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Document and Entity Information - USD ($)	12 Months Ended
Document and Entity Information - USD ($)	Dec. 31, 2013	Feb. 28, 2014	Jun. 28, 2013
Document Documentand Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2013
Document Fiscal Year Focus	2013
Document Fiscal Period Focus	FY
Trading Symbol	CCRN
Entity Registrant Name	CROSS COUNTRY HEALTHCARE INC
Entity Central Index Key	0001141103
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	No
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Filer Category	Accelerated Filer
Entity Common Stock, Shares Outstanding		31,085,289
Entity Public Float			$ 155,431,281

CONSOLIDATED BALANCE SHEETS - USD ($)	Dec. 31, 2013	Dec. 31, 2012
Current assets:
Cash and cash equivalents	$ 8,054,613	$ 10,462,692
Accounts receivable, less allowance for doubtful accounts of $1,650,973 in 2013 and $1,841,136 in 2012	60,750,181	62,674,176
Deferred tax assets	0	5,983,483
Income taxes receivable	537,912	585,709
Prepaid expenses	6,162,730	5,580,473
Insurance recovery receivable	3,886,285	5,483,889
Indemnity escrow receivable	3,750,000	0
Assets held for sale	0	46,970,964
Other current assets	793,197	1,049,275
Total current assets	83,934,918	138,790,661
Property and equipment, net of accumulated depreciation of $44,778,602 in 2013 and $41,917,771 in 2012	6,170,499	8,234,812
Trade Names, net	42,301,331	48,701,331
Goodwill	77,265,907	62,712,109
Other identifiable intangible assets, net	26,197,905	14,491,982
Debt issuance costs, net of accumulated amortization of $221,588 in 2013 and $3,594,511 in 2012	463,594	1,609,954
Non-current deferred tax assets	0	22,760,052
Non-current insurance recovery receivable	10,913,527	8,210,139
Non-current security deposits	996,885	412,515
Total assets	248,244,566	305,923,555
Current liabilities:
Accounts payable and accrued expenses	10,272,039	10,129,605
Accrued compensation and benefits	19,148,312	21,650,233
Current portion of long-term debt and capital lease obligations	8,483,088	33,682,348
Sales tax payable	2,403,994	1,545,062
Liabilities related to assets held for sale	0	2,834,516
Deferred tax liabilities	534,827	0
Other current liabilities	4,062,875	2,744,341
Total current liabilities	44,905,135	72,586,105
Long-term debt and capital lease obligations	93,231	176,309
Non-current deferred tax liabilities	16,849,051	0
Long-term accrued claims	18,303,096	16,347,342
Long-term unrecognized tax benefits	4,012,524	4,655,720
Other long-term liabilities	3,414,949	3,035,290
Total liabilities	87,577,986	96,800,766
Commitments and contingencies
Stockholders' equity:
Common stock—$0.0001 par value; 100,000,000 shares authorized; 31,085,289 and 30,902,314 shares issued and outstanding at December 31, 2013 and 2012, respectively	3,109	3,090
Additional paid-in capital	246,324,580	244,924,076
Accumulated other comprehensive loss	(970,113)	(3,082,704)
Accumulated deficit	(84,690,996)	(32,721,673)
Total stockholders' equity	160,666,580	209,122,789
Total liabilities and stockholders' equity	$ 248,244,566	$ 305,923,555

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($)	Dec. 31, 2013	Dec. 31, 2012
Statement of Financial Position [Abstract]
Accounts receivable, allowance for doubtful accounts	$ 1,650,973	$ 1,841,136
Property and equipment, accumulated depreciation and amortization	44,778,602	41,917,771
Debt issuance costs, accumulated amortization	$ 221,588	$ 3,594,511
Common stock, par value (usd per share)	$ 0.0001	$ 0.0001
Common stock, shares authorized	100,000,000	100,000,000
Common stock, shares issued	31,085,289	30,902,314
Common stock, shares outstanding	31,085,289	30,902,314

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($)	12 Months Ended
CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($)	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Income Statement [Abstract]
Revenue from services	$ 438,310,716	$ 442,635,146	$ 439,377,460
Operating expenses:
Direct operating expenses	324,850,878	331,050,041	319,988,729
Selling, general and administrative expenses	106,116,849	109,416,687	104,544,116
Bad debt expense	1,078,195	786,107	574,457
Depreciation	3,885,688	4,904,845	5,965,002
Amortization	2,294,077	2,263,556	2,393,722
Acquisition costs	473,488	0	0
Restructuring costs	483,578	0	0
Legal settlement charge	750,000	0	0
Impairment charges	6,400,000	18,732,407	0
Total operating expenses	446,332,753	467,153,643	433,466,026
(Loss) income from continuing operations	(8,022,037)	(24,518,497)	5,911,434
Other expenses (income):
Foreign exchange gain	(132,058)	(62,231)	(263,967)
Interest expense	849,149	2,341,299	2,856,043
Loss on early extinguishment and modification of debt	1,419,010	81,503	0
Other (income) expense, net	(118,675)	15,790	(297,728)
(Loss) income from continuing operations before income taxes	(10,039,463)	(26,894,858)	3,617,086
Income tax expense (benefit)	44,210,548	(6,149,889)	2,069,447
(Loss) income from continuing operations	(54,250,011)	(20,744,969)	1,547,639
Income (loss) from discontinued operations, net of income taxes	2,280,688	(21,476,528)	2,550,210
Net (loss) income	$ (51,969,323)	$ (42,221,497)	$ 4,097,849
Basic (loss) income per common share from:
Continuing operations (usd per share)	$ (1.75)	$ (0.67)	$ 0.05
Discontinued operations (usd per share)	0.07	(0.70)	0.08
Net (loss) income (usd per share)	(1.68)	(1.37)	0.13
Diluted (loss) income per common share from:
Continuing operations (usd per share)	(1.75)	(0.67)	0.05
Discontinued operations (usd per share)	0.07	(0.70)	0.08
Net (loss) income (usd per share)	$ (1.68)	$ (1.37)	$ 0.13
Weighted average common shares outstanding—basic (shares)	31,009,218	30,842,723	31,146,165
Weighted average common shares outstanding—diluted (shares)	31,009,218	30,842,723	31,192,016

CONSOLIDATED STATEMENTS OF COMPREHENSIVE (LOSS) INCOME - USD ($)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Statement of Comprehensive Income [Abstract]
Net (loss) income	$ (51,969,323)	$ (42,221,497)	$ 4,097,849
Other comprehensive income (loss), before tax:
Foreign currency translation adjustments	(386,094)	267,809	(939,000)
Reclassification of currency translation adjustments related to sale of clinical trial services business (see Note 2 - Summary of Significant Accounting Policies)	2,336,201	0	0
Write-down of marketable securities	0	38,515	0
Net change in fair value of marketable securities	0	(915)	(55,815)
Other comprehensive income (loss), before tax	1,950,107	305,409	(994,815)
Income tax (benefit) expense related to items of other comprehensive (loss) income	(162,484)	14,951	(22,384)
Other comprehensive income (loss), net of tax	2,112,591	290,458	(972,431)
Comprehensive (loss) income	$ (49,856,732)	$ (41,931,039)	$ 3,125,418

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($)	Total	Common Stock	Additional Paid-In Capital	Accumulated Other Total Comprehensive Income (Loss)	(Accumulated Deficit) Retained Earnings
Beginning Balance (in shares) at Dec. 31, 2010		31,102,682
Beginning Balance at Dec. 31, 2010	$ 246,008,876	$ 3,110	$ 243,004,522	$ (2,400,731)	$ 5,401,975
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Repurchase of stock for tax withholdings (in shares)		(31,263)
Repurchase of stock for tax withholdings	(221,596)	$ (3)	(221,593)
Vesting of restricted stock (in shares)		167,647
Vesting of restricted stock	0	$ 17	(17)
Tax deficit of share-based compensation	(272,828)		(272,828)
Equity compensation	$ 2,895,012		2,895,012
Stock repurchase and retirement (in shares)	(427,043)	(427,043)
Stock repurchase and retirement	$ (2,234,585)	$ (43)	(2,234,542)
Foreign currency translation adjustment	(939,000)			(939,000)
Reclassification of currency translation adjustments related to sale of clinical trial services business	0
Net change in fair value of marketable securities	(33,431)			(33,431)
Net income (loss)	4,097,849				4,097,849
Ending Balance (in shares) at Dec. 31, 2011		30,812,023
Ending Balance at Dec. 31, 2011	249,300,297	$ 3,081	243,170,554	(3,373,162)	9,499,824
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Vesting of restricted stock (in shares)		161,944
Vesting of restricted stock	(152,430)	$ 16	(152,446)
Tax deficit of share-based compensation	(314,314)		(314,314)
Equity compensation	$ 2,594,523		2,594,523
Stock repurchase and retirement (in shares)	(71,653)	(71,653)
Stock repurchase and retirement	$ (374,248)	$ (7)	(374,241)
Foreign currency translation adjustment	267,809			267,809
Reclassification of currency translation adjustments related to sale of clinical trial services business	0
Net change in fair value of marketable securities	22,649			22,649
Net income (loss)	(42,221,497)				(42,221,497)
Ending Balance (in shares) at Dec. 31, 2012		30,902,314
Ending Balance at Dec. 31, 2012	$ 209,122,789	$ 3,090	244,924,076	(3,082,704)	(32,721,673)
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period	14,000	2,362
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options		$ 0
Vesting of restricted stock (in shares)		180,613
Vesting of restricted stock	$ (300,532)	$ 19	(300,551)
Tax deficit of share-based compensation	(398,886)		(398,886)
Equity compensation	2,099,941		2,099,941
Foreign currency translation adjustment, net of deferred taxes	(223,610)			(223,610)
Foreign currency translation adjustment	(386,094)
Reclassification of currency translation adjustments related to sale of clinical trial services business	2,336,201			2,336,201
Net income (loss)	(51,969,323)
Ending Balance (in shares) at Dec. 31, 2013		31,085,289
Ending Balance at Dec. 31, 2013	$ 160,666,580	$ 3,109	$ 246,324,580	$ (970,113)	$ (84,690,996)

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	12 Months Ended
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Operating activities
Net (loss) income	$ (51,969,323)	$ (42,221,497)	$ 4,097,849
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Bad debt expense	1,082,920	870,715	578,805
Depreciation	3,885,688	5,566,184	6,790,677
Amortization	2,294,077	3,381,743	3,493,408
Impairment charges	6,400,000	54,132,407	0
Loss on early extinguishment and modification of debt	1,419,010	81,503	0
Deferred income tax expense (benefit)	45,900,296	(18,520,360)	3,052,909
Amortization of debt issuance costs	233,256	605,558	913,509
Equity compensation	2,099,941	2,594,523	2,895,012
Gain on sale of clinical trial services business	(3,968,714)	0	0
Debt financing costs	0	279,005	0
Other noncash costs	11,890	543,296	22,832
Changes in operating assets and liabilities:
Accounts receivable	2,036,387	(4,255,411)	(7,973,162)
Prepaid expenses and other assets	(1,847,999)	(444,351)	1,878,943
Income taxes	(138,401)	1,748,750	4,310,626
Accounts payable and accrued expenses	(319,856)	4,128,000	(1,327,040)
Other liabilities	1,539,840	1,656,065	(438,168)
Net cash provided by operating activities	8,659,012	10,146,130	18,296,200
Investing activities
Proceeds from sale of business segment, net of cash sold and transaction costs	45,655,319	0	0
Acquisition of assets of On Assignment, Inc.	(28,700,000)	0	0
Purchases of property and equipment	(1,750,663)	(2,218,877)	(3,998,129)
Liquidation of foreign cash investments	0	2,652,335	0
Other investing activities	0	(258,832)	(197,907)
Net cash provided by (used in) investing activities	15,204,656	174,626	(4,196,036)
Financing activities
Debt issuance costs	(505,905)	(1,377,410)	0
Repurchase of stock for tax withholdings	(300,531)	(152,430)	(221,596)
Stock repurchase and retirement	0	(374,248)	(2,234,585)
Proceeds from borrowing on term loan	0	25,000,000	0
Principal payments on term loan	(23,125,000)	(43,326,056)	(14,088,284)
Borrowings under revolving credit facility	0	26,900,000	2,500,000
Repayments on revolving credit facility	(10,000,000)	(16,900,000)	0
Borrowings under asset-based revolving credit facility	63,444,175	0	0
Repayments on asset-based revolving credit facility	(55,044,175)	0	0
Repayments of capital lease obligations and note payable	(529,884)	(352,776)	(191,755)
Net cash used in financing activities	(26,061,320)	(10,582,920)	(14,236,220)
Effect of exchange rate changes on cash	(210,427)	76,821	(172,573)
Change in cash and cash equivalents	(2,408,079)	(185,343)	(308,629)
Cash and cash equivalents at beginning of year	10,462,692	10,648,035	10,956,664
Cash and cash equivalents at end of year	8,054,613	10,462,692	10,648,035
Supplemental disclosure of noncash investing and financing activities:
Equipment purchased through capital lease obligations	0	302,316	312,562
Insurance premium financing	0	189,654	0
Supplemental disclosure of cash flow information:
Interest paid	621,969	1,467,233	2,134,575
Income taxes paid	1,164,472	1,681,992	1,559,424
Income tax refunds	$ (322,512)	$ (564,430)	$ (4,792,495)

Organization and Basis of Presentation	12 Months Ended
Organization and Basis of Presentation	Dec. 31, 2013
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Basis of Presentation	Organization and Basis of Presentation On July 29, 1999, Cross Country Staffing, Inc. (CCS), a Delaware corporation, was established through an acquisition of certain assets and liabilities of Cross Country Staffing, a Delaware general partnership (the Partnership). The Partnership was engaged in the business of providing travel nurse and allied health staffing services to healthcare providers primarily on a contract basis. Subsequent acquisitions and dispositions were made and, as of December 31, 2013, Cross Country Healthcare, Inc. (the Company) has become a leading provider of nurse and allied staffing services in the United States, a national provider of multi-specialty locum tenens (temporary physician staffing) services, as well as a provider of other human capital management services focused on healthcare. During the first quarter of 2013, the Company completed the sale of its clinical trial services business segment as a result of an extensive review of its business and the changing competitive landscape in the pharmaceutical outsourcing industry. As of December 31, 2012, this segment was classified as a disposal group held for sale, and the results of its operations have been classified as discontinued operations for all periods presented. See Note 3 - Assets Held for Sale and Discontinued Operations. In the fourth quarter of 2013, the Company acquired the operating assets of On Assignment, Inc.’s Allied Healthcare Staffing division, which results have been included with the Company's nurse and allied staffing business segment. See Note 5 - Acquisitions. The consolidated financial statements include the accounts of the Company and its wholly-owned direct and indirect subsidiaries. All material intercompany transactions and balances have been eliminated in consolidation.

- Definition

The entire disclosure for organization, consolidation and basis of presentation of financial statements disclosure.

+ References

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+ Details

Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2013

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

Use of Estimates

The preparation of consolidated financial statements, in conformity with accounting principles generally accepted in the United States, requires management to make estimates and assumptions that affect the reported amounts in the consolidated financial statements and accompanying notes. Estimates are used for, but not limited to, the valuation of accounts receivable, goodwill and intangible assets, other long-lived assets, share-based compensation, accruals for health, workers’ compensation, professional liability claims, valuation of our deferred tax assets and purchase price allocation (See Note 7 - Balance Sheet Details), legal contingencies, income taxes and sales and other non-income tax liabilities. Accrued insurance claims and reserves include estimated settlements from known claims and actuarial estimates for claims incurred but not reported. Actual results could differ from those estimates.

Cash and Cash Equivalents

The Company considers all investments with original maturities of three months or less to be cash and cash equivalents. The Company invests its excess cash in highly rated overnight funds and other highly rated liquid accounts. The Company is exposed to credit risk associated with these investments. The Company minimizes its credit risk relating to these positions by monitoring the financial condition of the financial institutions involved and by primarily conducting business with large, well established financial institutions and diversifying its counterparties. The Company does not currently anticipate nonperformance by any of its significant counterparties.

Interest income on cash and cash equivalents is included in other (income) expense , net, on the Company’s consolidated statements of operations.

Accounts Receivable and Concentration of Credit Risk

Accounts receivable potentially subject the Company to concentrations of credit risk. The Company’s customers are primarily healthcare providers, and accounts receivable represent amounts due from them. The Company generally does not require collateral and mitigates its credit risk by performing credit evaluations and monitoring at-risk accounts. The allowance for doubtful accounts represents the Company’s estimate of uncollectible receivables based on a review of specific accounts and the Company’s historical collection experience. The Company writes off specific accounts based on an ongoing review of collectability as well as past experience with the customer. The Company’s contract terms typically require payment between 15 to 60 days from the date services are provided and are considered past due based on the particular negotiated contract terms. The majority of the Company's business activity is with hospitals located throughout the United States. No single customer accounted for more than 10% of the Company’s accounts receivable balance as of December 31, 2013 and 2012, or revenue for the years ended December 31, 2013, 2012 and 2011.

Prepaid Rent and Deposits

The Company leases apartments for eligible field employees under short-term agreements (typically three to six months), which generally coincide with each employee’s staffing contract. Costs relating to these leases are included in direct operating expenses on the accompanying consolidated statements of operations. As a condition of these agreements, the Company may place security deposits on the leased apartments. Deposits on field employees’ apartments related to these short-term agreements are included in other current assets on the accompanying consolidated balance sheets.

Property and Equipment

Property and equipment are stated at cost, less accumulated depreciation. Depreciation is determined on a straight-line basis over the estimated useful lives of the assets, which generally range from three to seven years. Leasehold improvements are depreciated over the shorter of their estimated useful life or the term of the individual lease. Depreciation related to assets recorded under capital lease obligations is included in depreciation expense on the consolidated statements of operations and calculated using the straight-line method over the term of the related capital lease.

Certain software development costs have been capitalized in accordance with the provisions of the Intangibles-Goodwill and Other/Internal-Use Software Topic of the Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC). Such costs include charges for consulting services and costs for personnel associated with programming, coding and testing such software. Amortization of capitalized software costs begins when the software is ready for use and is included in depreciation expense in the accompanying consolidated statements of operations. Software development costs are being amortized using the straight-line method over three to five years.

Business Combinations

In accordance with ASC 805, Topic 805-Business Combinations,assets acquired and liabilities assumed are recorded at their fair values on the date of a business combination. Our consolidated financial statements and results of operations reflect an acquired business from the completion date of an acquisition.

Goodwill, Trade Names and Other Identifiable Intangible Assets

Goodwill represents the excess of purchase price and related costs over the fair value assigned to the net tangible and identifiable intangible assets of businesses acquired. Other identifiable intangible assets with definite lives are being amortized using the straight-line method over their estimated useful lives which range from 5 to 16 years. Goodwill and certain intangible assets with indefinite lives are not amortized. Instead, in accordance with the Intangibles-Goodwill and Other Topic of the FASB ASC, these assets are reviewed for impairment annually at December 31, and whenever circumstances occur indicating potential impairment, with any related losses recognized in earnings.

If, after assessing the totality of events and circumstances, the Company determines that it is more likely than not that the fair value of the reporting unit is greater than its carrying amount, the quantitative impairment test is unnecessary. The performance of the quantitative impairment test involves a two-step process. The first step in its annual impairment assessment requires the Company to determine the fair value of each of its reporting units and compare it to the reporting unit’s carrying amount. The Company determines its reporting units by identifying components of its operating segments that constitute a business for which discrete financial information is available and management regularly reviews the operating results of that component. The Company has four reporting units that it reviews for impairment: 1) nurse and allied staffing, 2) physician staffing, 3) retained search and 4) education and training.

In its impairment analysis, the Company determines the fair value of its reporting units based on a combination of inputs including Level 3 inputs such as discounted cash flows which are not observable from the market, directly or indirectly, as well as inputs such as pricing multiples from publicly traded guideline companies and the market capitalization of the Company, including an estimated premium an investor would pay for a controlling interest. If the reporting unit’s carrying value exceeds its fair value, the Company then determines the amount of the impairment charge, if any. The Company recognizes an impairment charge if the carrying value of the reporting unit’s goodwill exceeds its implied fair value. Management considers historical experience and all available information at the time the fair values of its reporting units are estimated. However, fair values that could be realized in an actual transaction may differ from those used to evaluate the potential impairment of goodwill.

Long-lived assets and identifiable intangible assets with definite lives are evaluated for impairment in accordance with the Property, Plant, and Equipment Topic of the FASB ASC. In accordance with this Topic, long-lived assets and definite lived intangible assets are reviewed for impairment whenever events or changes in circumstances indicate the carrying amount may not be recoverable.

Recoverability of long-lived assets is measured by a comparison of the carrying amount of the asset group to the future undiscounted net cash flow that is expected to be generated by those assets. If such assets are considered to be impaired, the impairment charge recognized is the amount by which the carrying amounts of the assets exceeds the fair value of the assets. See Note 4 – Goodwill, Trade Names and Other Identifiable Intangible Assets for further information.

Debt Issuance Costs

Deferred costs related to the issuance of the Company’s senior secured revolving credit facility (see Note 8 – Long-term Debt) in 2013 and 2012 have been capitalized and amortized using the straight line method, over the term of the related credit agreement.

Deferred costs related to the Company’s prior senior secured term loan facility were capitalized and amortized using the effective interest method.

Sales & Other State Non-income Tax Liabilities

The Company accrues sales and other state non-income tax liabilities based on the Company’s best estimate of its probable liability utilizing currently available information and interpretation of relevant tax regulations. Given the nature of the Company’s business, significant subjectivity exists as to both whether sales and other state non-income taxes can be assessed on its activity and how the sales tax will ultimately be measured by the relevant jurisdictions. The Company makes a determination for each reporting period whether the estimates for sales and other non-income taxes in certain states should be revised.

Reserves for Claims

The Company provides workers’ compensation insurance coverage, professional liability coverage and health care benefits for eligible employees. The Company records its estimate of the ultimate cost of, and reserves for workers compensation and professional liability benefits based on actuarial models prepared or reviewed by an independent actuary using the Company’s loss history as well as industry statistics. The health care insurance accrual is for estimated claims that have occurred but have not been reported and is based on the Company’s historical claim submission patterns. Furthermore, in determining its reserves, the Company includes reserves for estimated claims incurred but not reported as well as unfavorable claims development (IBNR).

Other Expenses/Insurance Costs Topic of the FASB ASC (ASC 720), codified previously issued authoritative accounting guidance in the area of insurance contracts and related activity thereto. ASC 720 concluded that, under circumstances such as in the Company’s insured professional liability and worker’s compensation policies, since a right of legal offset does not exist due to the fact that there are three parties to an incurred claim, (the insured, the insurer and the claimant), the related liability to the claimant should be classified separately on a gross basis with a separate related receivable from insurer recognized as being due from insurance carriers. Accordingly, the Company’s consolidated balance sheets as of December 31, 2013 and 2012 reflect the related short-term liabilities in accrued compensation and benefits and the related long-term liabilities as long-term accrued claims, and the short-term receivable portion as insurance recovery receivable and the long-term portion as non-current insurance recovery receivable. See Note 7 – Balance Sheet Details. The ultimate cost of workers’ compensation, professional liability and health insurance claims will depend on actual amounts incurred to settle those claims and may differ from the amounts reserved by the Company for those claims.

Workers’ compensation benefits are provided under a partially self-insured plan. The Company has letters of credit to guarantee payments of claims. At December 31, 2013 and 2012, respectively, the Company had outstanding approximately $6,399,000 and $6,899,000 standby letters of credit as collateral to secure the self-insured portion of this plan.

The Company has occurrence-based primary professional liability policies that provide each working professional in its nurse and allied healthcare business with coverage. In addition, the Company has an occurrence-based professional liability policy for its independent contractor physicians, Certified Registered Nurse Anesthetists (CRNAs) and allied health professionals which is insured by a wholly-owned subsidiary (the Captive). Under the terms of the Captive’s reinsurance policy there is a requirement to guarantee the payment of claims to its insured party’s primary medical malpractice insurance carrier via a letter of credit. As of December 31, 2013 and 2012, the value of the letter of credit was $5,000,000 and $5,533,000, respectively.

Subject to certain limitations, the Company also has umbrella liability coverage for its working nurses and allied healthcare professionals. While this umbrella coverage does not extend to professional liability claims against its independent contractor physicians, CRNAs and allied health professionals, it does cover claims brought against all of the Company’s subsidiaries for non-patient general liability.

At December 31, 2013 and 2012, the Company had outstanding workers’ compensation benefit claims of 85 and 105, respectively. At December 31, 2013 and 2012, the Company had outstanding professional liability claims of 66 and 80, respectively. See Note 7 – Balance Sheet Details for further information.

Revenue Recognition

The Company recognizes revenue when it is earned and when all of the following criteria are met: persuasive evidence of the arrangement exists; delivery has occurred or the service has been provided and the Company has no remaining obligations; the fee is fixed or determinable; and collectability is reasonably assured. The Company includes reimbursed expenses in revenues,

and the associated amounts of reimbursable expenses in cost of services.

Temporary Staffing Revenue

Revenue from services consists primarily of temporary staffing revenue. Revenues from temporary staffing, net of sales adjustments and discounts, are recognized when earned, based on hours worked by the Company’s healthcare professionals. Accordingly, accounts receivable includes estimated revenue for employees’ and independent contractors’ time worked but not yet invoiced. At December 31, 2013 and 2012, such estimated accrued revenue is approximately $11,004,000 and $9,816,000, respectively.

