AMN Healthcare Services (AMN) Q4 2024 earnings summary

Executive summary

• Q4 2024 revenue reached $735 million, exceeding guidance by $30 million, but was down 10% year-over-year and up 7% sequentially; full-year revenue was $3 billion, down 21% year-over-year.

• Q4 adjusted EBITDA was $75 million, above expectations but down 28% year-over-year; full-year adjusted EBITDA was $341 million, a 41% decrease.

• Q4 net loss was $188 million, or $4.90 per share, driven by a $222 million non-cash goodwill impairment; full-year net loss was $147 million, or $3.85 per share.

• The company repaid $75 million in revolver debt in Q4 and $250 million for the full year; year-end cash was $11 million and total debt $1.06 billion.

• Q4 results exceeded expectations due to higher labor disruption and core staffing revenue, with $62 million in labor disruption revenue, $22 million above guidance.

Financial highlights

• Q4 gross margin was 29.8%, down 210 basis points year-over-year and 120 basis points sequentially; full-year gross margin was 30.8%, down from 33.0%.

• Q4 adjusted EBITDA margin was 10.2%, down 250 basis points year-over-year; full-year margin was 11.4%.

• Q4 SG&A was $159 million (21.6% of revenue), down from $185 million (22.7%) last year; full-year SG&A was $632 million (21.2% of revenue).

• Q4 net loss margin was 25.5%; full-year net loss margin was 4.9%.

• Full-year GAAP loss per share was $3.85; adjusted EPS was $3.31, down from $8.21 in the prior year.

Outlook and guidance

• Q1 2025 revenue guidance is $660–680 million, down 17–20% year-over-year.

• Q1 gross margin expected between 28.1% and 28.6%; adjusted EBITDA margin projected at 7.7–8.2%.

• Nurse and Allied Solutions revenue expected to decline 22–25% year-over-year; Physician and Leadership Solutions down 9–11%; Technology and Workforce Solutions down 8–10%.

• Guidance includes $24 million in labor disruption revenue for Q1 2025.

• Full-year 2025 capital expenditures expected to be $40–50 million.