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SEGMENT INFORMATION (Tables) | 9 Months Ended
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Sep. 30, 2025
Segment Reporting [Abstract] |
Schedule of Reconciliation of Revenue, Gross Profit and Operating Income by Reportable Segment | 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 Solutions |  | Physician and Leadership Solutions |  | Technology and Workforce Solutions |  | Total
Revenue | $ | 361,476 |  |  | $ | 178,214 |  |  | $ | 94,806 |  |  | $ | 634,496 |
Cost of revenue | 274,420 |  |  | 129,690 |  |  | 45,974 |  |  | 450,084 |
Gross profit | 87,056 |  |  | 48,524 |  |  | 48,832 |  |  | 184,412 |
Segment selling, general and administrative expenses | 58,295 |  |  | 32,794 |  |  | 20,191 |  |  | 111,280 |
Depreciation (included in cost of revenue) | — |  |  | — |  |  | (2,248) |  |  | (2,248) |
Segment operating income | $ | 28,761 |  |  | $ | 15,730 |  |  | $ | 30,889 |  |  | 75,380 |
Unallocated corporate overhead |  |  |  |  |  |  | 20,601 |
Depreciation and amortization |  |  |  |  |  |  | 37,380 |
Depreciation (included in cost of revenue) |  |  |  |  |  |  | 2,248 |
Share-based compensation |  |  |  |  |  |  | 6,713 |
Gain on sale of disposal group |  |  |  |  |  |  | (39,180) |
Interest expense, net, and other |  |  |  |  |  |  | 9,627 |
Income before income taxes |  |  |  |  |  |  | $ | 37,991 |
| Three Months Ended September 30, 2024
| Nurse and Allied Solutions |  | Physician and Leadership Solutions |  | Technology and Workforce Solutions |  | Total
Revenue | $ | 399,368 |  |  | $ | 180,605 |  |  | $ | 107,536 |  |  | $ | 687,509 |
Cost of revenue | 299,617 |  |  | 129,570 |  |  | 45,267 |  |  | 474,454 |
Gross profit | 99,751 |  |  | 51,035 |  |  | 62,269 |  |  | 213,055 |
Segment selling, general and administrative expenses | 64,641 |  |  | 32,901 |  |  | 22,249 |  |  | 119,791 |
Depreciation (included in cost of revenue) | — |  |  | — |  |  | (1,928) |  |  | (1,928) |
Segment operating income | $ | 35,110 |  |  | $ | 18,134 |  |  | $ | 41,948 |  |  | 95,192 |
Unallocated corporate overhead |  |  |  |  |  |  | 24,335 |
Depreciation and amortization |  |  |  |  |  |  | 41,122 |
Depreciation (included in cost of revenue) |  |  |  |  |  |  | 1,928 |
Share-based compensation |  |  |  |  |  |  | 5,555 |
Interest expense, net, and other |  |  |  |  |  |  | 14,444 |
Income before income taxes |  |  |  |  |  |  | $ | 7,808 |
| Nine Months Ended September 30, 2025
| Nurse and Allied Solutions |  | Physician and Leadership Solutions |  | Technology and Workforce Solutions |  | Total
Revenue | $ | 1,156,608 |  |  | $ | 526,810 |  |  | $ | 298,786 |  |  | $ | 1,982,204 |
Cost of revenue | 884,554 |  |  | 381,573 |  |  | 137,146 |  |  | 1,403,273 |
Gross profit | 272,054 |  |  | 145,237 |  |  | 161,640 |  |  | 578,931 |
Segment selling, general and administrative expenses | 182,572 |  |  | 101,559 |  |  | 66,647 |  |  | 350,778 |
Depreciation (included in cost of revenue) | — |  |  | — |  |  | (6,355) |  |  | (6,355) |
Segment operating income | $ | 89,482 |  |  | $ | 43,678 |  |  | $ | 101,348 |  |  | 234,508 |
Unallocated corporate overhead |  |  |  |  |  |  | 65,210 |
Depreciation and amortization |  |  |  |  |  |  | 113,015 |
