Quarterly revenue of
GAAP income of
Dollars in millions, except per share amounts.
| Q1 2026 | % Change Q1 2025 | ||
| Revenue | 100% | ||
| Gross profit | 86% | ||
| Net income | nm | ||
| GAAP diluted EPS | nm | ||
| Adjusted diluted EPS* | 366% | ||
| Adjusted EBITDA* | 159% | ||
* 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
- First quarter revenue and earnings exceeded guidance with labor disruption, travel nurse, allied, and international nurse exceeding expectations.
- Travel nursing volume and revenue grew year over year for the first time since 2022.
- Allied, schools, international nurse, and search also delivered year-over-year revenue growth.
- Cash flow from operations of
$562 million and our quarter-end cash balance of$561 million benefited from favorable timing of working capital related to recent labor disruption events. - We ended the quarter with
$750 million of debt, an undrawn revolving credit facility and a leverage ratio, calculated under the terms of our credit agreement, of 1.6x.
“Our first quarter performance demonstrated strong execution across AMN, with results exceeding our expectations and guidance while navigating a dynamic market environment,” said
First Quarter 2026 Results
Consolidated revenue for the quarter was
Revenue for the Nurse and
The Physician and
Technology and Workforce Solutions segment revenue was
Consolidated gross margin was 26.8%, 190 basis points lower year over year and up 70 basis points sequentially. Higher margins in the Nurse and
Consolidated SG&A expenses were
Income from operations was
At
Second Quarter 2026 Outlook
| Metric | Guidance* |
| Consolidated revenue | |
| Gross margin | 28.0% - 28.5% |
| SG&A as percentage of revenue | 23.0% - 23.5% |
| Operating margin | (0.6%) - 0.1% |
| Adjusted EBITDA margin | 6.7% - 7.2% |
*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 second quarter of 2026 is expected to be 4-6% lower than the prior year, or down 3-5% excluding labor disruption revenue of approximately
Second quarter estimates for certain other financial items include depreciation of
Conference Call on
About
The Company’s common stock is listed on the
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 future demand and supply for healthcare, contingent staffing and other services, client preferences, momentum in international staffing and search, our ability to advance our technology-enabled workforce solutions, settlement of client deposits, second quarter 2026 financial projections for consolidated and segment revenue, consolidated gross margin, operating margin, SG&A as a percent of revenue, adjusted EBITDA margin, labor disruption revenue, depreciation expense, depreciation in cost of revenue, share-based compensation expense, non-cash amortization 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 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, (ii) 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 or economic conditions, (iii) 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, (iv) our ability to effectively address client demand by attracting and placing nurses and other clinicians, (v) our ability to recruit and retain sufficient quality healthcare professionals at reasonable costs, (vi) 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, (vii) our ability to manage the pricing impact that the labor market or consolidation of healthcare delivery organizations may have on our business, (viii) 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, (ix) 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, (x) 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, (xi) our ability to consummate and effectively incorporate acquisitions into our business, (xii) the negative effects that intermediary organizations may have on our ability to secure new and profitable contracts, (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 any future pandemic or health crisis 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
Contact:
Vice President, Investor Relations & Strategy
866.861.3229
Condensed Consolidated Statements of Comprehensive Income (Loss) (in thousands, except per share amounts) (unaudited) | |||||||||||