Permanent Placement

Revenue on permanent placements is recognized when services provided are substantially completed. The Company does not, in the ordinary course of business, give refunds. If a candidate leaves a permanent placement within a relatively short period of time, it is customary for the Company to provide a replacement at no additional cost. Allowances are established as considered necessary to estimate significant losses due to placed candidates not remaining employed for the Company’s guarantee period. During 2013, 2012, and 2011, such losses, if any, were nominal.

Gross Versus Net Policies

The Company records revenue on a gross basis as a principal or on a net basis as an agent depending on the arrangement, as follows:

Managed Service Programs Arrangements

The Company has entered into certain contracts with acute care facilities to provide comprehensive managed service programs (MSP) services. Under these contract arrangements, the Company uses its healthcare professionals along with those of third-party subcontractors to fulfill customer orders. If a subcontractor is used, the customer is invoiced for their services and, a subcontractor liability is recorded in accrued expenses, but only the resulting administrative fee is recognized as revenue. The subcontractor is paid after the Company has received payment from the acute care facility. The Company determined that it acts as an agent in these arrangements based on the following factors:


•	The subcontractor is the primary obligor in the arrangement and is responsible for fulfillment.


•	The amount the Company earns is fixed, typically a stated percentage of the amount billed to the customer.


•	The subcontractor bears the credit risk, not the Company.

Physician Staffing

In the Company’s physician staffing business, revenue is recorded on a gross basis as a principal versus on a net basis as an agent in the consolidated statement of operations. The Company has determined that gross reporting as a principal is the appropriate accounting treatment based upon the following factors:


•	The Company maintains the direct contractual relationship with the customer.


•	The Company performs part of the service by credentialing all of the providers and providing them with professional liability insurance.


•	The Company establishes the price for its services.


•	The Company bears the risk and rewards of the transaction including credit risk if the customer fails to pay for services performed.

Education and Training

Revenue from the Company’s education and training services is recognized as the independent contractor-led seminars are performed. In the Company’s education and training business, revenue is recorded in the consolidated statement of operations on a gross basis as a principal versus on a net basis as an agent. The Company has determined that gross reporting as a principal is the appropriate accounting treatment based upon the following factors:


•	The Company bears the risk and rewards of the transaction including credit risk if the customer fails to pay for services performed.


•	The Company performs part of the service by being involved with the program development and handling accreditation of the courses.


•	The Company establishes the price for its service.

Deferred Revenue

Amounts collected in advance of the services being substantially complete are recorded as deferred revenue in other current liabilities on the consolidated balance sheets. At December 31, 2013 and 2012, the Company had $1,293,000 and $1,574,000, respectively recorded as deferred revenue included in other current liabilities on the accompanying consolidated balance sheets.

Share-Based Compensation

The Company has, from time to time, granted stock options, stock appreciation rights and restricted stock for a fixed number of common shares to employees. In accordance with the Compensation-Stock-Compensation Topic of the FASB ASC, companies may choose from alternative valuation models. The Company uses the Black-Scholes method of valuing its options and stock appreciation rights. The Company values its restricted stock awards by reference to the Company’s stock price on the date of grant.

The Company has elected to recognize compensation expense on a straight-line basis over the requisite service period of the entire award. The Company uses historical data of options with similar characteristics to estimate pre-vesting option forfeitures, as it believes that historical behavior patterns are the best indicators of future behavior patterns. Compensation expense related to share-based payments is included in selling, general and administrative expenses in the consolidated statements of operations and totaled $2,099,941; $2,594,523 and $2,895,012, during the years ended December 31, 2013, 2012 and 2011, respectively. Because the Company has a full valuation allowance on its deferred tax assets, the granting and exercise of share-based payments during the year ended December 31, 2013 had no impact on the income tax provision. For the years ended December 31, 2012 and 2011, related deferred tax benefits of approximately $955,000 and $1,126,000, respectively, were recorded. See Note 13 – Stockholders’ Equity for further information about the Company’s current share-based compensation programs.

Advertising

The Company’s advertising expense consists primarily of direct mail marketing, online advertising, print media, and promotional material. Advertising costs are expensed as incurred and were approximately $3,230,000; $3,186,000 and $3,180,000 for the years ended December 31, 2013, 2012 and 2011, respectively. Direct response advertising costs associated with the Company’s education and training services are capitalized when the Company determines that there is a reasonable expectation that the cost of the incurred advertising will be recovered from the gross profit generated by the advertised event and expensed when the related event takes place. At December 31, 2013 and 2012, approximately $1,338,000 and $958,000, respectively, of these costs are included in prepaid expenses on the consolidated balance sheets.

Restructuring and Cost Reduction Plan

During 2013, the Company went through a restructuring to reduce operating costs. For the year ended December 31, 2013, the Company incurred $483,578 primarily related to senior management employee severance pay. These costs are included as restructuring costs in the consolidated statements of operations.

Operating Leases

The Company accounts for all operating leases on a straight-line basis over the term of the lease. In accordance with the provisions of the Leases Topic of the FASB ASC, any incentives or rent escalations are recorded as deferred rent and amortized with rent expense over the respective lease term.

Income Taxes

The Company accounts for income taxes under the Income Taxes Topic of the FASB ASC. Deferred income tax assets and liabilities are determined based upon differences between the financial reporting and tax basis of assets and liabilities, and are measured using the enacted tax rates and laws that will be in effect when the differences are expected to reverse.

The Company recognizes in its financial statements the impact of a tax position if that position is more likely than not of being sustained on audit, based on the technical merits of the position. The Company recognizes interest and penalties related to unrecognized tax benefits in the provision for income taxes. See Note 12 - Income Taxes for further information.

The Company records valuation allowances to reduce deferred tax assets when it is more likely than not that a tax benefit will not be realized. The assessment of whether or not a valuation allowance is required often requires significant judgment, including the long-range forecast of future taxable income and the evaluation of tax planning initiatives. Adjustments to the deferred tax valuation allowances are made to earnings in the period when such assessments are made. Due to the historical losses from the Company's operations, it has recorded a full valuation allowance on its deferred tax assets.

Comprehensive (Loss) Income

Total comprehensive (loss) income includes net income or loss, foreign currency translation adjustments, reclassification of foreign currency adjustments, write-down of marketable securities, and net changes in the fair value of marketable securities available for sale, net of any related deferred taxes.

Certain of the Company’s foreign subsidiaries use their respective local currency as their functional currency. In accordance with the Foreign Currency Matters Topic of the FASB ASC, 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 consolidated balance sheets and was approximately $1,133,000 and $3,083,000 at December 31, 2013 and 2012, respectively.

The Company adopted FASB issued ASU 2013-2, Comprehensive Income (Topic 220): Reporting of Amounts Reclassified Out of Accumulated Other Comprehensive Income (ASU 2013-2) for its consolidated financial statements in the first quarter of 2013. ASU 2013-2 adds new disclosure requirements for items reclassified out of accumulated other comprehensive income (AOCI), including (1) disaggregating and separately presenting changes in AOCI balances by component and (2) presenting significant items reclassified out of AOCI either on the face of the statement where net income is presented or as a separate disclosure in the notes to the financial statements. It does not amend any existing requirements for reporting net income or other comprehensive income in the financial statements.

In March 2013, the FASB issued ASU 2013-5, Foreign Currency Matters (Topic 830), Parent’s Accounting for the Cumulative Translation Adjustment upon Derecognition of Certain Subsidiaries or Groups of Assets within a Foreign Entity or of an Investment in a Foreign Entity (a consensus of the FASB Emerging Issues Task Force (ASU 2013-5). The objective of ASU 2013-5 is to resolve the diversity in practice as to the release of the cumulative translation adjustment into net income when a parent either sells a part or all of its investment in a foreign entity or no longer holds a controlling financial interest in a subsidiary or group of assets that is a nonprofit activity or a business (other than a sale of in substance real estate or conveyance of oil and gas mineral rights) within a foreign entity.

ASU 2013-5 clarifies that a cumulative translation adjustment (CTA) should be released into earnings when an entity ceases to have a controlling financial interest in a subsidiary or group of assets within a consolidated foreign entity and the sale or transfer results in the complete or substantially complete liquidation of the foreign entity. For sales of an equity method investment that is a foreign entity, a pro rata portion of CTA attributable to the investment would be recognized in earnings when the investment is sold. When an entity sells either a part or all of its investment in a consolidated foreign entity, CTA would be recognized in earnings only if the sale results in the parent no longer having a controlling financial interest in the foreign entity. In addition, CTA should be recognized in earnings in a business combination achieved in stages (i.e., a step acquisition). This ASU is effective for years beginning after December 15, 2013. Early adoption is permitted. The Company adopted this guidance and released into earnings $2,336,201 of its cumulative currency translation losses related to the sale of clinical trial services business in the first quarter of 2013, which was included in the income (loss) from discontinued operations, net of income taxes on the consolidated statements of operations.

As of December 31, 2013, $162,484 of income tax benefit related to foreign currency translation adjustments was included on the Company's consolidated statements of comprehensive (loss) income. During December 31, 2012 and 2011, income tax expense of $14,951 and income tax benefit of $22,384, respectively related to the Company's marketable securities.

Fair Value Measurements

The Company complies with the provisions of the Fair Value Measurements and Disclosures Topic of the FASB ASC, which defines fair value, establishes a framework for measuring fair value under U.S. generally accepted accounting principles and expands disclosures about fair value measurements. As of December 31, 2013 and 2012, the Company’s only financial assets or liabilities required to be measured on a recurring basis were its deferred compensation liability and its contingent consideration receivable. See Note 9 – Fair Value Measurements for relevant disclosures.

Recent Accounting Pronouncements

In July 2013, the FASB issued Accounting Standards Update 2013-11, Income Taxes - Presentation of an Unrecognized Tax Benefit When a Net Operating Loss Carry forward, a Similar Tax Loss, or a Tax Credit Carry forwards Exists (ASU 2013-11). ASU 2013-11 requires entities to present the unrecognized tax benefits in the financial statements as a liability and not combine it with deferred tax assets to the extent a net operating loss carry-forward, a similar tax loss, or a tax credit carry-forward is not available at the reporting date under the tax law of the applicable jurisdiction to settle any additional income taxes that would result from the disallowance of a tax position or the tax law of the applicable jurisdiction does not require the entity to use, and the entity does not intend to use, the deferred tax asset for such purpose. The assessment of whether a deferred tax asset is available is based on the unrecognized tax benefit and deferred tax asset that exist at the reporting date and should be made presuming disallowance of the tax position at the reporting date. ASU 2013-11 is effective for annual and interim periods for fiscal years beginning on or after December 15, 2013. The Company does not currently net unrecognized tax benefits with deferred tax assets and therefore does not expect this ASU to have any impact on the financial statements and disclosures.

Assets Held for Sale and Discontinued Operations

12 Months Ended

Dec. 31, 2013

Discontinued Operations and Disposal Groups [Abstract]

Assets Held for Sale and Discontinued Operations

The clinical trial services business segment provided clinical trial, drug safety, and regulatory professionals and services on a contract staffing and outsourced basis to companies in the pharmaceutical, biotechnology and medical device industries, as well as to contract research organizations, primarily in the United States, and also in Canada and Europe. During the fourth quarter of 2012, the Company’s Board of Directors approved a plan to exit the clinical trial services business as a result of an extensive review of its business and the changing landscape in the pharmaceutical outsourcing industry. Classification of a disposal group as held for sale occurs when sufficient authority to sell the disposal group has been obtained, the disposal group is available for immediate sale, an active program to sell the disposal group has been initiated and its sale is probable within one year. Accordingly, the assets to be disposed of are presented as assets held for sale and the liabilities to be disposed of are presented as liabilities related to assets held for sale on the Company’s consolidated balance sheets as of December 31, 2012.

On February 15, 2013, the Company completed the sale of its clinical trial services business to ICON Clinical Research, Inc. and ICON Clinical Research UK Limited (Buyer) for an aggregate $52,000,000 in cash, subject to certain adjustments. At closing, the total amount paid was reduced by approximately $100,000 for the amount the Targeted Net Working Capital exceeded the Estimated Net Working Capital. During the fourth quarter of 2013, the Company paid an additional $200,000 to the Buyer to finalize the Net Working Capital adjustment, pursuant to the agreement which reduced the gain on the sale included in discontinued operations.

The agreement included a provision for an earn-out of up to $3,750,000 related to certain performance-based milestones. The maximum earn-out amount of $3,750,000 was deposited in escrow by Buyer as security for the earn-out payment, if any. The $3,750,000 earn-out related to certain performance-based milestones was treated as contingent consideration and the Company assigned no fair value to this earn-out as of December 31, 2013 based on recent information available to the Company. In addition, a portion of the performance-based milestones was not earned, and as a result $1,500,000 of the original escrow was released to the Buyer in the second quarter of 2013, leaving a balance of $2,250,000 as of December 31, 2013 (see Note 9 – Fair Value Measurements for more information).

Of the $52,000,000 purchase price paid at closing, $3,750,000 was also placed in escrow for a period of 18 months following the closing to provide partial security to the Buyer in the event of any breach of the representations, warranties and covenants of the Company. The Company recorded the $3,750,000 indemnity escrow funds as an escrow receivable, and will adjust the amount, each reporting period, based on any known information that may arise that would be reasonable and estimable. As of December 31, 2013 there was no known information about any indemnity claims.

As a result of the disposal, the underlying operations and cash flows of the clinical trial services business have been eliminated from the Company’s continuing operations and the Company no longer has the ability to influence the operating and/or financial policies of the disposal group. In addition, continuing cash flows from the disposed business resulting from a short-term transitional services agreement were not expected to be significant and did not constitute a material continuing financial interest in the clinical trial services business. As a result, pursuant to generally accepted accounting principles, the historical financial results of operations, except for disclosures related to cash flows, have been presented as discontinued operations for all periods presented.

The following table presents the revenues and the components of discontinued operations, net of tax:



	Years Ended December 31,
	2013			2012			2011
Revenue	$	7,939,150		$	67,626,715		$	64,608,763

Income (loss) from discontinued operations before gain on sale and income taxes	433,915			(30,973,520		)	4,613,260
Gain on sale of discontinued operations	3,968,714			—			—
Income tax (expense) benefit	(2,121,941		)	9,496,992			(2,063,050		)
Income (loss) from discontinued operations, net of income taxes	$	2,280,688		$	(21,476,528	)	$	2,550,210

For the year ended December 31, 2012, the loss before income taxes is comprised of $34,000,000 of goodwill impairment charges described previously, $1,400,000 of a trade name impairment charge, and results from operations of approximately $4,426,000.

Consistent with the approach described in Note 4 - Goodwill, Trade Names and Other Identifiable Intangible Assets, the Company used the income approach and the market approach to evaluate the potential impairment of goodwill related to the clinical trial services staffing reporting unit. Discounted cash flows served as the primary basis for the income approach. Pricing multiples derived from publicly-traded guideline companies that are comparable served as the basis for the market approach. Pursuant to the second step of the Company’s third quarter interim impairment testing, the Company was required to calculate an implied fair value of goodwill based on a hypothetical purchase price allocation. The Company recorded a pre-tax goodwill impairment charge of approximately $22,100,000 as of September 30, 2012. In addition, in the fourth quarter of 2012, in conjunction with the Company’s evaluation of its assets held for sale, an additional impairment charge was recorded of approximately $11,900,000. The Company considered the sale price from the buyer as its best indication of fair value as of December 31, 2012.

The following table represents the major classes of assets and liabilities related to assets held for sale as of December 31, 2012.



	December 31, 2012
Assets:
Accounts receivable, net	$	12,553,056
Other prepaid expenses	485,840
Other current assets	13,771
Property and Equipment, net	364,972
Goodwill	28,175,772
Other intangible assets, net	5,335,816
Other long-term assets	41,737
Total assets held for sale	$	46,970,964
Liabilities:
Accounts payable and accrued expenses	$	354,453
Accrued employee compensation and benefits	1,478,638
Other current liabilities	984,978
Other non-current liabilities	16,447
Total liabilities related to assets held for sale	$	2,834,516

- Definition

The entire disclosure for the facts and circumstances leading to the completed or expected disposal, manner and timing of disposal, the gain (loss) recognized in the income statement and the income statement caption that includes that gain (loss), amounts of revenues and pretax profit or loss reported in discontinued operations, the segment in which the disposal group was reported, and the classification (whether sold or classified as held for sale) and carrying value of the assets and liabilities comprising the disposal group. Includes all disposal groups, including those classified as components of the entity (discontinued operations).

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 2
-URI http://asc.fasb.org/extlink&oid=6360339&loc=d3e1436-107760

Reference 2: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 1
-URI http://asc.fasb.org/extlink&oid=6360339&loc=d3e1361-107760

Reference 3: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=6360339&loc=d3e1474-107760

Reference 4: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=6360339&loc=d3e1510-107760

Reference 5: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 45
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=6892542&loc=d3e957-107759

Reference 6: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 45
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=6892542&loc=d3e1020-107759

Reference 7: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 45
-Paragraph 4
-URI http://asc.fasb.org/extlink&oid=6892542&loc=d3e1012-107759

Reference 8: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 360
-SubTopic 10
-Section 45
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=8077374&loc=d3e2443-110228

Reference 9: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 360
-SubTopic 10
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=6391110&loc=d3e2941-110230

+ Details

Goodwill and Other Identifiable Intangible Assets

12 Months Ended

Dec. 31, 2013

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Other Identifiable Intangible Assets

Goodwill, Trade Names and Other Identifiable Intangible Assets

As of December 31, 2013 and 2012, the Company had the following acquired intangible assets:



	December 31, 2013						December 31, 2012
	Gross Carrying Amount		Accumulated Amortization		Net Carrying Amount		Gross Carrying Amount		Accumulated Amortization		Net Carrying Amount
Intangible assets subject to amortization:
Databases	$	15,925,000	$	12,102,685	$	3,822,315	$	12,525,000	$	11,954,630	$	570,370
Customer relationships	37,304,000		15,125,076		22,178,924		26,904,000		13,089,055		13,814,945
Non-compete agreements	3,603,000		3,406,334		196,666		3,403,000		3,296,333		106,667
	$	56,832,000	$	30,634,095	$	26,197,905	$	42,832,000	$	28,340,018	$	14,491,982

Intangible assets not subject to amortization:
Goodwill					$	77,265,907					$	62,712,109
Trade Names					42,301,331						48,701,331
					$	119,567,238					$	111,413,440

As of December 31, 2013, estimated annual amortization expense for continuing operations is as follows:



Year Ending December 31:
2014	$	3,063,146
2015	2,906,222
2016	2,906,222
2017	2,861,481
2018	2,776,667
Thereafter	11,684,167
	$	26,197,905

The changes in the carrying amount of goodwill by segment are as follows:



	Nurse and Allied Staffing Segment			Physician Staffing Segment		Other Human Capital Management Services Segment		Total
Balances as of December 31, 2012
Aggregate goodwill acquired	$	259,732,408		$	43,405,047	$	19,307,062	$	322,444,517
Accumulated impairment loss (a)	(259,732,408		)	—		—		(259,732,408		)
Goodwill, net of impairment loss	—			43,405,047		19,307,062		62,712,109
Changes to aggregate goodwill in 2013
Goodwill acquired (b)	14,553,798			—		—		14,553,798
Balances as of December 31, 2013
Aggregate goodwill acquired	274,286,206			43,405,047		19,307,062		336,998,315
Accumulated impairment loss	(259,732,408		)	—		—		(259,732,408		)
Goodwill, net of impairment loss	$	14,553,798		$	43,405,047	$	19,307,062	$	77,265,907

_______________

(a)

A non-cash pretax impairment charge of approximately $241,000,000 was recorded to reduce the carrying value of goodwill to its estimated fair value in the fourth quarter of 2008 for its nurse and allied staffing business segment. The majority of the goodwill impairment was attributable to the Company’s initial capitalization in 1999, which was accounted for as an asset purchase (see Note 1 – Organization and Basis of Presentation), and subsequent nurse staffing acquisitions made through 2003. In addition, in the second quarter of 2012, a non-cash pretax impairment charge of approximately $18,732,000 was recorded for the Company’s nurse and allied staffing reporting unit. See impairment review disclosures that follow.


(b)	Goodwill acquired from the acquisition of On Assignment's allied health business. See Note 5 - Acquisitions.

2013 annual impairment testing results

The Company performed its annual impairment test as of December 31, 2013. Upon completion of the fourth quarter 2013 impairment testing, the Company determined that the estimated fair value of the Company’s reporting units, exceeded their respective carrying values. Accordingly, no goodwill impairment charges were warranted for these reporting units as of December 31, 2013.

In the fourth quarter of 2013, in conjunction with the annual testing of trade names, the Company recorded a pre-tax non-cash impairment charge of approximately $6,400,000 of which $6,174,000 related to the physician staffing segment and $226,000 related to the nurse and allied staffing segment. The Company reduced its long term revenue forecast for these businesses in the fourth quarter and as a result, the calculation of estimated fair value was less than the carrying amount of the trade names, resulting in an impairment charge.

The assessment was impacted by a then recent reduction in locum tenens usage and the overall physician staffing needs of the Company's customers. Based on the impact those trends had on the long term revenue forecast, the calculation of estimated fair value using the projected revenue stream indicated the carrying amount of the trade names may not have been fully recoverable.

2012 annual impairment testing results

During the second quarter of 2012, the Company’s stock price declined further from December 31, 2011. In addition, slower than expected booking momentum and reduced contribution income in the Company’s nurse and allied staffing segment resulted in a downward revision to this segment’s forecast. Additionally, the Company was closely monitoring the performance of the clinical trial services and physician staffing reporting units due to a small margin between the carrying amount and fair value of those respective reporting units as of the December 31, 2011 annual impairment testing and the small margin between the carrying amount and fair value of the nurse and allied staffing reporting unit as of the March 31, 2012 interim impairment testing. These factors warranted impairment testing in the second quarter of 2012.

The discounted cash flows for each reporting unit that served as the primary basis for the income approach were based on discrete financial forecasts developed by the Company for planning purposes and consistent with those distributed within the Company and externally. A number of significant assumptions and estimates were involved in the application of the income methodology including forecasted revenue, margins, operating cash flows, discount rate, and working capital changes. Cash flows beyond the discrete forecast period of ten years were estimated using a terminal value calculation. A terminal value growth rate of 2.5% was used for each reporting unit. The income approach valuations included reporting unit cash flow discount rates, representing each of the reporting unit’s weighted average cost of capital, ranging from 11% to 18.7%.

The market approach generally applied pricing multiples derived from publicly-traded guideline companies that are comparable to the Company’s respective reporting units, and other specific data points, to determine their value. The Company utilized total enterprise value/revenue multiples ranging from 0.43 to 1.00, and total enterprise value/Earnings Before Interest Taxes Depreciation and Amortization (EBITDA) multiples ranging from 4.17 to 10.00.

The reporting units’ values based on the market approach were determined assuming a 50% weighting to revenue multiples and a 50% weighting to EBITDA multiples for for its physician staffing, clinical trial services and retained search reporting units; and a 100% weighting to the EBITDA multiples for the education and training reporting unit.

The total fair value of the Company’s reporting units was reconciled to its June 30, 2012 market capitalization. The reasonableness of the resulting control premium was assessed based on a review of comparative market transactions and other qualitative factors that might have influenced the Company’s stock price. The Company’s market capitalization was also considered in assessing the reasonableness of the fair values of the reporting units. In performing the reconciliation of the Company’s market capitalization to fair value, the Company considered both quantitative and qualitative factors which supported the implied control premium. The Company believes that a reasonable buyer would offer a control premium for the business that would adequately cover the difference between its market price at June 30, 2012 and its book value.

Upon completion of the second quarter 2012 interim impairment testing, the Company determined that the estimated fair value of the Company’s reporting units, with the exception of nurse and allied staffing, exceeded their respective carrying values. As a result of the June 30, 2012 interim impairment testing, the Company determined that the fair value of the nurse and allied staffing reporting unit was lower than the respective carrying value. The decrease in value was due to slower than expected booking momentum and reduced contribution income in the Company’s second quarter of 2012 which lowered the anticipated growth trend used for goodwill impairment testing. Pursuant to the second step of the interim impairment testing the Company was required to calculate an implied fair value of goodwill based on a hypothetical purchase price allocation. Based on these results, the Company wrote off the remaining goodwill which resulted in a pre-tax goodwill impairment charge of approximately $18,732,000 as of June 30, 2012.

In conjunction with the 2012 annual testing of indefinite-lived intangible assets, no additional impairments of indefinite-lived intangible assets were identified.

2011 annual impairment testing results

Upon completion of the annual impairment assessment as of December 31, 2011 the Company determined that no impairment was indicated.

In conjunction with the 2011 annual testing of indefinite-lived intangible assets, no additional impairments of indefinite-lived intangible assets were identified.

