1) a year-over-year increase in net income (loss) excluding non-cash items of $95.5 million primarily due to higher segment operating income in our nurse and allied solutions segment, (2) an increase in other liabilities between periods of $91.2 million primarily related to receipts of client deposits and related reserves, (3) an increase in accounts payable and accrued expenses between periods of $37.9 million primarily due to the timing of payments, and (4) an increase in accrued compensation and benefits between periods of $33.2 million primarily related to our labor disruption services.
Previous wording
The overall increase in net cash provided by operating activities was partially offset by (1) an increase in other current assets between periods of $45.2 million primarily due to subcontractor deposits related to labor disruption services in the current year and (2) an increase in accounts receivable and subcontractor receivables between periods of $41.6 million primarily due to the timing of collections.
Current wording
The overall increase in net cash provided by operating activities was partially offset by an increase in accounts receivable and subcontractor receivables between periods of $52.4 million primarily due to the timing of collections.
Previous wording
Our Days Sales Outstanding (“DSO”) was 26 days as of March 31, 2026, 47 days as of December 31, 2025, and 55 days as of March 31, 2025; excluding our labor disruption business, DSO was 54 days, 56 days and 58 days, respectively.
Current wording
Our Days Sales Outstanding (“DSO”) was 52 days as of June 30, 2026, 47 days as of December 31, 2025, and 54 days as of June 30, 2025; excluding our labor disruption business, DSO was 54 days, 56 days and 56 days, respectively.
Previous wording
Net cash used in investing activities for the three months ended March 31, 2026 was $7.5 million, compared to net cash used in investing activities of $26.0 million for the same period in 2025. The decrease was primarily due to a net purchase of investments of $0.3 million during the three months ended March 31, 2026, as compared to a net purchase of $14.5 million during the three months ended March 31, 2025. In addition, capital expenditures were $7.2 million and $10.0 million for the three months ended March 31, 2026 and 2025, respectively.
Current wording
Net cash used in investing activities for the six months ended June 30, 2026 was $19.7 million, compared to net cash used in investing activities of $46.6 million for the same period in 2025. The decrease was primarily due to net proceeds of investments of $0.2 million during the six months ended June 30, 2026, as compared to a net purchase of $26.9 million during the six months ended June 30, 2025. In addition, capital expenditures were $15.8 million and $19.8 million for the six months ended June 30, 2026 and 2025, respectively.
Previous wording
Net cash used in financing activities during the three months ended March 31, 2026 was $27.1 million, due to repayments of $25.0 million under the Senior Credit Facility and $2.1 million in cash paid for shares withheld for payroll taxes resulting from the vesting of employee equity awards. Net cash used in financing activities during the three months ended March 31, 2025 was $61.2 million, due to repayments of $95.0 million under the Senior Credit Facility and $1.2 million in cash paid for shares withheld for payroll taxes resulting from the vesting of employee equity awards, partially offset by borrowings of $35.0 million under the Senior Credit Facility.
Current wording
Net cash used in financing activities during the six months ended June 30, 2026 was $29.5 million, due to repayments of $25.0 million under the Senior Credit Facility, $2.3 million paid in connection with the repurchase of our common stock, and $2.2 million in cash paid for shares withheld for payroll taxes resulting from the vesting of employee equity awards. Net cash used in financing activities during the six months ended June 30, 2025 was $141.4 million, due to repayments of $185.0 million under the Senior Credit Facility and $1.4 million in cash paid for shares withheld for payroll taxes resulting from the vesting of employee equity awards, partially offset by borrowings of $45.0 million under the Senior Credit Facility.
Previous wording
At March 31, 2026, we maintained outstanding standby letters of credit totaling $20.8 million as collateral in relation to our workers’ compensation insurance agreements and a corporate office lease agreement. Of the $20.8 million of outstanding letters of credit, we have collateralized approximately $0.7 million in cash and cash equivalents and the remaining approximately $20.2 million is collateralized by the Senior Credit Facility. Outstanding standby letters of credit at December 31, 2025 totaled $20.8 million.
Current wording
At June 30, 2026, we maintained outstanding standby letters of credit totaling $20.7 million as collateral in relation to our workers’ compensation insurance agreements and a corporate office lease agreement. Of the $20.7 million of outstanding letters of credit, we have collateralized approximately $0.7 million in cash and cash equivalents and the remaining approximately $20.0 million is collateralized by the Senior Credit Facility. Outstanding standby letters of credit at December 31, 2025 totaled $20.8 million.
