AMN Healthcare Services (AMN) Q4 2025 earnings summary

Executive summary

• Q4 2025 revenue reached $748 million, up 2% year-over-year and 18% sequentially, driven by strong nurse and allied staffing and significant labor disruption revenue of $124 million, nearly double the prior year.

• Full year 2025 revenue was $2.73 billion, with Adjusted EBITDA of $234 million; debt was reduced by $285 million.

• Labor disruption events were a major revenue driver in Q4 and are expected to contribute $600 million in Q1 2026.

• The company invested in technology, automation, and AI to enhance operational agility and support both core and strike-related business.

• Travel nurse volume increased 5% sequentially, with allied business also showing sequential growth.

Financial highlights

• Q4 consolidated gross margin was 26.1%, down 370 bps year-over-year, with labor disruption revenue reducing margin by 130 bps.

• Adjusted EBITDA for Q4 was $54 million (7.3% margin), down 27% year-over-year; full year adjusted EBITDA was $234 million (8.6% margin), down 31%.

• Q4 net loss was $8 million, compared to a $188 million loss in the prior year (which included a goodwill impairment); full year net loss was $96 million.

• Adjusted EPS for Q4 was $0.22, down 70% year-over-year; full year Adjusted EPS was $1.36.

• Operating cash flow for Q4 was $76 million; year-end cash was $34 million, with total debt at $775 million and net leverage ratio of 3.3x.

Outlook and guidance

• Q1 2026 revenue guidance is $1.225–$1.24 billion, including $600 million from labor disruption.

• Gross margin expected at 23.5%–24%, with labor disruption reducing margin by ~300 bps.

• Adjusted EBITDA margin projected at 9.7%–10.2%; SG&A expected at 14.5%–15% of revenue, including $40 million in strike-related costs.

• Nurse and Allied Solutions revenue expected to be up 137–139% year-over-year; Physician and Leadership Solutions down 5–8%; Technology and Workforce Solutions down 16–18%.

• Long-term organic revenue growth targeted at 4%–6% annually, with 10%–15% Adjusted EBITDA growth post-2026.