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AMN Healthcare Announces Second Quarter 2018 Results

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AMN Healthcare Announces Second Quarter 2018 Results

Quarterly revenue of $558 million, up 14% over prior year; GAAP EPS of $0.73 and adjusted EPS of $0.83

PR Newswire

SAN DIEGO, Aug. 2, 2018 /PRNewswire/ -- AMN Healthcare Services, Inc. (NYSE:AMN), the leader and innovator in healthcare workforce solutions and staffing services, today announced its second quarter 2018 financial results. Financial highlights are as follows:

Dollars in millions, except per share amounts.


Q2 2018

% Change
Q2 2017

YTD  June
30, 2018

% Change
YTD  June
30, 2017

Revenue

$558.1

14%

$1,080.6

10%

Gross profit

$181.0

12%

$348.8

8%

Net income

$35.5

14%

$78.2

24%

Diluted EPS

$0.73

16%

$1.60

25%

Adj. diluted EPS*

$0.83

24%

$1.64

26%

Adjusted EBITDA*

$70.1

4%

$136.6

5%


*  See "Non-GAAP Measures" below for a discussion of our use of non-GAAP items and the table entitled "Supplemental Financial and Operating Data" for a reconciliation of non-GAAP items.

Highlights

  • AMN Healthcare reached record highs for revenue and adjusted EPS in the quarter.
  • Second quarter consolidated revenue of $558 million increased 14% year over year, with organic growth of 7%.
  • Growth was led by our Nurse and Allied Solutions segment with revenue up by 11% year over year.
  • Adjusted EBITDA of $70 million grew 4% year over year and was 12.6% of revenue.
  • Operating cash flow in the second quarter was $66 million. In the first half of 2018, cash flow from operations totaled $126 million, up 80% year over year.
  • The April acquisitions of MedPartners, Phillips DiPisa and Leaders For Today contributed $36 million of revenue in the quarter.

"Solid execution in the second quarter enabled AMN to reach all-time highs in revenue and adjusted EBITDA. We continue to expand and add new MSP clients and have a strong pipeline," said Susan R. Salka, Chief Executive Officer of AMN Healthcare. "Our team delivered well for Nurse and Allied clients, with strong fill rates amid a relatively tepid demand environment and pricing headwinds. Solid performance in several of our businesses is being offset by a decline in Locum Tenens, where we continue to see below-market performance due to the disruption from business model and technology changes made earlier this year. Our recent acquisitions are integrating with the AMN family and are off to a good start. The primary macro drivers of our industry appear favorable for the foreseeable future, and we remain confident in the long-term growth of AMN."

Second Quarter 2018 Results

Consolidated revenue for the quarter was $558 million, a 14% increase over prior year and 7% higher than prior quarter. Revenue for the Nurse and Allied Solutions segment was $333 million, higher by 11% year over year and down 2% sequentially. The quarter included $25 million of labor disruption revenue. Excluding this event, segment revenue grew 2% year over year and seasonally declined 9% sequentially, in line with expectations. Growth of the Travel Nurse division was in line with expectations with revenue up 2% year over year, driven by a volume increase partly offset by a lower mix of premium-rate assignments. Allied division revenue increased 7% year over year, driven primarily by volume increases.

The Locum Tenens Solutions segment reported revenue of $107 million, down by 1% year over year, with lower volumes being offset by positive pricing. Other Workforce Solutions segment revenue was $118 million reflecting an increase of 46% year over year, with the benefit of acquisitions made in April 2018. Organic growth of 2% year over year was driven by the mid-revenue cycle and interim leadership businesses.

Gross margin was 32.4%, lower by 50 basis points year over year and higher by 30 basis points sequentially. The variances were positively impacted by higher-than-average gross margins from the recently acquired companies and a change in our physician permanent placement business model that prompted a recording of certain recruiter expenses in SG&A that were previously in cost of revenue. These positives were partly offset by a below-average labor disruption gross margin. Net of these factors, our year-over-year gross margin declined primarily due to a lower margin in our Nurse and Allied and Other Workforce Solutions segments.

