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Document and Entity Information - USD ($)	12 Months Ended
Document and Entity Information - USD ($)	Dec. 31, 2014	Feb. 28, 2015	Jun. 30, 2014
Document Documentand Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2014
Document Fiscal Year Focus	2014
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		31,931,356
Entity Public Float			$ 201,393,913

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013
Current assets:
Cash and cash equivalents	$ 4,995	$ 8,055
Accounts receivable, less allowance for doubtful accounts of $1,425 and $1,651 at December 31, 2014 and 2013, respectively	113,129	60,750
Income taxes receivable	307	538
Prepaid expenses	6,073	6,163
Insurance recovery receivable	5,624	3,886
Indemnity escrow receivable	0	3,750
Other current assets	1,055	793
Total current assets	131,183	83,935
Property and equipment, net of accumulated depreciation	12,133	6,170
Trade Names, net	38,201	42,301
Goodwill	90,647	77,266
Other identifiable intangible assets, net	33,823	26,198
Debt issuance costs, net of accumulated amortization of $522 and $222 at December 31, 2014 and 2013, respectively	1,257	464
Non-current insurance recovery receivable	16,825	10,914
Non-current security deposits	1,064	997
Total assets	325,133	248,245
Current liabilities:
Accounts payable and accrued expenses	27,314	10,272
Accrued compensation and benefits	28,731	19,148
Current portion of long-term debt and capital lease obligations	3,607	8,483
Sales tax payable	2,573	2,404
Deferred tax liabilities	1,981	535
Other current liabilities	2,790	4,063
Total current liabilities	66,996	44,905
Long-term debt and capital lease obligations, less current portion	70,467	93
Non-current deferred tax liabilities	18,038	16,849
Long-term accrued claims	32,068	18,303
Long-term deferred purchase price	2,333	0
Long-term unrecognized tax benefits	889	4,013
Other long-term liabilities	4,010	3,415
Total liabilities	194,801	87,578
Commitments and contingencies
Stockholders' equity:
Common stock—$0.0001 par value; 100,000,000 shares authorized; 31,292,596 and 31,085,289 shares issued and outstanding at December 31, 2014 and 2013, respectively	3	3
Additional paid-in capital	247,467	246,325
Accumulated other comprehensive loss	(1,118)	(970)
Accumulated deficit	(116,474)	(84,691)
Total Cross Country Healthcare, Inc. stockholders' equity	129,878	160,667
Noncontrolling interest	454	0
Total stockholders' equity	130,332	160,667
Total liabilities and stockholders' equity	$ 325,133	$ 248,245

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013
Statement of Financial Position [Abstract]
Accounts receivable, allowance for doubtful accounts	$ 1,425	$ 1,651
Debt issuance costs, accumulated amortization	$ 522	$ 222
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	31,292,596	31,085,289
Common stock, shares outstanding	31,292,596	31,085,289

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Income Statement [Abstract]
Revenue from services	$ 617,825	$ 438,311	$ 442,635
Operating expenses:
Direct operating expenses	460,021	324,851	331,050
Selling, general and administrative expenses	141,018	106,117	109,417
Bad debt expense	1,016	1,078	786
Depreciation	3,866	3,886	4,905
Amortization	3,575	2,294	2,263
Acquisition and integration costs	7,957	473	0
Restructuring costs	840	484	0
Legal settlement charge	0	750	0
Impairment charges	10,000	6,400	18,732
Total operating expenses	628,293	446,333	467,153
Loss from operations	(10,468)	(8,022)	(24,518)
Other expenses (income):
Foreign exchange loss (gain)	49	(132)	(62)
Interest expense	4,160	849	2,341
Change in fair value of convertible note derivatives liability	16,671	0	0
Loss on early extinguishment and modification of debt	0	1,419	82
Other (income) expense, net	(30)	(119)	16
Loss from continuing operations before income taxes	(31,318)	(10,039)	(26,895)
Income tax expense (benefit)	216	44,211	(6,150)
Loss from continuing operations	(31,534)	(54,250)	(20,745)
Income (loss) from discontinued operations, net of income taxes	0	2,281	(21,476)
Consolidated net loss	(31,534)	(51,969)	(42,221)
Less: Net income attributable to noncontrolling interest in subsidiary	249	0	0
Net loss attributable to common shareholders	$ (31,783)	$ (51,969)	$ (42,221)
Basic (loss) income per share attributable to common shareholders
Continuing operations (usd per share)	$ (1.02)	$ (1.75)	$ (0.67)
Discontinued operations (usd per share)	0.00	0.07	(0.70)
Net (loss) income (usd per share)	(1.02)	(1.68)	(1.37)
Diluted (loss) income per share attributable to common shareholders
Continuing operations (usd per share)	(1.02)	(1.75)	(0.67)
Discontinued operations (usd per share)	0.00	0.07	(0.70)
Net (loss) income (usd per share)	$ (1.02)	$ (1.68)	$ (1.37)
Weighted average common shares outstanding—basic (shares)	31,190	31,009	30,843
Weighted average common shares outstanding—diluted (shares)	31,190	31,009	30,843