- Definition

The entire disclosure for the aggregate amount of goodwill and a description of intangible assets, which may include (a) for amortizable intangible assets (also referred to as finite-lived intangible assets), the carrying amount, the amount of any significant residual value, and the weighted-average amortization period, (b) for intangible assets not subject to amortization (also referred to as indefinite-lived intangible assets), the carrying amount, and (c) the amount of research and development assets acquired and written off in the period, including the line item in the income statement in which the amounts written off are aggregated, if not readily apparent from the income statement. Also discloses (a) for amortizable intangibles assets in total and by major class, the gross carrying amount and accumulated amortization, the total amortization expense for the period, and the estimated aggregate amortization expense for each of the five succeeding fiscal years, (b) for intangible assets not subject to amortization the carrying amount in total and by major class, and (c) for goodwill, in total and for each reportable segment, the changes in the carrying amount of goodwill during the period (including the aggregate amount of goodwill acquired, the aggregate amount of impairment losses recognized, and the amount of goodwill included in the gain (loss) on disposal of a reporting unit). If any part of goodwill has not been allocated to a reportable segment, discloses the unallocated amount and the reasons for not allocating. For each impairment loss recognized related to an intangible asset (excluding goodwill), discloses: (a) a description of the impaired intangible asset and the facts and circumstances leading to the impairment, (b) the amount of the impairment loss and the method for determining fair value, (c) the caption in the income statement or the statement of activities in which the impairment loss is aggregated, and (d) the segment in which the impaired intangible asset is reported. For each goodwill impairment loss recognized, discloses: (a) a description of the facts and circumstances leading to the impairment, (b) the amount of the impairment loss and the method of determining the fair value of the associated reporting unit, and (c) if a recognized impairment loss is an estimate not finalized and the reasons why the estimate is not final. May also disclose the nature and amount of any significant adjustments made to a previous estimate of an impairment loss.

+ References + Details

Acquisitions

12 Months Ended

Dec. 31, 2013

Business Combinations [Abstract]

Acquisitions

On Assignment, Inc.

In December 2013, the Company acquired the operating assets of On Assignment, Inc.’s Allied Healthcare Staffing division for an aggregate purchase price of $28,700,000, subject to certain post-closing adjustments. Excluded from the transaction were the accounts receivable, accounts payable and accrued compensation of the business being acquired. The Company used $24,673,000 in cash on hand and $4,500,000 from borrowings under its current revolver facility with Bank of America, N.A. to pay the purchase price and approximately $473,000 in transaction costs. Subsequent to December 31, 2013, an immaterial post-closing adjustment was made. However, the purchase price is subject to potential adjustment downward contingent upon retention of certain contracts as defined in the agreement, which will be resolved by the end of the Company's second quarter of 2014. The Company does not expect any further adjustment.

Pursuant to the Asset Purchase Agreement, the Company will be working with the seller to assume 15 leases and sublet 7 leases related to its branch offices. As of the date of this filing, 4 leases have been assumed by the Company representing $383,765 of operating lease future payments.

The Company believes the acquisition complements its current nurse and allied staffing business segment by: (1) adding new skillsets to its traditional staffing offerings, (2) expanding its local branch network, which will allow it to expand its local market presence and its MSP business, (3) diversifying its customer base into the local ambulatory care and smaller local healthcare facilities, which the Company believes will provide more balance between its large volume based customers and its local retail market.

The Allied Healthcare business has 84 branch-based employees and makes placements in more than 125 specialties from 23 branch offices.

The acquisition has been accounted for in accordance with FASB ASC Topic 805-Business Combination, using the purchase method. The results of the acquisition's operations have been included in the consolidated statements of operations since December 2, 2013, the date of the acquisition. On Assignment's allied staffing services have been included with the Company's nurse and allied staffing business segment. The Company's nurse and allied staffing business segment results in 2013 included $3,407,193 of revenue and $295,251 in contribution income (as defined in Note 16 - Segment Information) from the acquisition.

The following table summarizes the approximate fair values of the assets acquired and liabilities assumed. The Company used a third-party appraiser to determine the fair value and estimated useful lives of acquired assets and liabilities.



Other current assets	$	61,837
Property and equipment	160,921
Goodwill	14,553,798
Other intangible assets	14,000,000
Other assets	52,444
Total assets acquired	28,829,000

Accrued employee compensation and benefits	111,789
Total liabilities assumed	111,789

Net assets acquired	$	28,717,211

Based on the final independent third-party appraisal, the Company assigned the following values to intangible and other identifiable assets: $10,400,000 to customer relations with an estimated useful life of 16 years, $3,400,000 to database with an estimated useful life of 10 years, and $200,000 to non-compete agreements with a useful life of 5 years. The remaining excess of purchase price over the fair value of net assets acquired $14,553,798 and was recorded as goodwill, which is expected to be deductible for tax purposes. Additional acquisition-related costs of approximately $473,000 were incurred and are reflected as acquisition costs on the Company's consolidated statement of operations for the year ended December 31, 2013.

The following unaudited pro forma financial information approximates the consolidated results of operations of the Company as if the On Assignment acquisition had occurred as of January 1, 2012, after giving effect to certain adjustments, including additional interest expense on the amount the Company borrowed on the date of the transaction. These results are not necessarily indicative of future results as they do not include incremental investments in support functions, an estimate of any impact on interest expense resulting from the operating cash flow of the acquired business, among other adjustments that could be made in the future but are not factually supportable on the date of the transaction.



	Year Ended December 31,
	2013			2012
	(unaudited, amounts in thousands)

Revenue from services	$	476,456		$	482,142

Net income (loss)	$	(50,336	)	$	(40,543	)

Net income (loss) per common share - basic	$	(1.62	)	$	(1.31	)

Net income (loss) per common share - diluted	$	(1.62	)	$	(1.31	)

MDA Holdings, Inc.

In September 2008, the Company completed the acquisition of substantially all of the assets of privately-held MDA Holdings, Inc. and its subsidiaries and all of the outstanding stock of a subsidiary of MDA Holdings, Inc. (collectively, MDA). Part of the cash paid at closing was held in escrow to cover any post-closing liabilities (Indemnification Escrow).

During the year ended December 31, 2010, approximately $3,541,000 was released to the seller from the Indemnification Escrow account leaving a balance of approximately $3,566,000 at December 31, 2013 and 2012. The escrow will be released upon full satisfaction of certain tax matters and the resolution of indemnity claims. The transaction also included an earnout provision based on 2008 and 2009 performance criteria. This contingent consideration was not related to the sellers’ employment. In the second quarter 2009, the Company paid approximately $6,748,000 related to the 2008 performance. In the second quarter of 2010, the Company paid approximately $12,826,000 related to the 2009 performance, satisfying all earnout amounts potentially due to the seller in accordance with the asset purchase agreement. Earnout payments were allocated to goodwill as additional purchase price, in accordance with the Business Combinations Topic of the FASB ASC.

- Definition

The entire disclosure for a business combination (or series of individually immaterial business combinations) completed during the period, including background, timing, and recognized assets and liabilities. The disclosure may include leverage buyout transactions (as applicable).

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 10
-Section 50
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=25497992&loc=d3e1497-128463

Reference 2: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 10
-Section 50
-Paragraph 4
-URI http://asc.fasb.org/extlink&oid=25497992&loc=d3e1490-128463

Reference 3: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 10
-Section 50
-Paragraph 2
-URI http://asc.fasb.org/extlink&oid=25497992&loc=d3e1392-128463

Reference 4: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 30
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-URI http://asc.fasb.org/extlink&oid=7488404&loc=d3e7008-128479

Reference 5: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 10
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=25497992&loc=d3e1486-128463

Reference 6: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 30
-Section 50
-Paragraph 1
-URI http://asc.fasb.org/extlink&oid=7488404&loc=d3e6927-128479

Reference 7: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 20
-Section 50
-Paragraph 1
-URI http://asc.fasb.org/extlink&oid=6910749&loc=d3e4845-128472

Reference 8: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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-SubTopic 10
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-Paragraph 6
-URI http://asc.fasb.org/extlink&oid=25497992&loc=d3e1500-128463

Reference 9: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 10
-Section 50
-Paragraph 7
-URI http://asc.fasb.org/extlink&oid=25497992&loc=d3e1524-128463

Reference 10: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 30
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=7488404&loc=d3e7000-128479

Reference 11: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
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-Paragraph 2
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Reference 12: http://www.xbrl.org/2003/role/presentationRef
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-Name Accounting Standards Codification
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Reference 13: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 20
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-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=6910749&loc=d3e4926-128472

Reference 14: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 10
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-Paragraph 1
-URI http://asc.fasb.org/extlink&oid=25497992&loc=d3e1383-128463

Reference 15: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 30
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-Paragraph 2
-URI http://asc.fasb.org/extlink&oid=7488404&loc=d3e6996-128479

+ Details

Property and Equipment

12 Months Ended

Dec. 31, 2013

Property, Plant and Equipment [Abstract]

Property and Equipment

At December 31, 2013 and 2012, property and equipment consist of the following:



		December 31,
	Useful Lives	2013			2012
Computer equipment	3-5 years	$	12,115,305		$	12,373,042
Computer software	3-5 years	30,059,145			29,929,913
Office equipment	5-7 years	3,306,824			3,307,815
Furniture and fixtures	5-7 years	1,751,669			1,704,073
Leasehold improvements	(a)	3,716,158			2,837,740
		50,949,101			50,152,583
Less accumulated depreciation and amortization		(44,778,602		)	(41,917,771		)
		$	6,170,499		$	8,234,812

_______________


(a)	See Note 2 – Summary of Significant Accounting Policies.

Balance Sheet Details

12 Months Ended

Dec. 31, 2013

Balance Sheet Related Disclosures [Abstract]

Balance Sheet Details



	December 31,
	2013		2012
Insurance recovery receivable:
Insurance recovery for workers’ compensation	$	2,093,000	$	2,427,994
Insurance recovery for professional liability	1,793,285		3,055,895
	$	3,886,285	$	5,483,889

Non-current insurance recovery receivable:
Insurance recovery for workers’ compensation – long term	$	3,336,000	$	3,694,006
Insurance recovery for professional liability – long term	7,577,527		4,516,133
	$	10,913,527	$	8,210,139

Accrued compensation and benefits:
Salaries and payroll taxes	$	6,874,644	$	6,931,650
Bonuses	2,199,559		1,648,979
Accrual for workers’ compensation claims	3,236,428		3,800,526
Accrual for health care benefits	1,385,115		2,005,486
Accrual for professional liability insurance	4,091,405		5,847,638
Accrual for vacation	1,361,161		1,415,954
	$	19,148,312	$	21,650,233

Long-term accrued claims:
Accrual for workers’ compensation claims	$	5,076,000	$	5,748,506
Accrual for professional liability insurance	13,227,096		10,598,836
	$	18,303,096	$	16,347,342

Other long-term liabilities:
Deferred compensation	$	1,638,334	$	1,471,091
Deferred rent	1,776,615		1,564,199
	$	3,414,949	$	3,035,290

Long-Term Debt

12 Months Ended

Dec. 31, 2013

Debt Disclosure [Abstract]

Long-Term Debt

At December 31, 2013 and 2012, long-term debt consists of the following:



	December 31,
	2013			2012
Term loan, interest 2.72% at December 31, 2012	$	—		$	23,125,000
Revolving credit facility, interest 3.27% and 2.72% at December 31, 2013 and 2012, respectively	8,400,000			10,000,000
Capital lease obligations and note payable	176,319			733,657
Total debt	8,576,319			33,858,657
Less current portion	(8,483,088		)	(33,682,348		)
Long-term debt	$	93,231		$	176,309

Long-term debt includes capital lease obligations that are subordinate to the Company’s senior secured facility. As of December 31, 2013, the aggregate scheduled maturities of debt are as follows:



Through Year Ending December 31:	Revolver		Capital Leases and Note Payable
2014	$	8,400,000	$	83,088
2015	—		65,409
2016	—		27,822
2017	—		—
2018	—		—
Total	$	8,400,000	$	176,319

Loan Agreement

On January 9, 2013, the Company terminated its commitments under the July 2012 Credit Agreement (defined below) and entered into a Loan and Security Agreement, (Loan Agreement), by and among the Company and certain of its domestic subsidiaries, as borrowers, and Bank of America, N.A., as agent.

The Loan Agreement provides for: a three-year senior secured asset-based revolving credit facility in the aggregate principal amount of up to $65,000,000 (as described below), which includes a subfacility for swingline loans up to an amount equal to 10% of the aggregate Revolver Commitments, and a $20,000,000 subfacility for standby letters of credit. Swingline loans and letters of credit issued under the Loan Agreement reduce available revolving credit commitments on a dollar-for-dollar basis. Subject to certain conditions, the Company is permitted, at any time prior to the maturity date for the revolving credit facility, to increase the total revolving credit commitments in an aggregate principal amount of up to $20,000,000, with additional commitments from Lenders or new commitments from financial institutions, subject to certain conditions as described in the Loan Agreement. Pursuant to the Loan Agreement, the aggregate amount of advances under the Line of Credit (Borrowing Base) cannot exceed the lesser of (a) (i) $65,000,000, or (ii) 85% of eligible billed accounts receivable as defined in the Loan Agreement; plus (b) the lesser of (i) 85% of eligible unbilled accounts receivable and (ii) $12,000,000; minus (c) reserves as defined by the Loan Agreement, which include one week’s worth of W-2 payroll and fees payable to independent contractors. As of December 31, 2013, the gross availability under the Loan Agreement was approximately $39,482,000 based on the Company's November accounts receivable. The Company had $11,399,000 letters of credit outstanding and $8,400,000 drawn under its revolving credit, leaving $19,683,000 available as of December 31, 2013. The letters of credit relate to the Company's workers' compensation and professional liability policies. See Note 2 - Summary of Significant Accounting Policies.

The initial proceeds from the revolving credit facility were used to finance the repayment of existing indebtedness of the Company under its prior credit agreement and the payment of fees and expenses. The repayment of the term loan portion of the Company’s debt outstanding in the first quarter of 2013 was treated as extinguishment of debt, and, as a result, the Company recognized a loss on extinguishment in the first quarter of 2013, related to the write-off of unamortized net debt issuance costs of approximately $295,000. The repayment of the revolver portion of the Company’s debt outstanding in the first quarter of 2013 was treated partially as extinguishment and partially as a modification. The fees related to the modified portion of approximately $86,000 relate to the continuation of credit provided by Bank of America, N.A. in its Loan Agreement. The Company wrote-off the remaining unamortized net debt issuance costs of approximately $1,124,000 in the first quarter of 2013.

The revolving credit facility is used to provide ongoing working capital and for other general corporate purposes of the Company and its subsidiaries. As of December 31, 2013, the interest rate spreads and fees under the Loan Agreement are based on LIBOR plus 1.5% or Base Rate plus 0.50%. The LIBOR and Base Rate margins are subject to performance pricing adjustments, pursuant to a pricing matrix based on the Company’s excess availability under the revolving credit facility, and would increase by 200 basis points if an event of default exists. The Company is required to pay a monthly commitment fee on the average daily unused portion of the revolving loan facility, which, as of December 31, 2013, was 0.375%.

The Loan Agreement contains customary representations, warranties, and affirmative covenants. The Loan Agreement also contains customary negative covenants; including covenants with respect to, among other things, (i) indebtedness, (ii) liens, (iii) investments, (iv) significant corporate changes, including mergers and acquisitions, (v) dispositions, (vi) dividend, distributions and other restricted payments, (vii) transactions with affiliates and (viii) restrictive agreements. In addition, if the Company’s excess availability under the revolving credit facility is less than the greater of (i) 12.5% of the Loan Cap, as defined, and (ii) $6,250,000, the Company is required to meet a minimum fixed charge coverage ratio of 1.0, as defined in the Loan Agreement. The Loan Agreement also contains customary events of default, such as payment defaults, cross-defaults to other material indebtedness, bankruptcy and insolvency, the occurrence of a defined change in control and the failure to observe covenants or conditions under the credit facility documents.

The Company’s obligations under the Loan Agreement are guaranteed by all material domestic subsidiaries of the Company that are not co-borrowers (Subsidiary Guarantors). As collateral security for their obligations under the Loan Agreement and guarantees thereof, the Company and the Subsidiary Guarantors have granted to Bank of America, N.A., a security interest in substantially all of their tangible and intangible assets.

July 2012 Credit Agreement

The Company entered into a senior secured credit agreement on July 10, 2012 (July 2012 Credit Agreement), by and among the Company, as borrower, a syndicate of lenders, Wells Fargo Bank, National Association, as administrative agent, swingline lender and issuing lender, Bank of America, N.A., as syndication agent, and U.S. Bank National Association, as documentation agent. The July 2012 Credit Agreement provided for: (i) a five-year senior secured term loan facility in the aggregate principal amount of $25,000,000, and (ii) a five-year senior secured revolving credit facility in the aggregate principal amount of up to $50,000,000, which included a $10,000,000 subfacility for swingline loans, and a $20,000,000 subfacility for standby letters of credit. Swingline loans and letters of credit issued under the July 2012 Credit Agreement reduced available revolving credit commitments on a dollar-for-dollar basis. Subject to certain conditions under the Credit Agreement, the Company was permitted, at any time prior to the maturity date for the revolving credit facility, to increase its total revolving credit commitments in an aggregate principal amount of up to $25,000,000.

Upon closing of the July 2012 Credit Agreement, the Company borrowed $25,000,000 in term loan and $11,000,000 from the revolving credit facility. The proceeds were used to repay the indebtedness on its prior credit agreement and for the payment of fees and expenses. During 2012, approximately $962,000 of financing fees were deferred and included in debt issuance costs on the accompanying consolidated balance sheets. The deferred costs related to the revolving credit facility have been amortized on a straight-line basis, and the deferred costs related to the term loan facility have been amortized using the effective interest method, both over the life of the July 2012 Credit Agreement. In addition, approximately $279,000 of third party debt financing costs relating to the July 2012 Credit Agreement were expensed as incurred and are included in interest expense on the Company’s consolidated statement of operations as required by the Debt Topic of the FASB ASC.

The revolving credit facility was to be used to provide ongoing working capital and for other general corporate purposes of the Company and its subsidiaries. Through December 31, 2012, interest on the term loan and revolving credit portion of the July 2012 Credit Agreement was based on LIBOR plus a margin of 2.50% or Base Rate (as defined by the July 2012 Credit Agreement, as modified) plus a margin of 1.50%. In addition, the Company was required to pay a quarterly commitment fee on its average daily unused portion of the revolving loan facility of 0.50%. The interest rate spreads and fees fluctuated during the term of the July 2012 Credit Agreement based on the consolidated total leverage ratio at each calculation date, as defined.

Modification of July 2012 Credit Agreement

On September 28, 2012, the Company entered into a First Modification Agreement with the lenders of its July 2012 Credit Agreement, which, for the third quarter ending September 30, 2012, modified the maximum consolidated total leverage ratio to 2.75 to 1.00 and modified the minimum consolidated fixed charge coverage ratio to 1.25 to 1.00. In addition, the aggregate amount of new revolving credit loans and swingline loans made to the Company could not exceed $3,000,000 (above the $10,000,000 outstanding) at any time, and new Letters of Credit issued on behalf of the Company could not exceed $1,000,000 (above the $12,432,000 outstanding), during the period commencing on September 28, 2012 and ending upon the delivery by the Company of an Officer’s Compliance Certificate to the lender’s administrative agent for the fiscal year ending December 31, 2012 (which would have occurred in March 2013). Further, during the modification period, the Company was also prohibited from making investments and purchasing, redeeming, retiring or otherwise acquiring any shares of its capital stock as otherwise permitted under the credit agreement.

Due to Company’s change in lenders’ participations as a result of the July 2012 Credit Agreement and subsequent modification agreement, the Company wrote off debt issuance costs of approximately $82,000 as loss on modification of debt on the accompanying consolidated statements of operations for the year ended December 31, 2012.

Covenants of July 2012 Credit Agreement

As of December 31, 2012, the Company would not have complied with the financial covenants in its July Credit Agreement, specifically, its Maximum Leverage Ratio or its Minimum Fixed Charge Coverage Ratio. Generally accepted accounting principles require that long-term debt be classified as a current liability when a covenant violation that gives the lender the right to call the debt has occurred at the balance sheet date. As a result, amounts outstanding under the credit agreement are included in current liabilities in the accompanying December 31, 2012 consolidated balance sheets.

Fair Value Measurements

12 Months Ended

Dec. 31, 2013

Fair Value Disclosures [Abstract]

Fair Value Measurements

The Fair Value Measurements and Disclosures Topic of the FASB ASC, defines fair value as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. The Fair Value Measurements and Disclosures Topic also establishes a fair value hierarchy which requires an entity to maximize the use of observable inputs and minimize the use of unobservable inputs when measuring fair value. The standard describes three levels of inputs that may be used to measure fair value:

Level 1—Quoted prices in active markets for identical assets or liabilities.

Level 2—Observable inputs other than Level 1 prices such as quoted prices for similar assets or liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities.

Level 3—Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities.

Items Measured at Fair Value on a Recurring Basis:

At December 31, 2013 and December 31, 2012, the Company’s financial assets/liabilities required to be measured on a recurring basis were its deferred compensation liability included in other long-term liabilities and contingent consideration receivable related to the sale of its clinical trial services business.

Deferred compensation —The Company utilizes Level 1 inputs to value its deferred compensation liability. The Company’s deferred compensation liability is measured using publicly available indices that define the liability amounts, as per the plan documents.

Contingent Consideration Receivable—The earn out related to the Company’s sale of its clinical trial services business is treated as a contingent consideration receivable for accounting purposes. The Company utilizes Level 3 inputs to value its contingent consideration receivable as significant unobservable inputs are used in the calculation of its fair value and are related to future performance of the disposed business. The fair value of the contingent consideration receivable will be adjusted to its fair value on a quarterly basis with the adjustment to the related receivable and the gain/loss on the sale of assets (included in discontinued operations). The future performance of the disposed business directly impacts the contingent consideration that could be paid to the Company, thus performance that exceeds target could result in a higher payout, and a performance under target could result in a lower payout. As of December 31, 2013, the Company assigned no value to the performance earn-out based on recent information available to the Company. See Note 3- Assets Held for Sale and Discontinued Operations for further information. The Company had no performance earn-outs as of December 31, 2012.

The table below summarizes the estimated fair values, which approximate their carrying value, of the Company’s financial assets and liabilities measured on a recurring basis as of December 31, 2013 and 2012:

Fair Value Measurements



	December 31, 2013				December 31, 2012
	Total		Quoted Prices in Active Markets for Identical Assets (Level 1)		Total		Quoted Prices in Active Markets for Identical Assets (Level 1)
Financial Liabilities:
Deferred compensation	$	1,638,334	$	1,638,334	$	1,471,091	$	1,471,091

Items Measured at Fair Value on a Nonrecurring Basis:

The Company’s assets held for sale, liabilities related to assets held for sale and goodwill and other identifiable intangible assets are measured at fair value on a nonrecurring basis using significant unobservable inputs (Level 3) described in Note 3 – Assets Held For Sale and Discontinued Operations, Note 4 – Goodwill, Trade Names and Other Identifiable Intangible Assets and Note 2 – Summary of Significant Accounting Policies.

Goodwill and other identifiable intangible assets with indefinite lives are reviewed for impairment annually, and whenever events or changes in circumstances indicate that the carrying value may not be recoverable. Long-lived assets and identifiable intangible assets are also reviewed for impairment whenever events or changes in circumstances indicate that amounts may not be recoverable. If the testing performed indicates that impairment has occurred, the Company records a noncash impairment charge for the difference between the carrying amount of the goodwill or other intangible assets and the implied fair value of the goodwill or other intangible assets in the period the determination is made.

In the fourth quarter of 2013, in conjunction with the annual testing of indefinite-lived intangible assets not subject to amortization, the Company recorded a pre-tax non-cash impairment charge of approximately $6,400,000 related to its MDA acquisition (see Note 4 – Goodwill, Trade Names and Other Identifiable Intangible Assets). The Company reduced its long term revenue forecast for these businesses in the fourth quarter and as a result, the calculation of estimated fair value was less than the carrying amount of the trade names, resulting in an impairment charge. The table below presents the fair value of the MDA trade names as of December 31, 2013.

At December 31, 2012, all the assets and liabilities that were held for sale are stated at fair value with the exception of other intangible assets whose carrying value was below fair value. For those assets and liabilities except for goodwill, fair value approximates their carrying amount due to their short-term nature. The following table presents the fair value of goodwill, which is the most significant component of the assets held for sale, measured on a non-recurring basis for the Company’s clinical trial services reporting unit included in assets held for sale as of December 31, 2012:

Fair Value Measurements



	December 31, 2013		December 31, 2012
(Level 3)
MDA trade names	$	28,836,000	n/a
Clinical trial services segment goodwill	n/a		$	28,175,722

n/a - Not applicable

Other Fair Value Disclosures:

Financial instruments not measured or recorded at fair value in the accompanying consolidated balance sheets consist of cash and cash equivalents, accounts receivable, accounts payable and accrued expenses and short and long-term debt. The estimated fair value of accounts receivable, accounts payable and accrued expenses approximate their carrying amount due to the short-term nature of these instruments. The fair value of the Company’s term loan and revolver credit facility included in the current portion of long term debt on its consolidated balance sheet is estimated using Level 2 inputs utilizing interest rates that were indirectly observable in markets for similar liabilities. The estimated fair value of the Company’s debt was calculated using discounted cash flow analysis and appropriate valuation methodologies using Level 2 inputs available market information.

The Company recorded the $3,750,000 indemnity escrow funds related to the sale of its clinical trial services business as an escrow receivable (see Note 3 - Assets Held for Sale and Discontinued Operations for more information), and will adjust the amount to the estimated fair value, each reporting period, based on any known information. As of December 31, 2013, the fair value of the escrow receivable was calculated using Level 2 inputs and reflecting a discount for the time value of money.

