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 2023 financial
results. Financial highlights are as follows:
Dollars in millions, except per share
amounts.
|
Q3 2023 |
% Change Q3 2022 |
YTD September 30, 2023 |
% Change YTD September 30, 2022 |
Revenue |
$853.5 |
(25%) |
$2,971.0 |
(28%) |
Gross profit |
$289.5 |
(25%) |
$988.6 |
(26%) |
Net income |
$53.2 |
(42%) |
$198.2 |
(45%) |
GAAP diluted EPS |
$1.39 |
(34%) |
$4.99 |
(38%) |
Adjusted diluted EPS* |
$1.97 |
(23%) |
$6.86 |
(27%) |
Adjusted EBITDA* |
$133.7 |
(26%) |
$475.1 |
(29%) |
* 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
- AMN made significant progress in the third quarter, staying
aligned with clients’ changing needs and delivering on a full slate
of technology and process milestones that are transforming our
go-to-market and value proposition.
- Third quarter revenue was in line with expectations with
outperformance from Nurse and Allied Solutions. Earnings were
better than expected as in-line core results were augmented by
several favorable factors that we expect will not recur in the
fourth quarter.
- Fourth quarter expectations call for tapering of the
post-pandemic downtrend in the nurse and allied staffing
market.
- Cash flow from operations remained strong at $172 million in
the quarter and $413 million year to date.
- AMN net leverage ratio at quarter end remained modest at
1.4:1.
“The AMN team did an impressive job balancing
business execution in the third quarter alongside our initiatives
to sharpen our strategic plan and implement powerful advancements
in our technology platform and processes,” said Cary Grace,
President and Chief Executive Officer of AMN Healthcare. “At the
same time, we made an important strategic move with the pending
acquisition of MSDR, which will bolster our presence in the robust
locum tenens market.”
Ms. Grace continued, “I am pleased to report
that, through the course of 2023, we have progressed from
identifying needed changes to delivering enhanced
technology-enabled solutions that help clients with their ongoing
workforce objectives. These are key milestones on our path toward
defining the new normal for healthcare workforce solutions.”
Third Quarter 2023 Results
Consolidated revenue for the quarter was $853.5
million, a 25% decrease from prior year and 14% lower than the
prior quarter. Net income was $53 million (6.2% of revenue), or
$1.39 per diluted share, compared with $92 million (8.1% of
revenue), or $2.10 per diluted share, in the third quarter of 2022.
Adjusted diluted EPS in the third quarter was $1.97 compared with
$2.57 in the same quarter a year ago.
Revenue for the Nurse and Allied Solutions
segment was $573 million, lower by 31% year over year and down 17%
from the prior quarter. Travel nurse staffing revenue dropped by
34% year over year and 20% sequentially. Allied division revenue
declined 12% year over year and 8% versus prior quarter.
The Physician and Leadership Solutions segment
reported revenue of $160 million, down 9% year over year and down
9% sequentially. Locum tenens revenue was $113 million, 6% higher
year over year and down 8% sequentially. Interim leadership revenue
fell by 35% year over year and was down 15% from prior quarter. Our
physician and leadership search businesses saw revenue decline by
25% year over year and 10% quarter over quarter.
Technology and Workforce Solutions segment
revenue was $120 million, a decrease of 11% year over year and down
4% sequentially. Language services revenue was $66 million in the
quarter, 20% higher than the prior year and up 4% sequentially.
Vendor management systems revenue was $38 million, 37% lower year
over year and down 18% from the prior quarter.
Consolidated gross margin was 33.9%, 10 basis
points higher year over year and improved by 60 basis points
sequentially. Gross margin improved year over year and
sequentially, primarily from the release of a workers' compensation
reserve in the Nurse and Allied Solutions segment. On a sequential
basis, improvement was partly offset by a drop in margin for
Technology and Workforce Solutions from a change in revenue mix
within the segment.
Consolidated SG&A expenses were $163
million, or 19.1% of revenue, compared with $215 million, or 18.9%
of revenue, in the same quarter last year. SG&A was $202
million, or 20.4% of revenue, in the previous quarter. The
year-over-year decrease in SG&A costs was driven primarily by
lower employee compensation with the drop in revenue and a higher
allowance for bad debt in the prior-year period. Several favorable
items that we expect will not recur in the fourth quarter reduced
SG&A expense by $5 million in the third quarter.
