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For the Transition Period From _________ to _________

———————

Delaware			0-33169			13-4066229
(State or other jurisdiction of Incorporation or organization)			Commission file number			(I.R.S. Employer Identification Number)

Securities registered pursuant to Section 12(b) of the Act:

Title of each class			Trading Symbol			Name of each exchange on which registered
Common stock, par value $0.0001 per share			CCRN			The Nasdaq Stock Market

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Sections 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files). ☒ Yes ☐ No

Large accelerated filer ☐ Accelerated filer ☒ Non-accelerated filer ☐

Smaller reporting company ☐ Emerging growth company ☐

period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes ☐ No ☒

The registrant had outstanding 38,213,868 shares of common stock, par value $0.0001 per share, as of April 30, 2022.

March 31, 2022

						PAGE
PART I. – FINANCIAL INFORMATION						1
Item 1.			Condensed Consolidated Financial Statements			1
			Condensed Consolidated Balance Sheets (Unaudited)			1
			Condensed Consolidated Statements of Operations (Unaudited)			2
			Condensed Consolidated Statements of Stockholders' Equity (Unaudited)			3
			Condensed Consolidated Statements of Cash Flows (Unaudited)			4
			Notes to Condensed Consolidated Financial Statements (Unaudited)			5
Item 2.			Management’s Discussion and Analysis of Financial Condition and Results of Operations			20
Item 3.			Quantitative and Qualitative Disclosures About Market Risk			29
Item 4.			Controls and Procedures			29
PART II. – OTHER INFORMATION						30
Item 1.			Legal Proceedings			30
Item 1A.			Risk Factors			30
Item 6.			Exhibits			31
Signatures						32

			March 31, 2022						December 31, 2021
Assets
Current assets:
Cash and cash equivalents			$	1,208					$	1,036
Accounts receivable, net of allowances of $9,141 in 2022 and $6,881 in 2021			677,432						493,910
Prepaid expenses			7,689						7,648
Insurance recovery receivable			5,336						5,041
Other current assets			641						638
Total current assets			692,306						508,273
Property and equipment, net of accumulated depreciation of $18,092 in 2022 and $17,729 in 2021			16,706						15,833
Operating lease right-of-use assets			5,447						7,488
Goodwill			119,490						119,490
Trade names, indefinite-lived			5,900						5,900
Other intangible assets, net			40,543						42,344
Non-current deferred tax assets			9,117						11,525
Other non-current assets			26,925						21,956
Total assets			$	916,434					$	732,809
Liabilities and Stockholders' Equity
Current liabilities:
Accounts payable and accrued expenses			$	164,224					$	109,753
Accrued compensation and benefits			74,733						65,580
Current portion of debt			1,750						4,176
Operating lease liabilities - current			4,026						4,090
Income tax payable			29,140						7,307
Current portion of earnout liability			8,250						7,500
Other current liabilities			1,122						1,364
Total current liabilities			283,245						199,770
Long-term debt, less current portion			218,475						176,366
Operating lease liabilities - non-current			9,704						10,853
Non-current deferred tax liabilities			207						190
Long-term accrued claims			26,443						25,314
Non-current earnout liability			8,250						9,000
Other long-term liabilities			14,037						13,788
Total liabilities			560,361						435,281
Commitments and contingencies
Stockholders' equity:
Common stock			4						4
Additional paid-in capital			318,125						321,552
Accumulated other comprehensive loss			(1,304)						(1,293)
Retained earnings (accumulated deficit)			39,248						(22,735)
Total stockholders' equity			356,073						297,528
Total liabilities and stockholders' equity			$	916,434					$	732,809

			Three Months Ended
			March 31,
			2022						2021
Revenue from services			$	788,732					$	329,241
Operating expenses:
Direct operating expenses			613,938						257,776
Selling, general and administrative expenses			76,813						46,327
Bad debt expense			2,369						504
Depreciation and amortization			2,719						2,253
Acquisition and integration-related costs			40						—
Restructuring costs			480						1,238
Impairment charges			1,741						149
Total operating expenses			698,100						308,247
Income from operations			90,632						20,994
Other expenses (income):
Interest expense			3,521						671
Other income, net			(8)						(37)
Income before income taxes			87,119						20,360
Income tax expense			25,136						912
Net income attributable to common stockholders			$	61,983					$	19,448
Other comprehensive income:
Unrealized foreign currency translation loss			(11)						(6)
Comprehensive income			$	61,972					$	19,442
Net income per share attributable to common stockholders - Basic			$	1.67					$	0.54
Net income per share attributable to common stockholders - Diluted			$	1.63					$	0.53
Weighted average common shares outstanding:
Basic			37,028						36,181
Diluted			37,973						37,034