Depreciation (included in cost of revenue) |  |  |  |  |  |  | 6,355 |
Share-based compensation |  |  |  |  |  |  | 24,921 |
Gain on sale of disposal group |  |  |  |  |  |  | (39,180) |
Goodwill impairment loss |  |  |  |  |  |  | 109,515 |
Long-lived assets impairment loss |  |  |  |  |  |  | 18,262 |
Interest expense, net, and other |  |  |  |  |  |  | 33,311 |
Loss before income taxes |  |  |  |  |  |  | $ | (96,901) |
| Nine Months Ended September 30, 2024
| Nurse and Allied Solutions |  | Physician and Leadership Solutions |  | Technology and Workforce Solutions |  | Total
Revenue | $ | 1,361,064 |  |  | $ | 555,467 |  |  | $ | 332,541 |  |  | $ | 2,249,072 |
Cost of revenue | 1,025,384 |  |  | 388,141 |  |  | 135,159 |  |  | 1,548,684 |
Gross profit | 335,680 |  |  | 167,326 |  |  | 197,382 |  |  | 700,388 |
Segment selling, general and administrative expenses | 201,021 |  |  | 105,309 |  |  | 69,268 |  |  | 375,598 |
Depreciation (included in cost of revenue) | — |  |  | — |  |  | (5,363) |  |  | (5,363) |
Segment operating income | $ | 134,659 |  |  | $ | 62,017 |  |  | $ | 133,477 |  |  | 330,153 |
Unallocated corporate overhead |  |  |  |  |  |  | 78,318 |
Depreciation and amortization |  |  |  |  |  |  | 126,942 |
Depreciation (included in cost of revenue) |  |  |  |  |  |  | 5,363 |
Share-based compensation |  |  |  |  |  |  | 19,651 |
Interest expense, net, and other |  |  |  |  |  |  | 46,787 |
Income before income taxes |  |  |  |  |  |  | $ | 53,092 |
Schedule of Disaggregation of Revenue | The following tables present the Company’s revenue disaggregated by service type:
| Three Months Ended September 30, 2025
| Nurse and Allied Solutions |  | Physician and Leadership Solutions |  | Technology and Workforce Solutions |  | Total
Travel nurse staffing | $ | 195,895 |  |  | $ | — |  |  | $ | — |  |  | $ | 195,895 |
Labor disruption services | 12,465 |  |  | — |  |  | — |  |  | 12,465 |
Local staffing | 8,778 |  |  | — |  |  | — |  |  | 8,778 |
Allied staffing | 142,291 |  |  | — |  |  | — |  |  | 142,291 |
Locum tenens staffing | — |  |  | 145,710 |  |  | — |  |  | 145,710 |
Interim leadership staffing | — |  |  | 23,225 |  |  | — |  |  | 23,225 |
Temporary staffing | 359,429 |  |  | 168,935 |  |  | — |  |  | 528,364 |
Permanent placement (1) | 2,047 |  |  | 9,279 |  |  | — |  |  | 11,326 |
Language services | — |  |  | — |  |  | 75,005 |  |  | 75,005 |
Vendor management systems | — |  |  | — |  |  | 16,951 |  |  | 16,951 |
Technology-enabled services | — |  |  | — |  |  | 91,956 |  |  | 91,956 |
Talent planning and acquisition | — |  |  | — |  |  | 2,850 |  |  | 2,850 |
Total revenue | $ | 361,476 |  |  | $ | 178,214 |  |  | $ | 94,806 |  |  | $ | 634,496 |
| Three Months Ended September 30, 2024
| Nurse and Allied Solutions |  | Physician and Leadership Solutions |  | Technology and Workforce Solutions |  | Total
Travel nurse staffing | $ | 243,745 |  |  | $ | — |  |  | $ | — |  |  | $ | 243,745 |
Labor disruption services | 486 |  |  | — |  |  | — |  |  | 486 |
Local staffing | 10,494 |  |  | — |  |  | — |  |  | 10,494 |
Allied staffing | 140,872 |  |  | — |  |  | — |  |  | 140,872 |
Locum tenens staffing | — |  |  | 141,716 |  |  | — |  |  | 141,716 |
Interim leadership staffing | — |  |  | 28,862 |  |  | — |  |  | 28,862 |