| Three Months Ended | |||||||||||
| 2026 | 2025 | 2025 | |||||||||
| Revenue | $ | 1,378,361 | $ | 689,533 | $ | 748,225 | |||||
| Cost of revenue | 1,009,525 | 491,413 | 553,098 | ||||||||
| Gross profit | 368,836 | 198,120 | 195,127 | ||||||||
| Gross margin | 26.8 | % | 28.7 | % | 26.1 | % | |||||
| Operating expenses: | |||||||||||
| Selling, general and administrative (SG&A) | 218,425 | 147,731 | 152,113 | ||||||||
| SG&A as a % of revenue | 15.8 | % | 21.4 | % | 20.3 | % | |||||
| Depreciation and amortization (exclusive of depreciation included in cost of revenue) | 33,240 | 37,882 | 34,854 | ||||||||
| Loss on sale of disposal group | — | — | 42 | ||||||||
| Total operating expenses | 251,665 | 185,613 | 187,009 | ||||||||
| Income from operations | 117,171 | 12,507 | 8,118 | ||||||||
| Operating margin (1) | 8.5 | % | 1.8 | % | 1.1 | % | |||||
| Interest expense, net, and other | 6,712 | 12,324 | 12,280 | ||||||||
| Income (loss) before income taxes | 110,459 | 183 | (4,162 | ) | |||||||
| Income tax expense | 48,293 | 1,275 | 3,534 | ||||||||
| Net income (loss) | $ | 62,166 | $ | (1,092 | ) | $ | (7,696 | ) | |||
| Net income (loss) as a % of revenue | 4.5 | % | (0.2 | )% | (1.0 | )% | |||||
| Other comprehensive income (loss): | |||||||||||
| Unrealized gains (losses) on available-for-sale securities, net, and other | (185 | ) | 61 | (286 | ) | ||||||
| Other comprehensive income (loss) | (185 | ) | 61 | (286 | ) | ||||||
| Comprehensive income (loss) | $ | 61,981 | $ | (1,031 | ) | $ | (7,982 | ) | |||
| Net income (loss) per common share: | |||||||||||
| Basic | $ | 1.60 | $ | (0.03 | ) | $ | (0.20 | ) | |||
| Diluted | $ | 1.59 | $ | (0.03 | ) | $ | (0.20 | ) | |||
| Weighted average common shares outstanding: | |||||||||||
| Basic | 38,902 | 38,312 | 38,733 | ||||||||
| Diluted | 39,118 | 38,312 | 38,733 | ||||||||
Condensed Consolidated Balance Sheets (dollars in thousands) (unaudited) | |||||||||||
| Assets | |||||||||||
| Current assets: | |||||||||||
| Cash and cash equivalents | $ | 560,738 | $ | 33,972 | $ | 55,777 | |||||
| Accounts receivable, net | 394,668 | 382,560 | 421,869 | ||||||||
| Accounts receivable, subcontractor | 47,501 | 48,041 | 65,307 | ||||||||
| Prepaid and other current assets | 133,613 | 80,803 | 84,404 | ||||||||
| Total current assets | 1,136,520 | 545,376 | 627,357 | ||||||||
| Restricted cash, cash equivalents and investments | 45,814 | 45,606 | 45,070 | ||||||||
| Fixed assets, net | 126,029 | 136,361 | 177,996 | ||||||||
| Other assets | 263,408 | 282,552 | 253,670 | ||||||||
| Deferred income taxes, net | 11,212 | 44,877 | 31,637 | ||||||||
| 755,809 | 755,809 | 897,456 | |||||||||
| Intangible assets, net | 265,581 | 283,526 | 361,937 | ||||||||
| Total assets | $ | 2,604,373 | $ | 2,094,107 | $ | 2,395,123 | |||||
| Liabilities and stockholders’ equity | |||||||||||
| Current liabilities: | |||||||||||
| Accounts payable and accrued expenses | $ | 197,385 | $ | 161,968 | $ | 195,974 | |||||
| Accrued compensation and benefits | 317,137 | 298,837 | 269,497 | ||||||||
| Other current liabilities | 529,668 | 116,809 | 116,778 | ||||||||
| Total current liabilities | 1,044,190 | 577,614 | 582,249 | ||||||||
| Revolving credit facility | — | 25,000 | 150,000 | ||||||||
| Notes payable, net | 742,491 | 742,053 | 846,167 | ||||||||
| Other long-term liabilities | 104,886 | 107,334 | 101,656 | ||||||||
| Total liabilities | 1,891,567 | 1,452,001 | 1,680,072 | ||||||||
| Commitments and contingencies | |||||||||||
| Stockholders’ equity: | 712,806 | 642,106 | 715,051 | ||||||||
| Total liabilities and stockholders’ equity | $ | 2,604,373 | $ | 2,094,107 | $ | 2,395,123 | |||||
Summary Condensed Consolidated Statements of Cash Flows (dollars in thousands) (unaudited) | |||||||||||
| Three Months Ended | |||||||||||
| 2026 | 2025 | 2025 | |||||||||
| Net cash provided by operating activities | $ | 562,452 | $ | 92,671 | $ | 75,572 | |||||
| Net cash used in investing activities | (7,504 | ) | (26,046 | ) | (8,053 | ) | |||||
| Net cash used in financing activities | (27,135 | ) | (61,211 | ) | (83,242 | ) | |||||
| Net increase (decrease) in cash, cash equivalents and restricted cash | 527,813 | 5,414 | (15,723 | ) | |||||||