			Common Stock												Additional Paid-In Capital						Accumulated Other Comprehensive Loss, net						(Accumulated Deficit) Retained Earnings						Noncontrolling Interest in Subsidiary						Stockholders’ Equity
			Shares						Dollars
Balances at December 31, 2021			37,024						$	4					$	321,552					$	(1,293)					$	(22,735)					$	—					$	297,528
Vesting of restricted stock			419						—						(5,028)						—						—						—						(5,028)
Equity compensation			—						—						1,601						—						—						—						1,601
Foreign currency translation adjustment, net of taxes			—						—						—						(11)						—						—						(11)
Net income			—						—						—						—						61,983						—						61,983
Balances at March 31, 2022			37,443						$	4					$	318,125					$	(1,304)					$	39,248					$	—					$	356,073
			Common Stock												Additional Paid-In Capital						Accumulated Other Comprehensive Loss, net						Accumulated Deficit						Noncontrolling Interest in Subsidiary						Stockholders’ Equity
			Shares						Dollars
Balances at December 31, 2020			36,177						$	4					$	310,388					$	(1,280)					$	(154,737)					$	534					$	154,909
Vesting of restricted stock			318						—						(2,026)						—						—						—						(2,026)
Equity compensation			—						—						1,349						—						—						—						1,349
Foreign currency translation adjustment, net of taxes			—						—						—						(6)						—						—						(6)
Net income			—						—						—						—						19,448						—						19,448
Balances at March 31, 2021			36,495						$	4					$	309,711					$	(1,286)					$	(135,289)					$	534					$	173,674

			Three Months Ended
			March 31,
			2022						2021
Cash flows from operating activities
Consolidated net income			$	61,983					$	19,448
Adjustments to reconcile net income to net cash used in operating activities:
Depreciation and amortization			2,719						2,253
Provision for allowances			3,179						1,095
Deferred income tax expense			2,428						266
Non-cash lease expense			567						622
Impairment charges			1,741						149
Equity compensation			1,601						1,349
Other non-cash costs			446						214
Changes in operating assets and liabilities:
Accounts receivable			(186,701)						(76,581)
Prepaid expenses and other assets			(557)						568
Income taxes			22,050						617
Accounts payable and accrued expenses			62,979						26,507
Operating lease liabilities			(1,273)						(1,115)
Other			(200)						(319)
Net cash used in operating activities			(29,038)						(24,927)
Cash flows from investing activities
Purchases of property and equipment			(2,096)						(1,186)
Net cash used in investing activities			(2,096)						(1,186)
Cash flows from financing activities
Principal payments on term loan			(437)						—
Debt issuance costs			(3,092)						(150)
Borrowings under Senior Secured Asset-Based revolving credit facility			415,176						148,016
Repayments on Senior Secured Asset-Based revolving credit facility			(372,874)						(105,400)
Cash paid for shares withheld for taxes			(5,028)						(2,026)
Principal payments on note payable			(2,426)						(2,425)
Other			(11)						(11)
Net cash provided by financing activities			31,308						38,004
Effect of exchange rate changes on cash			(2)						(3)
Change in cash and cash equivalents			172						11,888
Cash and cash equivalents at beginning of period			1,036						1,600
Cash and cash equivalents at end of period			$	1,208					$	13,488

The preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts in the condensed consolidated financial statements and accompanying notes. Management has assessed various accounting estimates and other matters, including those that require consideration of forecasted financial information, in context of the unknown future impacts of the global COVID-19 (COVID) pandemic using information that is reasonably available to the Company at the time. Significant estimates and assumptions are used for, but not limited to: (i) the valuation of accounts receivable; (ii) goodwill, trade names, and other intangible assets; (iii) other long-lived assets; (iv) revenue recognition; (v) accruals for health, workers’ compensation, and professional liability claims; (vi) valuation of deferred tax assets; (vii) legal contingencies; and (viii) income taxes. Accrued insurance claims and reserves include estimated settlements from known claims and actuarial estimates for claims incurred but not reported. As additional information becomes available to the Company, its future assessment of these estimates, including management's expectations at the time regarding the duration, scope and severity of the pandemic, as well as other factors, could materially and adversely impact the Company's consolidated financial statements in future reporting periods. Actual results could differ from those estimates.