CONSOLIDATED STATEMENTS OF COMPREHENSIVE (LOSS) INCOME - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Statement of Comprehensive Income [Abstract]
Net (loss) income	$ (31,534)	$ (51,969)	$ (42,221)
Other comprehensive income, before income taxes:
Unrealized foreign currency translation gain (loss)	14	(386)	268
Reclassification of currency translation adjustments related to sale of clinical trial services business (See Note 2 - Summary of Significant Accounting Policies)	0	2,336	0
Write-down of marketable securities	0	0	38
Net change in fair value of marketable securities	0	0	(1)
Other comprehensive income, before income taxes	14	1,950	305
Income tax expense (benefit) related to items of other comprehensive income	162	(162)	15
Other comprehensive (loss) income, net of tax	(148)	2,112	290
Consolidated comprehensive loss	(31,682)	(49,857)	(41,931)
Less: Net income attributable to noncontrolling interest in subsidiary	249	0	0
Consolidated comprehensive loss	$ (31,931)	$ (49,857)	$ (41,931)

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-In Capital	Accumulated Other Comprehensive Income (Loss)	Retained Earnings	Noncontrolling Interest [Member]
Beginning Balance (in shares) at Dec. 31, 2011		30,812,023.000
Beginning Balance at Dec. 31, 2011	$ 249,300	$ 3	$ 243,171	$ (3,373)	$ 9,499	$ 0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Vesting of restricted stock (in shares)		161,944.000
Vesting of restricted stock	(153)	$ 0	(153)
Tax deficit of share-based compensation	(314)		(314)
Equity compensation	$ 2,594		2,594
Stock repurchase and retirement (in shares)	(71,653)	(71,653.000)
Stock repurchase and retirement	$ (374)	$ 0	(374)
Foreign currency translation adjustment, net of deferred taxes	268			268
Net change in fair value of marketable securities	23			23
Reclassification of currency translation adjustments related to sale of clinical trial services business (See Note 2 - Summary of Significant Accounting Policies)	0
Net (loss) income	(42,221)				(42,221)	0
Ending Balance (in shares) at Dec. 31, 2012		30,902,000
Ending Balance at Dec. 31, 2012	209,123	$ 3	244,924	(3,082)	(32,722)	0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options (in shares)		2,362.000
Vesting of restricted stock (in shares)		180,613.000
Vesting of restricted stock	(300)		(300)
Tax deficit of share-based compensation	(399)		(399)
Equity compensation	2,100		2,100
Foreign currency translation adjustment, net of deferred taxes	(224)			(224)
Reclassification of currency translation adjustments related to sale of clinical trial services business (See Note 2 - Summary of Significant Accounting Policies)	2,336			2,336
Net (loss) income	(51,969)				(51,969)	0
Ending Balance (in shares) at Dec. 31, 2013		31,085,000
Ending Balance at Dec. 31, 2013	$ 160,667	$ 3	246,325	(970)	(84,691)	0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options (in shares)	228,500	66,119.000
Vesting of restricted stock (in shares)		141,188.000
Vesting of restricted stock	$ (245)		(245)
Equity compensation	1,387		1,387
Foreign currency translation adjustment, net of deferred taxes	(148)			(148)
Reclassification of currency translation adjustments related to sale of clinical trial services business (See Note 2 - Summary of Significant Accounting Policies)	0
Acquisition of InteliStaf of Oklahoma, LLC	324					324
Distribution to noncontrolling shareholder	(119)					(119)
Net (loss) income	(31,534)				(31,783)	249
Ending Balance (in shares) at Dec. 31, 2014		31,292,000
Ending Balance at Dec. 31, 2014	$ 130,332	$ 3	$ 247,467	$ (1,118)	$ (116,474)	$ 454