The following table represents the carrying amounts and estimated fair values of the Company’s significant financial instruments that were not measured at fair value:



	December 31, 2013				December 31, 2012
	Carrying Amount		Fair Value		Carrying Amount		Fair Value
(Level 2)
Financial Assets:
Escrow Receivable	$	3,750,000	$	3,700,373	$	—	$	—
Financial Liabilities:
Term loan and revolver credit facility	$	—	$	—	$	33,125,000	$	32,654,213
Asset-based revolving credit facility (a)	$	8,400,000	$	8,400,000	$	—	$	—

_______________


(a)	Carrying value of the asset-based revolving credit facility approximates estimated fair value based on the short-term nature and the pricing at varying interest rates.

Concentration of Risk:

The Company has invested its excess cash in highly rated overnight funds and other highly rated liquid accounts. The Company has been exposed to credit risk associated with these investments. The Company minimizes its credit risk relating to these positions by monitoring the financial condition of the financial institutions involved and by primarily conducting business with large, well established financial institutions and diversifying its counterparties.

The Company generally does not require collateral and mitigates its credit risk by performing credit evaluations and monitoring at-risk accounts. The allowance for doubtful accounts represents the Company’s estimate of uncollectible receivables based on a review of specific accounts and the Company’s historical collection experience. The Company writes off specific accounts based on an ongoing review of collectability as well as past experience with the customer. The Company’s contract terms typically require payment between 15 to 60 days from the date services are provided and are considered past due based on the particular negotiated contract terms. 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.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Employee Benefit Plans	12 Months Ended
Employee Benefit Plans	Dec. 31, 2013
Compensation and Retirement Disclosure [Abstract]
Employee Benefit Plans	Employee Benefit Plans The Company maintains a voluntary defined contribution 401(k) profit-sharing plan covering all eligible employees as defined in the plan documents. The plan provides for a discretionary matching contribution, which is equal to a percentage of each eligible contributing participant’s elective deferral, which the Company, at its sole discretion, determines from year to year. Contributions by the Company, net of forfeitures, under this plan amounted to $557,000 and $556,000 for the years ended December 31, 2013 and 2012, respectively. Due to accumulated forfeiture credits on account, the matching contributions, net of forfeitures, for the year ended December 31, 2011, were not material. Eligible employees who elect to participate in the plan are generally vested in any existing matching contribution after three years of service with the Company. The Company offers a non-qualified deferred compensation program to certain key employees whereby they may defer a portion of annual compensation for payment upon retirement. The program is unfunded for tax purposes and for purposes of Title I of the Employee Retirement Income Security Act of 1974. The liability for the deferred compensation is included in other long-term liabilities on the consolidated balance sheets and amounted 1,638,334 and 1,471,091 at December 31, 2013 and 2012, respectively.

Commitments and Contingencies

12 Months Ended

Dec. 31, 2013

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

Commitments:

The Company has entered into non-cancelable operating lease agreements for the rental of office space and equipment. Certain of these leases include options to renew as well as rent escalation clauses and in certain cases, incentives from the landlord for rent-free months and allowances for tenant improvements. The rent escalations and incentives have been reflected in the table below.

In July 2013, the Company entered into an agreement to lease 41,607 square feet of space in Berkeley Lake, Georgia for its physician staffing business. The commitment is for ten years, eight months, subject to adjustment and earlier termination as provided in the lease, and totals approximately $4,241,000, excluding operating costs. The lease also contains certain lease incentives including a tenant improvement allowance of up to $1,456,000, of which any excess may be used for moving expenses.

Future minimum lease payments, as of December 31, 2013, associated with these agreements with terms of one year or more are as follows:



Through Year Ending December 31:
2014	$	4,267,124
2015	3,914,971
2016	3,958,695
2017	3,016,878
2018	1,304,860
Thereafter	2,602,718
	$	19,065,246

Total operating lease expense included in selling, general and administrative expenses was approximately $5,481,000, $5,791,000 and $6,159,000 for the years ending December 31, 2013, 2012 and 2011, respectively.

Sales & Other State Non-income Tax Liabilities

The Company's sales and other state non-income tax filings are subject to routine audits by authorities in the jurisdictions where it conducts business in the United States which may result in assessments of additional taxes. The Company accrues sales and other non-income tax liabilities based on the Company's best estimate of its probable liability utilizing currently available information and interpretation of relevant tax regulations. Given the nature of the Company's business, significant subjectivity exists as to both whether sales and other state non-income taxes can be assessed on its activity and how the sales tax will ultimately be measured by the relevant jurisdictions. The Company makes a determination for each reporting period whether the estimates for sales and other non-income taxes in certain states should be revised.

During 2011, a state administrative ruling related to certain service tax matters was released which indicated that services performed in that particular state are subject to a tax not previously paid by the Company. As a result, the Company conducted an initial review of certain other states to determine if any additional exposures may exist and determined that it was probable that some of its previous tax positions would be challenged. As a result, the Company changed its assessment of certain non-income tax positions and estimated a liability related to these matters. Based on its best estimate of probable settlement, the Company accrued a pretax liability related to the non-income tax matters of approximately $526,000 in the year ended December 31, 2011, of which approximately $395,000 related to the 2008-2010 tax years. The Company accrued an additional pretax liability related to the non-income tax matters of approximately $1,019,000 in the year ended December 31, 2012, of which approximately $301,000 related to the 2005-2011 tax years. For the year ended December 31, 2013, the Company accrued an additional pretax liability related to the non-income tax matters of approximately $841,000, of which approximately $352,000 related to the 2007-2012 tax years, and paid approximately $306,000 to settle with certain states. The expense is included in selling, general and administrative expenses on its consolidated statements of operations and the liability is reflected as sales tax payable as of December 31, 2013 and 2012, on its consolidated balance sheets. The Company is continuing to work with professional tax advisors and state authorities to resolve the remaining matters.

Contingencies:

On December 4, 2012, the Company’s subsidiary, CC Staffing, Inc. (now known as Travel Staff, LLC) became the subject of a purported class action lawsuit (Alice Ogues, on behalf of herself and all others similarly situated, Plaintiffs, vs. CC Staffing, Inc., a Delaware corporation; and DOES 1-50, inclusive, Defendants) filed in the United States District Court, Northern District of California. Plaintiff alleges that traveling employees were denied meal periods and rest breaks, that they should have been paid overtime on reimbursement amounts, various other wage and hour claims, and that they are entitled to associated penalties. The parties have agreed to settle this lawsuit for $750,000. The Company accrued a reserve of $750,000 for this claim which is included in other current liabilities and legal settlement charge on its consolidated balance sheets and statements of operations, respectively. The United States District Court, Northern District of California granted preliminary approval of the settlement on January 17, 2014, subject to the inclusion of language requiring a five-day cure period for deficient requests for exclusion from class members. On February 6, 2014, the parties amended the settlement agreement to include such language. A hearing for final approval of the settlement agreement is scheduled for May 16, 2014.

On September 8, 2010, the Company's subsidiary, Cross Country TravCorps, Inc. became the subject of an indemnity lawsuit (New Hanover Regional Medical Center vs. Cross Country TravCorps, Inc., d/b/a Cross Country Staffing, and Christina Lynn White) filed in the New Hanover County Civil Superior Court, State of North Carolina. Plaintiff alleged that a former employee of Cross Country TravCorps was negligent in caring for a patient which resulted in the death of that patient. New Hanover Regional Medical Center settled the claim pre-suit and subsequently brought an indemnity claim against the former nurse and Cross Country TravCorps for the actions of the nurse pursuant to the Staffing Agreement between Cross Country TravCorps and the hospital. On April 19, 2013, an arbitration panel found the nurse negligently caused the death of the patient and that New Hanover Regional Medical Center had no active negligence contributing to that death. Furthermore, the arbitration panel found that the facility was entitled to recover compensatory damages from the nurse and Cross Country Staffing in the amount of approximately $2,000,000, plus pre-judgment interest (from September 8, 2010) at 8% per year. In addition, New Hanover Regional Medical Center was entitled to recover from Cross Country prejudgment interest on the compensatory damages from March 31, 2008 through September 7, 2010 at the rate of 8% per year and approximately $41,000 in attorneys' fees. The panel also found that, but for the negligence of the nurse, Cross Country would have no liability to New Hanover Regional Medical Center; therefore, as a matter of equity Cross Country was entitled to recover indemnity from the former nurse to the full extent Cross Country actually paid New Hanover Regional Medical Center any portion of the award (other than the prejudgment interest from March 31, 2008 through September 7, 2010 and the approximately $41,000 in attorneys' fees). The nurse had insurance coverage for this claim with $2,000,000 (individual)/$4,000,000 (aggregate) limits and no deductible. In addition, the Company has excess coverage that was expected to cover the amount of loss over $2,000,000. During the second quarter of 2013, the nurse's insurance carrier paid New Hanover Regional Medical Center $2,000,000 and Cross Country made an indemnity payment to the facility in the amount of $920,450. Cross Country was fully reimbursed by the nurse’s insurance company indemnity payment as well as a reimbursement for additional legal expenses related to this claim of $273,474, which was collected in October 2013.

The Company is also subject to other legal proceedings and claims that arise in the ordinary course of its business. In the opinion of management, the outcome of these other matters will not have a significant effect on the Company’s consolidated financial position or results of operations.

Income Taxes

12 Months Ended

Dec. 31, 2013

Income Tax Disclosure [Abstract]

Income Taxes

The components of the Company’s income (loss) before income taxes are as follows:



	Year Ended December 31,
	2013			2012			2011
United States	$	(11,216,037	)	$	(28,599,481	)	$	1,384,963
Foreign	1,176,574			1,704,623			2,232,123
	$	(10,039,463	)	$	(26,894,858	)	$	3,617,086

The components of the Company’s income tax expense (benefit) are as follows:



	Year Ended December 31,
	2013		2012			2011
Continuing operations:
Current
Federal	$	—	$	411,767		$	(29,716	)
State	540,266		811,760			355,142
Foreign	415,806		1,561,492			632,415
	956,072		2,785,019			957,841
Deferred
Federal	37,821,541		(4,048,064		)	444,193
State	5,133,844		(5,251,385		)	681,076
Foreign	299,091		364,541			(13,663		)
Total	43,254,476		(8,934,908		)	1,111,606
	$	44,210,548	$	(6,149,889	)	$	2,069,447
The total income tax provision is summarized as follows:
Continuing operations	$	44,210,548	$	(6,149,889	)	$	2,069,447
Discontinued operations	2,121,941		(9,496,992		)	2,063,050
	$	46,332,489	$	(15,646,881	)	$	4,132,497

Deferred income taxes reflect the net tax effect of temporary differences between the carrying amount of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes.

Significant components of the Company’s deferred tax assets and liabilities are as follows:



	December 31,
	2013			2012
Current deferred tax assets (liabilities):
Accrued other and prepaid expenses	$	2,591,944		$	2,302,277
Accrued settlement charge	283,534			—
Allowance for doubtful accounts	649,790			808,466
Assets held for sale	—			2,826,663
Other	468,082			597,237
Gross deferred tax assets	3,993,350			6,534,643
Valuation allowance	(4,528,177		)	(551,160		)
Deferred tax assets (liabilities)	(534,827		)	5,983,483
Non-current deferred tax (liabilities) and assets:
Amortization	(1,313,863		)	4,377,573
Depreciation	(383,895		)	(1,631,495		)
Identifiable intangibles	(2,237,409		)	(2,409,238		)
Net operating loss carryforwards	32,531,221			23,616,558
Accrued professional liability	(117,842		)	293,815
Accrued workers’ compensation	675,201			768,617
Tax on unrepatriated earnings	(453,298		)	(1,860,656		)
Share-based compensation	1,610,346			2,120,269
Other	313,898			966,361
Gross deferred tax assets	30,624,359			26,241,804
Valuation allowance	(47,473,410		)	(3,481,752		)
Deferred tax (liabilities) assets	(16,849,051		)	22,760,052
Net deferred taxes	$	(17,383,878	)	$	28,743,535

Subsequent to the issuance of the Company's 2012 Annual Report on Form 10-K, the Company determined that its deferred tax assets (liabilities) as presented on its consolidated balance sheets were inappropriately classified. The Company has corrected the 2012 information on its consolidated balance sheets and in the preceding table. Management does not believe such correction is material to the previously issued consolidated financial statements.

The Company determines the need for a valuation allowance under Income Taxes topic of the FASB ASC by assessing the probability of realizing deferred tax assets, taking into consideration all available positive and negative evidence, including historical operating results, expectations of future taxable income, carryforward periods available to the Company for tax reporting purposes, the evaluation of various income tax planning strategies and other relevant factors. The Company maintains a valuation allowance when it is more likely than not that all or a portion of a deferred tax asset will not be realized based on consideration of all available evidence. Adjustments to the deferred tax valuation allowances are made to earnings in the period when such assessments are made. Significant judgment is required in making this assessment and to the extent future expectations change, the Company would have to assess the recoverability of its deferred tax assets at that time. The Company's cumulative loss position was significant negative evidence in assessing the need for a valuation allowance. As of December 31, 2013, the Company determined that it could not sustain a conclusion that it was more likely than not that it would realize any of its deferred tax assets resulting from recent losses, the difficulty of forecasting future taxable income, and other factors. The Company intends to maintain a valuation allowance until sufficient positive evidence exists to support its reversal. To be considered a source of future taxable income to support realizability of a deferred tax asset, a taxable temporary difference must reverse in a period such that it would result in the realization of the deferred tax asset. Taxable temporary differences related to indefinite-lived intangibles, such as goodwill, are by their nature not predicted to reverse and therefore not considered a source of future taxable income in accordance with ASC 740. The Company had $17,383,878 of deferred tax liabilities relating to indefinite lived intangible assets that it was not able to offset against deferred tax assets. As of December 31, 2013 and 2012, the Company recorded valuation allowances of $52,001,587 and $4,032,912, respectively. The December 31, 2013 valuation allowance applied to all its deferred tax assets. The December 31, 2012 valuation allowance related to the uncertainty of the realization of a particular subsidiary’s state portion of its deferred tax asset that arose from the goodwill impairment and certain separate state net operating losses.

As of December 31, 2013 and 2012, respectively, the Company had approximately $78,120,000 and $53,844,000 of federal, state and foreign net operating loss carryforwards. The federal carryforwards expire between 2030 and 2033. The state carryforwards expire between 2013 and 2033. The majority of the foreign carryforwards are in a jurisdiction with no expiration. A valuation allowance for the net operating losses has been recorded at December 31, 2013 and 2012, to reduce the Company’s deferred tax asset to an amount that is more likely than not to be realized.

The reconciliation of income tax computed at the U. S. federal statutory rate to income tax expense (benefit) is as follows:



	Year Ended December 31,
	2013			2012			2011
Tax at U.S. statutory rate	$	(3,513,812	)	$	(9,413,200	)	$	1,266,166
State taxes, net of federal benefit	(190,656		)	(1,226,475		)	(64,608		)
Non-deductible meals and entertainment	449,780			961,933			290,280
Foreign tax expense	554,314			(221,897		)	(162,448		)
Valuation allowances	48,556,357			(43,657		)	367,068
Uncertain tax positions	(257,488		)	647,720			174,045
Deferred tax rate differential	312			150,583			(107,057		)
Deferred tax write-offs (a)	221,028			—			301,765
Audit settlements	160,026			—			(391,822		)
Tax on unrepatriated earnings	(1,464,728		)	2,004,596			—
Tax on repatriated earnings	—			519,072			—
Tax true ups and other	(304,585		)	471,436			396,058
Total income tax expense (benefit)	$	44,210,548		$	(6,149,889	)	$	2,069,447

_______________


(a)	During 2013 and 2011, the Company recorded deferred tax expense related to an overstatement of deferred tax assets for share-based payments related to prior periods of approximately $221,000 and $302,000, respectively.

The tax years of 2004, 2005, and 2008 through 2012 remain open to examination by the major taxing jurisdictions to which the Company is subject, with the exception of certain states in which the statute of limitations has been extended. In mid-July of 2013, the Company received a notice of proposed audit adjustments from the State of New York relating to the examination of its tax years ending December 31, 2006 through 2009. The settlement was for less than the amount accrued as of December 31, 2013.

As of December 31, 2011, pursuant to the subtopic of Other Considerations or Special Areas of the Income Taxes Topic in the FASB ASC, the Company did not provide for United States income taxes or foreign withholding taxes on undistributed earnings from certain non-U.S. subsidiaries (located in the United Kingdom and India that had tax rates of approximately 27% and 34%, respectively) that were expected to be permanently reinvested outside of the United States. In the fourth quarter of 2012, the Company changed its position regarding permanent reinvestment and accrued approximately $1,371,000 of U.S. tax and $633,000 of India tax on earnings of approximately $9,528,000. During the fourth quarter of 2012, the company repatriated approximately $3,268,000 of foreign earnings from its Indian subsidiary. U.S. income taxes on those repatriated earnings have been offset by its U.S. losses. The sale of the Company’s clinical trial services unit located outside the US in the UK during 2013 resulted in write-offs of the investment in those subsidiaries and offset the amount of US taxes that would need to be accrued on the India earnings to zero. India withholding taxes on a dividend of India earnings are not affected by the calculation of US taxes due and continue to be accrued.

The Company’s Indian subsidiary, Cross Country Infotech Private, Ltd is located in a software technology park and was entitled to 100% tax holiday until March 2011. The effect of the income tax holiday was a reduction to the income tax provision in 2011 of approximately $178,000.

The Company recognizes in its financial statements the impact of a tax position if that position is more likely than not of being sustained on audit, based on the technical merits of the position.

A reconciliation of the beginning and ending amounts of unrecognized tax benefits is approximately as follows:



	2013			2012
Balance at January 1	$	5,204,000		$	4,500,000
Additions based on tax positions related to the current year	496,000			852,000
Additions based on tax positions related to prior years	681,000			152,000
Reductions based on settlements of tax positions related to the prior year	(292,000		)	(30,000		)
Reductions for tax positions as a result of a lapse of the applicable statute of limitations	(1,076,000		)	(263,000		)
Other	(27,000		)	(7,000		)
Balance at December 31	$	4,986,000		$	5,204,000

Short-term unrecognized tax benefits are included in other current liabilities on the consolidated balance sheets and were approximately $973,000 and $548,000 as of December 31, 2013 and 2012, respectively. As of December 31, 2013 and 2012, the Company had unrecognized tax benefits, which would affect the effective tax rate if recognized of approximately $4,399,000 and $4,700,000, respectively. During 2013, the Company had gross increases of $1,177,000 to its current year unrecognized tax benefits, related to federal and state tax issues. In addition, the Company had gross decreases of $1,394,000 to its unrecognized tax benefits related to settlement refunds and the closure of open tax years.

The Company recognizes interest and penalties related to unrecognized tax benefits in the provision for income taxes. During the years ended December 31, 2013, 2012 and 2011, the Company recognized interest and penalties of $81,000, $124,000, and $27,000, respectively. The Company had accrued approximately $1,015,000 and $886,000 for the payment of interest and penalties at December 31, 2013 and 2012, respectively.

Stockholders' Equity

12 Months Ended

Dec. 31, 2013

Equity [Abstract]

Stockholders' Equity

Stockholders’ Equity

Stock Repurchase Programs

In February 2008, the Company’s Board of Directors authorized its most recent stock repurchase program whereby the Company may purchase up to 1,500,000 shares of its common stock, subject to terms of the Company’s Credit Agreement. The shares may be repurchased from time-to-time in the open market and the repurchase program may be discontinued at any time at the Company’s discretion.

During the year ended December 31, 2012, the Company repurchased, under this program, a total of 71,653 shares at an average price of $5.22. The cost of such purchases was $374,248. All of the common stock was retired. During the year ended December 31, 2011, the Company repurchased, under this program, a total of 427,043 shares at an average price of $5.23. The cost of such purchases was $2,234,585. All of the common stock was retired.

At December 31, 2013, the Company had 942,443 shares of common stock left remaining to repurchase under its February 2008 authorization, subject to the limitations of the Company’s Credit Agreement. Subject to certain conditions as described in its Loan Agreement entered into on January 9, 2013, the Company may repurchase up to an aggregate amount of $5,000,000 of its Equity Interests. See Note 8- Long-term Debt for further information.

Stock Options

2007 Stock Incentive Plan

The Company’s 2007 Stock Incentive Plan (2007 Plan) was approved by its stockholders at its Annual Meeting of Stockholders, held in May of 2007, and was amended at its Annual Meeting held in May of 2010. Key modifications in the amendment were to increase the aggregate share reserve and increase the share sub-limit for Awards that are not Appreciation Awards (as defined by the Plan). Other clarifying amendments to reflect recent developments in equity compensation practices and applicable law were also included.

The 2007 Plan provides for the issuance of stock options, stock appreciation rights, restricted stock, performance shares, and other stock-based awards, all as defined by the 2007 Plan, to eligible employees, consultants and non-employee Directors. The aggregate number of shares of common stock which may be issued or used for reference purposes under the 2007 Plan or with respect to which awards may be granted may not exceed 3,500,000 shares, which may be either authorized and unissued common stock or common stock held in or acquired for the treasury of the Company; provided, however, that 1,700,000 shares of this aggregate limit may be used for awards that are not Appreciation Awards (including restricted stock, performance shares or certain other stock-based awards).

Under the 2007 Plan, the Compensation Committee of the Company’s Board of Directors (the Committee), has the discretion to determine the terms of the awards at the time of the grant. Provided, however, that, in the case of stock options and stock appreciation rights (share options): 1) the exercise price per share of the award is not less than 100% (or, in the case of 10% or more stockholders, the exercise price of the incentive stock options (ISOs) granted may not be less than 110%) of the fair market value of the common stock at the time of the grant; and 2) the term of the award will be no more than 10 years after the date the option is granted (or, shall not exceed five years, in the case of a 10% or more stockholder). In the case of restricted stock, the purchase price may be zero to the extent permitted by applicable law.

The following awards were granted under the 2007 Plan to the Company’s non-employee Directors and management team:



	Year Ended December 31,
	2013	2012	2011
Stock appreciation rights	324,000	344,500	261,500
Restricted stock	340,509	337,220	216,538

The stock appreciation rights can only be settled with stock or cash, at the discretion of the Committee. The stock appreciation rights vest 25% per year over a 4 year period and expire after 7 years. The restricted stock awards vest 25% per year over a 4 year period on the anniversary date of the grant. The Company’s policy is to issue new shares from its authorized but unissued balance of common stock outstanding or shares of common stock reacquired by the Company if stock appreciation rights are settled with stock.

Due to the adoption of the 2007 Plan, no further grants will be issued under the Company’s 1999 Plans referred to below.

1999 Stock Option Plan and Equity Participation Plan

On December 16, 1999, the Company’s Board of Directors approved the 1999 Stock Option Plan and Equity Participation Plan (collectively, the 1999 Plans), which was amended and restated on October 25, 2001 and provided for the issuance of ISOs and non-qualified stock options to eligible employees and non-employee directors for the purchase of up to 4,398,001 shares of common stock.

The following table summarizes the Company’s activities with respect to all of its share option plans for the year ended 2013:



	Shares		Option Price	Weighted Average Exercise Price	Weighted- Average Remaining Contractual Life (in years)	Aggregate Intrinsic Value
Share options outstanding at beginning of year	1,922,756		$4.16-$22.50	$9.67
Granted	324,000		$4.92-$5.61	$5.25
Exercised	(14,000	)	$4.35	$4.35
Forfeited/expired	(686,457	)	$4.35-$22.50	$9.36
Share options outstanding at end of year	1,546,299		$4.16-$22.50	$8.93	3.28	$	3,770,958
Share options exercisable at end of year	1,006,674		$4.16-$22.50	$10.79	1.99	$	1,329,153
Share options unvested at end of year	539,625		$4.16-$8.09	$5.46	5.69	$	2,441,805

As of December 31, 2013, the Company had 1,546,299 share options outstanding of which 1,433,047 were vested or expected to vest at a weighted average exercise price of $9.20, intrinsic value of $3,270,748 and a weighted average contractual life of 3.10 years. As of December 31, 2013, the Company had approximately $884,579 pretax of total unrecognized compensation cost related to share options which may be adjusted for future changes in forfeitures. The Company expects to recognize such cost over a period of 2.54 years.

The following table represents information about stock options and stock appreciation rights granted and exercised in each year. During the years ended December 31, 2013, 2012 and 2011, the Company issued options and stock appreciation rights at market price.



	Year Ended December 31,
	2013		2012		2011
Share option grants	324,000		344,500		261,500
Weighted average grant date fair value of options granted during the period	$	1.77	$	1.65	$	2.63
Total intrinsic value of options exercised	$	12,465	$	—	$	—

The Company records compensation expense for stock options based on the estimated fair value of the options on the date of grant using the Black-Scholes option-pricing model with the assumptions included in the table below. The Company computes expected volatility using the historical volatility of the market price of the Company’s common stock. Historical data is used to estimate the expected option life and the expected forfeiture rate. The risk-free rate is based on the U.S. Treasury yield curve in effect at the time of grant for the estimated life of the option. The following assumptions were used to estimate the fair value of options granted using the Black-Scholes option-pricing model:



	Year Ended December 31,
	2013		2012		2011
Expected dividend yield	—	%	—	%	—	%
Expected volatility	48.00	%	47.00	%	42.00	%
Risk-free interest rate	0.79	%	0.58	%	1.33	%
Expected life	4.2 years		4.3 years		4.3 years

Restricted Stock

Restricted stock awards granted under the Company’s 2007 Plan entitle the holder to receive, at the end of a vesting period, a specified number of shares of the Company’s common stock. Share-based compensation expense is measured by the market value of the Company’s stock on the date of grant. The shares vest ratably over a four year period ending on the anniversary date of the grant. There is no partial vesting and any unvested portion is forfeited.