The opening balance of the allowance for doubtful accounts is reconciled to the closing balance for expected credit losses as follows:

			2022						2021
			(amounts in thousands)
Balance at January 1			$	6,087					$	3,416
Bad Debt Expense			2,369						504
Write-Offs, net of Recoveries			(365)						(699)
Balance at March 31			$	8,091					$	3,221

The Company’s contract terms typically require payment between 30 to 60 days from the date of invoice and are considered past due based on the particular negotiated contract terms. The majority of the Company's customers are U.S. based healthcare systems with a significant percentage in acute-care facilities. No single customer accounted for more than 10% of the Company’s revenue for the three months ended March 31, 2022 and 2021, or the accounts receivable balance as of March 31, 2022 and December 31, 2021.

Reconciliation of the employee termination costs and lease-related exit costs beginning and ending liability balance is presented below:

			Employee Termination Costs						Lease-Related Exit Costs
			(amounts in thousands)
Balance at January 1, 2022			$	160					$	2,423
Charged to restructuring costs (a)			—						389
Payments and adjustments			(160)						(192)
Balance at March 31, 2022			$	—					$	2,620

			Three Months ended March 31, 2022
			Nurse And Allied Staffing						Physician Staffing												Total Segments
			(amounts in thousands)
Temporary Staffing Services			$	749,447					$	22,104											$	771,551
Other Services			16,133						1,048												17,181
Total			$	765,580					$	23,152											$	788,732
			Three Months ended March 31, 2021
			Nurse And Allied Staffing						Physician Staffing												Total Segments
			(amounts in thousands)
Temporary Staffing Services			$	305,975					$	15,406											$	321,381
Other Services			7,033						827												7,860
Total			$	313,008					$	16,233											$	329,241

			(amounts in thousands)
Cash and cash equivalents			$	957
Accounts receivable			11,991
Other current assets			59
Property and equipment			10
Right-of-use assets			1,078
Goodwill			22,066
Other intangible assets			14,200
Total assets acquired			50,361
Accounts payable and accrued expenses			3,562
Accrued compensation and benefits			1,387
Lease liability - current			316
Lease liability - non-current			762
Earnout liability			15,000
Total liabilities assumed			21,027
Net assets acquired			$	29,334

Total comprehensive income includes net income or loss and foreign currency translation adjustments, net of any related deferred taxes, and is included within the accompanying condensed consolidated statements of operations. Certain of the Company’s foreign subsidiaries use their respective local currency as their functional currency. Assets and liabilities of these operations are translated at the exchange rates in effect on the balance sheet date. Income statement items are translated at the average exchange rates for the period. The cumulative impact of currency fluctuations related to the balance sheet translation is included in accumulated other comprehensive loss in the accompanying condensed consolidated balance sheets and was an unrealized loss of $1.4 million at March 31, 2022 and $1.3 million at December 31, 2021.

The following table sets forth the components of the numerator and denominator for the computation of the basic and diluted earnings per share:

			Three Months Ended
			March 31,
			2022						2021
			(amounts in thousands, except per share data)
Numerator:
Net income attributable to common stockholders - Basic and Diluted			$	61,983					$	19,448
Denominator:
Weighted average common shares - Basic			37,028						36,181
Effect of diluted shares:
Share-based awards			945						853
Weighted average common shares - Diluted			37,973						37,034
Net income per share attributable to common stockholders - Basic			$	1.67					$	0.54
Net income per share attributable to common stockholders - Diluted			$	1.63					$	0.53

The Company had the following acquired intangible assets:

			March 31, 2022																		December 31, 2021
			Gross Carrying Amount						Accumulated Amortization						Net Carrying Amount						Gross Carrying Amount						Accumulated Amortization						Net Carrying Amount
			(amounts in thousands)
Intangible assets subject to amortization:
Databases			$	30,530					$	19,138					$	11,392					$	30,530					$	18,375					$	12,155
Customer relationships			47,738						18,603						29,135						47,738						17,581						30,157
Non-compete agreements			304						288						16						304						272						32
Other intangible assets, net			$	78,572					$	38,029					$	40,543					$	78,572					$	36,228					$	42,344
Intangible assets not subject to amortization:
Trade names, indefinite-lived															$	5,900																	$	5,900

			(amounts in thousands)
Years Ending December 31:
2022			$	5,374
2023			7,117
2024			6,479
2025			5,921
2026			4,751
Thereafter			10,901
			$	40,543

As of March 31, 2022, the Company performed a qualitative assessment of each of its reporting units and determined it was not more likely than not that the fair value of its reporting units dropped below their carrying value. Although management believes that the Company's current estimates and assumptions utilized in its qualitative testing are reasonable and supportable, including its assumptions on the impact and timing related to COVID, there can be no assurance that the estimates and assumptions management used for purposes of its qualitative assessment as of March 31, 2022 will prove to be accurate predictions of future performance.

			March 31, 2022												December 31, 2021
			Principal						Debt Issuance Costs						Principal						Debt Issuance Costs
			(amounts in thousands)
Term Loan, interest of 6.50% at March 31, 2022 and December 31, 2021			$	173,875					$	(5,151)					$	174,312					$	(5,396)
Senior Secured Asset-Based Loan, interest of 1.88% and 1.60% at March 31, 2022 and December 31, 2021, respectively			51,501						(3,990)						9,200						(991)
Note Payable, interest of 2.00% per annum at December 31, 2021			—						—						2,426						—
Total debt			225,376						(9,141)						185,938						(6,387)
Less current portion - note payable			—						—						2,426						—
Less current portion - term loan			1,750						—						1,750						—
Long-term debt			$	223,626					$	(9,141)					$	181,762					$	(6,387)

			Term Loan						Senior Secured Asset-Based Loan
			(amounts in thousands)
Through Years Ending December 31:
2022			$	1,312					$	—
2023			1,750						—
2024			1,750						—
2025			1,750						—
2026			1,750						—
Thereafter			165,563						51,501
Total			$	173,875					$	51,501

On June 8, 2021, the Company entered into a Term Loan Credit Agreement (Term Loan Agreement) with certain lenders identified therein (collectively, the Lenders) and Wilmington Trust, National Association as administrative agent and collateral agent, pursuant to which the Lenders extended to the Company a six-year second lien subordinated term loan in the amount of $100.0 million (term loan). The term loan has an interest rate of one-month London Inter-Bank Offered Rate (LIBOR) plus 5.75% per annum, subject to a 0.75% LIBOR floor. The term loan was used to pay the cash consideration, as well as any costs, fees, and expenses in connection with the WSG acquisition (see Note 4 - Acquisitions), with the remainder used to pay down a

As of March 31, 2022, the interest rate spreads and fees under the Loan Agreement were based on SOFR plus 1.85% for the revolving portion of the borrowing base. The Base Rate (as defined by the Loan Agreement) margin would have been 0.75% for the revolving portion. The SOFR and Base Rate margins are subject to monthly pricing adjustments, pursuant to a pricing matrix based on the Company’s excess availability under the revolving credit facility. In addition, the facility is subject to an unused line fee, letter of credit fees, and an administrative fee. The unused line fee is 0.375% of the average daily unused portion of the revolving credit facility.