Previous wording
•the effects of the COVID-19 pandemic or any future pandemic or health crisis on our business, financial condition and results of operations;
Current wording
•the effects of any future pandemic or health crisis on our business, financial condition and results of operations;
Rearranged current paragraphs (8)
Current report — wording carried from elsewhere
The increase in our nurse and allied solutions segment was primarily attributable to a $9.3 million increase in clinician pay package costs, including housing, travel and allowances, primarily due to the increase in the average number of travelers on assignment.
Current report — wording carried from elsewhere
Gross Profit. Gross profit increased 5% to $205.9 million for the three months ended June 30, 2026 from $196.4 million for the same period in 2025, representing gross margins of 30.6% and 29.8%, respectively. The increase in consolidated gross margin for the three months ended June 30, 2026, as compared to the same period in 2025, was primarily due to higher margin in our nurse and allied solutions segment driven by reserve releases and billing true ups from multiple large scale labor disruption events that we supported in the prior periods. The overall increase was partially offset by (1) a lower margin in our physician and leadership solutions segment driven by increases in sales reserve and allowances and (2) a lower margin in our technology and workforce solutions segment primarily due to lower bill rates in our language services business due to increased market competition, a shift in sales mix resulting from reduced revenue in our higher-margin VMS business, and the sale of our Smart Square scheduling software. Gross margin by reportable segment for the three months ended June 30, 2026 and 2025 was 28.4% and 23.9% for nurse and allied solutions, 26.5% and 28.2% for physician and leadership solutions, and 48.6% and 55.1% for technology and workforce solutions, respectively. Gross profit broken down among the reportable segments is as follows:
Current report — wording carried from elsewhere
Comparison of Results for the Six Months Ended June 30, 2026 to the Six Months Ended June 30, 2025
Current report — wording carried from elsewhere
Technology and workforce solutions segment revenue decreased 15% to $173.8 million for the six months ended June 30, 2026 from $204.0 million for the same period in 2025. The $30.2 million decrease was primarily attributable to declines in our ongoing businesses and a service line divestiture. Revenue for our language services business declined $12.1 million (or 8%) primarily due to lower pricing, our other technology business declined $8.7 million (or 100%) due to the sale of our Smart Square scheduling software in the third quarter of 2025, and our VMS business declined $7.3 million (or 19%) primarily due to lower staffing utilization on the platforms along with several client losses.
Current report — wording carried from elsewhere
For the six months ended June 30, 2026 and 2025, revenue under our MSP arrangements comprised approximately 65% and 46% of consolidated revenue, 82% and 69% of nurse and allied solutions segment revenue, 20% and 18% of physician and leadership solutions segment revenue, and 1% and 4% of technology and workforce solutions segment revenue, respectively.
Current report — wording carried from elsewhere
Selling, General and Administrative Expenses. SG&A expenses were $365.8 million, representing 17.8% of revenue, for the six months ended June 30, 2026, as compared to $302.3 million, representing 22.4% of revenue, for the same period in 2025. The increase in SG&A expenses was primarily due to a $43.7 million increase in employee compensation and benefits (inclusive of share-based compensation) and a $21.8 million increase in other expenses primarily in support of the large labor disruption events in the current year. SG&A expenses broken down among the reportable segments, unallocated corporate overhead, and share-based compensation are as follows:
Current report — wording carried from elsewhere
Depreciation and Amortization Expenses. Amortization expense decreased 9% to $35.4 million for the six months ended June 30, 2026 from $39.0 million for the same period in 2025, primarily attributable to certain intangible assets becoming fully amortized during the six months ended June 30, 2026. Depreciation expense (exclusive of depreciation included in cost of revenue) decreased 20% to $29.4 million for the six months ended June 30, 2026 from $36.6 million for the same period in 2025, primarily attributable to the mix of depreciable assets and their useful lives. Additionally, $4.9 million and $4.1 million of depreciation expense for our language services business is included in cost of revenue for the six months ended June 30, 2026 and 2025, respectively.
Current report — wording carried from elsewhere
Interest Expense, Net, and Other. Interest expense, net, and other was $13.7 million during the six months ended June 30, 2026 as compared to $23.7 million for the same period in 2025. The decrease was primarily due to a lower average debt outstanding balance, as well as interest income earned on excess cash during the six months ended June 30, 2026.