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Operating activities
Net (loss) income	$ (31,534)	$ (51,969)	$ (42,221)
Adjustments to reconcile net loss to net cash (used in) provided by operating activities:
Bad debt expense	1,016	1,083	871
Depreciation	3,866	3,886	5,566
Amortization	3,575	2,294	3,382
Amortization of debt discount and debt issuance costs	1,064	233	606
Impairment charges	10,000	6,400	54,132
Loss on early extinguishment and modification of debt	0	1,419	82
Deferred income tax (benefit) expense	(857)	45,900	(18,520)
Change in fair value of convertible note derivatives liability	16,671	0	0
Equity compensation	1,387	2,100	2,594
Gain on sale of clinical trial services business	0	(3,969)	0
Other noncash costs	114	12	822
Changes in operating assets and liabilities:
Accounts receivable	(16,119)	2,036	(4,256)
Prepaid expenses and other assets	1,371	(1,848)	(444)
Income taxes	58	(138)	1,748
Accounts payable and accrued expenses	5,654	(320)	4,128
Other liabilities	(338)	1,540	1,656
Net cash (used in) provided by operating activities	(4,072)	8,659	10,146
Cash flows from investing activities
Proceeds from sale of business segment, net of cash sold and transaction costs	3,750	45,655	0
Acquisition of assets of Medical Staffing Network, net of cash acquired	(44,631)	0	0
Acquisition of assets of On Assignment, Inc.	0	(28,700)	0
Purchases of property and equipment	(4,571)	(1,750)	(2,219)
Liquidation of foreign cash investments	0	0	2,652
Other investing activities	0	0	(258)
Net cash (used in) provided by investing activities	(45,452)	15,205	175
Cash flows from financing activities
Debt issuance costs	1,093	506	1,377
Repurchase of stock for tax withholdings	(245)	(300)	(153)
Stock repurchase and retirement	0	0	(374)
Cash payment to noncontrolling shareholder	(119)	0	0
Proceeds from borrowing on Second Lien Term Loan	28,875	0	25,000
Principal payments on term loan	0	(23,125)	(43,326)
Proceeds from borrowing on Convertible Notes	24,063	0	0
Borrowings under revolving credit facility	0	0	26,900
Repayments on revolving credit facility	0	(10,000)	(16,900)
Borrowings under Senior Secured Asset-Based revolving credit facility	61,205	63,444	0
Repayments on Senior Secured Asset-Based revolving credit facility	(66,105)	(55,044)	0
Repayments of capital lease obligations and note payable	(122)	(530)	(353)
Net cash provided by (used in) financing activities	46,459	(26,061)	(10,583)
Effect of exchange rate changes on cash	5	(211)	77
Net decrease in cash and cash equivalents	(3,060)	(2,408)	(185)
Cash and cash equivalents at beginning of year	8,055	10,463	10,648
Cash and cash equivalents at end of year	4,995	8,055	10,463
Supplemental disclosure of noncash investing and financing activities:
Equipment purchased through capital lease obligations	0	0	302
Insurance premium financing	0	0	190
Supplemental disclosure of cash flow information:
Interest paid	2,512	622	1,467
Income taxes paid	1,374	1,164	1,682
Income tax refunds	$ (61)	$ (323)	$ (564)

Organization and Basis of Presentation	12 Months Ended
Organization and Basis of Presentation	Dec. 31, 2014
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, 2014, 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. On June 30, 2014, the Company acquired substantially all of the assets and certain liabilities of Medical Staffing Network Healthcare, LLC (MSN), which results have been substantially reported through the Company's Nurse and Allied Staffing business segment. See Note 3 - Acquisitions. 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 4 - 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 3 - Acquisitions. The consolidated financial statements include the accounts of the Company and its wholly-owned direct and indirect subsidiaries. The consolidated financial statements include all assets, liabilities, revenue, and expenses of InteliStaf of Oklahoma, LLC, which is controlled by the Company but not wholly owned. The Company records the ownership interest of the noncontrolling shareholder as noncontrolling interest in subsidiary. See Note 3 - Acquisitions for further information. All material intercompany transactions and balances have been eliminated in consolidation.

Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2014

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 and professional liability claims, valuation of deferred tax assets and the purchase price allocation, derivative liability, legal contingencies, future contingent considerations, 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, Allowance for Doubtful Accounts, 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

2. Summary of Significant Accounting Policies (continued)

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, 2014 and 2013, or revenue for the years ended December 31, 2014, 2013 and 2012.

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 the beginning of the fourth quarter, and whenever circumstances occur indicating potential impairment, with any related losses recognized in earnings and included in the caption impairment charges on the consolidated statement of operations.

Historically, the Company completed the annual goodwill impairment test as of December 31 of each fiscal year. During the quarter ended September 30, 2014, the Company voluntarily changed the date of its goodwill and other indefinite-lived intangible assets impairment testing from December 31 to the first day of its fourth quarter. This voluntary change is preferable under the circumstances as it provides the Company with additional time to complete its annual goodwill and indefinite-lived intangible asset impairment testing in advance of its year-end reporting. The voluntary change in accounting principle related to the annual testing date will not delay, accelerate, or avoid an impairment charge. This change is not applied retrospectively as it is impracticable to do so because retrospective application would require application of significant estimates and assumptions with the use of hindsight. Accordingly, the change will be applied prospectively.

2. Summary of Significant Accounting Policies (continued)

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 5 – Goodwill, Trade Names, and Other Identifiable Intangible Assets for further information.

Debt Discount and Debt Issuance Costs

Stated discounts on proceeds, and other fees reimbursed to lender, as well as the initial value of any embedded derivative features of the Convertible Notes and Term Loans, as defined in Note 8 - Long-Term Debt, are treated as a discount associated with the respective debt instrument and presented in the balance sheet as an offset to the carrying amount of the debt. Discounts are amortized to interest expense using the effective interest rate method, or a method that approximates the effective interest rate method, over the expected life of the debt.

Deferred costs related to the issuance of Convertible Notes and Term Loans, as defined in Note 8 - Long-Term Debt, are capitalized and amortized using the effective interest method. Deferred costs related to the issuance of the Company’s Senior Secured Asset-based Loan, as defined in Note 8 – Long-Term Debt, have been capitalized and amortized using the straight line method, over the term of the related credit agreement.

Derivative Financial Instruments

The Company evaluates embedded conversion features within convertible debt under FASB ASC 815, Derivatives and Hedging, to determine whether the embedded conversion feature should be bifurcated from the host instrument and accounted for as a derivative at fair value with changes in fair value recorded within other expenses (income) on our consolidated statements of operations. The Company uses a trinomial lattice model to estimate the fair value of embedded conversion and redemption features in its convertible debt at the end of each applicable reporting period. Changes in the fair value of these derivatives during each reporting period are reported in the consolidated statement of operations. The fair value at inception has been recorded as debt discount and is being amortized to interest expense over the term of the note using the effective interest method or another method that approximates the effective interest method.

2. Summary of Significant Accounting Policies (continued)

Sales and 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).

The Other Expenses/Insurance Costs Topic of FASB ASC 720, 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 workers' 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 the insurer recognized as being due from insurance carriers. Accordingly, the Company’s consolidated balance sheets as of December 31, 2014 and 2013 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, 2014 and 2013, respectively, the Company had outstanding approximately $21.5 million and $6.4 million 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 and advance practitioners 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, 2014 and 2013, the value of the letter of credit was $5.0 million.

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 and advance practitioners, it does cover claims brought against all of the Company’s subsidiaries for non-patient general liability.

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.

2. Summary of Significant Accounting Policies (continued)

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, 2014 and 2013, such estimated accrued revenue is approximately $21.9 million and $11.0 million, 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, provide 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.

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 its healthcare professional is used, revenue is recorded on a gross basis. 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.

2. Summary of Significant Accounting Policies (continued)


•	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, 2014 and 2013, the Company had $1.2 million and $1.3 million, 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, performance-based share awards, 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 has elected to recognize compensation expense on a straight-line basis over the requisite service period of the entire award. The Company values its restricted stock awards and the fair value of its performance-based share awards by reference to the Company’s stock price on the date of grant.

