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SEGMENT INFORMATION | 9 Months Ended
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Sep. 30, 2025
Segment Reporting [Abstract] |
SEGMENT INFORMATION | SEGMENT INFORMATION The Company’s operating segments are identified in the same manner as they are reported internally and used by the Company’s chief operating decision maker (“CODM”) for the purpose of evaluating performance and allocating resources. The Company has three reportable segments: (1) nurse and allied solutions, (2) physician and leadership solutions, and (3) technology and workforce solutions. The nurse and allied solutions segment includes the Company’s travel nurse staffing (including international nurse staffing and rapid response nurse staffing), labor disruption staffing, local staffing, international nurse permanent placement, and allied staffing (including revenue cycle solutions) businesses. The physician and leadership solutions segment includes the Company’s locum tenens staffing, healthcare interim leadership staffing, executive search, and physician permanent placement businesses. The technology and workforce solutions segment includes the Company’s language services, vendor management systems (“VMS”), workforce optimization, and outsourced solutions businesses. The Company’s CODM relies on internal management reporting processes that provide revenue, gross profit and operating income by reportable segment. These financial measures are used by the CODM to evaluate segment performance, monitor variances between periods and against projections, make key operating decisions, and allocate resources such as capital and personnel to each segment. The CODM does not evaluate or measure performance of segments using asset information; accordingly, asset information by segment is not prepared or disclosed. Beginning this year, the Company revised its corporate resource allocation methodology to better match actual consumption by reportable segments. The following tables provide reconciliations of revenue, gross profit and operating income by reportable segment to consolidated results and were derived from each segment’s internal financial information as used for corporate management purposes. Segment operating income represents income (loss) before income taxes plus depreciation, amortization of intangible assets, share-based compensation, impairment losses for goodwill and long-lived assets, gain on sale of disposal group, interest expense, net, and other, and unallocated corporate overhead.
| Three Months Ended September 30, 2025
| Nurse and Allied 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 |
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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- Definition The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Topic 280 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 21 -Subparagraph (b) -Publisher FASB -URI https://asc.fasb.org/1943274/2147482810/280-10-50-21 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Topic 280 -SubTopic 10 -Name 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