Classification on Condensed Consolidated Balance Sheets:			March 31, 2022						December 31, 2021
			(amounts in thousands)
Operating lease right-of-use assets			$	5,447					$	7,488
Operating lease liabilities - current			$	4,026					$	4,090
Operating lease liabilities - non-current			$	9,704					$	10,853

			March 31, 2022						December 31, 2021
Weighted-average remaining lease term			3.2 years						3.4 years
Weighted average discount rate			6.41		%				6.39		%

			(amounts in thousands)
Years Ending December 31:
2022			$	3,499
2023			4,998
2024			3,956
2025			2,759
Total minimum lease payments			15,212
Less: amount of lease payments representing interest			(1,482)
Present value of future minimum lease payments			13,730
Less: operating lease liabilities - current			(4,026)
Operating lease liabilities - non-current			$	9,704

The table below provides information regarding supplemental cash flows:

			Three Months Ended
			March 31,
			2022						2021
			(amounts in thousands)
Supplemental Cash Flow Information:
Cash paid for amounts included in the measurement of operating lease liabilities			$	1,383					$	1,637
Right-of-use assets acquired under operating lease			$	—					$	—

The components of lease expense are as follows:

			Three Months Ended
			March 31,
			2022						2021
			(amounts in thousands)
Amounts Included in Condensed Consolidated Statements of Operations:
Operating lease expense			$	802					$	914
Short-term lease expense			$	1,144					$	849
Variable and other lease costs			$	757					$	468

As of March 31, 2022, the Company does not have any material operating leases which have not yet commenced. The Company has an immaterial amount of finance lease contracts related to other equipment rentals which are not included in the above disclosures.

Fair Value Measurements

			March 31, 2022						December 31, 2021
			(amounts in thousands)
Financial Assets:
(Level 1)
Deferred compensation asset			$	1,305					$	1,398
Financial Liabilities:
(Level 1)
Deferred compensation liability			$	2,450					$	2,457

The carrying amounts and estimated fair value of the Company’s significant financial instruments that were not measured at fair value are as follows:

			March 31, 2022												December 31, 2021
			Carrying Amount						Fair Value						Carrying Amount						Fair Value
									(amounts in thousands)
Financial Liabilities:
(Level 2)
Note Payable			$	—					$	—					$	2,426					$	2,426
Senior Secured Asset-Based Loan			$	51,501					$	51,501					$	9,200					$	9,200
Term Loan, net			$	173,875					$	174,387					$	174,312					$	174,845
Earnout Liability (WSG)			$	15,000					$	15,000					$	15,000					$	15,000
Earnout Liability (Selected)			$	1,500					$	1,500					$	1,500					$	1,500

See discussion of credit losses and allowance for doubtful accounts in Note 2 - Summary of Significant Accounting Policies. Overall, based on the large number of customers in differing geographic areas, primarily throughout the United States and its territories, the Company believes the concentration of credit risk is limited.

The following table summarizes restricted stock awards and performance stock awards activity issued under the 2017 Plan and the 2020 Plan (Plans) for the three months ended March 31, 2022:

			Restricted Stock Awards												Performance Stock Awards
			Number of Shares						Weighted Average Grant Date Fair Value						Number of Target Shares						Weighted Average Grant Date Fair Value
Unvested restricted stock awards, January 1, 2022			1,039,455						$	9.75					522,166						$	8.64
Granted			215,006						$	21.67					154,952						$	18.99
Vested			(481,231)						$	8.30					(170,278)						$	7.03
Forfeited			—						$	—					—						$	—
Unvested restricted stock awards, March 31, 2022			773,230						$	13.97					506,840						$	12.34

Awards granted to non-employee directors under the 2017 Plan, prior to the adoption of the 2020 Plan, vest in three equal installments on the first, second and third anniversaries of the grant date, while restricted shares granted under the 2020 Plan on and subsequent to June 2020 will vest on the first anniversary of such grant date, or earlier subject to retirement eligibility. In addition, effective in the three months ended June 30, 2020, the Company implemented modified guidelines that provide for accelerated vesting of restricted stock grants on the last date of service when a retirement-eligible director retires.

●    Nurse and Allied Staffing – Nurse and Allied Staffing provides traditional staffing, recruiting, and value-added total talent solutions including: temporary and permanent placement of travel and local nurse and allied professionals, managed services programs (MSP) services, education healthcare services, in-home care services, and outsourcing services. In addition, Nurse and Allied Staffing provides retained search services for healthcare professionals, as well as contingent search and recruitment process outsourcing services. Its clients include: public and private acute-care and non-acute care hospitals, government facilities, local and national healthcare plans, managed care providers, public schools and charter schools, outpatient clinics, ambulatory care facilities, physician practice groups, and many other healthcare providers throughout the United States.