The Company granted performance-based share awards to certain key personnel pursuant to its 2014 Omnibus Incentive Plan as described in Note 14- Stockholders' Equity. Pursuant to the Plan, the number of target shares that will vest are determined based on the level of attainment of the targets. If the minimum level of performance is attained, and restricted stock issued, they will vest on December 31, 2016. The Company recognizes performance-based restricted stock as compensation expense based on the most likely probability of attaining the prescribed performance and over the requisite service period beginning at its grant date and through the date the restricted stock vests.

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 $1.4 million; $2.1 million and $2.6 million, during the years ended December 31, 2014, 2013 and 2012, respectively. Because the Company has a full valuation allowance on its deferred tax assets, the granting and exercise of share-based payments during the years ended December 31, 2014 and 2013 had no impact on the income tax provision. For the year ended December 31, 2012, related deferred tax benefits of approximately $1.0 million were recorded. See Note 14 – 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 $4.1 million for the year ended December 31, 2014 and $3.2 million for the years ended December 31, 2013 and 2012. 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, 2014 and 2013, approximately $1.0 million and $1.3 million, respectively, of these costs are included in prepaid expenses on the consolidated balance sheets.

Restructuring Costs

Restructuring costs included in the consolidated statements of operations are primarily related to senior management employee severance pay.

Acquisition and Integration Costs

During the years ended December 31, 2014 and 2013, the Company incurred acquisition and integration related costs of $8.0 million and $0.5 million, respectively. Acquisition costs totaled $2.2 million and $0.5 million for the periods ending December 31, 2014 and 2013, respectively, and included transaction advisory fees, as well as other costs directly attributable to the

2. Summary of Significant Accounting Policies (continued)

transaction. Integration costs for the year ended December 31, 2014 included $1.6 million for ongoing post-employment benefits and $1.1 million for exit costs associated with redundant facilities. As of December 31, 2014, the Company had accrued integration liabilities of $1.9 million, which included $0.9 million for exit costs and $0.8 million for ongoing post-employment benefits. There were no similar amounts accrued as of December 31, 2013.

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 also recognized on a straight-line basis over the term of the lease.

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 13 - 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

Total comprehensive loss 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 $1.1 million at December 31, 2014 and 2013.

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.

2. Summary of Significant Accounting Policies (continued)

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). The Company adopted this guidance and released into earnings $2.3 million 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.

During the periods ended December 31, 2014 and 2013, $0.2 million of income tax expense and $0.2 million of income tax benefit, respectively, related to foreign currency translation adjustments were included on the Company's consolidated statements of comprehensive loss. During December 31, 2012 an immaterial amount of income tax expense related to the Company's marketable securities was included on the Company's consolidated statements of comprehensive loss.

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, 2014 and 2013, the Company’s financial assets and liabilities required to be measured on a recurring basis were its indemnity escrow receivable, its deferred compensation liability, its convertible notes derivative liability and its contingent consideration receivable. See Note 10 – Fair Value Measurements for relevant disclosures.

Recent Accounting Pronouncements

In April 2014, the FASB issued ASU 2014-08, Reporting Discontinued Operations and Disclosures of Disposals of Components of an Entity to reduce diversity in practice for reporting discontinued operations. Under the previous guidance, any component of an entity that was a reportable segment, an operating segment, a reporting unit, a subsidiary, or an asset group was eligible for discontinued operations presentation. The revised guidance only allows disposals of components of an entity that represent a strategic shift (e.g., disposal of a major geographical area, a major line of business, a major equity method investment, or other major parts of an entity) and that have a major effect on a reporting entity’s operations and financial results to be reported as discontinued operations. The revised guidance also requires expanded disclosure in the financial statements for discontinued operations as well as for disposals of significant components of an entity that do not qualify for discontinued operations presentation. The updated guidance is effective for periods beginning after December 15, 2014. The Company had operations that were reported as discontinued operations for the years ended December 31, 2013 and 2012. The Company did not adopt this guidance.

In May 2014, the FASB and the International Accounting Standards Board (IASB) jointly issued ASU No. 2014-9, Revenue from Contracts with Customers (Topic 606), which clarifies the principles for recognizing revenue and develops a common revenue standard for GAAP and International Financial Reporting Standards (IFRS). The core principle of the guidance is that an entity should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods and services. The ASU is effective for public entities for annual and interim periods beginning after December 15, 2016. Early adoption is not permitted under GAAP and retrospective application is permitted, but not required. The Company is currently evaluating the impact of adopting this guidance on its financial position and results of operations.