The following table summarizes restricted stock award activity for the year ended December 31, 2013:



	Number of Shares		Weighted Average Grant Date Fair Value
Unvested restricted stock awards, January 1, 2013	661,648		$	6.08
Granted	340,509		$	4.64
Vested	(238,296	)	$	6.86
Forfeited	(211,630	)	$	4.73
Unvested restricted stock awards, December 31, 2013	552,231		$	5.37

As of December 31, 2013, the Company had approximately $2,372,238 pretax of total unrecognized compensation cost related to non-vested restricted stock awards which may be adjusted for future changes in forfeitures. The Company expects to recognize such cost over a weighted average period of 2.59 years. The fair value of shares vested was approximately $2,378,194; $944,976 and $1,190,000 during the years ended December 31, 2013, 2012 and 2011, respectively.

Secondary Offerings

In November 2004, the Company filed a registration statement on Form S-3 with the Securities and Exchange Commission for the registration of 11,403,455 shares of common stock held by three of its existing shareholders. No members of management registered shares pursuant to this registration statement. Prior to 2013, 8,172,868 shares were sold in a public offering with net proceeds from the sale going to the selling stockholders. During 2013, the remaining shares were sold by the existing shareholders and as a result, the registration statement is no longer active.

Earnings Per Share

12 Months Ended

Dec. 31, 2013

Earnings Per Share [Abstract]

Earnings Per Share

In accordance with the requirements of the Earnings Per Share Topic of the FASB ASC, basic earnings per share is computed by dividing net income by the weighted average number of shares outstanding (excluding unvested restricted stock) and diluted earnings per share reflects the dilutive effects of unvested stock options and restricted stock (as calculated utilizing the treasury stock method). Certain shares of common stock that are issuable upon the exercise of options and vesting of restricted stock have been excluded from the 2013, 2012 and 2011 per share calculations because their effect would have been anti-dilutive. Such shares amounted to 1,547,814; 2,033,632 and 1,962,265, during the years ended December 31, 2013, 2012 and 2011, respectively. For purposes of calculating net income (loss) per common share - diluted for the years ending December 31, 2013 and 2012, the Company excluded potentially dilutive shares of 149,453, and 47,258, respectively, as their effect would have been anti-dilutive, due to the Company’s net loss from continuing operations in the respective years.

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



	Year Ended December 31,
	2013			2012			2011
(Loss) income from continuing operations	$	(54,250,011	)	$	(20,744,969	)	$	1,547,639
Income (loss) from discontinued operations, net of income taxes	2,280,688			(21,476,528		)	2,550,210
Net (loss) income	$	(51,969,323	)	$	(42,221,497	)	$	4,097,849

Basic (loss) income per common share from:
Continuing operations	$	(1.75	)	$	(0.67	)	$	0.05
Discontinued operations	0.07			(0.70		)	0.08
Net (loss) income	$	(1.68	)	$	(1.37	)	$	0.13

Diluted (loss) income per common share from:
Continuing operations	$	(1.75	)	$	(0.67	)	$	0.05
Discontinued operations	0.07			(0.70		)	0.08
Net (loss) income	$	(1.68	)	$	(1.37	)	$	0.13

Weighted-average number of shares outstanding-basic	31,009,218			30,842,723			31,146,165
Plus dilutive equity awards	—			—			45,851
Weighted-average number of shares outstanding-diluted	31,009,218			30,842,723			31,192,016

Related Party Transactions	12 Months Ended
Related Party Transactions	Dec. 31, 2013
Related Party Transactions [Abstract]
Related Party Transactions	Related Party Transactions The Company provides services to hospitals which are affiliated with certain members of the Company’s Board of Directors. Management believes the pricing for the Company’s services is consistent with its other hospital customers. Revenue related to these transactions amounted to approximately $3,897,000, $3,804,000 and $2,097,000 in 2013, 2012 and 2011, respectively. Accounts receivable due from these hospitals at December 31, 2013 and 2012 were approximately $424,000 and $570,000, respectively. In the year ended December 31, 2010, the Company entered into an exclusive MSP arrangement with one of these hospital systems.

- Definition

The entire disclosure for related party transactions. Examples of related party transactions include transactions between (a) a parent company and its subsidiary; (b) subsidiaries of a common parent; (c) and entity and its principal owners; and (d) affiliates.

+ References + Details

Segment Information

12 Months Ended

Dec. 31, 2013

Segment Reporting [Abstract]

Segment Information

In accordance with the Segment Reporting Topic of the FASB ASC, the Company reports three business segments – nurse and allied staffing, physician staffing, and other human capital management services, described below:

Nurse and allied staffing - The nurse and allied staffing segment provides traditional staffing, including temporary and permanent placement of travel nurses and allied professionals, and branch based local nurses and allied staffing. Its clients include: public and private acute-care and non-acute care hospitals, government facilities, schools, outpatient clinics, ambulatory care facilities, retailers, and many other healthcare providers throughout the U.S. The Company aggregates its Cross Country Staffing and Allied Health Group brands that it markets to its customers in this business segment.

Physician staffing – The physician staffing business segment provides physicians in many specialties as independent contractors on temporary assignments throughout the U.S. at various healthcare facilities, such as acute and non-acute care facilities, medical group practices, government facilities, and managed care organizations.

Other human capital management services - The other human capital management services business segment provides education and training programs to the healthcare industry and retained search services for physicians and healthcare executives, within the U.S.

The Company’s management evaluates performance of each segment primarily based on revenue and contribution income. The Company’s management does not evaluate, manage or measure performance of segments using asset information; accordingly, total asset information by segment is not prepared or disclosed. See Note 4 – Goodwill and Other Identifiable Intangible Assets for further information. The information in the following table is derived from the segments’ internal financial information as used for corporate management purposes. Certain corporate expenses are not allocated to and/or among the operating segments.

Information on operating segments and a reconciliation of such information to (loss) income from continuing operations for the periods indicated are as follows:



	Year ended December 31,
	2013			2012			2011
Revenue from unaffiliated customers:
Nurse and allied staffing	$	278,972,901		$	277,753,525		$	278,793,599
Physician staffing	121,371,017			123,545,045			118,780,800
Other human capital management services	37,966,798			41,336,576			41,803,061
	$	438,310,716		$	442,635,146		$	439,377,460
Contribution income (a):
Nurse and allied staffing (b)	$	19,188,403		$	11,360,870		$	20,077,583
Physician staffing	8,616,916			10,651,879			11,320,076
Other human capital management services	745,506			1,943,628			3,172,282
	28,550,825			23,956,377			34,569,941

Unallocated corporate overhead (b)	22,286,031			22,574,066			20,299,783
Depreciation	3,885,688			4,904,845			5,965,002
Amortization	2,294,077			2,263,556			2,393,722
Acquisition costs	473,488			—			—
Restructuring costs	483,578			—			—
Legal settlement charge	750,000			—			—
Impairment charges (c)	6,400,000			18,732,407			—
(Loss) income from continuing operations	$	(8,022,037	)	$	(24,518,497	)	$	5,911,434

_______________

(a)

The Company defines contribution income as income from operations before depreciation, amortization, acquisition costs, restructuring costs, legal settlement charges, impairment charges and corporate expenses not specifically identified to a reporting segment. Contribution income is used by management when assessing segment performance and is provided in accordance with the Segment Reporting Topic of the FASB ASC.


(b)	In 2013, the Company refined its methodology for allocating certain corporate overhead expenses to its nurse and allied staffing segment expenses to more accurately reflect this segment’s profitability. Prior year information has been reclassified to conform to current year presentation.


(c)	During the fourth quarter of 2013, the Company recorded a trade names impairment charge of $6,400,000. During the year ended December 31, 2012, the Company recorded pretax impairment charges in its continuing operations of $18,732,407. Refer to discussion in Note 4-Goodwill, Trade Names and Other Identifiable Intangible Assets.

Effective January 1, 2014, the Company merged its Allied Health Group, LLC subsidiary with its Medical Doctor Associates, LLC subsidiary. The decision to merge these companies was based a number of factors including the consolidation of back office processes and other operational efficiencies. Along with this merger, the Company evaluated the Allied Health Group trade name and determined that it would be more valuable to use it for the Company’s nurse and allied staffing business, and as a result, transferred the trade name effective January 1, 2014. The process to effect the merger and move the trade name did not occur until 2014 and included: merging their general ledgers, communicating to clients and providers, and changing our processes to pay our advanced practice providers.

The allied health staffing business of MDA has primarily consisted of higher level allied professional, such as physician assistants and nurse practitioners, whose job functions are becoming increasingly more similar to those of physicians than to other allied health professionals. The 2014 change in legal structure and processes, along with the current market dynamics has changed the Company’s approach/ conclusion to aggregate this business with its nurse and allied staffing business segment for 2014. This subsequent change in reporting occurred after the balance sheet date but before the Company issued financial statements. The Company will be revising its segments for 2014 reporting to include this business with its physician staffing business segment.

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 34
-URI http://asc.fasb.org/extlink&oid=6534315&loc=d3e8981-108599

Reference 2: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 41
-URI http://asc.fasb.org/extlink&oid=6534315&loc=d3e9038-108599

Reference 3: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 33
-URI http://asc.fasb.org/extlink&oid=6534315&loc=d3e8971-108599

Reference 4: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 12
-URI http://asc.fasb.org/extlink&oid=6534315&loc=d3e8595-108599

Reference 5: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 1
-URI http://asc.fasb.org/extlink&oid=6534315&loc=d3e8380-108599

Reference 6: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-URI http://asc.fasb.org/extlink&oid=6534315&loc=d3e8933-108599

Reference 7: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 26
-URI http://asc.fasb.org/extlink&oid=6534315&loc=d3e8844-108599

Reference 8: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
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-Paragraph 35
-URI http://asc.fasb.org/extlink&oid=6534315&loc=d3e8984-108599

Reference 9: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 40
-URI http://asc.fasb.org/extlink&oid=6534315&loc=d3e9031-108599

Reference 10: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 42
-URI http://asc.fasb.org/extlink&oid=6534315&loc=d3e9054-108599

Reference 11: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 10
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Reference 12: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
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-URI http://asc.fasb.org/extlink&oid=6534315&loc=d3e8864-108599

Reference 13: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
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-Section 50
-Paragraph 31
-URI http://asc.fasb.org/extlink&oid=6534315&loc=d3e8924-108599

Reference 14: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
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-Section 50
-Paragraph 30
-URI http://asc.fasb.org/extlink&oid=6534315&loc=d3e8906-108599

+ Details

Quarterly Financial Data (Unaudited)

12 Months Ended

Dec. 31, 2013

Quarterly Financial Information Disclosure [Abstract]

Quarterly Financial Data (Unaudited)



	First Quarter (a)			Second Quarter			Third Quarter			Fourth Quarter (b)
2013
Revenue from services	$	110,315,840		$	110,768,343		$	108,047,986		$	109,178,547
Gross profit	$	28,875,395		$	27,838,891		$	28,184,087		$	28,561,465

(Loss) income from continuing operations, net of tax	$	(1,345,729	)	$	(1,435,829	)	$	1,453,590		$	(52,922,043	)
Income (loss) from discontinued operations, net of tax	$	2,503,763		$	(21,393	)	$	(538,916	)	$	337,234
Net income (loss)	$	1,158,034		$	(1,457,222	)	$	914,674		$	(52,584,809	)

Basic income (loss) per common share from:
Continuing operations	$	(0.04	)	$	(0.05	)	$	0.05		$	(1.70	)
Discontinuing operations	0.08			—			(0.02		)	0.01
Net income (loss)	$	0.04		$	(0.05	)	$	0.03		$	(1.69	)

Diluted income (loss) per common share from:
Continuing operations	$	(0.04	)	$	(0.05	)	$	0.05		$	(1.70	)
Discontinuing operations	0.08			—			(0.02		)	0.01
Net income (loss)	$	0.04		$	(0.05	)	$	0.03		$	(1.69	)



	First Quarter			Second Quarter (c)			Third Quarter (c)			Fourth Quarter (c)
2012
Revenue from services	$	109,799,496		$	108,847,135		$	112,257,707		$	111,730,808
Gross profit	$	29,049,682		$	27,136,129		$	27,455,827		$	27,943,467

Income (loss) from continuing operations, net of tax	$	361,955		$	(18,841,283	)	$	719,539		$	(2,985,180	)
(Loss) income from discontinued operations, net of tax	$	(946,322	)	$	4,337,450		$	(18,319,626	)	$	(6,548,030	)
Net loss	$	(584,367	)	$	(14,503,833	)	$	(17,600,087	)	$	(9,533,210	)

Basic (loss) income per common share from:
Continuing operations	$	0.01		$	(0.61	)	$	0.02		$	(0.10	)
Discontinuing operations	(0.03		)	0.14			(0.59		)	(0.21		)
Net loss	$	(0.02	)	$	(0.47	)	$	(0.57	)	$	(0.31	)

Diluted (loss) income per common share from:
Continuing operations	$	0.01		$	(0.61	)	$	0.02		$	(0.10	)
Discontinuing operations	(0.03		)	0.14			(0.59		)	(0.21		)
Net loss	$	(0.02	)	$	(0.47	)	$	(0.57	)	$	(0.31	)

________________


(a)	The Company sold its clinical trial services business on February 15, 2013. The clinical trial services business has been classified as discontinued operations. The transaction resulted in a gain on sale of $3,968,714 pretax, or $2,055,907 after tax. See Note 3 – Assets Held for Sale and Discontinued Operations.

(b)

On December 2, 2013, the Company acquired the operating assets of On Assignment, Inc.’s Allied Healthcare Staffing division. The acquisition has been accounted for in accordance with FASB ASC Topic 805-Business Combinations, using the purchase method. The results of On Assignment's operations have been included in the Company's consolidated statements of operations since December 2, 2013, the date of the acquisition. See Note 5 - Acquisitions. During the fourth quarter of 2013, the Company recorded a deferred tax assets valuation allowance of approximately $48,406,398 and a trade names impairment charge of $6,400,000. See Note 12 - Income Taxes and Note 4 - Goodwill, Trade Names and Other Identifiable Intangible Assets.


(c)	During the second, third and fourth quarters of 2012, the Company recorded impairment charges of approximately $18,732,000, $23,500,000 and $11,900,000, respectively. See Note 4 – Goodwill, Trade Names and Other Identifiable Intangible Assets and Note 3 – Assets Held for Sale and Discontinued Operations.

Schedule II

12 Months Ended

Dec. 31, 2013

Valuation and Qualifying Accounts [Abstract]

Schedule II - Valuation and Qualifying Accounts

Schedule II

CROSS COUNTRY HEALTHCARE, INC.

VALUATION AND QUALIFYING ACCOUNTS

FOR THE YEARS ENDED DECEMBER 31, 2013, 2012, AND 2011



Allowance for Doubtful Accounts	Balance at Beginning of Period		Charged to Costs and Expenses			Write-offs				Recoveries		Other Changes				Balance at End of Period
Year ended December 31, 2013	$	1,841,136	$	1,078,195		$	(1,324,027	)		$	55,669	$	—			$	1,650,973
Year ended December 31, 2012	$	2,180,125	$	786,107		$	(912,797	)		$	16,076	$	(228,375	)	(a)	$	1,841,136
Year ended December 31, 2011	$	3,500,968	$	578,805		$	(1,903,539	)		$	3,891	$	—			$	2,180,125

Valuation Allowance for Deferred Tax Assets
Year ended December 31, 2013	$	4,032,912	$	48,406,398	(b)	$	(437,723	)	(b)	$	—	$	—			$	52,001,587
Year ended December 31, 2012	$	3,678,183	$	354,729	(c)	$	—			$	—	$	—			$	4,032,912
Year ended December 31, 2011	$	3,311,831	$	366,352	(c)	$	—			$	—	$	—			$	3,678,183

________________


(a)	Represents the reclassification of the allowance for doubtful accounts related to Assets Held for Sale. See Note 3 – Assets Held for Sale and Discontinued Operations.


(b)	Related to deferred tax assets, Cyprus NOL's, and reversal of deferred tax assets related to the clinical trial services business.


(c)	Related to deferred tax assets on state net operating losses and a particular subsidiary’s state portion of its deferred tax asset that arose from goodwill impairment.

Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2013

Accounting Policies [Abstract]

Use of Estimates

Cash and Cash Equivalents and Cash Investments

Cash and Cash Equivalents

Interest income on cash and cash equivalents is included in other (income) expense , net, on the Company’s consolidated statements of operations.

Accounts Receivable and Concentration of Credit Risk

Prepaid Rent and Deposits

Property and Equipment

Goodwill and Other Identifiable Intangible Assets

Goodwill, Trade Names and Other Identifiable Intangible Assets

Business Combinations

Debt Issuance Costs

Deferred costs related to the Company’s prior senior secured term loan facility were capitalized and amortized using the effective interest method.

Sales & Other State Non-income Tax Liabilities

Reserves for Claims

Revenue Recognition

and the associated amounts of reimbursable expenses in cost of services.

Temporary Staffing Revenue

Permanent Placement

Gross Versus Net Policies

The Company records revenue on a gross basis as a principal or on a net basis as an agent depending on the arrangement, as follows:

Managed Service Programs Arrangements


•	The subcontractor is the primary obligor in the arrangement and is responsible for fulfillment.


•	The amount the Company earns is fixed, typically a stated percentage of the amount billed to the customer.


•	The subcontractor bears the credit risk, not the Company.

Physician Staffing


•	The Company maintains the direct contractual relationship with the customer.


•	The Company performs part of the service by credentialing all of the providers and providing them with professional liability insurance.


•	The Company establishes the price for its services.


•	The Company bears the risk and rewards of the transaction including credit risk if the customer fails to pay for services performed.

Education and Training


•	The Company bears the risk and rewards of the transaction including credit risk if the customer fails to pay for services performed.


•	The Company performs part of the service by being involved with the program development and handling accreditation of the courses.


•	The Company establishes the price for its service.

Deferred Revenue

Share-Based Compensation

Advertising

Restructuring and Cost Reduction Plan

Operating Leases

Income Taxes

Comprehensive (Loss) Income

Fair Value Measurements

Recent Accounting Pronouncements

Assets Held for Sale and Discontinued Operations (Tables)

12 Months Ended

Dec. 31, 2013

Discontinued Operations and Disposal Groups [Abstract]

Revenues and Components of Discontinued Operations, Net of Tax



	Years Ended December 31,
	2013			2012			2011
Revenue	$	7,939,150		$	67,626,715		$	64,608,763

Income (loss) from discontinued operations before gain on sale and income taxes	433,915			(30,973,520		)	4,613,260
Gain on sale of discontinued operations	3,968,714			—			—
Income tax (expense) benefit	(2,121,941		)	9,496,992			(2,063,050		)
Income (loss) from discontinued operations, net of income taxes	$	2,280,688		$	(21,476,528	)	$	2,550,210

Major Classes of Assets and Liabilities Related to Assets Held for Sale

The following table represents the major classes of assets and liabilities related to assets held for sale as of December 31, 2012.



	December 31, 2012
Assets:
Accounts receivable, net	$	12,553,056
Other prepaid expenses	485,840
Other current assets	13,771
Property and Equipment, net	364,972
Goodwill	28,175,772
Other intangible assets, net	5,335,816
Other long-term assets	41,737
Total assets held for sale	$	46,970,964
Liabilities:
Accounts payable and accrued expenses	$	354,453
Accrued employee compensation and benefits	1,478,638
Other current liabilities	984,978
Other non-current liabilities	16,447
Total liabilities related to assets held for sale	$	2,834,516

- Definition

Tabular disclosure of disposal groups, which may include the gain (loss) recognized in the income statement and the income statement caption that includes that gain (loss), amounts of revenues and pretax profit or loss reported in discontinued operations, the classification and carrying value of the assets and liabilities comprising the disposal group, and the segment in which the disposal group was reported. Also may include the amount of adjustments to amounts previously reported in discontinued operations such as resolution of contingencies arising from the disposal transaction or the operations of the component prior to disposal.

+ References + Details

Goodwill and Other Identifiable Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2013

Goodwill and Intangible Assets Disclosure [Abstract]

Acquired Intangible Assets

As of December 31, 2013 and 2012, the Company had the following acquired intangible assets:



	December 31, 2013						December 31, 2012
	Gross Carrying Amount		Accumulated Amortization		Net Carrying Amount		Gross Carrying Amount		Accumulated Amortization		Net Carrying Amount
Intangible assets subject to amortization:
Databases	$	15,925,000	$	12,102,685	$	3,822,315	$	12,525,000	$	11,954,630	$	570,370
Customer relationships	37,304,000		15,125,076		22,178,924		26,904,000		13,089,055		13,814,945
Non-compete agreements	3,603,000		3,406,334		196,666		3,403,000		3,296,333		106,667
	$	56,832,000	$	30,634,095	$	26,197,905	$	42,832,000	$	28,340,018	$	14,491,982

Intangible assets not subject to amortization:
Goodwill					$	77,265,907					$	62,712,109
Trade Names					42,301,331						48,701,331
					$	119,567,238					$	111,413,440

Estimated Annual Amortization Expense

As of December 31, 2013, estimated annual amortization expense for continuing operations is as follows:



Year Ending December 31:
2014	$	3,063,146
2015	2,906,222
2016	2,906,222
2017	2,861,481
2018	2,776,667
Thereafter	11,684,167
	$	26,197,905

Changes in Carrying Amount of Goodwill by Segment

The changes in the carrying amount of goodwill by segment are as follows:



	Nurse and Allied Staffing Segment			Physician Staffing Segment		Other Human Capital Management Services Segment		Total
Balances as of December 31, 2012
Aggregate goodwill acquired	$	259,732,408		$	43,405,047	$	19,307,062	$	322,444,517
Accumulated impairment loss (a)	(259,732,408		)	—		—		(259,732,408		)
Goodwill, net of impairment loss	—			43,405,047		19,307,062		62,712,109
Changes to aggregate goodwill in 2013
Goodwill acquired (b)	14,553,798			—		—		14,553,798
Balances as of December 31, 2013
Aggregate goodwill acquired	274,286,206			43,405,047		19,307,062		336,998,315
Accumulated impairment loss	(259,732,408		)	—		—		(259,732,408		)
Goodwill, net of impairment loss	$	14,553,798		$	43,405,047	$	19,307,062	$	77,265,907

_______________

(a)


(b)	Goodwill acquired from the acquisition of On Assignment's allied health business. See Note 5 - Acquisitions.

Acquisitions Acquisitions (Tables)

12 Months Ended

Dec. 31, 2013

Business Combinations [Abstract]

Schedule of Business Acquisitions, by Acquisition



Other current assets	$	61,837
Property and equipment	160,921
Goodwill	14,553,798
Other intangible assets	14,000,000
Other assets	52,444
Total assets acquired	28,829,000

Accrued employee compensation and benefits	111,789
Total liabilities assumed	111,789

Net assets acquired	$	28,717,211

Business Acquisition, Pro Forma Information



	Year Ended December 31,
	2013			2012
	(unaudited, amounts in thousands)

Revenue from services	$	476,456		$	482,142

Net income (loss)	$	(50,336	)	$	(40,543	)

Net income (loss) per common share - basic	$	(1.62	)	$	(1.31	)

Net income (loss) per common share - diluted	$	(1.62	)	$	(1.31	)

Property and Equipment (Tables)

12 Months Ended

Dec. 31, 2013

Property, Plant and Equipment [Abstract]

Property and Equipment

At December 31, 2013 and 2012, property and equipment consist of the following:



		December 31,
	Useful Lives	2013			2012
Computer equipment	3-5 years	$	12,115,305		$	12,373,042
Computer software	3-5 years	30,059,145			29,929,913
Office equipment	5-7 years	3,306,824			3,307,815
Furniture and fixtures	5-7 years	1,751,669			1,704,073
Leasehold improvements	(a)	3,716,158			2,837,740
		50,949,101			50,152,583
Less accumulated depreciation and amortization		(44,778,602		)	(41,917,771		)
		$	6,170,499		$	8,234,812

_______________


(a)	See Note 2 – Summary of Significant Accounting Policies.