Income from operations was $87 million with an
operating margin of 10.2%, compared with $136 million and 12.0%,
respectively, in the same quarter last year. Adjusted EBITDA was
$134 million, a year-over-year decrease of 26%. Adjusted EBITDA
margin was 15.7%, 30 basis points lower than the year-ago
period.
At September 30, 2023, cash and cash
equivalents totaled $29 million. Cash flow from operations was $172
million for the third quarter, and capital expenditures were $30
million. The Company ended the quarter with total debt outstanding
of $945 million and a net leverage ratio of 1.4 to 1.
MSDR Acquisition Agreement
In October 2023, AMN signed a definitive
agreement to acquire MSDR, which includes two locum tenens and
advanced practices staffing companies, Medical Search International
and DRW Healthcare Staffing. The purchase price is approximately
$300 million, which we expect to fund with cash on hand and
borrowings on our revolving credit facility. Closing of the
transaction is anticipated in the fourth quarter, subject to
customary closing conditions and regulatory approval.
Stock Repurchase Update
We completed the $200 million accelerated share
repurchase program in August 2023. As of September 30, 2023, $227
million remained on the repurchase program authorized by our Board
of Directors.
Fourth Quarter 2023 Outlook
Metric |
Guidance* |
Consolidated revenue |
$790 - $810 million |
Gross margin |
32.3% - 32.8% |
SG&A as percentage of revenue |
21.0% - 21.5% |
Operating margin |
5.9% - 6.5% |
Adjusted EBITDA margin |
12.5% - 13.0% |
*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 2023 is
expected to be 28-30% lower than prior year and 5-7% lower
sequentially. Nurse and Allied Solutions segment revenue is
expected to be down 33-35% year over year. Physician and Leadership
Solutions segment revenue is expected to be down 12-14% year over
year. For the Technology and Workforce Solutions segment, we expect
revenue to be approximately 18% lower year over year. Guidance does
not include any contribution from the MSDR acquisition, which we
expect to close later in the fourth quarter.
Fourth quarter estimates for certain other
financial items include depreciation of $17 million, depreciation
in cost of revenue of $1.5 million, non-cash amortization expense
of $22 million, share-based compensation expense of $5 million,
integration and other expenses of $7 million, interest expense of
$11 million, an adjusted tax rate of 28%, and 38.2 million diluted
average shares outstanding.
Conference Call on November 2,
2023
AMN Healthcare Services, Inc. (NYSE: AMN) will
host a conference call to discuss its third quarter 2023 financial
results and fourth quarter 2023 outlook on Thursday,
November 2, 2023 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 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 the labor market conditions, future
demand for staffing and other services, wage and bill rates, our
ability to meet the needs of our markets or align with our clients,
our competitive position in technology-enabled solutions, our
ability to implement our strategic plan and advancement in our
technology platform and processes to transform our services and
improve our value proposition, our ability to deliver enhanced
technology-enabled solutions, our long-term growth opportunities
and sales pipeline, that we will have sufficient capital to invest