Temporary staffing | 395,597 |  |  | 170,578 |  |  | — |  |  | 566,175 |
Permanent placement (1) | 3,771 |  |  | 10,027 |  |  | — |  |  | 13,798 |
Language services | — |  |  | — |  |  | 75,009 |  |  | 75,009 |
Vendor management systems | — |  |  | — |  |  | 25,018 |  |  | 25,018 |
Other solutions | — |  |  | — |  |  | 5,044 |  |  | 5,044 |
Technology-enabled services | — |  |  | — |  |  | 105,071 |  |  | 105,071 |
Talent planning and acquisition | — |  |  | — |  |  | 2,465 |  |  | 2,465 |
Total revenue | $ | 399,368 |  |  | $ | 180,605 |  |  | $ | 107,536 |  |  | $ | 687,509 |
| Nine Months Ended September 30, 2025
| Nurse and Allied Solutions |  | Physician and Leadership Solutions |  | Technology and Workforce Solutions |  | Total
Travel nurse staffing | $ | 619,360 |  |  | $ | — |  |  | $ | — |  |  | $ | 619,360 |
Labor disruption services | 66,847 |  |  | — |  |  | — |  |  | 66,847 |
Local staffing | 28,207 |  |  | — |  |  | — |  |  | 28,207 |
Allied staffing | 435,424 |  |  | — |  |  | — |  |  | 435,424 |
Locum tenens staffing | — |  |  | 429,107 |  |  | — |  |  | 429,107 |
Interim leadership staffing | — |  |  | 69,784 |  |  | — |  |  | 69,784 |
Temporary staffing | 1,149,838 |  |  | 498,891 |  |  | — |  |  | 1,648,729 |
Permanent placement (1) | 6,770 |  |  | 27,919 |  |  | — |  |  | 34,689 |
Language services | — |  |  | — |  |  | 225,621 |  |  | 225,621 |
Vendor management systems | — |  |  | — |  |  | 55,385 |  |  | 55,385 |
Other solutions | — |  |  | — |  |  | 9,734 |  |  | 9,734 |
Technology-enabled services | — |  |  | — |  |  | 290,740 |  |  | 290,740 |
Talent planning and acquisition | — |  |  | — |  |  | 8,046 |  |  | 8,046 |
Total revenue | $ | 1,156,608 |  |  | $ | 526,810 |  |  | $ | 298,786 |  |  | $ | 1,982,204 |
| Nine Months Ended September 30, 2024
| Nurse and Allied Solutions |  | Physician and Leadership Solutions |  | Technology and Workforce Solutions |  | Total
Travel nurse staffing | $ | 854,746 |  |  | $ | — |  |  | $ | — |  |  | $ | 854,746 |
Labor disruption services | 886 |  |  | — |  |  | — |  |  | 886 |
Local staffing | 33,786 |  |  | — |  |  | — |  |  | 33,786 |
Allied staffing | 462,001 |  |  | — |  |  | — |  |  | 462,001 |
Locum tenens staffing | — |  |  | 429,700 |  |  | — |  |  | 429,700 |
Interim leadership staffing | — |  |  | 89,373 |  |  | — |  |  | 89,373 |
Temporary staffing | 1,351,419 |  |  | 519,073 |  |  | — |  |  | 1,870,492 |
Permanent placement (1) | 9,645 |  |  | 36,394 |  |  | — |  |  | 46,039 |
Language services | — |  |  | — |  |  | 221,749 |  |  | 221,749 |
Vendor management systems | — |  |  | — |  |  | 81,671 |  |  | 81,671 |
Other solutions | — |  |  | — |  |  | 15,993 |  |  | 15,993 |
Technology-enabled services | — |  |  | — |  |  | 319,413 |  |  | 319,413 |
Talent planning and acquisition | — |  |  | — |  |  | 13,128 |  |  | 13,128 |
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,
| 2025 |  | 2024 |  | 2025 |  | 2024
International nurse staffing (1) | $ | 28,644 |  |  | $ | 41,376 |  |  | $ | 90,169 |  |  | $ | 129,668 |
International nurse permanent placement (2) | 2,047 |  |  | 3,771 |  |  | 6,770 |  |  | 9,645 |
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.

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