●    Physician Staffing – Physician Staffing provides physicians in many specialties, as well as certified registered nurse anesthetists, nurse practitioners, and physician assistants as independent contractors on temporary assignments

Information on operating segments and a reconciliation to income from operations for the periods indicated are as follows:

			Three Months Ended
			March 31,
			2022						2021
			(amounts in thousands)
Revenue from services:
Nurse and Allied Staffing			$	765,580					$	313,008
Physician Staffing			23,152						16,233
			$	788,732					$	329,241
Contribution income:
Nurse and Allied Staffing			$	110,101					$	37,417
Physician Staffing			1,765						1,428
			111,866						38,845
Corporate overhead (a)			16,254						14,211
Depreciation and amortization			2,719						2,253
Acquisition and integration-related costs			40						—
Restructuring costs			480						1,238
Impairment charges			1,741						149
Income from operations			$	90,632					$	20,994

During the fourth quarter of 2021, the Company concluded that it was more likely than not that a benefit from a substantial portion of its United States federal and state deferred tax assets would be realized and released the majority of its valuation allowance. As of March 31, 2022 and December 31, 2021, the Company had an immaterial amount of valuation allowance on its deferred tax assets related to state net operating losses not expected to be realized before expiration.

On October 28, 2021, the FASB issued ASU No. 2021-08, Business Combinations (Topic 805): Accounting for Contract Assets and Contract Liabilities from Contracts with Customers, which requires contract assets and contract liabilities such as deferred revenue acquired in a business combination to be recognized and measured by the acquirer on the acquisition date in accordance with ASC 606, Revenue from Contracts with Customers. Generally, this amendment will result in the acquirer recognizing contract assets and contract liabilities at the same amounts recorded by the acquiree. Historically such amounts were recognized by the acquirer at fair value in acquisition accounting. This guidance is effective for fiscal years beginning after December 15, 2022, including interim periods within those fiscal years. The amendments should be applied prospectively to business combinations occurring on or after the effective date of the amendments. Early adoption is permitted, including adoption in an interim period. The Company is currently in the process of evaluating this standard and expects to adopt this standard in its first quarter of 2023.

Our workforce solutions include managed service programs (MSPs), recruitment process outsourcing (RPO), project management, and other outsourcing and consultative services as described in Item 1. “Business” in our 2021 Form 10-K. By utilizing the solutions we offer, customers are able to better plan their personnel needs, optimize their talent acquisition and management processes, strategically flex and balance their workforce, have access to quality healthcare personnel, and provide continuity of care for improved patient outcomes. We have a history of investing in diversity, equality, and inclusion as a key component of the organization’s overall corporate social responsibility program, closely aligned with our core values to create a better future for our people, communities, and our stockholders.

●    Nurse and Allied Staffing – Nurse and Allied Staffing represented approximately 97% of our total revenue in the first quarter of 2022. The Nurse and Allied Staffing segment provides workforce solutions and traditional staffing, including temporary and permanent placement of travel nurses and allied professionals, as well as per diem and contract nurses and allied personnel. We also provide clinical and non-clinical professionals on short-term and long-term assignments to clients such as local and national healthcare plans, managed care providers, public and charter schools, correctional facilities, skilled nursing facilities, and other non-acute settings. In addition, Nurse and Allied Staffing provides retained search services for healthcare professionals, as well as contingent search and recruitment process outsourcing services. We provide flexible workforce solutions to our healthcare customers through diversified offerings designed to meet their unique needs, including: MSP, RPO, and consulting services.

●    Physician Staffing – Physician Staffing represented approximately 3% of our total revenue in the first quarter of 2022. Physician Staffing provides physicians in many specialties, as well as certified registered nurse anesthetists, nurse practitioners, and physician assistants as independent contractors on temporary assignments throughout the United States.

Business Segment			Business Measurement
Nurse and Allied Staffing			FTEs represent the average number of Nurse and Allied Staffing contract personnel on a full-time equivalent basis.
			Average revenue per FTE per day is calculated by dividing the Nurse and Allied Staffing revenue, excluding permanent placement, per FTE by the number of days worked in the respective periods.
Physician Staffing			Days filled is calculated by dividing the total hours invoiced during the period, including an estimate for the impact of accrued revenue, by eight hours.
			Revenue per day filled is calculated by dividing revenue as reported by days filled for the period presented.