Acquisitions

12 Months Ended

Dec. 31, 2014

Business Combinations [Abstract]

Acquisitions

Medical Staffing Network

On June 30, 2014, the Company acquired substantially all of the assets and certain liabilities of MSN for an aggregate purchase price of $48.1 million, subject to certain post-closing net working capital adjustments. The Company paid $44.6 million, net of cash acquired, of which $1.0 million was funded to an escrow account for the net working capital adjustment. An additional $2.5 million was deferred and is due to the seller in 21 months, less any COBRA expenses incurred by the Company on behalf of former MSN employees over that period. During the fourth quarter of 2014, the Company received $0.2 million from the escrow account to finalize the net working capital adjustment and the remaining balance in the escrow account was released to the seller.

The Company financed the purchase price using $55.0 million in new subordinated debt consisting of a $30.0 million, 5-year term loan and $25.0 million of convertible notes having a 6-year maturity and a conversion price of $7.10. The Company also amended its loan agreement with Bank of America. N.A. to increase its borrowing capacity under its senior secured asset-based revolving credit facility from $65.0 million to $85.0 million. See Note 8 - Long-Term Debt for further information.

At the time of the acquisition, MSN had 55 locations throughout the U.S. that provide per diem, local, contract, travel, and permanent hire staffing services. This acquisition increases the Company's branch network and market share, diversifies its customer base and brings new service lines. Management believes it positions the Company to serve its customers better and to increase earnings growth through improved fill rates, expansion of its managed service programs and per diem activities, and the recognition of cost synergies.

The acquisition has been accounted for in accordance with FASB ASC 805, Business Combinations, using the acquisition method of accounting. The results of the acquisition's operations have been included in the consolidated statements of operations from July 1, 2014. The acquisition results have been substantially reported through the Company's Nurse and Allied Staffing business segment. As such, the associated goodwill related to the acquisition of MSN has been fully allocated to Nurse and Allied Staffing.

The following table is an estimate of the fair value of the assets acquired and liabilities assumed.



	(amounts in thousands)
Cash acquired	$	989
Accounts receivable, net	37,275
Other current assets	3,378
Property and equipment	5,329
Goodwill	13,381
Other intangible assets	17,100
Other assets	2,325
Total assets acquired	79,777

Accounts payable	6,736
Accrued employee compensation and benefits	14,731
Other liabilities	9,867
Total liabilities assumed	31,334

Noncontrolling interest	324

Net assets acquired	$	48,119

3. Acquisitions (continued)

The Company used a third-party appraiser to determine the fair value and estimated useful lives of certain acquired assets and liabilities. The gross contractual accounts receivable of the business were $38.1 million and were recorded net of the Company's best estimate of receivables not expected to be collected of $0.8 million.

The self-insurance accruals and liabilities for workers' compensation and professional liability were based on third-party appraisals. The Company provides workers’ compensation insurance coverage and professional liability coverage for our eligible temporary healthcare professionals. As part of the MSN acquisition, the Company assumed MSN’s workers' compensation and professional liability claims (both known claims and those incurred but not reported or IBNR). The MSN workers’ compensation benefits are provided under a partially self-insured plan. The workers' compensation insurer requires that the Company provide a letter of credit to guarantee payments of those workers' compensation claims. The Company also purchased an aggregate stop loss policy that attaches at $2.3 million for known MSN professional liability claims with a policy limit of $5.0 million. At the date of acquisition. the estimated fair value of the related liability was $5.6 million and the estimated recovery receivable was $0.4 million. For IBNR professional liability claims of MSN, the Company purchased a primary policy that provides each temporary healthcare professional with coverage of $1.0 million per occurrence and $5.0 million in the aggregate. This policy does not have a deductible. The Company also purchased an excess layer of insurance for MSN IBNR professional liability claims having limits of $1.0 million per occurrence and $6.0 million in the aggregate.

