Market Overview

AMN Healthcare Announces Second Quarter 2019 Results

Share:

DALLAS and SAN DIEGO, Aug. 6, 2019 /PRNewswire/ -- AMN Healthcare Services, Inc. (NYSE:AMN), the leader and innovator in healthcare workforce solutions and staffing services, today announced its second quarter 2019 financial results. Financial highlights are as follows:

Dollars in millions, except per share amounts.



Q2 2019

% Change
Q2 2018

YTD June
30, 2019

% Change
YTD June
30, 2018

Revenue

$535.2

(4)%

$1,067.6

(1)%

Gross profit

$179.5

(1)%

$356.3

2%

Net income

$28.9

(19)%

$63.0

(19)%

Diluted EPS

$0.61

(16)%

$1.32

(18)%

Adjusted diluted EPS*

$0.77

(7)%

$1.52

(7)%

Adjusted EBITDA*

$66.7

(5)%

$132.7

(3)%




*  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.

AMN Healthcare Logo. (PRNewsFoto/AMN Healthcare)

Highlights

  • Second quarter revenue and earnings above Company guidance due primarily to higher performance in the Nurse and Allied segment
  • Allied division continued strong organic revenue growth of 9% over prior year
  • Closed and began integration of Advanced Medical, enhancing MSP fulfillment and expanding our clinical staffing in school settings
  • New and expanded MSP contracts signed year to date, valued at nearly $200 million annualized gross spend at maturity

"The AMN team is performing exceptionally well during this time of increasing need for workforce solutions and severe talent shortages within healthcare," said Susan R. Salka, Chief Executive Officer of AMN Healthcare. "Demand for contingent labor and our solutions continues to rise, with requests for nursing and allied professionals more than 20% above prior-year levels. This reflects the difficulties of an extremely tight labor market and growing demand for healthcare services. AMN is partnering with our clients to deliver innovative solutions and analytics to improve efficiency and the clinician and patient experience."

Second Quarter 2019 Results

Consolidated revenue for the quarter was $535 million, a 4% decrease over prior year but 1% higher than prior quarter. Revenue for the Nurse and Allied Solutions segment was $332 million, flat year over year and down 2% sequentially. Advanced Medical, which was acquired in June, contributed $5 million of revenue in the quarter. Travel Nurse division revenue increased 3% year over year, and Allied division revenue increased 14% year over year, 9% organic. The quarter included revenue from labor disruption activity, but this revenue was lower than prior year due to a large strike last year.

In line with expectations, the Locum Tenens Solutions segment reported revenue of $82 million, down by 24% year over year but up 2% sequentially. Other Workforce Solutions segment revenue was higher than anticipated at $121 million for an increase of 3% year over year, driven by growth in our interim leadership, physician permanent placement and VMS businesses.

Gross margin was 33.5%, higher by 110 basis points year over year and higher by 30 basis points sequentially. The year-over-year variance was driven in part by higher gross margins on labor disruption revenue and a favorable segment revenue mix.

SG&A expenses were $122 million, or 22.7% of revenue, compared with $116 million, or 20.7% of revenue, in the same quarter last year. SG&A was $120 million, or 22.5% of revenue, in the previous quarter. The year-over-year increase was mainly from the recent acquisitions and increased employee-related costs, partially offset by a more favorable professional liability insurance actuarial adjustment.

Income from operations was $45 million, or 8.4% of revenue, compared with $55 million, or 9.8% of revenue, in the same quarter last year. Adjusted EBITDA was $67 million, a year-over-year decrease of 5%. Adjusted EBITDA margin was 12.5%, representing a decrease of 10 basis points year over year and up 10 basis points from prior quarter.

Net income was $29 million, or $0.61 per diluted share, compared with $36 million, or $0.73 per diluted share, in the same quarter last year. Adjusted diluted EPS was $0.77.

At June 30, 2019, cash and cash equivalents totaled $21 million. Cash flow from operations was $29 million for the quarter, and capital expenditures were $8 million. The Company ended the quarter with total debt outstanding of $671 million, with a leverage ratio as calculated in accordance with the Company's credit agreement of 2.4 to 1.