Balance Sheet Details (Tables)

12 Months Ended

Dec. 31, 2013

Balance Sheet Related Disclosures [Abstract]

Balance Sheet Details



	December 31,
	2013		2012
Insurance recovery receivable:
Insurance recovery for workers’ compensation	$	2,093,000	$	2,427,994
Insurance recovery for professional liability	1,793,285		3,055,895
	$	3,886,285	$	5,483,889

Non-current insurance recovery receivable:
Insurance recovery for workers’ compensation – long term	$	3,336,000	$	3,694,006
Insurance recovery for professional liability – long term	7,577,527		4,516,133
	$	10,913,527	$	8,210,139

Accrued compensation and benefits:
Salaries and payroll taxes	$	6,874,644	$	6,931,650
Bonuses	2,199,559		1,648,979
Accrual for workers’ compensation claims	3,236,428		3,800,526
Accrual for health care benefits	1,385,115		2,005,486
Accrual for professional liability insurance	4,091,405		5,847,638
Accrual for vacation	1,361,161		1,415,954
	$	19,148,312	$	21,650,233

Long-term accrued claims:
Accrual for workers’ compensation claims	$	5,076,000	$	5,748,506
Accrual for professional liability insurance	13,227,096		10,598,836
	$	18,303,096	$	16,347,342

Other long-term liabilities:
Deferred compensation	$	1,638,334	$	1,471,091
Deferred rent	1,776,615		1,564,199
	$	3,414,949	$	3,035,290

Long-Term Debt (Tables)

12 Months Ended

Dec. 31, 2013

Debt Disclosure [Abstract]

Long-term Debt

At December 31, 2013 and 2012, long-term debt consists of the following:



	December 31,
	2013			2012
Term loan, interest 2.72% at December 31, 2012	$	—		$	23,125,000
Revolving credit facility, interest 3.27% and 2.72% at December 31, 2013 and 2012, respectively	8,400,000			10,000,000
Capital lease obligations and note payable	176,319			733,657
Total debt	8,576,319			33,858,657
Less current portion	(8,483,088		)	(33,682,348		)
Long-term debt	$	93,231		$	176,309

Aggregate Scheduled Maturities of Debt

Long-term debt includes capital lease obligations that are subordinate to the Company’s senior secured facility. As of December 31, 2013, the aggregate scheduled maturities of debt are as follows:



Through Year Ending December 31:	Revolver		Capital Leases and Note Payable
2014	$	8,400,000	$	83,088
2015	—		65,409
2016	—		27,822
2017	—		—
2018	—		—
Total	$	8,400,000	$	176,319

Fair Value Measurements (Tables)

12 Months Ended

Dec. 31, 2013

Fair Value Disclosures [Abstract]

Summary of Estimated Fair Values of Financial Assets and Liabilities Measured on a Recurring Basis

Fair Value Measurements



	December 31, 2013				December 31, 2012
	Total		Quoted Prices in Active Markets for Identical Assets (Level 1)		Total		Quoted Prices in Active Markets for Identical Assets (Level 1)
Financial Liabilities:
Deferred compensation	$	1,638,334	$	1,638,334	$	1,471,091	$	1,471,091

Fair Value of Goodwill Measured On Non-Recurring Basis

The following table presents the fair value of goodwill, which is the most significant component of the assets held for sale, measured on a non-recurring basis for the Company’s clinical trial services reporting unit included in assets held for sale as of December 31, 2012:

Fair Value Measurements



	December 31, 2013		December 31, 2012
(Level 3)
MDA trade names	$	28,836,000	n/a
Clinical trial services segment goodwill	n/a		$	28,175,722

Carrying Amounts and Estimated Fair Values of Significant Financial Instrument that were not Measured at Fair Value

The following table represents the carrying amounts and estimated fair values of the Company’s significant financial instruments that were not measured at fair value:



	December 31, 2013				December 31, 2012
	Carrying Amount		Fair Value		Carrying Amount		Fair Value
(Level 2)
Financial Assets:
Escrow Receivable	$	3,750,000	$	3,700,373	$	—	$	—
Financial Liabilities:
Term loan and revolver credit facility	$	—	$	—	$	33,125,000	$	32,654,213
Asset-based revolving credit facility (a)	$	8,400,000	$	8,400,000	$	—	$	—

_______________


(a)	Carrying value of the asset-based revolving credit facility approximates estimated fair value based on the short-term nature and the pricing at varying interest rates.

Commitments and Contingencies (Tables)

12 Months Ended

Dec. 31, 2013

Commitments and Contingencies Disclosure [Abstract]

Future Minimum Lease Payments

Future minimum lease payments, as of December 31, 2013, associated with these agreements with terms of one year or more are as follows:



Through Year Ending December 31:
2014	$	4,267,124
2015	3,914,971
2016	3,958,695
2017	3,016,878
2018	1,304,860
Thereafter	2,602,718
	$	19,065,246

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2013

Income Tax Disclosure [Abstract]

Components of Income (Loss) Before Income Taxes

The components of the Company’s income (loss) before income taxes are as follows:



	Year Ended December 31,
	2013			2012			2011
United States	$	(11,216,037	)	$	(28,599,481	)	$	1,384,963
Foreign	1,176,574			1,704,623			2,232,123
	$	(10,039,463	)	$	(26,894,858	)	$	3,617,086

Components of Income Tax Expense (Benefit)

The components of the Company’s income tax expense (benefit) are as follows:



	Year Ended December 31,
	2013		2012			2011
Continuing operations:
Current
Federal	$	—	$	411,767		$	(29,716	)
State	540,266		811,760			355,142
Foreign	415,806		1,561,492			632,415
	956,072		2,785,019			957,841
Deferred
Federal	37,821,541		(4,048,064		)	444,193
State	5,133,844		(5,251,385		)	681,076
Foreign	299,091		364,541			(13,663		)
Total	43,254,476		(8,934,908		)	1,111,606
	$	44,210,548	$	(6,149,889	)	$	2,069,447
The total income tax provision is summarized as follows:
Continuing operations	$	44,210,548	$	(6,149,889	)	$	2,069,447
Discontinued operations	2,121,941		(9,496,992		)	2,063,050
	$	46,332,489	$	(15,646,881	)	$	4,132,497

Significant Components of Deferred Tax Assets and Liabilities

Significant components of the Company’s deferred tax assets and liabilities are as follows:



	December 31,
	2013			2012
Current deferred tax assets (liabilities):
Accrued other and prepaid expenses	$	2,591,944		$	2,302,277
Accrued settlement charge	283,534			—
Allowance for doubtful accounts	649,790			808,466
Assets held for sale	—			2,826,663
Other	468,082			597,237
Gross deferred tax assets	3,993,350			6,534,643
Valuation allowance	(4,528,177		)	(551,160		)
Deferred tax assets (liabilities)	(534,827		)	5,983,483
Non-current deferred tax (liabilities) and assets:
Amortization	(1,313,863		)	4,377,573
Depreciation	(383,895		)	(1,631,495		)
Identifiable intangibles	(2,237,409		)	(2,409,238		)
Net operating loss carryforwards	32,531,221			23,616,558
Accrued professional liability	(117,842		)	293,815
Accrued workers’ compensation	675,201			768,617
Tax on unrepatriated earnings	(453,298		)	(1,860,656		)
Share-based compensation	1,610,346			2,120,269
Other	313,898			966,361
Gross deferred tax assets	30,624,359			26,241,804
Valuation allowance	(47,473,410		)	(3,481,752		)
Deferred tax (liabilities) assets	(16,849,051		)	22,760,052
Net deferred taxes	$	(17,383,878	)	$	28,743,535

Reconciliation of Income Tax Computed At U. S. Federal Statutory Rate to Income Tax (Benefit) Expense

The reconciliation of income tax computed at the U. S. federal statutory rate to income tax expense (benefit) is as follows:



	Year Ended December 31,
	2013			2012			2011
Tax at U.S. statutory rate	$	(3,513,812	)	$	(9,413,200	)	$	1,266,166
State taxes, net of federal benefit	(190,656		)	(1,226,475		)	(64,608		)
Non-deductible meals and entertainment	449,780			961,933			290,280
Foreign tax expense	554,314			(221,897		)	(162,448		)
Valuation allowances	48,556,357			(43,657		)	367,068
Uncertain tax positions	(257,488		)	647,720			174,045
Deferred tax rate differential	312			150,583			(107,057		)
Deferred tax write-offs (a)	221,028			—			301,765
Audit settlements	160,026			—			(391,822		)
Tax on unrepatriated earnings	(1,464,728		)	2,004,596			—
Tax on repatriated earnings	—			519,072			—
Tax true ups and other	(304,585		)	471,436			396,058
Total income tax expense (benefit)	$	44,210,548		$	(6,149,889	)	$	2,069,447

_______________


(a)	During 2013 and 2011, the Company recorded deferred tax expense related to an overstatement of deferred tax assets for share-based payments related to prior periods of approximately $221,000 and $302,000, respectively.

Reconciliation of Beginning and Ending Amounts of Unrecognized Tax Benefits

A reconciliation of the beginning and ending amounts of unrecognized tax benefits is approximately as follows:



	2013			2012
Balance at January 1	$	5,204,000		$	4,500,000
Additions based on tax positions related to the current year	496,000			852,000
Additions based on tax positions related to prior years	681,000			152,000
Reductions based on settlements of tax positions related to the prior year	(292,000		)	(30,000		)
Reductions for tax positions as a result of a lapse of the applicable statute of limitations	(1,076,000		)	(263,000		)
Other	(27,000		)	(7,000		)
Balance at December 31	$	4,986,000		$	5,204,000

Stockholders' Equity (Tables)

12 Months Ended

Dec. 31, 2013

Equity [Abstract]

Awards Granted Under the 2007 Plan to Non-Employee Directors and Management Team

The following awards were granted under the 2007 Plan to the Company’s non-employee Directors and management team:



	Year Ended December 31,
	2013	2012	2011
Stock appreciation rights	324,000	344,500	261,500
Restricted stock	340,509	337,220	216,538

Summary of Share Option Plans Activities

The following table summarizes the Company’s activities with respect to all of its share option plans for the year ended 2013:



	Shares		Option Price	Weighted Average Exercise Price	Weighted- Average Remaining Contractual Life (in years)	Aggregate Intrinsic Value
Share options outstanding at beginning of year	1,922,756		$4.16-$22.50	$9.67
Granted	324,000		$4.92-$5.61	$5.25
Exercised	(14,000	)	$4.35	$4.35
Forfeited/expired	(686,457	)	$4.35-$22.50	$9.36
Share options outstanding at end of year	1,546,299		$4.16-$22.50	$8.93	3.28	$	3,770,958
Share options exercisable at end of year	1,006,674		$4.16-$22.50	$10.79	1.99	$	1,329,153
Share options unvested at end of year	539,625		$4.16-$8.09	$5.46	5.69	$	2,441,805

Stock Options and Stock Appreciation Rights Granted and Exercised

During the years ended December 31, 2013, 2012 and 2011, the Company issued options and stock appreciation rights at market price.



	Year Ended December 31,
	2013		2012		2011
Share option grants	324,000		344,500		261,500
Weighted average grant date fair value of options granted during the period	$	1.77	$	1.65	$	2.63
Total intrinsic value of options exercised	$	12,465	$	—	$	—

Assumptions Used to Estimate Fair Value of Options Granted

The following assumptions were used to estimate the fair value of options granted using the Black-Scholes option-pricing model:



	Year Ended December 31,
	2013		2012		2011
Expected dividend yield	—	%	—	%	—	%
Expected volatility	48.00	%	47.00	%	42.00	%
Risk-free interest rate	0.79	%	0.58	%	1.33	%
Expected life	4.2 years		4.3 years		4.3 years

Summary of Restricted Stock Award Activity

The following table summarizes restricted stock award activity for the year ended December 31, 2013:



	Number of Shares		Weighted Average Grant Date Fair Value
Unvested restricted stock awards, January 1, 2013	661,648		$	6.08
Granted	340,509		$	4.64
Vested	(238,296	)	$	6.86
Forfeited	(211,630	)	$	4.73
Unvested restricted stock awards, December 31, 2013	552,231		$	5.37

Earnings Per Share (Tables)

12 Months Ended

Dec. 31, 2013

Earnings Per Share [Abstract]

Components of Numerator and Denominator for Computation of Basic and Diluted Earnings per Share

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



	Year Ended December 31,
	2013			2012			2011
(Loss) income from continuing operations	$	(54,250,011	)	$	(20,744,969	)	$	1,547,639
Income (loss) from discontinued operations, net of income taxes	2,280,688			(21,476,528		)	2,550,210
Net (loss) income	$	(51,969,323	)	$	(42,221,497	)	$	4,097,849

Basic (loss) income per common share from:
Continuing operations	$	(1.75	)	$	(0.67	)	$	0.05
Discontinued operations	0.07			(0.70		)	0.08
Net (loss) income	$	(1.68	)	$	(1.37	)	$	0.13

Diluted (loss) income per common share from:
Continuing operations	$	(1.75	)	$	(0.67	)	$	0.05
Discontinued operations	0.07			(0.70		)	0.08
Net (loss) income	$	(1.68	)	$	(1.37	)	$	0.13

Weighted-average number of shares outstanding-basic	31,009,218			30,842,723			31,146,165
Plus dilutive equity awards	—			—			45,851
Weighted-average number of shares outstanding-diluted	31,009,218			30,842,723			31,192,016

Segment Information (Tables)

12 Months Ended

Dec. 31, 2013

Segment Reporting [Abstract]

Information on Operating Segments and Reconciliation to Income From Operations

Information on operating segments and a reconciliation of such information to (loss) income from continuing operations for the periods indicated are as follows:



	Year ended December 31,
	2013			2012			2011
Revenue from unaffiliated customers:
Nurse and allied staffing	$	278,972,901		$	277,753,525		$	278,793,599
Physician staffing	121,371,017			123,545,045			118,780,800
Other human capital management services	37,966,798			41,336,576			41,803,061
	$	438,310,716		$	442,635,146		$	439,377,460
Contribution income (a):
Nurse and allied staffing (b)	$	19,188,403		$	11,360,870		$	20,077,583
Physician staffing	8,616,916			10,651,879			11,320,076
Other human capital management services	745,506			1,943,628			3,172,282
	28,550,825			23,956,377			34,569,941

Unallocated corporate overhead (b)	22,286,031			22,574,066			20,299,783
Depreciation	3,885,688			4,904,845			5,965,002
Amortization	2,294,077			2,263,556			2,393,722
Acquisition costs	473,488			—			—
Restructuring costs	483,578			—			—
Legal settlement charge	750,000			—			—
Impairment charges (c)	6,400,000			18,732,407			—
(Loss) income from continuing operations	$	(8,022,037	)	$	(24,518,497	)	$	5,911,434

_______________

(a)


(b)	In 2013, the Company refined its methodology for allocating certain corporate overhead expenses to its nurse and allied staffing segment expenses to more accurately reflect this segment’s profitability. Prior year information has been reclassified to conform to current year presentation.


(c)	During the fourth quarter of 2013, the Company recorded a trade names impairment charge of $6,400,000. During the year ended December 31, 2012, the Company recorded pretax impairment charges in its continuing operations of $18,732,407. Refer to discussion in Note 4-Goodwill, Trade Names and Other Identifiable Intangible Assets.

Quarterly Financial Data (Unaudited) (Tables)

12 Months Ended

Dec. 31, 2013

Quarterly Financial Information Disclosure [Abstract]

Quarterly Financial Data



	First Quarter (a)			Second Quarter			Third Quarter			Fourth Quarter (b)
2013
Revenue from services	$	110,315,840		$	110,768,343		$	108,047,986		$	109,178,547
Gross profit	$	28,875,395		$	27,838,891		$	28,184,087		$	28,561,465

(Loss) income from continuing operations, net of tax	$	(1,345,729	)	$	(1,435,829	)	$	1,453,590		$	(52,922,043	)
Income (loss) from discontinued operations, net of tax	$	2,503,763		$	(21,393	)	$	(538,916	)	$	337,234
Net income (loss)	$	1,158,034		$	(1,457,222	)	$	914,674		$	(52,584,809	)

Basic income (loss) per common share from:
Continuing operations	$	(0.04	)	$	(0.05	)	$	0.05		$	(1.70	)
Discontinuing operations	0.08			—			(0.02		)	0.01
Net income (loss)	$	0.04		$	(0.05	)	$	0.03		$	(1.69	)

Diluted income (loss) per common share from:
Continuing operations	$	(0.04	)	$	(0.05	)	$	0.05		$	(1.70	)
Discontinuing operations	0.08			—			(0.02		)	0.01
Net income (loss)	$	0.04		$	(0.05	)	$	0.03		$	(1.69	)



	First Quarter			Second Quarter (c)			Third Quarter (c)			Fourth Quarter (c)
2012
Revenue from services	$	109,799,496		$	108,847,135		$	112,257,707		$	111,730,808
Gross profit	$	29,049,682		$	27,136,129		$	27,455,827		$	27,943,467

Income (loss) from continuing operations, net of tax	$	361,955		$	(18,841,283	)	$	719,539		$	(2,985,180	)
(Loss) income from discontinued operations, net of tax	$	(946,322	)	$	4,337,450		$	(18,319,626	)	$	(6,548,030	)
Net loss	$	(584,367	)	$	(14,503,833	)	$	(17,600,087	)	$	(9,533,210	)

Basic (loss) income per common share from:
Continuing operations	$	0.01		$	(0.61	)	$	0.02		$	(0.10	)
Discontinuing operations	(0.03		)	0.14			(0.59		)	(0.21		)
Net loss	$	(0.02	)	$	(0.47	)	$	(0.57	)	$	(0.31	)

Diluted (loss) income per common share from:
Continuing operations	$	0.01		$	(0.61	)	$	0.02		$	(0.10	)
Discontinuing operations	(0.03		)	0.14			(0.59		)	(0.21		)
Net loss	$	(0.02	)	$	(0.47	)	$	(0.57	)	$	(0.31	)

________________


(a)	The Company sold its clinical trial services business on February 15, 2013. The clinical trial services business has been classified as discontinued operations. The transaction resulted in a gain on sale of $3,968,714 pretax, or $2,055,907 after tax. See Note 3 – Assets Held for Sale and Discontinued Operations.

(b)


(c)	During the second, third and fourth quarters of 2012, the Company recorded impairment charges of approximately $18,732,000, $23,500,000 and $11,900,000, respectively. See Note 4 – Goodwill, Trade Names and Other Identifiable Intangible Assets and Note 3 – Assets Held for Sale and Discontinued Operations.

Summary of Significant Accounting Policies - Narrative (Detail)	12 Months Ended
	Dec. 31, 2013 USD ($) Claim	Dec. 31, 2012 USD ($) Claim	Dec. 31, 2011 USD ($)
Significant Accounting Policies [Line Items]
Outstanding standby letters of credit as collateral	$ 6,399,000	$ 6,899,000
Outstanding workers' compensation benefit claims \| Claim	85	105
Outstanding professional liability claims \| Claim	66	80
Accrued revenue	$ 11,004,000	$ 9,816,000
Deferred tax benefits related to share based compensation		955,000	$ 1,126,000
Advertising costs	3,230,000	3,186,000	3,180,000
Prepaid expenses, advertising	1,338,000	958,000
Restructuring costs	483,578	0	0
Cumulative impact of currency fluctuations	1,133,000	3,083,000
Reclassification of currency translation adjustments related to sale of clinical trial services business	2,336,201	0	0
Income tax (benefit) expense related to items of other comprehensive (loss) income	(162,484)	14,951	(22,384)
Employee Severance [Member]
Significant Accounting Policies [Line Items]
Restructuring costs	484,000
Selling, General and Administrative Expenses [Member]
Significant Accounting Policies [Line Items]
Equity compensation	2,099,941	2,594,523	$ 2,895,012
Occurrence-Based Professional Liability Insurance [Member] \| MDA Holdings Inc [Member]
Significant Accounting Policies [Line Items]
Letter of credit for malpractice claims	5,000,000	5,533,000
Other Current Liabilities [Member]
Significant Accounting Policies [Line Items]
Deferred revenue	$ 1,293,000	$ 1,574,000
Minimum [Member]
Significant Accounting Policies [Line Items]
Contract terms	15 days
Short term leases period	3 months
Estimated useful life of assets	3 years
Intangible assets- useful life	5 years
Minimum [Member] \| Computer software [Member]
Significant Accounting Policies [Line Items]
Estimated useful life of assets	3 years
Maximum [Member]
Significant Accounting Policies [Line Items]
Contract terms	60 days
Short term leases period	6 months
Estimated useful life of assets	7 years
Intangible assets- useful life	16 years
Maximum [Member] \| Computer software [Member]
Significant Accounting Policies [Line Items]
Estimated useful life of assets	5 years

Assets Held for Sale and Discontinued Operations (Detail) - USD ($)		3 Months Ended					9 Months Ended	12 Months Ended
	Feb. 15, 2013	Dec. 31, 2013	Jun. 30, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Sep. 30, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Escrow Deposit		$ 3,750,000		$ 0				$ 3,750,000	$ 0
Goodwill impairment charge				11,900,000	$ 23,500,000	$ 18,732,000
Trademark impairment charge								6,400,000	54,132,407	$ 0
Income from operations								433,915	(30,973,520)	$ 4,613,260
Clinical Trial Services [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from Divestiture of Businesses	$ 52,000,000
Adjustment	100,000	200,000
Earnout Consideration From Divestiture Of Business	3,750,000	$ 2,250,000						$ 2,250,000
release of escrow to the buyer			$ 1,500,000
Escrow Deposit Term								18 months
Escrow Deposit	$ 3,750,000
Clinical Trial Services [Member] \| Segment, Discontinued Operations [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Goodwill impairment charge				$ 11,900,000			$ 22,100,000		34,000,000
Income from operations									4,426,000
Clinical Trial Services [Member] \| Segment, Discontinued Operations [Member] \| Trademarks [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Trademark impairment charge									$ 1,400,000

Revenues And Components Of Discontinued Operations (Detail) - USD ($)

3 Months Ended

12 Months Ended

Dec. 31, 2013

^[1]

Sep. 30, 2013

Jun. 30, 2013

Mar. 31, 2013

^[2]

Dec. 31, 2012

^[3]

Sep. 30, 2012

^[3]

Jun. 30, 2012

^[3]

Mar. 31, 2012

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Discontinued Operations and Disposal Groups [Abstract]

Revenue

$ 7,939,150

$ 67,626,715

$ 64,608,763

(Loss) income before income taxes

433,915

(30,973,520)

4,613,260

Income tax benefit (expense)

(2,121,941)

9,496,992

(2,063,050)

Gain on sale of discontinued operations

3,968,714

(Loss) income from discontinued operations

$ 337,234

$ (538,916)

$ (21,393)

$ 2,503,763

$ (6,548,030)

$ (18,319,626)

$ 4,337,450

$ (946,322)

$ 2,280,688

$ (21,476,528)

$ 2,550,210

[1]	On December 2, 2013, the Company acquired the operating assets of On Assignment, Inc.’s Allied Healthcare Staffing division. The acquisition has been accounted for in accordance with FASB ASC Topic 805-Business Combinations, using the purchase method. The results of On Assignment's operations have been included in the Company's consolidated statements of operations since December 2, 2013, the date of the acquisition. See Note 5 - Acquisitions. During the fourth quarter of 2013, the Company recorded a deferred tax assets valuation allowance of approximately $48,406,398 and a trade names impairment charge of $6,400,000. See Note 12 - Income Taxes and Note 4 - Goodwill, Trade Names and Other Identifiable Intangible Assets.
[2]	The Company sold its clinical trial services business on February 15, 2013. The clinical trial services business has been classified as discontinued operations. The transaction resulted in a gain on sale of $3,968,714 pretax, or $2,055,907 after tax. See Note 3 – Assets Held for Sale and Discontinued Operations.
[3]	During the second, third and fourth quarters of 2012, the Company recorded impairment charges of approximately $18,732,000, $23,500,000 and $11,900,000, respectively. See Note 4 – Goodwill, Trade Names and Other Identifiable Intangible Assets and Note 3 – Assets Held for Sale and Discontinued Operations.