in growth through capital expenditures and potential acquisitions
or make future repurchases under our stock repurchase program,
fourth quarter 2023 financial projections for consolidated and
segment revenue, consolidated gross margin, operating margin,
SG&A as a percent of revenue, adjusted EBITDA margin,
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 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, (ii) our ability to effectively address client demand
by attracting and placing nurses and other clinicians, (iii) our
ability to recruit and retain sufficient quality healthcare
professionals at reasonable costs, (iv) our ability to anticipate
and quickly respond to changing marketplace conditions, such as
alternative modes of healthcare delivery, reimbursement, or client
needs and requirements, including implementing changes that will
make our services more tech-enabled and integrated, (v) our ability
to manage the pricing impact that the labor market or consolidation
of healthcare delivery organizations may have on our business, (vi)
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, economic conditions or COVID-19 or
other pandemic or health crisis, (vii) 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, (viii) our ability
to develop and evolve our current technology offerings and
capabilities and implement new infrastructure and technology
systems to optimize our operating results and manage our business
effectively, (ix) our ability 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, (x) our ability to consummate and effectively
incorporate acquisitions into our business, (xi) the negative
effects that intermediary organizations may have on our ability to
secure new and profitable contracts, (xii) 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, (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, 2022. 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 ReeceSenior
Director, Investor Relations 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, |
|
|
2023 |
|
|
|
2022 |
|
|
|
2023 |
|
|
|
2023 |
|
|
|
2022 |
|
Revenue |
$ |
853,463 |
|
|
$ |
1,138,586 |
|
|
$ |
991,299 |
|
|
$ |
2,970,985 |
|
|
$ |
4,117,731 |
|
Cost of revenue |
|
563,957 |
|
|
|
753,560 |
|
|
|
661,018 |
|
|
|
1,982,352 |
|
|
|
2,776,300 |
|
Gross profit |
|
289,506 |
|
|
|
385,026 |
|
|
|
330,281 |
|
|
|
988,633 |
|
|
|
1,341,431 |
|
Gross margin |
|
33.9 |
% |
|
|
33.8 |
% |
|
|
33.3 |
% |
|
|
33.3 |
% |
|
|
32.6 |
% |
Operating
expenses: |
|
|
|
|
|
|
|
|
|
Selling, general and
administrative (SG&A) |
|
163,405 |
|
|
|
215,419 |
|
|
|
201,771 |
|
|
|
570,775 |
|
|
|
717,428 |
|
SG&A as a % of revenue |
|
19.1 |
% |
|
|
18.9 |
% |
|
|
20.4 |
% |
|
|
19.2 |
% |
|
|
17.4 |
% |
|
|
|
|
|
|
|
|
|
|
Depreciation and amortization
(exclusive of depreciation included in cost of revenue) |
|
39,175 |
|
|
|
33,239 |
|
|
|
36,847 |
|
|
|
113,599 |
|
|
|
96,169 |
|
Total operating expenses |
|
202,580 |
|
|
|
248,658 |
|
|
|
238,618 |
|
|
|
684,374 |
|
|
|
813,597 |
|
Income from operations |
|
86,926 |
|
|
|
136,368 |
|
|
|
91,663 |
|
|
|
304,259 |
|
|
|
527,834 |
|
Operating margin (1) |
|
10.2 |
% |
|
|
12.0 |
% |
|
|
9.2 |
% |
|
|
10.2 |
% |
|
|
12.8 |
% |
|
|
|
|
|
|
|
|
|
|
Interest expense, net, and
other |
|
11,541 |
|
|
|
8,961 |
|
|
|
12,175 |
|
|
|
33,975 |
|
|
|
28,630 |
|