The following table summarizes, for the periods indicated, selected condensed consolidated statements of operations data expressed as a percentage of revenue. Our historical results of operations are not necessarily indicative of future operating results. 

			Three Months Ended
			March 31,
			2022						2021
Revenue from services			100.0		%				100.0		%
Direct operating expenses			77.8						78.3
Selling, general and administrative expenses			9.7						14.1
Bad debt expense			0.3						0.1
Depreciation and amortization			0.4						0.7
Restructuring costs			0.1						0.4
Impairment charges			0.2						—
Income from operations			11.5						6.4
Interest expense			0.4						0.2
Income before income taxes			11.1						6.2
Income tax expense			3.2						0.3
Net income attributable to common stockholders			7.9		%				5.9		%

Comparison of Results for the Three Months Ended March 31, 2022 compared to the Three Months Ended March 31, 2021

			Three Months Ended March 31,
															Increase (Decrease)						Increase (Decrease)
			2022						2021						$						%
			(Amounts in thousands)
Revenue from services			$	788,732					$	329,241					$	459,491					139.6		%
Direct operating expenses			613,938						257,776						356,162						138.2		%
Selling, general and administrative expenses			76,813						46,327						30,486						65.8		%
Bad debt expense			2,369						504						1,865						370.0		%
Depreciation and amortization			2,719						2,253						466						20.7		%
Acquisition and integration-related costs			40						—						40						100.0		%
Restructuring costs			480						1,238						(758)						(61.2)		%
Impairment charges			1,741						149						1,592						NM
Income from operations			90,632						20,994						69,638						331.7		%
Interest expense			3,521						671						2,850						424.7		%
Other income, net			(8)						(37)						29						78.4		%
Income before income taxes			87,119						20,360						66,759						327.9		%
Income tax expense			25,136						912						24,224						NM
Net income attributable to common stockholders			$	61,983					$	19,448					$	42,535					218.7		%

Revenue from services increased 139.6% to $788.7 million for the three months ended March 31, 2022, as compared to $329.2 million for the three months ended March 31, 2021, due to strong performance in both our Nurse and Allied and Physician Staffing segments, both resulting from an increase in volume, and higher bill rates in Nurse and Allied. The increase in bill rates is a result of the continued high level of demand for our services due to the overall tight supply for clinicians and professionals. See further discussion in Segment Results.

Selling, general and administrative expenses increased 65.8% to $76.8 million for the three months ended March 31, 2022, as compared to $46.3 million for the three months ended March 31, 2021, primarily due to increases in compensation and benefit expense, as well as marketing and consulting expense and computer subscription fees, partially offset by decreases in legal expenses. As a percentage of total revenue, selling, general and administrative expenses decreased to 9.7% for the three months ended March 31, 2022, as compared to 14.1% for the three months ended March 31, 2021.

			Three Months Ended
			March 31,
			2022						2021
			(amounts in thousands)
Revenue from services:
Nurse and Allied Staffing			$	765,580					$	313,008
Physician Staffing			23,152						16,233
			$	788,732					$	329,241
Contribution income:
Nurse and Allied Staffing			$	110,101					$	37,417
Physician Staffing			1,765						1,428
			111,866						38,845
Corporate overhead			16,254						14,211
Depreciation and amortization			2,719						2,253
Acquisition and integration-related costs			40						—
Restructuring costs			480						1,238
Impairment charges			1,741						149
Income from operations			$	90,632					$	20,994

Certain statistical data for our business segments for the periods indicated are as follows:

			Three Months Ended
			March 31,						March 31,												Percent
			2022						2021						Change						Change
Nurse and Allied Staffing statistical data:
FTEs			13,454						6,614						6,840						103.4		%
Average Nurse and Allied Staffing revenue per FTE per day			$	628					$	522					106						20.3		%
Physician Staffing statistical data:
Days filled			13,068						9,469						3,599						38.0		%
Revenue per day filled			$	1,772					$	1,714					58						3.4		%