Third Quarter 2019 Outlook

Metric

Guidance*

Consolidated revenue

$560 - $566 million

Gross margin

33.0%

SG&A as percentage of revenue

22.5%

Operating margin

7.7%

Adjusted EBITDA margin

12.0%



*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.

Revenue in the third quarter of 2019 is expected to be approximately 7% higher year over year, including a full-quarter contribution from the Advanced acquisition. Organic consolidated revenue would be expected to be flat to up 1%.

Conference Call on August 6, 2019

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 2019 financial results on Tuesday, August 6, 2019, 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) 230-1092 in the U.S. or (612) 288-0329 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 6, 2019, and can be accessed until 11:59 p.m. Eastern Time on August 20, 2019, by calling (800) 475-6701 in the U.S. or (320) 365-3844 internationally, with access code 469775.

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 labor analytics, mid-revenue cycle management, credentialing solutions, and other services. 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 2019 revenue, gross margin, SG&A expenses as a percentage of revenue and adjusted EBITDA margin, the demand for healthcare services and the labor shortage. 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.

The Company's ability to meet the targets and expectations noted in our third quarter 2019 outlook depends upon, among other factors, our ability to  (i) manage the pricing impact that the consolidation of healthcare delivery organizations may have on our business, (ii) 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, (iii) implement new infrastructure and technology systems to optimize our operating results and manage our business effectively, (iv) develop and evolve our current technology offerings and capabilities, (v) recruit and retain sufficient quality healthcare professionals at reasonable costs, and (vi) consummate and effectively incorporate acquisitions into our business.

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 December 31, 2018, 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,


2019


2018


2019


2019


2018

Revenue

$

535,177



$

558,108



$

532,441



$

1,067,618



$

1,080,597


Cost of revenue

355,635



377,152



355,682



711,317



731,817


Gross profit

179,542



180,956



176,759



356,301



348,780


Gross margin

33.5%



32.4%



33.2%



33.4%



32.3%


Operating expenses:










Selling, general and administrative (SG&A)

121,668



115,535



119,997



241,665



220,272


SG&A as a % of revenue

22.7%



20.7%



22.5%



22.6%



20.4%












Depreciation and amortization

12,718



10,606



11,710



24,428



18,492


Total operating expenses

134,386



126,141



131,707



266,093



238,764


Income from operations

45,156



54,815



45,052



90,208



110,016


Operating margin (1)

8.4%



9.8%



8.5%



8.4%



10.2%












Interest expense, net, and other

6,065



6,376



5,673



11,738



11,711












Income before income taxes

39,091



48,439



39,379



78,470



98,305












Income tax expense

10,222



12,910



5,257



15,479



20,095


Net income

$

28,869



$

35,529



$

34,122



$

62,991



$

78,210


Net income as a % of revenue

5.4%



6.4%



6.4%



5.9%



7.2%












Other comprehensive income (loss):










Foreign currency translation and other

(89)



91



(101)



(190)



72


Other comprehensive income (loss)

(89)



91



(101)



(190)



72












Comprehensive income

$

28,780



$

35,620



$

34,021



$

62,801



$

78,282












Net income per common share:










Basic

$

0.62



$

0.75



$

0.73



$

1.35



$

1.64


Diluted

$

0.61



$

0.73



$

0.71



$

1.32



$

1.60


Weighted average common shares outstanding:










Basic

46,644



47,653



46,784



46,713



47,693


Diluted

47,424



48,936



47,772



47,597



49,026












 

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,


2019


2018


2019


2019


2018

Revenue










Nurse and allied solutions

$

331,627



$

332,728



$

337,029



$

668,656



$

670,907


Locum tenens solutions

82,074



107,297



80,490



162,564



210,414


Other workforce solutions

121,476



118,083



114,922



236,398



199,276



$

535,177



$

558,108



$

532,441



$

1,067,618



$

1,080,597












Reconciliation of Non-GAAP Items:




















Segment operating income (2)