|
|
|
|
|
|
|
|
|
|
Income before income
taxes |
|
75,385 |
|
|
|
127,407 |
|
|
|
79,488 |
|
|
|
270,284 |
|
|
|
499,204 |
|
|
|
|
|
|
|
|
|
|
|
Income tax expense |
|
22,211 |
|
|
|
34,962 |
|
|
|
18,582 |
|
|
|
72,094 |
|
|
|
136,951 |
|
Net income |
$ |
53,174 |
|
|
$ |
92,445 |
|
|
$ |
60,906 |
|
|
$ |
198,190 |
|
|
$ |
362,253 |
|
Net income as a % of
revenue |
|
6.2 |
% |
|
|
8.1 |
% |
|
|
6.1 |
% |
|
|
6.7 |
% |
|
|
8.8 |
% |
|
|
|
|
|
|
|
|
|
|
Other comprehensive
income (loss): |
|
|
|
|
|
|
|
|
|
Unrealized gains (losses) on
available-for-sale securities, net, and other |
|
133 |
|
|
|
(219 |
) |
|
|
50 |
|
|
|
329 |
|
|
|
(794 |
) |
Other comprehensive income
(loss) |
|
133 |
|
|
|
(219 |
) |
|
|
50 |
|
|
|
329 |
|
|
|
(794 |
) |
|
|
|
|
|
|
|
|
|
|
Comprehensive income |
$ |
53,307 |
|
|
$ |
92,226 |
|
|
$ |
60,956 |
|
|
$ |
198,519 |
|
|
$ |
361,459 |
|
|
|
|
|
|
|
|
|
|
|
Net income per common
share: |
|
|
|
|
|
|
|
|
|
Basic |
$ |
1.39 |
|
|
$ |
2.11 |
|
|
$ |
1.56 |
|
|
$ |
5.01 |
|
|
$ |
8.04 |
|
Diluted |
$ |
1.39 |
|
|
$ |
2.10 |
|
|
$ |
1.55 |
|
|
$ |
4.99 |
|
|
$ |
7.99 |
|
Weighted average
common shares outstanding: |
|
|
|
|
|
|
|
|
|
Basic |
|
38,147 |
|
|
|
43,785 |
|
|
|
39,151 |
|
|
|
39,547 |
|
|
|
45,056 |
|
Diluted |
|
38,325 |
|
|
|
44,039 |
|
|
|
39,341 |
|
|
|
39,734 |
|
|
|
45,332 |
|
|
|
|
|
|
|
|
|
|
|
AMN Healthcare Services, Inc.Condensed
Consolidated Balance Sheets(dollars in
thousands)(unaudited) |
|
|
September 30, 2023 |
|
December 31, 2022 |
|
September 30, 2022 |
Assets |
|
|
|
|
|
Current
assets: |
|
|
|
|
|
Cash and cash equivalents |
$ |
29,377 |
|
|
$ |
64,524 |
|
|
$ |
155,723 |
|
Accounts receivable, net |
|
565,724 |
|
|
|
675,650 |
|
|
|
724,966 |
|
Accounts receivable, subcontractor |
|
175,976 |
|
|
|
268,726 |
|
|
|
253,954 |
|
Prepaid and other current assets |
|
60,043 |
|
|
|
84,745 |
|
|
|
71,523 |
|
Total current assets |
|
831,120 |
|
|
|
1,093,645 |
|
|
|
1,206,166 |
|
Restricted cash, cash equivalents and investments |
|
69,995 |
|
|
|
61,218 |
|
|
|
64,883 |
|
Fixed
assets, net |
|
187,557 |
|
|
|
149,276 |
|
|
|
140,995 |
|
Other
assets |
|
220,512 |
|
|
|
172,016 |
|
|
|
171,475 |
|
Goodwill |
|
935,779 |
|
|
|
935,364 |
|
|
|
935,675 |
|
Intangible assets, net |
|
409,803 |
|
|
|
476,832 |
|
|
|
499,067 |
|
Total assets |
$ |
2,654,766 |
|
|
$ |
2,888,351 |
|
|
$ |
3,018,261 |
|
|
|
|
|
|
|
Liabilities and stockholders’ equity |
|
|
|
|
|
Current
liabilities: |
|
|
|
|
|
Accounts payable and accrued expenses |
$ |
362,907 |
|
|
$ |
476,452 |
|
|
$ |
459,237 |
|
Accrued compensation and benefits |
|
263,697 |
|
|
|
333,244 |
|
|
|
338,833 |
|
Other current liabilities |
|
80,522 |
|
|
|
48,237 |
|
|
|
93,176 |
|
Total current liabilities |
|
707,126 |
|
|
|
857,933 |
|
|
|
891,246 |
|
Revolving credit facility |
|
95,000 |
|
|
|
— |
|
|
|
— |
|
Notes
payable, net |
|
844,393 |
|
|
|
843,505 |
|
|
|
843,210 |
|
Deferred
income taxes, net |
|
31,296 |
|
|
|
22,713 |
|
|
|
42,159 |
|
Other
long-term liabilities |
|
159,782 |
|
|
|
120,566 |
|
|
|
109,013 |
|
Total liabilities |
|
1,837,597 |
|
|
|
1,844,717 |
|
|
|
1,885,628 |
|
|
|
|
|
|
|
Commitments and contingencies |
|
|
|
|
|
|
|
|
|
|
|
Stockholders’ equity: |
|
817,169 |
|
|
|
1,043,634 |
|
|
|
1,132,633 |
|
|
|
|
|
|
|
Total
liabilities and stockholders’ equity |
$ |
2,654,766 |
|
|
$ |