Carrying Amounts of Major Classes of Assets and Liabilities Related to Assets Held for Sale (Detail) - USD ($)	Dec. 31, 2013	Dec. 31, 2012
Assets:
Accounts receivable, net		$ 12,553,056
Other prepaid expenses		485,840
Other current assets		13,771
Property and Equipment, net		364,972
Goodwill		28,175,772
Other intangible assets, net		5,335,816
Other long-term assets		41,737
Total assets held for sale		46,970,964
Liabilities:
Accounts payable and accrued expenses		354,453
Accrued employee compensation and benefits		1,478,638
Other current liabilities		984,978
Other non-current liabilities		16,447
Total liabilities related to assets held for sale	$ 0	$ 2,834,516

Acquired Intangible Assets (Detail) - USD ($)	Dec. 31, 2013	Dec. 31, 2012
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, gross carrying amount	$ 56,832,000	$ 42,832,000
Intangible assets subject to amortization, accumulated amortization	30,634,095	28,340,018
Intangible assets subject to amortization, net carrying amount	26,197,905	14,491,982
Goodwill	77,265,907	62,712,109
Trade names	42,301,331	48,701,331
Intangible assets not subject to amortization, net	119,567,238	111,413,440
Database Rights [Member]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, gross carrying amount	15,925,000	12,525,000
Intangible assets subject to amortization, accumulated amortization	12,102,685	11,954,630
Intangible assets subject to amortization, net carrying amount	3,822,315	570,370
Customer Relationships [Member]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, gross carrying amount	37,304,000	26,904,000
Intangible assets subject to amortization, accumulated amortization	15,125,076	13,089,055
Intangible assets subject to amortization, net carrying amount	22,178,924	13,814,945
Noncompete Agreements [Member]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, gross carrying amount	3,603,000	3,403,000
Intangible assets subject to amortization, accumulated amortization	3,406,334	3,296,333
Intangible assets subject to amortization, net carrying amount	$ 196,666	$ 106,667

Estimated Annual Amortization Expense (Detail) - USD ($)	Dec. 31, 2013	Dec. 31, 2012
Goodwill and Intangible Assets Disclosure [Abstract]
2014	$ 3,063,146
2015	2,906,222
2016	2,906,222
2017	2,861,481
2018	2,776,667
Thereafter	11,684,167
Intangible assets subject to amortization, net carrying amount	$ 26,197,905	$ 14,491,982

Changes in Carrying Amount of Goodwill by Segment (Detail) - USD ($)

3 Months Ended

12 Months Ended

Dec. 31, 2012

Sep. 30, 2012

Jun. 30, 2012

Dec. 31, 2013

Dec. 31, 2008

Goodwill balances

Goodwill, net of impairment loss

$ 62,712,109

Aggregate goodwill acquired

$ 322,444,517

336,998,315

Accumulated impairment loss

(259,732,408)

$ (241,000,000)

Goodwill, net of impairment loss

62,712,109

77,265,907

Changes to aggregate goodwill in 2013

Goodwill acquired

14,553,798

Impairment charges

11,900,000

$ 23,500,000

$ 18,732,000

Nurse and allied staffing [Member]

Goodwill balances

Goodwill, net of impairment loss

Aggregate goodwill acquired

259,732,408

274,286,206

Accumulated impairment loss

(259,732,408)

^[1]

(259,732,408)

Goodwill, net of impairment loss

14,553,798

Changes to aggregate goodwill in 2013

Goodwill acquired

14,553,798

Physician Staffing [Member]

Goodwill balances

Goodwill, net of impairment loss

43,405,047

Aggregate goodwill acquired

43,405,047

Accumulated impairment loss

Goodwill, net of impairment loss

43,405,047

Changes to aggregate goodwill in 2013

Goodwill acquired

Other human capital management services [Member]

Goodwill balances

Goodwill, net of impairment loss

19,307,062

Aggregate goodwill acquired

19,307,062

Accumulated impairment loss

Goodwill, net of impairment loss

$ 19,307,062

19,307,062

Changes to aggregate goodwill in 2013

Goodwill acquired

$ 0

[1]

Changes in Carrying Amount of Goodwill by Segment (Parenthetical) (Detail) - USD ($)	3 Months Ended
	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Dec. 31, 2013	Dec. 31, 2008
Disclosure Changes In Carrying Amount Of Goodwill By Segment [Abstract]
Non-cash pretax charge of goodwill	$ 259,732,408			$ 259,732,408	$ 241,000,000
Goodwill impairment charge	$ 11,900,000	$ 23,500,000	$ 18,732,000

Goodwill and Other Identifiable Intangible Assets - Narrative (Detail) - USD ($)	3 Months Ended				12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Dec. 31, 2012
Goodwill and Intangible Assets Disclosure [Line Items]
Goodwill impairment charge		$ 11,900,000	$ 23,500,000	$ 18,732,000
Impairment of intangibles	$ 6,400,000
Income Approach Valuation Technique [Member]
Goodwill and Intangible Assets Disclosure [Line Items]
Forecast period used to calculate discounted cash flows		10 years			10 years
Terminal value growth rate					2.50%
Income Approach Valuation Technique [Member] \| Minimum [Member]
Goodwill and Intangible Assets Disclosure [Line Items]
Cash flow discount rates					11.00%
Income Approach Valuation Technique [Member] \| Maximum [Member]
Goodwill and Intangible Assets Disclosure [Line Items]
Cash flow discount rates					18.70%
Market Approach Valuation Technique [Member]
Goodwill and Intangible Assets Disclosure [Line Items]
Percentage assumed - weighting to revenue multiples					50.00%
Percentage assumed - weighting to EBITDA multiples					50.00%
Market Approach Valuation Technique [Member] \| Minimum [Member]
Goodwill and Intangible Assets Disclosure [Line Items]
Total enterprise value/revenue multiples					0.43
Total enterprise value/EBITDA multiples					4.17
Market Approach Valuation Technique [Member] \| Maximum [Member]
Goodwill and Intangible Assets Disclosure [Line Items]
Total enterprise value/revenue multiples					1.0
Total enterprise value/EBITDA multiples					10.0
Physician Staffing [Member]
Goodwill and Intangible Assets Disclosure [Line Items]
Impairment of intangibles	6,174,000
Nurse and allied staffing [Member]
Goodwill and Intangible Assets Disclosure [Line Items]
Impairment of intangibles	$ 226,000

Acquisitions - On Assignment Narrative (Details)	1 Months Ended	4 Months Ended	12 Months Ended
Acquisitions - On Assignment Narrative (Details)	Dec. 31, 2013 USD ($) branch lease specialty	Mar. 17, 2014 USD ($) lease	Dec. 31, 2013 USD ($) lease	Dec. 31, 2012 USD ($)	Dec. 31, 2011 USD ($)
Business Acquisition [Line Items]
Acquisition costs			$ 473,488	$ 0	$ 0
Amount of operating lease future payments assumed	$ 19,065,246		19,065,246
Goodwill	77,265,907		77,265,907	62,712,109
Nurse and allied staffing [Member]
Business Acquisition [Line Items]
Goodwill	14,553,798		14,553,798	$ 0
Revolving Credit Facility [Member]
Business Acquisition [Line Items]
Debt	8,400,000		8,400,000
On Assignment [Member]
Business Acquisition [Line Items]
Consideration transferred	28,700,000
Cash	24,673,000		$ 24,673,000
Acquisition costs	$ 473,000
Number of leases to be assumed \| lease	15		15
Number of Subleases Assumed \| lease	7
Number of branch-based employees acquired \| branch	84
Number of staffing specialties acquired \| specialty	125
Number of branch offices acquired \| branch	23
Intangible assets	$ 14,000,000		$ 14,000,000
Goodwill	14,553,798		14,553,798
On Assignment [Member] \| Customer Relationships [Member]
Business Acquisition [Line Items]
Intangible assets	10,400,000		$ 10,400,000
Intangible assets- useful life			16 years
On Assignment [Member] \| Customer Lists [Member]
Business Acquisition [Line Items]
Intangible assets	3,400,000		$ 3,400,000
Intangible assets- useful life			10 years
On Assignment [Member] \| Noncompete Agreements [Member]
Business Acquisition [Line Items]
Intangible assets	200,000		$ 200,000
Intangible assets- useful life			5 years
On Assignment [Member] \| Nurse and allied staffing [Member]
Business Acquisition [Line Items]
Actual revenue from acquisition			$ 3,407,193
Actual earnings from acquisition			295,251
On Assignment [Member] \| Revolving Credit Facility [Member] \| Line of Credit [Member]
Business Acquisition [Line Items]
Debt	$ 4,500,000		$ 4,500,000
Subsequent Event [Member] \| On Assignment [Member]
Business Acquisition [Line Items]
Number of leases assumed \| lease		4
Amount of operating lease future payments assumed		$ 383,765

Acquisitions - Schedule of Assets Acquired and Liabilities Assumed (Details) - USD ($)	Dec. 31, 2013	Dec. 31, 2012
Business Acquisition [Line Items]
Goodwill	$ 77,265,907	$ 62,712,109
On Assignment [Member]
Business Acquisition [Line Items]
Other current assets	61,837
Property and equipment	160,921
Goodwill	14,553,798
Other intangible assets	14,000,000
Other assets	52,444
Total assets acquired	28,829,000
Accrued employee compensation and benefits	111,789
Total liabilities assumed	111,789
Net assets acquired	$ 28,717,211

Acquisitions - Schedule of Pro-forma Information (Details) - On Assignment [Member] - USD ($)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012
Business Acquisition [Line Items]
Revenue from services	$ 476,456	$ 482,142
Net income (loss)	$ (50,336)	$ (40,543)
Net income (loss) per common share - basic (usd per share)	$ (1.62)	$ (1.31)
Net income (loss) per common share - diluted (usd per share)	$ (1.62)	$ (1.31)

Acquisitions - MDA Holdings Narrative (Detail) - USD ($)	3 Months Ended		12 Months Ended
	Jun. 30, 2010	Jun. 30, 2009	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
Business Acquisition, Contingent Consideration [Line Items]
Payments to acquire businesses net of cash acquired			$ 28,700,000	$ 0	$ 0
MDA Holdings Inc [Member]
Business Acquisition, Contingent Consideration [Line Items]
Release from escrow account						$ 3,541,000
Remaining escrow deposit balance			$ 3,566,000	$ 3,566,000
Related to the 2008 performance [Member]
Business Acquisition, Contingent Consideration [Line Items]
Payments to acquire businesses net of cash acquired		$ 6,748,000
Related to the 2009 performance [Member] \| MDA Holdings Inc [Member]
Business Acquisition, Contingent Consideration [Line Items]
Payments to acquire businesses net of cash acquired	$ 12,826,000

Property and Equipment (Detail) - USD ($)	12 Months Ended
Property and Equipment (Detail) - USD ($)	Dec. 31, 2013	Dec. 31, 2012
Property, Plant and Equipment [Line Items]
Property and equipment	$ 50,949,101	$ 50,152,583
Less accumulated depreciation and amortization	(44,778,602)	(41,917,771)
Property and equipment, net of accumulated depreciation and amortization	$ 6,170,499	8,234,812
Minimum [Member]
Property, Plant and Equipment [Line Items]
Estimated useful life	3 years
Maximum [Member]
Property, Plant and Equipment [Line Items]
Estimated useful life	7 years
Computer Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment	$ 12,115,305	12,373,042
Computer Equipment [Member] \| Minimum [Member]
Property, Plant and Equipment [Line Items]
Estimated useful life	3 years
Computer Equipment [Member] \| Maximum [Member]
Property, Plant and Equipment [Line Items]
Estimated useful life	5 years
Computer software [Member]
Property, Plant and Equipment [Line Items]
Property and equipment	$ 30,059,145	29,929,913
Computer software [Member] \| Minimum [Member]
Property, Plant and Equipment [Line Items]
Estimated useful life	3 years
Computer software [Member] \| Maximum [Member]
Property, Plant and Equipment [Line Items]
Estimated useful life	5 years
Office Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment	$ 3,306,824	3,307,815
Office Equipment [Member] \| Minimum [Member]
Property, Plant and Equipment [Line Items]
Estimated useful life	5 years
Office Equipment [Member] \| Maximum [Member]
Property, Plant and Equipment [Line Items]
Estimated useful life	7 years
Furniture and Fixtures [Member]
Property, Plant and Equipment [Line Items]
Property and equipment	$ 1,751,669	1,704,073
Furniture and Fixtures [Member] \| Minimum [Member]
Property, Plant and Equipment [Line Items]
Estimated useful life	5 years
Furniture and Fixtures [Member] \| Maximum [Member]
Property, Plant and Equipment [Line Items]
Estimated useful life	7 years
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Property and equipment	$ 3,716,158	$ 2,837,740

Balance Sheet Details (Detail) - USD ($)	Dec. 31, 2013	Dec. 31, 2012
Balance Sheet Related Disclosures [Abstract]
Insurance Recovery For Workers Compensation Current	$ 2,093,000	$ 2,427,994
Insurance Receivable for Malpractice, Current	1,793,285	3,055,895
Insurance recovery receivable	3,886,285	5,483,889
Insurance recovery for workers’ compensation – long term	3,336,000	3,694,006
Insurance recovery for professional liability – long term	7,577,527	4,516,133
Non-current insurance recovery receivable	10,913,527	8,210,139
Salaries and payroll taxes	6,874,644	6,931,650
Bonuses	2,199,559	1,648,979
Accrual for workers' compensation claims	3,236,428	3,800,526
Accrual for health care benefits	1,385,115	2,005,486
Accrual for professional liability insurance	4,091,405	5,847,638
Accrual for vacation	1,361,161	1,415,954
Accrued compensation and benefits	19,148,312	21,650,233
Accrual for workers’ compensation claims	5,076,000	5,748,506
Accrual for professional liability insurance	13,227,096	10,598,836
Long-term accrued claims	18,303,096	16,347,342
Deferred compensation	1,638,334	1,471,091
Deferred rent	1,776,615	1,564,199
Other long-term liabilities	$ 3,414,949	$ 3,035,290

Long-Term Debt Long- Term Debt (Detail) - USD ($)	Dec. 31, 2013	Dec. 31, 2012
Debt Disclosure [Abstract]
Loans Payable to Bank	$ 0	$ 23,125,000
Line of Credit Facility, Amount Outstanding	8,400,000	10,000,000
Capital Lease Obligations And Other	176,319	733,657
Debt and Capital Lease Obligations	8,576,319	33,858,657
Current portion of long-term debt and capital lease obligations	8,483,088	33,682,348
Long-term Debt and Capital Lease Obligations	$ 93,231	$ 176,309

Long- Term Debt (Parenthetical) (Detail)	Dec. 31, 2013	Dec. 31, 2012
Debt Disclosure [Abstract]
Term loan, interest		2.72%
Revolver credit facility, interest rate	3.27%	2.72%

Aggregate Scheduled Maturities of Debt (Detail)	Dec. 31, 2013 USD ($)
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
2014	$ 8,400,000
2015	0
2016	0
2017	0
2018	0
Total	8,400,000
Capital Lease and Note Payable [Member]
Debt Instrument [Line Items]
2014	83,088
2015	65,409
2016	27,822
2017	0
2018	0
Total	$ 176,319

Long-Term Debt - Narrative (Detail)			3 Months Ended		12 Months Ended
Long-Term Debt - Narrative (Detail)	Jan. 09, 2013 USD ($)	Jul. 10, 2012 USD ($)	Mar. 31, 2013 USD ($)	Sep. 30, 2012 USD ($)	Dec. 31, 2013 USD ($)	Dec. 31, 2012 USD ($)	Dec. 31, 2011 USD ($)
Debt Instrument [Line Items]
Debt financing costs					$ 0	$ 279,005	$ 0
Deferred financing fees, capitalized						962,000
Borrowings under asset-based revolving credit facility					63,444,175	0	$ 0
Consolidated leverage ratio, maximum				2.75
Fixed charge coverage ratio, minimum				1.25
Revolving credit facility, interest 3.27% (weighted average) and 2.72% at December 31, 2013 and 2012, respectively					$ 8,400,000	10,000,000
Loan And Security Agreement [Member]
Debt Instrument [Line Items]
Quarterly commitment fee on the average daily unused portion					0.375%
July 2012 Credit Agreement [Member]
Debt Instrument [Line Items]
Write off debt issuance cost			$ 1,124,000			82,000
Term Loan Facility [Member]
Debt Instrument [Line Items]
Credit facility borrowing capacity		$ 25,000,000
Line of credit facility, term		5 years
Debt financing costs						$ 279,000
Borrowings under asset-based revolving credit facility					$ 25,000,000
Term Loan Facility [Member] \| Loan And Security Agreement [Member]
Debt Instrument [Line Items]
Credit facility borrowing capacity					39,482,000
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Quarterly commitment fee on the average daily unused portion						0.50%
Line of credit facility, term		5 years
Line of credit facility, additional borrowing capacity		$ 25,000,000
Borrowings under asset-based revolving credit facility					$ 11,000,000
Credit facility borrowing capacity		50,000,000
Revolving Credit Facility [Member] \| Loan And Security Agreement [Member]
Debt Instrument [Line Items]
Debt Instrument, Term					3 years
Credit facility borrowing capacity					$ 8,400,000
Line of credit facility, additional borrowing capacity	$ 20,000,000
Fixed charge coverage ratio, minimum	1.0
Credit facility borrowing capacity	$ 65,000,000
Aggregate amount of advances under the line of credit (borrowing base)	$ 65,000,000
Line of credit facility, eligible billed accounts receivable per the loan agreement	85.00%
Line of credit facility, eligible unbilled accounts receivable per the loan agreement	85.00%
Line of credit facility, eligible borrowing of unbilled accounts receivable	$ 12,000,000
Required percentage of aggregate amount of the commitment	12.50%
Required minimum availability under credit facility to avoid negative covenants	$ 6,250,000
Revolving Credit Facility [Member] \| July 2012 Credit Agreement [Member]
Debt Instrument [Line Items]
Write off debt issuance cost			$ 295,000
Letter of Credit [Member] \| Loan And Security Agreement [Member]
Debt Instrument [Line Items]
Revolving credit facility, interest 3.27% (weighted average) and 2.72% at December 31, 2013 and 2012, respectively					11,399,000
Line of Credit [Member]
Debt Instrument [Line Items]
Unamortized debt issuance expense					86,000
Line of Credit [Member] \| Loan And Security Agreement [Member]
Debt Instrument [Line Items]
Credit facility, remaining borrowing capacity					$ 19,683,000
Standby Letters of Credit [Member]
Debt Instrument [Line Items]
Letters of credit outstanding				$ 12,432,000
Line of credit facility, additional borrowing capacity				1,000,000
Standby Letters of Credit [Member] \| Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Line of credit, subfacility for standby letters of credit		20,000,000
Standby Letters of Credit [Member] \| Revolving Credit Facility [Member] \| Loan And Security Agreement [Member]
Debt Instrument [Line Items]
Line of credit, subfacility for standby letters of credit	$ 20,000,000
Swingline loans [Member] \| Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Line of credit, subfacility for swingline loans		$ 10,000,000
Line of credit facility, additional borrowing capacity				3,000,000
Maximum borrowing capacity				$ 10,000,000
Swingline loans [Member] \| Revolving Credit Facility [Member] \| Loan And Security Agreement [Member]
Debt Instrument [Line Items]
Subfacility loans percentage up to aggregate revolver commitments	10.00%
London Interbank Offered Rate (LIBOR) [Member] \| Term Loan Facility [Member]
Debt Instrument [Line Items]
Interest margin						2.50%
London Interbank Offered Rate (LIBOR) [Member] \| Revolving Credit Facility [Member] \| Loan And Security Agreement [Member]
Debt Instrument [Line Items]
Interest margin					1.50%
Base Rate [Member] \| Term Loan Facility [Member]
Debt Instrument [Line Items]
Interest margin						1.50%
Base Rate [Member] \| Revolving Credit Facility [Member] \| Loan And Security Agreement [Member]
Debt Instrument [Line Items]
Debt Instrument, Excess Basis Spread on Variable Interest Rate In Default					2.00%
Interest margin					0.50%

Estimated Fair values Assets and Liabilities Measured on Recurring Basis (Detail) - Deferred compensation [Member] - USD ($)	Dec. 31, 2013	Dec. 31, 2012
Total [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Deferred compensation	$ 1,638,334	$ 1,471,091
Quoted Prices in Active Markets for Identical Assets (Level 1) [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Deferred compensation	$ 1,638,334	$ 1,471,091

Estimated Fair Value of Goodwill Measured On Nonrecurring Basis (Detail) - Fair Value, Measurements, Nonrecurring [Member] - Fair Value, Inputs, Level 3 [Member] - USD ($)	Dec. 31, 2013	Dec. 31, 2012
Physician Staffing [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Goodwill	$ 28,836,000
Clinical Trial Services [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Goodwill		$ 28,175,722

Carrying Amounts and Estimated Fair Values of Significant Financial Instrument that were not Measured at Fair Value (Detail) - Fair Value, Inputs, Level 2 [Member] - USD ($)

Dec. 31, 2013

Dec. 31, 2012

Carrying (Reported) Amount, Fair Value Disclosure [Member]

Assets, Fair Value Disclosure [Abstract]

Escrow Receivable

$ 3,750,000

$ 0

Financial Liabilities

Term loan and revolver credit facility

33,125,000

Asset-based revolving credit facility (a)

8,400,000

^[1]

Estimate of Fair Value, Fair Value Disclosure [Member]

Assets, Fair Value Disclosure [Abstract]

Escrow Receivable

3,700,373

Financial Liabilities

Term loan and revolver credit facility

32,654,213

Asset-based revolving credit facility (a)

$ 8,400,000

^[1]

$ 0

[1]	Carrying value of the asset-based revolving credit facility approximates estimated fair value based on the short-term nature and the pricing at varying interest rates.

Fair Value Measurements - Narrative (Details) - USD ($)	3 Months Ended
Fair Value Measurements - Narrative (Details) - USD ($)	Dec. 31, 2013	Dec. 31, 2012
Fair Value Disclosures [Abstract]
Impairment of intangibles	$ 6,400,000
Indemnity escrow receivable	$ 3,750,000	$ 0

Employee Benefit Plans - Narrative (Detail) - USD ($)	12 Months Ended
Employee Benefit Plans - Narrative (Detail) - USD ($)	Dec. 31, 2013	Dec. 31, 2012
Compensation and Retirement Disclosure [Abstract]
Company contribution net of forfeitures	$ 557,000	$ 556,000
Deferred compensation liabilities	$ 1,638,334	$ 1,471,091

Future Minimum Lease Payments (Detail)	Dec. 31, 2013 USD ($)
Commitments and Contingencies Disclosure [Abstract]
2013	$ 4,267,124
2014	3,914,971
2015	3,958,695
2016	3,016,878
2017	1,304,860
Thereafter	2,602,718
Operating Leases, Future Minimum Payments Due, Total	$ 19,065,246

Commitment and Contingencies - Narrative (Detail)		1 Months Ended		6 Months Ended	9 Months Ended	12 Months Ended			29 Months Ended	31 Months Ended
Commitment and Contingencies - Narrative (Detail)	Apr. 19, 2013 USD ($)	Nov. 07, 2013 USD ($)	Jul. 31, 2013 USD ($) ft²	Jun. 30, 2013 USD ($)	Sep. 30, 2013 USD ($)	Dec. 31, 2013 USD ($)	Dec. 31, 2012 USD ($)	Dec. 31, 2011 USD ($)	Sep. 07, 2010 USD ($)	Apr. 19, 2013
Loss Contingencies [Line Items]
Area of Real Estate Property \| ft²			41,607
Operating lease expense						$ 5,481,000	$ 5,791,000	$ 6,159,000
Pretax liability related to the non-income tax matters						841,000	1,019,000	526,000
Taxes paid to settle with certain states						306,000
Commitments and Contintingencies Term			10 years 8 months
Lease Obligations			$ 4,241,000
Maximum Tenant Improvement Allowance			$ 1,456,000
Litigation Settlement, Amount					$ 750,000
Maureen Petray and Carina Higareda v. MedStaff, Inc. [Member] \| New Hanover Regional Medical Center [Member]
Loss Contingencies [Line Items]
Loss Contingency, Damages Sought, Value	$ 2,000,000
Loss Contingency Interest Rate									8.00%	8.00%
Legal Fees Included In Contingent Liability									$ 41,000
Insurance Annual Coverage Limit Per Claim									2,000,000
Insurance Annual Coverage Limit									$ 4,000,000
Malpractice Loss Contingency Insurance Payment				$ 2,000,000
Malpractice Loss Contingency, Period Cost				$ 920,450
Malpractice Loss Contingency, Insurance Recoveries		$ 273,474
Tax Years 2008 to 2010 [Member]
Loss Contingencies [Line Items]
Pretax liability related to the non-income tax matters								$ 395,000
Tax Years 2005 to 2011 [Member]
Loss Contingencies [Line Items]
Pretax liability related to the non-income tax matters							$ 301,000
Tax Years 2007 to 2012 [Member]
Loss Contingencies [Line Items]
Pretax liability related to the non-income tax matters						$ 352,000

Components of Income (Loss) Before Income Taxes (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Income Tax Disclosure [Abstract]
United States	$ (11,216,037)	$ (28,599,481)	$ 1,384,963
Foreign	1,176,574	1,704,623	2,232,123
(Loss) income from continuing operations before income taxes	$ (10,039,463)	$ (26,894,858)	$ 3,617,086

Components of Income Tax Expense (Benefit) (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Current
Federal	$ 0	$ 411,767	$ (29,716)
State	540,266	811,760	355,142
Foreign	415,806	1,561,492	632,415
Current Income Tax Expense (Benefit), Total	956,072	2,785,019	957,841
Deferred
Federal	37,821,541	(4,048,064)	444,193
State	5,133,844	(5,251,385)	681,076
Foreign	299,091	364,541	(13,663)
Total	43,254,476	(8,934,908)	1,111,606
Total income tax expense (benefit)	44,210,548	(6,149,889)	2,069,447
Continuing operations	44,210,548	(6,149,889)	2,069,447
Discontinued operations	2,121,941	(9,496,992)	2,063,050
Income tax expense (benefit), continuing operations, discontinued operations, total	$ 46,332,489	$ (15,646,881)	$ 4,132,497

Significant Components of Deferred Tax Assets and Liabilities (Detail) - USD ($)	Dec. 31, 2013	Dec. 31, 2012
Current deferred tax assets (liabilities):
Accrued other and prepaid expenses	$ 2,591,944	$ 2,302,277
Accrued settlement charge	283,534	0
Allowance for doubtful accounts	649,790	808,466
Assets held for sale	0	2,826,663
Other	468,082	597,237
Gross deferred tax assets	3,993,350	6,534,643
Valuation allowance	(4,528,177)	(551,160)
Deferred tax assets (liabilities)	(534,827)	5,983,483
Non-current deferred tax (liabilities) and assets:
Amortization	(1,313,863)	4,377,573
Depreciation	(383,895)	(1,631,495)
Identifiable intangibles	(2,237,409)	(2,409,238)
Net operating loss carryforwards	32,531,221	23,616,558
Accrued professional liability	(117,842)	293,815
Accrued workers' compensation	675,201	768,617
Tax on unrepatriated earnings	(453,298)	(1,860,656)
Share-based compensation	1,610,346	2,120,269
Other	313,898	966,361
Gross deferred tax assets	30,624,359	26,241,804
Valuation allowance	(47,473,410)	(3,481,752)
Deferred tax (liabilities) assets	(16,849,051)	22,760,052
Net deferred taxes	$ (17,383,878)	$ 28,743,535

