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AMN Healthcare announces full year and Q4 2014 results

Fourth quarter and full year financial highlights are as follows:

Dollars in millions, except per share amounts.

Q4 2014

% Change

Q4 2013

Full Year 2014

% Change Full Year 2013






Gross profit





Net income





Diluted EPS





Adjusted Diluted EPS*





Adjusted EBITDA*





*  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.

All AMN's business segments experienced year-over-year growth for the fourth quarter and full year.

The Nurse and Allied Healthcare Staffing and Physician Permanent Placement Services segments led with fourth quarter year-over-year revenue growth of 17% and 14%, respectively.

Full year gross margin of 30.5% represented an improvement of 110 basis points from the prior year.

Full year adjusted EBITDA margin of 8.8% reflected a 40 basis point improvement from the prior year.

The Company completed the acquisitions of Avantas in December 2014, and Onward Healthcare, Locum Leaders and Medefis in January 2015.

"During 2014, AMN Healthcare delivered a total shareholder return of 33% through solid execution and our differentiated strategy as the innovator in healthcare workforce solutions. The market environment accelerated mid-year as a stronger economy and millions of newly insured Americans released pent-up demand for both healthcare services and the underlying clinical labor that delivers patient care. Market trends continued to strengthen as the fourth quarter progressed, resulting in better than anticipated revenue and earnings growth," said Susan R. Salka, President and Chief Executive Officer of AMN Healthcare. "We were very pleased to add Avantas, Onward Healthcare, Locum Leaders and Medefis into the AMN family to bolster our workforce solutions and recruitment and supply capabilities. Our stronger portfolio of services and differentiated capabilities, combined with the favorable market conditions, give us a very optimistic outlook for 2015."  

Fourth Quarter 2014 Results

For the fourth quarter of 2014, consolidated revenue was $280 million, an increase of 12% from the same quarter last year and 6% sequentially. Fourth quarter revenue for the Nurse and Allied Healthcare Staffing segment was $192 million, up 17% from the same quarter last year and 10% sequentially. Locum Tenens Staffing segment revenue in the fourth quarter was $76 million, an increase of 3% from the same quarter last year and down 3% sequentially. Fourth quarter Physician Permanent Placement Services segment revenue was $12 million, an increase of 14% from the same quarter last year and 4% sequentially.

Fourth quarter gross margin of 30.3% was higher by 50 basis points than the same quarter last year but lower by 10 basis points sequentially. 

SG&A expenses for the fourth quarter were $62 million, representing 22.1% of revenue, compared to 21.9% in the same quarter last year and 22.8% in the prior quarter. The year-over-year increase in SG&A expenses as a percentage of revenue was due primarily to the additional SG&A expenses from ShiftWise. The lower sequential SG&A expenses as a percentage of revenue were driven by a favorable professional liability actuarial adjustment in the fourth quarter.

Fourth quarter net income was $10 million and net income per diluted share was $0.20. Excluding acquisition related costs, adjusted net income per diluted share was $0.21. Fourth quarter adjusted EBITDA was $25 million, a year-over-year increase of 19% and sequential increase of 16%. Adjusted EBITDA margin of 9.0% represented a 50 basis point increase over prior year. 

Full Year 2014 Results

Full year 2014 consolidated revenue was $1,036 million, an increase of 2% from prior year. Nurse and Allied Healthcare Staffing segment revenue was $695 million, a year-over-year  increase of 2%. Locum Tenens Staffing segment revenue was $296 million, a year-over-year increase of 3%. Physician Permanent Placement Services segment revenue was $45 million, a year-over-year increase of 5%.

Full year gross margin was 30.5% as compared to 29.4% for prior year, with gross margin expansion across all three reportable segments.

Full year SG&A expenses were $232 million, representing 22.4% of revenue as compared to 21.6% for the prior year. The increase in SG&A expenses was due primarily to the addition of a full year of our ShiftWise business in 2014 as well as higher employee, professional services and technology-related expenses to support business growth and strategic initiatives.

Full year net income was $33 million. Full year net income per diluted common share was $0.69. Excluding non-cash charges to interest expense associated with the execution of a new credit agreement and acquisition related costs incurred during the year, adjusted net income per diluted share was $0.74. Full year adjusted EBITDA grew 7% to $91 million. Adjusted EBITDA margin of 8.8% represented a 40 basis point increase over prior year. 

At December 31, 2014, cash and cash equivalents totaled $13 million. Full year cash flow from operations was $28 million and capital expenditures were $19 million. The Company ended the year with total debt outstanding of $162 million, with a leverage ratio of 1.9 to 1.

Business Trends and Outlook

The Company expects consolidated first quarter 2015 revenue of $310 million to $314 million. Gross margin is expected to be approximately 30.5%. SG&A expenses as a percentage of revenue are expected to be approximately 22.5%. Adjusted EBITDA margin is expected to be 8.5% to 9.0%.  This guidance includes the expected results for Avantas for the entire quarter and the Onward Healthcare, Locum Leaders and Medefis companies from the January 7th acquisition date.  

About AMN Healthcare

AMN Healthcare is the innovator in healthcare workforce solutions and staffing services to healthcare facilities across the nation. AMN Healthcare's workforce solutions - including managed services programs, vendor management systems, and recruitment process outsourcing - enable providers to successfully reduce complexity, increase efficiency and improve patient outcomes within the rapidly evolving healthcare environment. The Company provides unparalleled access to the most comprehensive network of quality healthcare professionals through its innovative recruitment strategies and breadth of career opportunities. 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 disseminates news and information about the Company through its website, which can be found at

Conference Call on February 19, 2015

AMN Healthcare Services, Inc.'s fourth quarter 2014 conference call will be held on Thursday, February 19, 2015, at 5:00 p.m. Eastern Time. A live webcast of the call can be accessed through AMN Healthcare's website at 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) 234-9960 internationally. Following the conclusion of the call, a replay of the webcast will be available at the Company's website. A telephonic replay of the call will be available at 7:30 p.m. Eastern Time on February 19, 2015, and can be accessed until 11:59 p.m. Eastern Time on March 5, 2015, by calling (800) 475-6701 in the U.S. or (320) 365-3844 internationally, with access code 351234.

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 and adjusted EBITDA margin serve as industry-wide financial measures, and it 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, and may be different from non-GAAP measures, or may be calculated differently than other similarly title-captioned 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" or on the Company's website at 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. Such statements include expectations regarding the 2015 outlook and first quarter revenue, gross margin, SG&A expenses and adjusted EBITDA margin. The Company based 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 the Company's Annual Report on Form 10-K for the year ended December 31, 2013 and its other periodic reports as well as the Company's current and other reports filed from time to time with the Securities and Exchange Commission. Be advised that developments subsequent to this press release are likely to cause these statements to become outdated with the passage of time.


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