2,888,351 |
|
|
$ |
3,018,261 |
|
|
|
|
|
|
|
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, |
|
|
2023 |
|
|
|
2022 |
|
|
|
2023 |
|
|
|
2023 |
|
|
|
2022 |
|
|
|
|
|
|
|
|
|
|
|
Net cash provided by operating
activities |
$ |
172,194 |
|
|
$ |
113,728 |
|
|
$ |
197,667 |
|
|
$ |
413,295 |
|
|
$ |
538,405 |
|
Net cash used in investing
activities |
|
(33,903 |
) |
|
|
(32,305 |
) |
|
|
(22,428 |
) |
|
|
(88,762 |
) |
|
|
(148,067 |
) |
Net cash used in financing
activities |
|
(105,022 |
) |
|
|
(3,835 |
) |
|
|
(203,287 |
) |
|
|
(352,766 |
) |
|
|
(415,523 |
) |
Net increase (decrease) in
cash, cash equivalents and restricted cash |
|
33,269 |
|
|
|
77,588 |
|
|
|
(28,048 |
) |
|
|
(28,233 |
) |
|
|
(25,185 |
) |
Cash, cash equivalents and
restricted cash at beginning of period |
|
76,370 |
|
|
|
143,941 |
|
|
|
104,418 |
|
|
|
137,872 |
|
|
|
246,714 |
|
Cash, cash equivalents and
restricted cash at end of period |
$ |
109,639 |
|
|
$ |
221,529 |
|
|
$ |
76,370 |
|
|
$ |
109,639 |
|
|
$ |
221,529 |
|
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, |
|
|
2023 |
|
|
|
2022 |
|
|
|
2023 |
|
|
|
2023 |
|
|
|
2022 |
|
Reconciliation of
Non-GAAP Items: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income |
$ |
53,174 |
|
|
$ |
92,445 |
|
|
$ |
60,906 |
|
|
$ |
198,190 |
|
|
$ |
362,253 |
|
Income tax expense |
|
22,211 |
|
|
|
34,962 |
|
|
|
18,582 |
|
|
|
72,094 |
|
|
|
136,951 |
|
Income before income
taxes |
|
75,385 |
|
|
|
127,407 |
|
|
|
79,488 |
|
|
|
270,284 |
|
|
|
499,204 |
|
Interest expense, net, and
other |
|
11,541 |
|
|
|
8,961 |
|
|
|
12,175 |
|
|
|
33,975 |
|
|
|
28,630 |
|
Income from operations |
|
86,926 |
|
|
|
136,368 |
|
|
|
91,663 |
|
|
|
304,259 |
|
|
|
527,834 |
|
Depreciation and
amortization |
|
39,175 |
|
|
|
33,239 |
|
|
|
36,847 |
|
|
|
113,599 |
|
|
|
96,169 |
|
Depreciation (included in cost
of revenue) (2) |
|
1,552 |
|
|
|
1,091 |
|
|
|
1,387 |
|
|
|
4,196 |
|
|
|
2,918 |
|
Share-based compensation |
|
306 |
|
|
|
4,898 |
|
|
|
4,818 |
|
|
|
15,442 |
|
|
|
24,670 |
|
Acquisition, integration, and
other costs (3) |
|
5,771 |
|
|
|
6,237 |
|
|
|
6,103 |
|
|
|
16,616 |
|
|
|
20,532 |
|
Legal settlement accrual
changes (4) |
|
— |
|
|
|
— |
|
|
|
21,000 |
|
|
|
21,000 |
|
|
|
— |
|
Adjusted EBITDA (5) |
$ |
133,730 |
|
|
$ |
181,833 |
|
|
$ |
161,818 |
|
|
$ |
475,112 |
|
|
$ |
672,123 |
|
|
|
|
|
|
|
|
|
|
|
Adjusted EBITDA margin
(6) |
|
15.7 |
% |
|
|
16.0 |
% |
|
|
16.3 |
% |
|
|
16.0 |
% |
|
|
16.3 |
% |
|
|
|
|
|
|
|
|
|
|
Net income |
$ |
53,174 |
|
|
$ |
92,445 |
|
|
$ |
60,906 |
|
|
$ |
198,190 |
|
|
$ |
362,253 |
|
Adjustments: |
|
|
|
|
|
|
|
|
|
Amortization of intangible assets |
|
22,563 |
|
|
|
20,884 |
|
|
|
22,120 |
|
|
|
66,340 |
|
|
|
60,843 |
|
Acquisition, integration, and other costs (3) |
|
5,771 |
|
|
|
6,237 |
|
|
|
6,103 |
|
|
|
16,616 |
|
|
|
20,532 |
|
Legal settlement accrual changes (4) |
|
— |
|
|
|
— |
|
|
|
21,000 |
|
|
|
21,000 |
|
|
|
— |
|
Cumulative effect of change in accounting principle (7) |
|
— |
|
|
|
— |
|
|
|
— |
|
|
|
2,974 |
|
|
|
— |
|
Tax effect on above adjustments |
|
(7,367 |
) |
|
|
(7,051 |
) |
|
|
(12,798 |
) |
|
|
(27,802 |
) |
|
|
(21,157 |
) |
Tax effect of COLI fair value changes (8) |
|
1,227 |
|
|
|
1,507 |
|
|
|
(1,744 |
) |
|
|
(2,324 |
) |
|
|
6,488 |
|
Excess tax deficiencies (benefits) related to equity awards