SG&A expenses were $116 million, or 20.7% of revenue, compared with $97 million, or 19.7% of revenue, in the same quarter last year. SG&A was $105 million, or 20.0% of revenue, in the previous quarter. The increase in expenses and expense margin was impacted by added costs from the recently acquired companies and the physician permanent placement cost change.

Net income was $36 million, or $0.73 per diluted share, compared with $31 million, or $0.63 per diluted share, in the same quarter last year. Adjusted diluted EPS was $0.83. Adjusted EBITDA was $70 million, a year-over-year increase of 4%. Adjusted EBITDA margin was 12.6%, representing a decrease of 110 basis points year over year and a decrease of 10 basis points sequentially.

At June 30, 2018, cash and cash equivalents totaled $23 million. Cash flow from operations was $66 million for the quarter, and capital expenditures were $11 million. AMN repurchased 385,000 shares of stock for $21 million during the quarter. The Company ended the quarter with total debt outstanding of $480 million, with a leverage ratio as calculated in accordance with the Company's credit agreement of 1.7 to 1.

Third Quarter 2018 Outlook

Metric

Guidance*

Consolidated revenue

$522 - $530 million

Gross margin

~33.0%

SG&A as percentage of revenue

 ~21.5%

Adjusted EBITDA margin

~12.5%


*Note: Guidance percentage metrics are approximate.  For a reconciliation of adjusted EBITDA margin, see the table entitled "Reconciliation of Guidance Adjusted EBITDA Margin to Guidance Operating Margin" below.

Projected year-over-year revenue growth in the third quarter of 2018 is approximately 6-7%. On an organic basis, revenue is projected to be down approximately 1% due primarily to disruption in the Locum Tenens business and a mix shift away from premium-rate assignments in Travel Nursing. No significant labor disruption revenue is included in third quarter guidance.

Conference Call on August 2, 2018

AMN Healthcare Services, Inc. (NYSE:AMN), healthcare's leader and innovator in workforce solutions and staffing services, will host a conference call to discuss its second quarter 2018 financial results on Thursday, August 2, 2018, at 5:00 p.m. Eastern Time. A live webcast of the call can be accessed through AMN Healthcare's website at http://amnhealthcare.investorroom.com/eventcalendar. Please log in at least 10 minutes prior to the conference call in order to download the applicable audio software. Interested parties may participate live via telephone by dialing (800) 230-1059 in the U.S. or (612) 234-9959 internationally. Following the conclusion of the call, a replay of the webcast will be available at the Company's website. Alternatively, a telephonic replay of the call will be available starting at 7:30 p.m. Eastern Time on August 2, 2018, and can be accessed until 11:59 p.m. Eastern Time on August 16, 2018, by calling (800) 475-6701 in the U.S. or (320) 365-3844 internationally, with access code 451076.

About AMN Healthcare

AMN Healthcare is the leader and innovator in healthcare workforce solutions and staffing services to healthcare facilities across the nation. The Company provides unparalleled 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 delivers managed services programs, healthcare executive search solutions, vendor management systems, recruitment process outsourcing, predictive modeling, mid-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 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://amnhealthcare.investorroom.com/emailalerts.

Non-GAAP Measures

This earnings release contains 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 and (3) adjusted diluted EPS.  The Company provides such non-GAAP financial measures because management believes that they are useful both to 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 and allocating resources. 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 "Supplemental Financial and Operating Data" under the caption entitled "Reconciliation of Non-GAAP Items" and the footnotes thereto or on the Company's website at http://amnhealthcare.investorroom.com/financialreports. 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 our guidance for third quarter 2018 revenue, gross margin, SG&A expenses as a percentage of revenue, adjusted EBITDA margin and long-term trends for our business. 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 identified by words such as "believe," "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. Factors that could cause actual results to differ from those implied by the forward-looking statements contained in this press release are set forth in our fillings with the Securities and Exchange Commission (SEC), including our most recent Annual Report on Form 10-K for the year ended December 31, 2017, our subsequent Quarterly Reports on Form 10-Q and our Current Reports on Form 8-K. 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 Reece
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