| Cash, cash equivalents and restricted cash at beginning of period | 67,171 | 89,305 | 82,894 | ||||||||
| Cash, cash equivalents and restricted cash at end of period | $ | 594,984 | $ | 94,719 | $ | 67,171 | |||||
Non-GAAP Reconciliation Tables (dollars in thousands, except per share data) (unaudited) | |||||||||||
| Three Months Ended | |||||||||||
| 2026 | 2025 | 2025 | |||||||||
| Reconciliation of Non-GAAP Items: | |||||||||||
| Net income (loss) | $ | 62,166 | $ | (1,092 | ) | $ | (7,696 | ) | |||
| Income tax expense | 48,293 | 1,275 | 3,534 | ||||||||
| Income (loss) before income taxes | 110,459 | 183 | (4,162 | ) | |||||||
| Interest expense, net, and other | 6,712 | 12,324 | 12,280 | ||||||||
| Income from operations | 117,171 | 12,507 | 8,118 | ||||||||
| Depreciation and amortization | 33,240 | 37,882 | 34,854 | ||||||||
| Depreciation (included in cost of revenue) (2) | 2,420 | 1,975 | 2,376 | ||||||||
| Loss on sale of disposal group | — | — | 42 | ||||||||
| Share-based compensation | 9,892 | 9,381 | 5,762 | ||||||||
| Acquisition, integration, and other costs (3) | 3,402 | 2,455 | 3,331 | ||||||||
| Adjusted EBITDA (4) | $ | 166,125 | $ | 64,200 | $ | 54,483 | |||||
| Adjusted EBITDA margin (5) | 12.1 | % | 9.3 | % | 7.3 | % | |||||
| Net income (loss) | $ | 62,166 | $ | (1,092 | ) | $ | (7,696 | ) | |||
| Adjustments: | |||||||||||
| Amortization of intangible assets | 17,945 | 19,427 | 18,551 | ||||||||
| Acquisition, integration, and other costs (3) | 3,402 | 2,455 | 3,331 | ||||||||
| Loss on sale of disposal group | — | — | 42 | ||||||||
| Debt financing related costs | — | — | 1,156 | ||||||||
| Tax effect on above adjustments | (5,550 | ) | (5,689 | ) | (6,001 | ) | |||||
| Tax effect of COLI fair value changes (6) | 2,065 | 703 | (1,713 | ) | |||||||
| Tax deficiencies (benefits) related to equity awards and ESPP (7) | 2,151 | 1,523 | 892 | ||||||||
| Adjusted net income (8) | $ | 82,179 | $ | 17,327 | $ | 8,562 | |||||
| GAAP diluted net income (loss) per share (EPS) | $ | 1.59 | $ | (0.03 | ) | $ | (0.20 | ) | |||
| Adjustments | 0.51 | 0.48 | 0.42 | ||||||||
| Adjusted diluted EPS (9) (10) | $ | 2.10 | $ | 0.45 | $ | 0.22 | |||||
Supplemental Segment Financial and Operating Data (dollars in thousands, except operating data) (unaudited) | |||||||||||
| Three Months Ended | |||||||||||
| 2026 | 2025 | 2025 | |||||||||
| Revenue | |||||||||||
| Nurse and allied solutions | $ | 1,127,342 | $ | 413,261 | $ | 490,710 | |||||
| Physician and leadership solutions | 163,924 | 174,065 | 169,552 | ||||||||
| Technology and workforce solutions | 87,095 | 102,207 | 87,963 | ||||||||
| $ | 1,378,361 | $ | 689,533 | $ | 748,225 | ||||||
| Segment operating income (11) | |||||||||||
| Nurse and allied solutions | $ | 153,330 | $ | 32,238 | $ | 36,484 | |||||
| Physician and leadership solutions | 10,818 | 14,462 | 12,918 | ||||||||
| Technology and workforce solutions | 25,270 | 35,250 | 24,896 | ||||||||
| 189,418 | 81,950 | 74,298 | |||||||||
| Unallocated corporate overhead (12) | 23,293 | 17,750 | 19,815 | ||||||||
| Adjusted EBITDA (4) | $ | 166,125 | $ | 64,200 | $ | 54,483 | |||||
| Gross Margin | |||||||||||
| Nurse and allied solutions | 25.1 | % | 22.7 | % | 21.6 | % | |||||
| Physician and leadership solutions | 26.1 | % | 27.3 | % | 27.5 | % | |||||
| Technology and workforce solutions | 50.0 | % | 55.5 | % | 48.1 | % | |||||
| Operating Data: | |||||||||||
| Nurse and allied solutions | |||||||||||
| Average travelers on assignment (13) | 9,227 | 8,981 | 8,722 | ||||||||
| Physician and leadership solutions | |||||||||||
| Days filled (14) | 46,645 | 51,342 | 48,004 | ||||||||
| Revenue per day filled (15) | $ | 2,812 | $ | 2,743 | $ | 2,834 | |||||
| As of | As of | ||||
| 2026 | 2025 | 2025 | |||
| Leverage ratio (16) | 1.6 | 3.1 | 3.3 | ||
Additional Supplemental Non-GAAP Disclosure Reconciliation of Guidance Operating Margin to Guidance Adjusted EBITDA Margin (unaudited) | |||
| Three Months Ended | |||
| Low(17) | High(17) | ||
| Operating margin | (0.6)% | 0.1% | |
| Depreciation and amortization (total) | 5.7% | 5.5% | |
| EBITDA margin | 5.1% | 5.6% | |