(9) |
|
134 |
|
|
|
(727 |
) |
|
|
(1,798 |
) |
|
|
(2,346 |
) |
|
|
(2,832 |
) |
Adjusted net income (10) |
$ |
75,502 |
|
|
$ |
113,295 |
|
|
$ |
93,789 |
|
|
$ |
272,648 |
|
|
$ |
426,127 |
|
|
|
|
|
|
|
|
|
|
|
GAAP diluted net income per
share (EPS) |
$ |
1.39 |
|
|
$ |
2.10 |
|
|
$ |
1.55 |
|
|
$ |
4.99 |
|
|
$ |
7.99 |
|
Adjustments |
|
0.58 |
|
|
|
0.47 |
|
|
|
0.83 |
|
|
|
1.87 |
|
|
|
1.41 |
|
Adjusted diluted EPS (11) |
$ |
1.97 |
|
|
$ |
2.57 |
|
|
$ |
2.38 |
|
|
$ |
6.86 |
|
|
$ |
9.40 |
|
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, |
|
|
2023 |
|
|
|
2022 |
|
|
|
2023 |
|
|
|
2023 |
|
|
|
2022 |
|
Revenue |
|
|
|
|
|
|
|
|
|
Nurse and allied solutions |
$ |
573,426 |
|
|
$ |
828,317 |
|
|
$ |
689,015 |
|
|
$ |
2,086,921 |
|
|
$ |
3,157,834 |
|
Physician and leadership solutions |
|
159,554 |
|
|
|
175,152 |
|
|
|
176,229 |
|
|
|
501,540 |
|
|
|
530,355 |
|
Technology and workforce solutions |
|
120,483 |
|
|
|
135,117 |
|
|
|
126,055 |
|
|
|
382,524 |
|
|
|
429,542 |
|
|
$ |
853,463 |
|
|
$ |
1,138,586 |
|
|
$ |
991,299 |
|
|
$ |
2,970,985 |
|
|
$ |
4,117,731 |
|
|
|
|
|
|
|
|
|
|
|
Segment operating income
(12) |
|
|
|
|
|
|
|
|
|
Nurse and allied solutions |
$ |
82,882 |
|
|
$ |
115,182 |
|
|
$ |
102,993 |
|
|
$ |
299,320 |
|
|
$ |
471,141 |
|
Physician and leadership solutions |
|
21,609 |
|
|
|
23,904 |
|
|
|
26,456 |
|
|
|
73,165 |
|
|
|
64,280 |
|
Technology and workforce solutions |
|
50,664 |
|
|
|
71,145 |
|
|
|
55,623 |
|
|
|
173,297 |
|
|
|
232,526 |
|
|
|
155,155 |
|
|
|
210,231 |
|
|
|
185,072 |
|
|
|
545,782 |
|
|
|
767,947 |
|
Unallocated corporate overhead
(13) |
|
21,425 |
|
|
|
28,398 |
|
|
|
23,254 |
|
|
|
70,670 |
|
|
|
95,824 |
|
Adjusted EBITDA (5) |
$ |
133,730 |
|
|
$ |
181,833 |
|
|
$ |
161,818 |
|
|
$ |
475,112 |
|
|
$ |
672,123 |
|
|
|
|
|
|
|
|
|
|
|
Gross Margin |
|
|
|
|
|
|
|
|
|
Nurse and allied solutions |
|
27.5 |
% |
|
|
27.0 |
% |
|
|
26.7 |
% |
|
|
26.6 |
% |
|
|
26.2 |
% |
Physician and leadership solutions |
|
33.4 |
% |
|
|
34.0 |
% |
|
|
35.1 |
% |
|
|
34.6 |
% |
|
|
34.4 |
% |
Technology and workforce solutions |
|
65.0 |
% |
|
|
75.6 |
% |
|
|
66.7 |
% |
|
|
67.9 |
% |
|
|
76.9 |
% |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Operating Data: |
|
|
|
|
|
|
|
|
|
Nurse and allied
solutions |
|
|
|
|
|
|
|
|
|
Average travelers on assignment (14) |
|
11,990 |
|
|
|
14,722 |
|
|
|
13,597 |
|
|
|
13,570 |
|
|
|
16,085 |
|
|
|
|
|
|
|
|
|
|
|
Physician and leadership
solutions |
|
|
|
|
|
|
|
|
|
Days filled (15) |
|
45,981 |
|
|
|
49,694 |
|
|
|
49,976 |
|
|
|
142,857 |
|
|
|
150,550 |
|
Revenue per day filled (16) |
$ |
2,447 |
|
|
$ |
2,134 |
|
|
$ |
2,439 |
|
|
$ |
2,388 |
|
|
$ |
2,157 |
|
|
|
|
|
|
|
|
|
|
|
|
As of September 30, |
|
As of December 31, |
|
2023 |
|
2022 |
|
2022 |
Leverage ratio (17) |
1.4 |
|
0.8 |
|
1.0 |
|
|
|
|
|
|
AMN Healthcare Services, Inc.Additional
Supplemental Non-GAAP DisclosureReconciliation of Guidance
Operating Margin to GuidanceAdjusted EBITDA
Margin(unaudited) |
|
|
Three Months Ended |
|
December 31, 2023 |
|
Low(18) |
|
High(18) |
|
|
|
|
Operating margin |
5.9 |
% |
|
6.5 |
% |
Depreciation and amortization (total) |
5.1 |
% |
|
5.0 |
% |
EBITDA margin |
11.0 |
% |
|
11.5 |
% |
Share-based compensation |
0.6 |
% |
|
0.6 |
% |
Acquisition, integration, and other costs |
0.9 |
% |
|
0.9 |
% |