Based on a final independent third-party appraisal, the Company assigned the following values to other identifiable intangible assets: $5.9 million to trade names with an indefinite life, $4.7 million to customer relations with a weighted average estimated useful life of 13 years, and $6.5 million to a database with an estimated useful life of 10 years, for a total of $11.2 million in definite life intangible assets with a weighted average estimated useful life of 11 years. The Company also assigned an estimated fair value of $0.3 million to the noncontrolling interest in InteliStaf of Oklahoma, LLC, a joint venture between MSN and a third party. The fair value assessment was determined based on a combination of the discounted cash flow method, the guideline public company method, and the merger and acquisition method, utilized at 80%, 10%, and 10%, respectively, discounted to reflect that the interest is noncontrolling, and that there is no ready public market for the interest.

The remaining excess purchase price over the fair value of net assets acquired of $13.4 million was recorded as goodwill, which is expected to be deductible for tax purposes. Additional acquisition and integration-related costs of approximately $7.3 million were incurred and are reflected as acquisition and integration costs on the Company's consolidated statement of operations for the year ended December 31, 2014.

Allied Healthcare Staffing

In December 2013, the Company acquired the operating assets of On Assignment, Inc.’s Allied Healthcare Staffing division for an aggregate purchase price of $28.7 million, 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 $24.7 million in cash on hand and $4.5 million from borrowings under its current revolver facility with Bank of America, N.A. to pay the purchase price and approximately $0.5 million in transaction costs.

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, and (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. At the time of the acquisition, the acquired allied staffing business had 84 branch-based employees and made 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 acquisition method of accounting. 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. The acquired allied staffing business has been included with the Company's Nurse and Allied Staffing business segment.

3. Acquisitions (continued)

The following table summarizes the fair value 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 assumed.



	(amounts in thousands)
Other current assets	$	62
Property and equipment	161
Goodwill	14,554
Other intangible assets	14,000
Other assets	52
Total assets acquired	28,829

Accrued employee compensation and benefits	112
Total liabilities assumed	112

Net assets acquired	$	28,717

Based on the final independent third-party appraisal, the Company assigned the following values to other identifiable intangible assets: $10.4 million to customer relations with an estimated useful life of 16 years, $3.4 million to database with an estimated useful life of 10 years, and $0.2 million to non-compete agreements with a useful life of 5 years, in a total $14.0 million in definite life intangible assets with a weighted average estimated useful life of 14 years. The remaining excess of purchase price over the fair value of net assets acquired $14.6 million and was recorded as goodwill, which is expected to be deductible for tax purposes. Additional acquisition and integration-related costs of approximately $0.7 million and $0.5 million were incurred and are reflected as acquisition and integration costs on the Company's consolidated statement of operations for the years ended December 31, 2014 and 2013, respectively.

Results of Recent Acquisitions

The Company is integrating the acquired businesses into its current operations, including the consolidation of branch and corporate offices and therefore, it is impracticable to separate their results from their respective dates of acquisition. The following unaudited pro forma financial information approximates the consolidated results of operations of the Company as if the MSN and allied staffing business acquisitions had occurred as of January 1, 2013, after giving effect to certain adjustments, including additional interest expense on the amount the Company borrowed on the date of the transaction, the amortization of acquired intangible assets, and the elimination of certain expenses that will not be recurring in post-acquisition periods, net of an estimated income tax impact. These adjustments include removing transaction-related expenses of approximately $6.2 million for the year ended December 31, 2014, related to the MSN acquisition. These results are not necessarily indicative of future results as they do not include incremental investments in support functions, elimination of costs for integration or operating synergies, estimates of the changes in the fair value of the embedded derivative in our Convertible Notes or 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.

3. Acquisitions (continued)



	Year Ended December 31,
	2014			2013
	(unaudited, amounts in thousands except per share data)

Revenue from services	$	739,895		$	705,477

Net loss attributable to common shareholders	$	(29,797	)	$	(66,232	)

Net loss per common share attributable to common shareholders - basic	$	(0.96	)	$	(2.14	)

Net loss per common share attributable to common shareholders - diluted	$	(0.96	)	$	(2.14	)

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). As of December 31, 2014 and 2013, the Indemnification Escrow balance was $3.6 million. The escrow will be released upon full satisfaction of certain tax matters and the resolution of indemnity claims.

