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SEGMENT INFORMATION
 9 Months Ended
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 SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Revenue
$361,476 $178,214 $94,806 $634,496 
Cost of revenue
274,420 129,690 45,974 450,084 
Gross profit87,056 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 overhead20,601 
Depreciation and amortization37,380 
Depreciation (included in cost of revenue)2,248 
Share-based compensation6,713 
Gain on sale of disposal group
(39,180)
Interest expense, net, and other9,627 
Income before income taxes$37,991 
Three Months Ended September 30, 2024
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Revenue
$399,368 $180,605 $107,536 $687,509 
Cost of 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 overhead24,335 
Depreciation and amortization41,122 
Depreciation (included in cost of revenue)1,928 
Share-based compensation5,555 
Interest expense, net, and other14,444 
Income before income taxes$7,808 
Nine Months Ended September 30, 2025
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Revenue
$1,156,608 $526,810 $298,786 $1,982,204 
Cost of revenue
884,554 381,573 137,146 1,403,273 
Gross profit272,054 145,237 161,640 578,931 
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 $101,348 234,508 
Unallocated corporate overhead65,210 
Depreciation and amortization113,015 
Depreciation (included in cost of revenue)6,355 
Share-based compensation24,921 
Gain on sale of disposal group
(39,180)
Goodwill impairment loss
109,515 
Long-lived assets impairment loss
18,262 
Interest expense, net, and other33,311 
Loss before income taxes$(96,901)
Nine Months Ended September 30, 2024
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Revenue
$1,361,064 $555,467 $332,541 $2,249,072 
Cost of 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 overhead78,318 
Depreciation and amortization126,942 
Depreciation (included in cost of revenue)5,363 
Share-based compensation19,651 
Interest expense, net, and other46,787 
Income before income taxes$53,092 
Disaggregation of Revenue
The following tables present the Company’s revenue disaggregated by service type:
Three Months Ended September 30, 2025
Nurse and Allied SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Travel nurse staffing$195,895 $— $— $195,895 
Labor disruption services12,465 — — 12,465 
Local staffing8,778 — — 8,778 
Allied staffing142,291 — — 142,291 
Locum tenens staffing— 145,710 — 145,710 
Interim leadership staffing— 23,225 — 23,225 
Temporary staffing359,429 168,935 — 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 SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Travel nurse staffing$243,745 $— $— $243,745 
Labor disruption services486 — — 486 
Local staffing10,494 — — 10,494 
Allied staffing140,872 — — 140,872 
Locum tenens staffing— 141,716 — 141,716 
Interim leadership staffing— 28,862 — 28,862 
Temporary staffing395,597 170,578 — 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 SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Travel nurse staffing$619,360 $— $— $619,360 
Labor disruption services66,847 — — 66,847 
Local staffing28,207 — — 28,207 
Allied staffing435,424 — — 435,424 
Locum tenens staffing— 429,107 — 429,107 
Interim leadership staffing— 69,784 — 69,784 
Temporary staffing1,149,838 498,891 — 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 SolutionsPhysician and Leadership SolutionsTechnology and Workforce SolutionsTotal
Travel nurse staffing$854,746 $— $— $854,746 
Labor disruption services886 — — 886 
Local staffing33,786 — — 33,786 
Allied staffing462,001 — — 462,001 
Locum tenens staffing— 429,700 — 429,700 
Interim leadership staffing— 89,373 — 89,373 
Temporary staffing1,351,419 519,073 — 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,
 2025202420252024
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.