Adjusted EBITDA margin |
12.5 |
% |
|
13.0 |
% |
(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
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, 2023, acquisition and
integration costs were approximately $1.3 million and
$3.3 million, respectively, expenses related to the closures
of certain office leases were approximately $1.7 million and
$3.7 million, respectively, increases in contingent
consideration liabilities for recently acquired companies were
approximately $2.4 million, certain legal expenses of
approximately $1.2 million and $2.2 million,
respectively, restructuring expenses were approximately
$0.2 million and $1.8 million, respectively, and other
nonrecurring expenses were approximately $1.4 million and
$3.2 million, respectively. For the three and nine months
ended September 30, 2022, acquisition and integration costs were
approximately $1.1 million and $3.1 million,
respectively, expenses related to the closures of certain office
leases were approximately $1.7 million and $12.6 million,
respectively, certain legal expenses were approximately
$4.8 million, and other nonrecurring expenses were
approximately $0.4 million and $1.2 million,
respectively. Additionally, the aforementioned costs for the three
and nine months ended September 30, 2022 were partially offset by
net decreases in contingent consideration liabilities for recently
acquired companies of approximately $1.8 million and
$1.2 million, respectively.(4) During the three months ended
June 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 three months ended
March 31, 2023. The cumulative effect of the change in accounting
principle is immaterial to prior periods and, therefore, was
recognized in the current period. 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
excess tax benefits and tax deficiencies relating to equity awards
vested during the period. As a result of the adoption of a new
accounting pronouncement on January 1, 2017, the Company no longer
records excess tax benefits and tax deficiencies to additional
paid-in capital, but such excess tax benefits and tax deficiencies
are now recognized in income tax expense. The magnitude of the
impact of excess tax benefits and tax deficiencies generated in the
future, which may be favorable or unfavorable, is dependent upon
the Company’s future grants of share-based compensation and the
Company’s future stock price on the date awards vest in relation to
the fair value of the awards on the grant date. Since these excess
tax benefits and tax deficiencies are largely unrelated to our
income before taxes and are unrepresentative of our normal
effective tax rate, we excluded their impact in the calculation of
adjusted net income and adjusted diluted EPS.(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 exercised since January 1, 2017, and (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
Company’s debt outstanding (including the outstanding letters of
credit collateralized by the senior credit facility) minus cash and
cash equivalents at the end of the subject period to adjusted
EBITDA for the twelve-month period ended at the end of the subject
period.(18) Guidance percentage metrics are approximate.
AMN Healthcare Services (NYSE:AMN)
Gráfica de Acción Histórica
De Ago 2024 a Sep 2024
AMN Healthcare Services (NYSE:AMN)
Gráfica de Acción Histórica
De Sep 2023 a Sep 2024