Income Taxes - Narrative (Detail) - USD ($)	3 Months Ended	12 Months Ended
Income Taxes - Narrative (Detail) - USD ($)	Dec. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Income Tax Contingency [Line Items]
Deferred tax liabilities relating to indefinite lived intangible assets	$ 2,409,238	$ 2,237,409	$ 2,409,238
Valuation allowance	4,032,912	52,001,587	4,032,912
Federal, state and foreign net operating loss carryforwards	53,844,000	78,120,000	53,844,000
Deferred tax expense on share based compensation from prior years		221,000		$ 302,000
Deferred liabilities on undistributed foreign earnings	1,371,000		1,371,000
Tax on unrepatriated earnings		(1,464,728)	2,004,596	0
Undistributed foreign earnings	9,528,000		9,528,000
Unrecognized tax benefits	5,204,000	4,986,000	5,204,000	4,500,000
Unrecognized tax benefits, which would affect the effective tax rate	4,700,000	4,399,000	4,700,000
Gross increases in current year unrecognized tax		1,177,000
Gross decreases in current year unrecognized tax related to prior year uncertain positions and the closure of tax years		1,394,000
Recognized interest and penalties		81,000	124,000	$ 27,000
Unrecognized tax benefit accrued interest and penalties	886,000	1,015,000	886,000
Other Current Liabilities [Member]
Income Tax Contingency [Line Items]
Unrecognized tax benefits	548,000	$ 973,000	$ 548,000
UNITED KINGDOM
Income Tax Contingency [Line Items]
Effective tax rate				27.00%
INDIA
Income Tax Contingency [Line Items]
Effective tax rate				34.00%
Tax on unrepatriated earnings	633,000
Repatriated amount of foreign earnings	$ 3,268,000
INDIA \| Cross Country Infotech Private, Ltd [Member]
Income Tax Contingency [Line Items]
Tax holiday entitlement percentage		100.00%
Tax holiday expiration date		March 2011
Tax holiday, reduction to the income tax				$ 178,000
Indefinite-lived Intangible Assets [Member]
Income Tax Contingency [Line Items]
Deferred tax liabilities relating to indefinite lived intangible assets		$ 17,383,878

Reconciliation of Income Tax Computed At U. S. Federal Statutory Rate to Income Tax (Benefit) Expense (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Income Tax Disclosure [Abstract]
Tax at U.S. statutory rate	$ (3,513,812)	$ (9,413,200)	$ 1,266,166
State taxes, net of federal benefit	(190,656)	(1,226,475)	(64,608)
Non-deductible meals and entertainment	449,780	961,933	290,280
Foreign tax expense	554,314	(221,897)	(162,448)
Valuation allowances	48,556,357	(43,657)	367,068
Uncertain tax positions	(257,488)	647,720	174,045
Deferred tax rate differential	312	150,583	(107,057)
Tax Reconciliation Deferred Tax Writeoffs	221,028	0	301,765
Audit settlements	160,026	0	(391,822)
Tax on unrepatriated earnings	(1,464,728)	2,004,596	0
Tax on repatriated earnings	0	519,072	0
Tax true ups and other	(304,585)	471,436	396,058
Total income tax expense (benefit)	$ 44,210,548	$ (6,149,889)	$ 2,069,447

Reconciliation of Beginning and Ending Balance of Unrecognized Tax Benefits (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Balance at January 1	$ 5,204,000	$ 4,500,000
Additions based on tax positions related to the current year	496,000	852,000
Additions based on tax positions related to prior years	681,000	152,000
Reductions based on settlements of tax positions related to the prior year	(292,000)	(30,000)
Reductions for tax positions as a result of a lapse of the applicable statute of limitations	(1,076,000)	(263,000)
Other	(27,000)	(7,000)
Balance at December 31	$ 4,986,000	$ 5,204,000

Stockholders' Equity- Narrative (Detail) - USD ($)		12 Months Ended
Stockholders' Equity- Narrative (Detail) - USD ($)	Jan. 09, 2013	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Feb. 28, 2008	Nov. 30, 2004	Oct. 25, 2001
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Common stock authorized for stock repurchase program					1,500,000
Stock repurchase and retirement(in shares)			71,653	427,043
Shares repurchased, average price per share			$ 5.22	$ 5.23
Stock repurchase and retirement			$ 374,248	$ 2,234,585
Common stock left remaining to repurchase under the plan		942,443
Share options outstanding at end of year		1,546,299	1,922,756
Shares options outstanding vested or expected to vest		1,433,047
Shares options outstanding vested or expected to vest ,intrinsic value		$ 3,270,748
Shares options outstanding vested or expected to vest -weighted average exercise price		$ 9.20
Shares options outstanding vested or expected to vest -weighted average contractual life		3 years 1 month 6 days
Pretax total unrecognized compensation cost related to share options		$ 884,579
Pretax total unrecognized compensation cost related to share options- period		2 years 6 months 15 days
Registration of common stock held by three existing shareholders						11,403,455
Public offering shares			8,172,868
Loan And Security Agreement [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate stock repurchase amount	$ 5,000,000
Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Pretax total unrecognized compensation cost related to share options- period		2 years 7 months 3 days
Pretax of total unrecognized compensation cost related to non-vested restricted stock awards		$ 2,372,238
Fair value of shares vested		$ 2,378,194	$ 944,976	$ 1,190,000
2007 Stock Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate number of common stock shares authorized for issuance		3,500,000
2007 Stock Incentive Plan [Member] \| Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exercise price of the fair market value of common stock		100.00%
2007 Stock Incentive Plan [Member] \| Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock expiration period		10 years
2007 Stock Incentive Plan [Member] \| Ten Percent Or More Stockholders [Member] \| Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exercise price of the fair market value of common stock		110.00%
2007 Stock Incentive Plan [Member] \| Ten Percent Or More Stockholders [Member] \| Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock expiration period		5 years
2007 Stock Incentive Plan [Member] \| Not Appreciation Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate number of common stock shares authorized for issuance		1,700,000
2007 Stock Incentive Plan [Member] \| Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock vesting percentage per year		25.00%
Stock vesting period		4 years
2007 Stock Incentive Plan [Member] \| Stock Appreciation Rights (SARs) [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock expiration period		7 years
Stock vesting percentage per year		25.00%
Stock vesting period		4 years
The 1999 Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate number of common stock shares authorized for issuance							4,398,001

Awards Granted Under the 2007 Plan to Non-Employee Directors and Management Team (Detail) - shares	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Stock Appreciation Rights (SARs) [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock appreciation rights	324,000	344,500	261,500
Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted stock	340,509	337,220	216,538

Summary of Company's Share Option Plans Activities (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding [Roll Forward]
Share options outstanding at beginning of year	1,922,756
Granted	324,000	344,500	261,500
Exercised	(14,000)
Forfeited/expired	(686,457)
Share options outstanding at end of year	1,546,299	1,922,756
Share options exercisable at end of year	1,006,674
Share options unvested at end of year	539,625
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract]
Share options outstanding at beginning of year, Weighted Average Exercise Price, (usd per share)	$ 9.67
Granted, Weighted Average Exercise Price, (usd per share)	5.25
Exercised, Weighted Average Exercise Price, (usd per share)	4.35
Forfeited/expired, Weighted Average Exercise Price, (usd per share)	9.36
Share options outstanding at end of year, Weighted Average Exercise Price, (usd per share)	8.93	$ 9.67
Share options exercisable at end of year, Weighted Average Exercise Price, (usd per share)	10.79
Share options unvested at end of year, Weighted Average Exercise Price, (usd per share)	$ 5.46
Share options outstanding at end of year, Weighted-Average Remaining Contractual Life	3 years 3 months 11 days
Share options exercisable at end of year, Weighted-Average Remaining Contractual Life	1 year 11 months 27 days
Share options unvested at end of year, Weighted-Average Remaining Contractual Life	5 years 8 months 9 days
Share options outstanding at end of year, Aggregate Intrinsic Value	$ 3,770,958
Share options exercisable at end of year, Aggregate Intrinsic Value	1,329,153
Share options unvested at end of year, Aggregate Intrinsic Value	$ 2,441,805
$4.16-$22.50 [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract]
Option price, lower limit	$ 4.16
Option price, upper limit	22.50
$4.92-$5.61 [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract]
Option price, lower limit	4.92
Option price, upper limit	5.61
$4.35 [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract]
Exercise price range	4.35
$4.35-$22.50 [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract]
Option price, lower limit	4.35
Option price, upper limit	22.50
$4.16-$22.50 [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract]
Option price, lower limit	4.16
Option price, upper limit	22.50
$4.16-$22.50 [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract]
Option price, lower limit	4.16
Option price, upper limit	22.50
$4.16-$8.09 [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract]
Option price, lower limit	4.16
Option price, upper limit	$ 8.09

Stock Options and Stock Appreciation Rights Granted and Exercised (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Equity [Abstract]
Granted	324,000	344,500	261,500
Weighted average grant date fair value of options granted during the period	$ 1.77	$ 1.65	$ 2.63
Total intrinsic value of options exercised	$ 12,465	$ 0	$ 0

Assumptions Used to Estimate Fair Value of Options Granted Using Black-Scholes Option-Pricing Model (Detail)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Equity [Abstract]
Expected dividend yield	0.00%	0.00%	0.00%
Expected volatility	48.00%	47.00%	42.00%
Risk-free interest rate	0.79%	0.58%	1.33%
Expected life	4 years 2 months	4 years 3 months 18 days	4 years 3 months 18 days

Summary of Restricted Stock Award Activity (Detail) - Restricted Stock [Member] - $ / shares	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Number of Shares
Unvested restricted stock awards, beginning balance	661,648
Granted	340,509	337,220	216,538
Vested	(238,296)
Forfeited	(211,630)
Unvested restricted stock awards, ending balance	552,231	661,648
Weighted average grant date fair value
Unvested restricted stock awards, January 1, 2012	$ 6.08
Granted	4.64
Vested	6.86
Forfeited	4.73
Unvested restricted stock awards at December 31, 2012	$ 5.37	$ 6.08

Earnings Per Share - Narrative (Detail) - shares	12 Months Ended
Earnings Per Share - Narrative (Detail) - shares	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Earnings Per Share [Abstract]
Common stock shares that have been excluded from the per share calculation	1,547,814	2,033,632	1,962,265
Dilutive shares excluded due to net loss	149,453	47,258

Components of Numerator and Denominator for Computation of Basic and Diluted Earnings per Share (Detail) - USD ($)

3 Months Ended

12 Months Ended

Dec. 31, 2013

^[1]

Sep. 30, 2013

Jun. 30, 2013

Mar. 31, 2013

^[2]

Dec. 31, 2012

^[3]

Sep. 30, 2012

^[3]

Jun. 30, 2012

^[3]

Mar. 31, 2012

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Earnings Per Share [Abstract]

(Loss) income from continuing operations

$ (52,922,043)

$ 1,453,590

$ (1,435,829)

$ (1,345,729)

$ (2,985,180)

$ 719,539

$ (18,841,283)

$ 361,955

$ (54,250,011)

$ (20,744,969)

$ 1,547,639

Income (loss) from discontinued operations, net of tax

337,234

(538,916)

(21,393)

2,503,763

(6,548,030)

(18,319,626)

4,337,450

(946,322)

2,280,688

(21,476,528)

2,550,210

Net (loss) income

$ (52,584,809)

$ 914,674

$ (1,457,222)

$ 1,158,034

$ (9,533,210)

$ (17,600,087)

$ (14,503,833)

$ (584,367)

$ (51,969,323)

$ (42,221,497)

$ 4,097,849

Basic (loss) income per common share:

Continuing operations (usd per share)

$ (1.70)

$ 0.05

$ (0.05)

$ (0.04)

$ (0.10)

$ 0.02

$ (0.61)

$ 0.01

$ (1.75)

$ (0.67)

$ 0.05

Discontinued operations (usd per share)

0.01

(0.02)

0.00

0.08

(0.21)

(0.59)

0.14

(0.03)

0.07

(0.70)

0.08

Diluted (loss) income per common share:

Continuing operations (usd per share)

(1.70)

0.05

(0.05)

(0.04)

(0.10)

0.02

(0.61)

0.01

(1.75)

(0.67)

0.05

Discontinued operations (usd per share)

0.01

(0.02)

0.00

0.08

(0.21)

(0.59)

0.14

(0.03)

0.07

(0.70)

0.08

Earnings Per Share, Diluted

(1.69)

0.03

(0.05)

0.04

(0.31)

(0.57)

(0.47)

(0.02)

(1.68)

(1.37)

0.13

Net (loss) income (usd per share)

$ (1.69)

$ 0.03

$ (0.05)

$ 0.04

$ (0.31)

$ (0.57)

$ (0.47)

$ (0.02)

$ (1.68)

$ (1.37)

$ 0.13

Weighted-average number of shares outstanding-basic (shares)

31,009,218

30,842,723

31,146,165

Plus dilutive equity awards

45,851

Weighted-average number of shares outstanding-diluted (shares)

31,009,218

30,842,723

31,192,016

[1]	On December 2, 2013, the Company acquired the operating assets of On Assignment, Inc.’s Allied Healthcare Staffing division. The acquisition has been accounted for in accordance with FASB ASC Topic 805-Business Combinations, using the purchase method. The results of On Assignment's operations have been included in the Company's consolidated statements of operations since December 2, 2013, the date of the acquisition. See Note 5 - Acquisitions. During the fourth quarter of 2013, the Company recorded a deferred tax assets valuation allowance of approximately $48,406,398 and a trade names impairment charge of $6,400,000. See Note 12 - Income Taxes and Note 4 - Goodwill, Trade Names and Other Identifiable Intangible Assets.
[2]	The Company sold its clinical trial services business on February 15, 2013. The clinical trial services business has been classified as discontinued operations. The transaction resulted in a gain on sale of $3,968,714 pretax, or $2,055,907 after tax. See Note 3 – Assets Held for Sale and Discontinued Operations.
[3]	During the second, third and fourth quarters of 2012, the Company recorded impairment charges of approximately $18,732,000, $23,500,000 and $11,900,000, respectively. See Note 4 – Goodwill, Trade Names and Other Identifiable Intangible Assets and Note 3 – Assets Held for Sale and Discontinued Operations.

Related Party Transactions - Narrative (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Related Party Transactions [Abstract]
Revenue- related party transaction	$ 3,897	$ 3,804	$ 2,097
Account receivable due from related parties	$ 424	$ 570

- Definition

For an unclassified balance sheet, amount of receivables arising from transactions with related parties.

+ References + Details

Segment Information - Narrative (Details)	12 Months Ended
Segment Information - Narrative (Details)	Dec. 31, 2013 segment
Segment Reporting [Abstract]
Number of operating segments	3

Information on Operating Segments and Reconciliation to Income From Operations (Detail) - USD ($)

3 Months Ended

12 Months Ended

Dec. 31, 2013

^[1]

Sep. 30, 2013

Jun. 30, 2013

Mar. 31, 2013

^[2]

Dec. 31, 2012

^[3]

Sep. 30, 2012

^[3]

Jun. 30, 2012

^[3]

Mar. 31, 2012

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]

Revenue from unaffiliated customers

$ 109,178,547

$ 108,047,986

$ 110,768,343

$ 110,315,840

$ 111,730,808

$ 112,257,707

$ 108,847,135

$ 109,799,496

$ 438,310,716

$ 442,635,146

$ 439,377,460

Contribution income

^[4]

28,550,825

23,956,377

34,569,941

Unallocated corporate overhead

^[5]

22,286,031

22,574,066

20,299,783

Depreciation

3,885,688

4,904,845

5,965,002

Amortization

2,294,077

3,381,743

3,493,408

Acquisition costs

473,488

Restructuring costs

483,578

Legal settlement charge

(750,000)

Impairment charges

6,400,000

54,132,407

(Loss) income from continuing operations

(8,022,037)

(24,518,497)

5,911,434

Nurse and allied staffing [Member]

Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]

Revenue from unaffiliated customers

278,972,901

277,753,525

278,793,599

Contribution income

^[4],[5]

19,188,403

11,360,870

20,077,583

Physician Staffing [Member]

Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]

Revenue from unaffiliated customers

121,371,017

123,545,045

118,780,800

Contribution income

^[4]

8,616,916

10,651,879

11,320,076

Other human capital management services [Member]

Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]

Revenue from unaffiliated customers

37,966,798

41,336,576

41,803,061

Contribution income

^[4]

745,506

1,943,628

3,172,282

Segment, Continuing Operations [Member]

Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]

Depreciation

3,885,688

4,904,845

5,965,002

Amortization

2,294,077

2,263,556

2,393,722

Restructuring costs

483,578

Legal settlement charge

750,000

Impairment charges

^[6]

$ 6,400,000

$ 18,732,407

$ 0

[1]	On December 2, 2013, the Company acquired the operating assets of On Assignment, Inc.’s Allied Healthcare Staffing division. The acquisition has been accounted for in accordance with FASB ASC Topic 805-Business Combinations, using the purchase method. The results of On Assignment's operations have been included in the Company's consolidated statements of operations since December 2, 2013, the date of the acquisition. See Note 5 - Acquisitions. During the fourth quarter of 2013, the Company recorded a deferred tax assets valuation allowance of approximately $48,406,398 and a trade names impairment charge of $6,400,000. See Note 12 - Income Taxes and Note 4 - Goodwill, Trade Names and Other Identifiable Intangible Assets.
[2]	The Company sold its clinical trial services business on February 15, 2013. The clinical trial services business has been classified as discontinued operations. The transaction resulted in a gain on sale of $3,968,714 pretax, or $2,055,907 after tax. See Note 3 – Assets Held for Sale and Discontinued Operations.
[3]	During the second, third and fourth quarters of 2012, the Company recorded impairment charges of approximately $18,732,000, $23,500,000 and $11,900,000, respectively. See Note 4 – Goodwill, Trade Names and Other Identifiable Intangible Assets and Note 3 – Assets Held for Sale and Discontinued Operations.
[4]	The Company defines contribution income as income from operations before depreciation, amortization, acquisition costs, restructuring costs, legal settlement charges, impairment charges and corporate expenses not specifically identified to a reporting segment. Contribution income is used by management when assessing segment performance and is provided in accordance with the Segment Reporting Topic of the FASB ASC
[5]	In 2013, the Company refined its methodology for allocating certain corporate overhead expenses to its nurse and allied staffing segment expenses to more accurately reflect this segment’s profitability. Prior year information has been reclassified to conform to current year presentation.
[6]	During the fourth quarter of 2013, the Company recorded a trade names impairment charge of $6,400,000. During the year ended December 31, 2012, the Company recorded pretax impairment charges in its continuing operations of $18,732,407. Refer to discussion in Note 4-Goodwill, Trade Names and Other Identifiable Intangible Assets.

Information on Operating Segments and Reconciliation to Income From Operations (Parenthetical) (Detail) - USD ($)

3 Months Ended

12 Months Ended

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]

Impairment of intangibles

$ 6,400,000

Impairment charges

$ 6,400,000

$ 54,132,407

$ 0

Segment, Continuing Operations [Member]

Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]

Impairment charges

^[1]

$ 6,400,000

$ 18,732,407

$ 0

[1]

During the fourth quarter of 2013, the Company recorded a trade names impairment charge of $6,400,000. During the year ended December 31, 2012, the Company recorded pretax impairment charges in its continuing operations of $18,732,407. Refer to discussion in Note 4-Goodwill, Trade Names and Other Identifiable Intangible Assets.

Quarterly Financial Data (Unaudited) (Detail) - USD ($)

3 Months Ended

12 Months Ended

Dec. 31, 2013

^[1]

Sep. 30, 2013

Jun. 30, 2013

Mar. 31, 2013

^[2]

Dec. 31, 2012

^[3]

Sep. 30, 2012

^[3]

Jun. 30, 2012

^[3]

Mar. 31, 2012

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Quarterly Financial Information Disclosure [Abstract]

Revenue from services

$ 109,178,547

$ 108,047,986

$ 110,768,343

$ 110,315,840

$ 111,730,808

$ 112,257,707

$ 108,847,135

$ 109,799,496

$ 438,310,716

$ 442,635,146

$ 439,377,460

Gross profit

28,561,465

28,184,087

27,838,891

28,875,395

27,943,467

27,455,827

27,136,129

29,049,682

(Loss) income from continuing operations, net of tax

(52,922,043)

1,453,590

(1,435,829)

(1,345,729)

(2,985,180)

719,539

(18,841,283)

361,955

(54,250,011)

(20,744,969)

1,547,639

Income (loss) from discontinued operations, net of tax

337,234

(538,916)

(21,393)

2,503,763

(6,548,030)

(18,319,626)

4,337,450

(946,322)

2,280,688

(21,476,528)

2,550,210

Net (loss) income

$ (52,584,809)

$ 914,674

$ (1,457,222)

$ 1,158,034

$ (9,533,210)

$ (17,600,087)

$ (14,503,833)

$ (584,367)

$ (51,969,323)

$ (42,221,497)

$ 4,097,849

Basic income (loss) per common share from:

Continuing operations (usd per share)

$ (1.70)

$ 0.05

$ (0.05)

$ (0.04)

$ (0.10)

$ 0.02

$ (0.61)

$ 0.01

$ (1.75)

$ (0.67)

$ 0.05

Discontinuing operations (usd per share)

0.01

(0.02)

0.00

0.08

(0.21)

(0.59)

0.14

(0.03)

0.07

(0.70)

0.08

Net (loss) income (usd per share)

(1.69)

0.03

(0.05)

0.04

(0.31)

(0.57)

(0.47)

(0.02)

(1.68)

(1.37)

0.13

Diluted income (loss) per common share from:

Continuing operations (usd per share)

(1.70)

0.05

(0.05)

(0.04)

(0.10)

0.02

(0.61)

0.01

(1.75)

(0.67)

0.05

Discontinuing operations (usd per share)

0.01

(0.02)

0.00

0.08

(0.21)

(0.59)

0.14

(0.03)

0.07

(0.70)

0.08

Net (loss) income (usd per share)

$ (1.69)

$ 0.03

$ (0.05)

$ 0.04

$ (0.31)

$ (0.57)

$ (0.47)

$ (0.02)

$ (1.68)

$ (1.37)

$ 0.13

[1]	On December 2, 2013, the Company acquired the operating assets of On Assignment, Inc.’s Allied Healthcare Staffing division. The acquisition has been accounted for in accordance with FASB ASC Topic 805-Business Combinations, using the purchase method. The results of On Assignment's operations have been included in the Company's consolidated statements of operations since December 2, 2013, the date of the acquisition. See Note 5 - Acquisitions. During the fourth quarter of 2013, the Company recorded a deferred tax assets valuation allowance of approximately $48,406,398 and a trade names impairment charge of $6,400,000. See Note 12 - Income Taxes and Note 4 - Goodwill, Trade Names and Other Identifiable Intangible Assets.
[2]	The Company sold its clinical trial services business on February 15, 2013. The clinical trial services business has been classified as discontinued operations. The transaction resulted in a gain on sale of $3,968,714 pretax, or $2,055,907 after tax. See Note 3 – Assets Held for Sale and Discontinued Operations.
[3]	During the second, third and fourth quarters of 2012, the Company recorded impairment charges of approximately $18,732,000, $23,500,000 and $11,900,000, respectively. See Note 4 – Goodwill, Trade Names and Other Identifiable Intangible Assets and Note 3 – Assets Held for Sale and Discontinued Operations.

Quarterly Financial Data (Unaudited) (Parenthetical) (Detail) - USD ($)

3 Months Ended

12 Months Ended

Feb. 15, 2013

Dec. 31, 2013

Dec. 31, 2012

Sep. 30, 2012

Jun. 30, 2012

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Effect of Fourth Quarter Events [Line Items]

Gain on sale of discontinued operations

$ 3,968,714

$ 0

Change in valuation allowance

^[1],[2]

$ (48,406,398)

Impairment of intangibles

$ 6,400,000

Goodwill impairment charge

$ 11,900,000

$ 23,500,000

$ 18,732,000

Clinical Trial Services [Member]

Effect of Fourth Quarter Events [Line Items]

Gain on disposal before taxes

$ 3,968,714

Gain on sale of discontinued operations

$ 2,055,907

[1]	Related to deferred tax assets on state net operating losses and a particular subsidiary’s state portion of its deferred tax asset that arose from goodwill impairment.
[2]	Related to deferred tax assets, Cyprus NOL's, and reversal of deferred tax assets related to the clinical trial services business.

VALUATION AND QUALIFYING ACCOUNTS (Detail) - USD ($)

12 Months Ended

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Valuation and Qualifying Accounts Disclosure [Line Items]

Valuation Allowance, Deferred Tax Asset, Change in Amount

^[1],[2]

$ 48,406,398

Allowance for Doubtful Accounts [Member]

Movement in Valuation Allowances and Reserves [Roll Forward]

Balance at Beginning of Period

1,841,136

$ 2,180,125

$ 3,500,968

Charged to Costs and Expenses

1,078,195

786,107

578,805

Write-offs

(1,324,027)

(912,797)

(1,903,539)

Recoveries

55,669

16,076

3,891

Other Changes

(228,375)

^[3]

Balance at End of Period

1,650,973

1,841,136

2,180,125

Valuation Allowance of Deferred Tax Assets [Member]

Movement in Valuation Allowances and Reserves [Roll Forward]

Balance at Beginning of Period

4,032,912

3,678,183

3,311,831

Charged to Costs and Expenses

^[1]

354,729

366,352

Write-offs

(437,723)

^[2]

Recoveries

Other Changes

^[3]

Balance at End of Period

$ 52,001,587

$ 4,032,912

$ 3,678,183

[1]	Related to deferred tax assets on state net operating losses and a particular subsidiary’s state portion of its deferred tax asset that arose from goodwill impairment.
[2]	Related to deferred tax assets, Cyprus NOL's, and reversal of deferred tax assets related to the clinical trial services business.
[3]	Represents the reclassification of the allowance for doubtful accounts related to Assets Held for Sale. See Note 3 – Assets Held for Sale and Discontinued Operations.