Nurse and allied solutions

$

48,694



$

43,936



$

47,922



$

96,616



$

95,741


Locum tenens solutions

7,128



13,371



5,701



12,829



23,329


Other workforce solutions

27,127



28,576



26,188



53,315



48,427



82,949



85,883



79,811



162,760



167,497


Unallocated corporate overhead

16,217



15,823



13,834



30,051



30,918


Adjusted EBITDA (3)

66,732



70,060



65,977



132,709



136,579


Adjusted EBITDA margin (4)

12.5%



12.6%



12.4%



12.4%



12.6%












Depreciation and amortization

12,718



10,606



11,710



24,428



18,492


Share-based compensation (5)

3,702



3,281



5,186



8,888



6,145


Acquisition, integration and other costs (6)

5,156



1,358



4,029



9,185



1,926


Income from operations

45,156



54,815



45,052



90,208



110,016


Interest expense, net, and other

6,065



6,376



5,673



11,738



11,711


Income before income taxes

39,091



48,439



39,379



78,470



98,305


Income tax expense

10,222



12,910



5,257



15,479



20,095


Net income

$

28,869



$

35,529



$

34,122



$

62,991



$

78,210












GAAP diluted net income per share (EPS)

$

0.61



$

0.73



$

0.71



$

1.32



$

1.60


Adjustments:










Amortization of intangible assets

0.15



0.13



0.14



0.29



0.22


Acquisition, integration and other costs (6)

0.11



0.02



0.09



0.20



0.03


Debt financing related costs









0.01


Tax effect on above adjustments

(0.07)



(0.04)



(0.06)



(0.13)



(0.07)


Tax correction related to prior periods (7)









(0.05)


Tax effect of COLI fair value changes (8)

(0.01)





(0.03)



(0.04)




Excess tax benefits (9)

(0.02)



(0.01)



(0.10)



(0.12)



(0.10)


Adjusted diluted EPS (10)

$

0.77



$

0.83



$

0.75



$

1.52



$

1.64













Three Months Ended


Six Months Ended


June 30,


March 31,


June 30,


2019


2018


2019


2019


2018

Gross Margin










Nurse and allied solutions

27.5%



26.3%



27.9%



27.7%



27.2%


Locum tenens solutions

27.8%



29.8%



27.7%



27.8%



29.2%


Other workforce solutions

54.0%



52.2%



52.6%



53.3%



52.7%






















Operating Data:










Nurse and allied solutions










Average healthcare

professionals on assignment (11)

9,393



9,095



9,580



9,487



9,331












Locum tenens solutions










Days filled (12)

41,563



55,225



40,496



82,059



108,020


Revenue per day filled (13)

$

1,975



$

1,943



$

1,988



$

1,981



$

1,948

































































As of June 30,


As of March 31,










2019


2018


2019

Leverage ratio (14)









2.4


1.7


1.9















 

AMN Healthcare Services, Inc.

Condensed Consolidated Balance Sheets

(dollars in thousands)

(unaudited)



June 30, 2019


December 31,
2018


June 30, 2018

Assets






Current assets:






Cash and cash equivalents

$

20,937



$

13,856



$

22,894


Accounts receivable, net

369,372



365,871



354,781


Accounts receivable, subcontractor

50,058



50,143



34,657


Prepaid and other current assets

49,501



52,296



56,189


Total current assets

489,868



482,166



468,521


Restricted cash, cash equivalents and investments

65,919



59,331



61,839


Fixed assets, net

97,249



90,419



81,221


Operating lease right-of-use assets

95,247






Other assets

109,909



96,152



83,034


Goodwill

588,457



438,506



439,134


Intangible assets, net

409,439



326,147



339,514


Total assets

$

1,856,088



$

1,492,721



$

1,473,263








Liabilities and stockholders' equity






Current liabilities:






Accounts payable and accrued expenses

$

124,672



$

149,603



$

123,105


Accrued compensation and benefits

149,937



135,059



130,258


Current portion of notes payable

3,750






Current portion of operating lease liabilities

13,068






Deferred revenue

11,053



12,365



13,615


Other current liabilities

14,344



10,243



16,261


Total current liabilities

316,824



307,270



283,239








Revolving credit facility

196,000



120,000



155,000


Notes payable, less unamortized fees

466,610



320,607



320,225


Deferred income taxes, net

39,273



27,326



19,863


Operating lease liabilities

97,355






Other long-term liabilities

59,586



78,528



78,192


Total liabilities

1,175,648



853,731



856,519








Commitments and contingencies












Stockholders' equity:

680,440



638,990



616,744








Total liabilities and stockholders' equity

$

1,856,088



$

1,492,721



$

1,473,263


 

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,


2019


2018


2019


2019


2018









Net cash provided by operating activities

$

29,077



$

66,203



$

36,214



$

65,291



$

125,938


Net cash used in investing activities

(204,443)



(229,337)



(36,248)



(240,691)



(238,950)


Net cash provided by financing activities

187,495



133,627



1,790



189,285



118,657


Effect of exchange rates on cash

(89)



91



(101)



(190)



72


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

12,040



(29,416)



1,655



13,695



5,717


Cash, cash equivalents and restricted cash at beginning of period

85,979



134,027



84,324



84,324



98,894


Cash, cash equivalents and restricted cash at end of period

$

98,019



$

104,611



$

85,979



$

98,019



$

104,611


 

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, 2019



Adjusted EBITDA margin (15)

12.0%

Deduct:


Share-based compensation

0.8%

Acquisition, integration and other costs

0.8%

EBITDA margin

10.4%

Depreciation and amortization

2.7%

Operating margin

7.7%

 

(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, extraordinary legal expenses, legal settlement accrual increases 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, extraordinary legal expenses, legal settlement accrual increases 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)

Share-based compensation for the six months ended June 30, 2019 was impacted by two modifications during the first quarter and effective in 2019, a new vesting condition that resulted in accelerated expense recognition.

(6)

Acquisition, integration and other costs of $5,156,000 and $9,185,000 for the three and six months ended June 30, 2019, respectively, include extraordinary legal expenses of approximately $2,500,000 and $4,600,000, respectively. These expenses were partially offset by decreases in contingent consideration liabilities for recently acquired companies of $1,458,000 and $2,158,000 for the three and six months ended June 30, 2019, respectively. Beginning in 2019, we exclude the impact of extraordinary legal expenses from the calculation of adjusted EBITDA because we believe that these expenses are not indicative of the Company's operating performance.

(7)

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 in that 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.

(8)

The Company recorded a net tax benefit of $575,000 and $2,102,000 related to the income tax treatment of the fair value changes in the cash surrender value of its company owned life insurance for the three and six months ended June 30, 2019, respectively. Since these changes in fair value are unrelated to the Company's operating performance, we exclude the impact on adjusted diluted EPS.

(9)

The consolidated effective tax rate for the three and six months ended June 30, 2019 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 $973,000 and $576,000 for the three months ended June 30, 2019 and 2018, respectively. For the six months ended June 30, 2019 and 2018, excess tax benefits recorded as a reduction of income tax expense were $5,542,000 and $5,094,000, 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 exclude their impact on adjusted diluted EPS.

(10)

Adjusted diluted EPS represents GAAP diluted EPS excluding the impact of the (A) amortization of intangible assets, (B) acquisition and integration costs, (C) extraordinary legal expenses, (D) legal settlement accrual increases, (E) changes in fair value of equity investments since January 1, 2018, (F) deferred financing costs, (G) tax effect, if any, of the foregoing adjustments, (H) excess tax benefits relating to equity awards vested and exercised since January 1, 2017, and (I) 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.

(11)

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

(12)

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

(13)

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

(14)

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.

(15)

Guidance percentage metrics are approximate.

 

Cision View original content to download multimedia:http://www.prnewswire.com/news-releases/amn-healthcare-announces-second-quarter-2019-results-300897312.html

SOURCE AMN Healthcare Services, Inc.

View Comments and Join the Discussion!