Six Months Ended


June 30,


March 31,


June 30,


2018


2017


2018


2018


2017

Revenue

$

558,108


$

489,803


$

522,489


$

1,080,597


$

984,972

Cost of revenue

377,152


328,791


354,665


731,817


662,184

Gross profit

180,956


161,012


167,824


348,780


322,788

Gross margin

32.4%


32.9%


32.1%


32.3%


32.8%

Operating expenses:










Selling, general and administrative (SG&A)

115,535


96,673


104,737


220,272


198,746

SG&A as a % of revenue

20.7%


19.7%


20.0%


20.4%


20.2%











Depreciation and amortization

10,606


7,959


7,886


18,492


15,627

Total operating expenses

126,141


104,632


112,623


238,764


214,373

Income from operations

54,815


56,380


55,201


110,016


108,415

Operating margin (1)

9.8%


11.5%


10.6%


10.2%


11.0%











Interest expense, net, and other

6,376


4,928


5,335


11,711


10,058











Income before income taxes

48,439


51,452


49,866


98,305


98,357











Income tax expense

12,910


20,197


7,185


20,095


35,094

Net income

$

35,529


$

31,255


$

42,681


$

78,210


$

63,263

Net income as a % of revenue

6.4%


6.4%


8.2%


7.2%


6.4%











Other comprehensive income (loss):










Foreign currency translation and other

91


(41)


(19)


72


(38)

Cash flow hedge, net of income taxes


(58)




(15)

Other comprehensive income (loss)

91


(99)


(19)


72


(53)











Comprehensive income

$

35,620


$

31,156


$

42,662


$

78,282


$

63,210











Net income per common share:










Basic

$

0.75


$

0.65


$

0.89


$

1.64


$

1.32

Diluted

$

0.73


$

0.63


$

0.87


$

1.60


$

1.28

Weighted average common shares outstanding:










Basic

47,653


47,916


47,733


47,693


47,849

Diluted

48,936


49,475


49,116


49,026


49,498

 

AMN Healthcare Services, Inc.

Supplemental Financial and Operating Data

(dollars in thousands, except per share data and operating data)

(unaudited)



Three Months Ended


Six Months Ended


June 30,


March 31,


June 30,


2018


2017


2018


2018


2017

Revenue










Nurse and allied solutions

$

332,728



$

300,727



$

338,179



$

670,907



$

614,250


Locum tenens solutions

107,297



108,215



103,117



210,414



211,058


Other workforce solutions

118,083



80,861



81,193



199,276



159,664



$

558,108



$

489,803



$

522,489



$

1,080,597



$

984,972












Reconciliation of Non-GAAP Items:




















Segment operating income (2)










Nurse and allied solutions

$

43,936



$

47,851



$

51,805



$

95,741



$

93,831


Locum tenens solutions

13,371



12,371



9,958



23,329



24,590


Other workforce solutions

28,576



22,041



19,851



48,427



41,898



85,883



82,263



81,614



167,497



160,319


Unallocated corporate overhead

15,823



15,080



15,095



30,918



29,971


Adjusted EBITDA (3)

70,060



67,183



66,519



136,579



130,348


Adjusted EBITDA margin (4)

12.6%



13.7%



12.7%



12.6%



13.2%












Depreciation and amortization

10,606



7,959



7,886



18,492



15,627


Share-based compensation

3,281



2,562



2,864



6,145



5,243


Acquisition and integration costs

1,358



282



568



1,926



1,063


Income from operations

54,815



56,380



55,201



110,016



108,415


Interest expense, net, and other

6,376



4,928



5,335



11,711



10,058


Income before income taxes

48,439



51,452



49,866



98,305



98,357


Income tax expense

12,910



20,197



7,185



20,095



35,094


Net Income

$

35,529



$

31,255



$

42,681



$

78,210



$

63,263












GAAP diluted net income per share (EPS)

$

0.73



$

0.63



$

0.87



$

1.60



$

1.28


Adjustments:










Amortization of intangible assets

0.13



0.09



0.09



0.22



0.19


Acquisition and integration costs

0.02



0.01



0.01



0.03



0.02


Debit financing related costs





0.01



0.01




Tax effect on above adjustments

(0.04)



(0.04)



(0.03)



(0.07)



(0.08)


Tax correction related to prior periods (5)





(0.05)



(0.05)




Excess tax benefits (6)

(0.01)



(0.02)



(0.09)



(0.10)



(0.11)


Adjusted diluted EPS (7)

$

0.83



$

0.67



$

0.81



$

1.64



$

1.30


 


Three Months Ended


Six Months Ended


June 30,


March 31,


June 30,


2018


2017


2018


2018


2017

Gross Margin










Nurse and allied solutions

26.3

%


27.8

%


28.0

%


27.2

%


27.7

%

Locum tenens solutions

29.8

%


30.0

%


28.7

%


29.2

%


30.3

%

Other workforce solutions

52.2

%


55.7

%


53.6

%


52.7

%


55.3

%





















Operating Data:










Nurse and allied solutions










Average healthcare
professionals on assignment (8)

9,095



8,776



9,567



9,331



8,913












Locum tenens solutions










Days filled (9)

55,225



58,660



52,794



108,020



113,903


Revenue per day filled (10)

$

1,943



$

1,845



$

1,953



$

1,948



$

1,853


 


As of June 30,


As of March 31,


2018


2017


2018

Leverage ratio (11)

1.7



1.4


1.2

 

AMN Healthcare Services, Inc.

Condensed Consolidated Balance Sheets

(dollars in thousands)

(unaudited)



June 30,
2018


December 31,
2017


June 30,
2017

Assets






Current assets:






Cash and cash equivalents

$

22,894



$

15,147



$

22,878


Accounts receivable, net

354,781



350,496



334,597


Accounts receivable, subcontractor

34,657



41,012



36,631


Prepaid and other current assets

56,189



67,498



46,938


Total current assets

468,521



474,153



441,044


Restricted cash, cash equivalents and investments

61,839



64,315



33,882


Fixed assets, net

81,221



73,431



65,368


Other assets

83,034



74,366



71,594


Goodwill

439,134



340,596



340,596


Intangible assets, net

339,514



227,096



236,486


Total assets

$

1,473,263



$

1,253,957



$

1,188,970








Liabilities and stockholders' equity






Current liabilities:






Accounts payable and accrued expenses

$

123,105



$

130,319



$

118,943


Accrued compensation and benefits

130,258



121,423



107,283


Current portion of notes payable



18,071


Deferred revenue

13,615



8,384



9,644


Other current liabilities

16,261



5,146



12,387


Total current liabilities

283,239



265,272



266,328








Revolving credit facility

155,000






Notes payable, less unamortized fees

320,225



319,843



319,462


Deferred income taxes, net

19,863



27,036



12,387


Other long-term liabilities

78,192



79,279



82,301


Total liabilities

856,519



691,430



680,478








Commitments and contingencies












Stockholders' equity:

616,744



562,527



508,492








Total liabilities and stockholders' equity

$

1,473,263



$

1,253,957



$

1,188,970


 

AMN Healthcare Services, Inc.

Summary Condensed Consolidated Statements of Cash Flows

(dollars in thousands)

(unaudited)



Three Months Ended


Six Months Ended


June 30,


March 31,


June 30,


2018


2017(12)


2018


2018


2017(12)









Net cash provided by operating activities

$

66,203



$

25,359



$

59,735



$

125,938



$

70,043


Net cash used in investing activities

(229,337)



(6,316)



(9,613)



(238,950)



(19,616)


Net cash provided by (used in) financing activities

133,627



(26,945)



(14,970)



118,657



(38,873)


Effect of exchange rates on cash

91



(42)



(19)



72



(38)


Net increase (decrease) in cash, cash equivalents and restricted cash

(29,416)



(7,944)



35,133



5,717



11,516


Cash, cash equivalents and restricted cash at beginning of period

134,027



70,488



98,894



98,894



51,028


Cash, cash equivalents and restricted cash at end of period

$

104,611



$

62,544



$

134,027



$

104,611



$

62,544


 

AMN Healthcare Services, Inc.