| Share-based compensation | 1.1% | 1.1% | |
| Integration and other costs | 0.5% | 0.5% | |
| Adjusted EBITDA margin | 6.7% | 7.2% | |
| (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 other costs associated with exit or disposal activities, 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 months ended |
| (4) | Adjusted EBITDA represents net income (loss) plus interest expense (net of interest income) and other, income tax expense, depreciation and amortization, depreciation (included in cost of revenue), loss on sale of disposal group, share-based compensation, acquisition, integration, and other costs, restructuring expenses, and certain legal expenses. 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 (loss) 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 (loss), and management therefore utilizes adjusted EBITDA as an operating performance measure in conjunction with GAAP measures such as net income (loss). |
| (5) | Adjusted EBITDA margin represents adjusted EBITDA divided by revenue. |
| (6) | 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 (“COLI”). 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. |
| (7) | The consolidated effective tax rate is affected by the recording of tax benefits and tax deficiencies related to equity awards vested during the period and tax benefits recognized for disqualifying dispositions related to our employee stock purchase plan (“ESPP”). The magnitude of the impact of tax benefits and tax deficiencies generated in the future related to equity awards and ESPP is dependent upon the Company’s future grants of share-based compensation, the Company’s future stock price on the date equity awards vest in relation to the fair value of the awards on the grant date, the Company’s future stock price on either the ESPP’s offering date or purchase date, whichever is lower, and the length of time the shares issued under the ESPP are held by employees. Since these tax benefits and tax deficiencies related to equity awards and ESPP are largely unrelated to our income (loss) before income 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. |
| (8) | Adjusted net income represents GAAP net income (loss) excluding the impact of the (A) amortization of intangible assets, (B) acquisition, integration, and other costs, (C) loss on sale of disposal group, (D) deferred financing related costs, (E) tax effect, if any, of the foregoing adjustments, (F) net tax expense (benefit) related to the income tax treatment of fair value changes in the cash surrender value of its COLI and (G) tax deficiencies and tax benefits related to equity awards vested and ESPP. 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 (loss), and management therefore utilizes adjusted net income as an operating performance measure in conjunction with GAAP measures such as GAAP net income (loss). |
| (9) | 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 (loss), and management therefore utilizes adjusted diluted EPS as an operating performance measure in conjunction with GAAP measures such as GAAP diluted EPS. |
| (10) | As GAAP net loss is reported for the three months ended |
| (11) | Segment operating income represents net income (loss) 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, share-based compensation, and loss on sale of disposal group. |
| (12) | 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 |
| (13) | Average travelers on assignment represents the average number of nurse and allied healthcare professionals on assignment during the period presented. |
| (14) | Days filled is calculated by dividing the locum tenens hours filled during the period by eight hours. |
| (15) | Revenue per day filled represents revenue of the Company’s locum tenens business divided by days filled for the period presented. |
| (16) | Leverage ratio represents the ratio of the consolidated funded indebtedness (as calculated per the Company’s credit agreement) at the end of the subject period to the consolidated adjusted EBITDA (as calculated per the Company’s credit agreement) for the twelve-month period ended at the end of the subject period. |
| (17) | Guidance percentage metrics are approximate. |