Additional Supplemental Non-GAAP Disclosures

Reconciliation of Guidance Adjusted EBITDA Margin to

Guidance Operating Margin

(unaudited)



Three Months Ended


September 30, 2018



Adjusted EBITDA margin(13)

12.5%

Deduct:


Share-based compensation

0.6%

Acquisition and integration costs

0.2%

EBITDA margin

11.7%

Depreciation and amortization

2.1%

Operating margin

9.6%



(1)

Operating margin represents income from operations divided by revenue.

(2)

Segment operating income represents net income plus interest expense (net of interest income) and other, income tax expense, depreciation and amortization, unallocated corporate overhead, acquisition and integration costs and share-based compensation.

(3)

Adjusted EBITDA represents net income plus interest expense (net of interest income) and other, income tax expense, depreciation and amortization, acquisition and integration costs 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 and is a measure used in the Company's credit agreement and the indenture governing our 5.125% Senior Notes due 2024. 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.

(4)

Adjusted EBITDA margin represents adjusted EBITDA divided by revenue.

(5)

During the first quarter of 2018, the Company recorded a net tax benefit of $2,501,000 to adjust for an immaterial out-of-period error identified this quarter related to the income tax treatment of fair value changes in the cash surrender value of its Company Owned Life Insurance for years ended December 31, 2015 through December 31, 2017. These fair value changes had not previously been included as a benefit in the tax provision of the related years.

(6)

The consolidated effective tax rate for the three and six months ended June 30, 2018 was favorably affected by the recording of excess tax benefits relating to equity awards vested and exercised during the period. As a result of the adoption of a new accounting pronouncement on January 1, 2017, we no longer record excess tax benefits as an increase to additional paid-in capital, but record such excess tax benefits on a prospective basis as a reduction of income tax expense, which amounted to $576,000 and $1,028,000 for the three months ended June 30, 2018 and 2017, respectively. For the six months ended June 30, 2018 and 2017, excess tax benefits recorded as a reduction of income tax expense were $5,094,000 and $5,325,000, respectively. The magnitude of the impact of excess tax benefits generated in the future, which may be favorable or unfavorable, is dependent upon the Company's future grants of share-based compensation, the Company's future stock price on the date awards vest or exercise in relation to the fair value of the awards on the grant date or the exercise behavior of the Company's stock appreciation rights holders. Since these favorable tax benefits are largely unrelated to our current year's income before taxes and is unrepresentative of our normal effective tax rate, we excluded their impact on adjusted diluted EPS for the three months and six months ended June 30, 2018 and 2017.

(7)

Adjusted diluted EPS represents GAAP diluted EPS excluding the impact of the (A) amortization of intangible assets, (B) acquisition and integration costs, (C) deferred financing costs, (D) tax effect, if any, of the foregoing adjustments, (E) excess tax benefits relating to equity awards vested and exercised since January 1, 2017, and (F) correction of prior periods error. 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 from adjusted diluted EPS). Although management believes the items excluded from adjusted diluted EPS 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.

(8)

Average healthcare professionals on assignment represents the average number of nurse and allied healthcare professionals on assignment during the period presented.

(9)

Days filled is calculated by dividing the locum tenens hours filled during the period by eight hours.

(10)

Revenue per day filled represents revenue of the Company's locum tenens solutions segment divided by days filled for the period presented.

(11)

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.

(12)

As a result of the adoption of ASU 2016-18, "Statement of Cash Flows (Topic 230): Restricted Cash" on January 1, 2018, we are required to present in the statement of cash flows the change during the period in the total of cash, cash equivalents, and amounts generally described as restricted cash or restricted cash equivalents. We adjusted certain restricted cash amounts for the three and six months ended June 30, 2017 in the cash flow table presented above. These adjustments had no effect on previously reported results of operations or retained earnings.

(13)

Guidance percentage metrics are approximate.

 

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SOURCE AMN Healthcare Services, Inc.

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