- 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
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-SubTopic 10
-Section 50
-Paragraph 5
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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
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Reference 4: http://www.xbrl.org/2003/role/presentationRef
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-Name Accounting Standards Codification
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Reference 5: http://www.xbrl.org/2003/role/presentationRef
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Reference 6: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
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Reference 7: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 8: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 9: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 10
-Section 50
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-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
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-URI http://asc.fasb.org/extlink&oid=35744584&loc=d3e7000-128479

Reference 11: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 12: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
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Reference 13: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
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-URI http://asc.fasb.org/extlink&oid=39739317&loc=d3e4926-128472

Reference 14: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
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Reference 15: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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+ Details

Discontinued Operations

12 Months Ended

Dec. 31, 2014

Discontinued Operations and Disposal Groups [Abstract]

Discontinued Operations

The Clinical Trial Services business 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.

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 $52.0 million in cash, subject to certain adjustments. At closing, the total amount paid was reduced by approximately $0.1 million 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 $0.2 million to the Buyer to finalize the Net Working Capital adjustment, pursuant to the assets purchase agreement.

The agreement included a provision for an earn-out of up to $3.8 million related to certain performance-based milestones. The maximum earn-out amount of $3.8 million was deposited in escrow by Buyer as security for the earn-out payment, if any. The $3.8 million 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 the information available to the Company. See Note 10 - Fair Value Measurements. The performance-based milestones were not earned, and as a result $1.5 million of the original escrow was released to the Buyer in the second quarter of 2013 and $2.3 million was released in July 2014.

Of the $52.0 million purchase price paid at closing, $3.8 million 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 $3.8 million indemnity escrow funds as an escrow receivable, and adjusted the amount, each reporting period, based on any known information that would be reasonable and estimable. See Note 10 - Fair Value Measurements. The total escrow amount was released to the Company in August 2014 and reported as additional proceeds from the sale in the investing activities on its consolidated statement of cash flows.

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. The historical financial results of operations, except for disclosures related to cash flows, have been presented as discontinued operations for the years ended December 31, 2013 and 2012.

4. Discontinued Operations (continued)

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



	Years Ended December 31,
		2013			2012
	(amounts in thousands)

Revenue		$	7,939		$	67,627

Income (loss) from discontinued operations before gain on sale and income taxes		434			(30,973		)
Gain on sale of discontinued operations		3,969			—
Income tax (expense) benefit		(2,122		)	9,497
Income (loss) from discontinued operations, net of income taxes		$	2,281		$	(21,476	)

For the year ended December 31, 2012, the loss before income taxes is comprised of $34.0 million of goodwill impairment charges, $1.4 million of a trade name impairment charge, and results from operations of approximately $4.4 million.

- 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, 2014

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Other Identifiable Intangible Assets

Goodwill, Trade Names, and Other Identifiable Intangible Assets

As of December 31, 2014 and 2013, the Company had the following acquired intangible assets:



	December 31, 2014						December 31, 2013
	Gross Carrying Amount		Accumulated Amortization		Net Carrying Amount		Gross Carrying Amount		Accumulated Amortization		Net Carrying Amount
	(amounts in thousands)
Intangible assets subject to amortization:
Databases	$	22,425	$	12,893	$	9,532	$	15,925	$	12,103	$	3,822
Customer relationships	42,004		17,870		24,134		37,304		15,125		22,179
Non-compete agreements	3,603		3,446		157		3,603		3,406		197
	$	68,032	$	34,209	$	33,823	$	56,832	$	30,634	$	26,198

Intangible assets not subject to amortization:
Goodwill					$	90,647					$	77,266
Trade names					38,201						42,301
					$	128,848					$	119,567

Additions to these intangible assets are related to the MSN acquisition. See Note 3 - Acquisitions.

5. Goodwill, Trade Names, and Other Identifiable Intangible Assets (continued)

As of December 31, 2014, estimated annual amortization expense for continuing operations is as follows:



Years Ending December 31:	(amounts in thousands)
2015	$	3,929
2016	3,929
2017	3,885
2018	3,800
2019	3,763
Thereafter	14,517
	$	33,823

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
	(amounts in thousands)
Balances as of December 31, 2013
Aggregate goodwill acquired	$	274,286		$	43,405	$	19,307	$	336,998
Accumulated impairment loss (a)	(259,732		)	—		—		(259,732		)
Goodwill, net of impairment loss	14,554			43,405		19,307		77,266
Changes to aggregate goodwill in 2014
Goodwill acquired (b)	13,381			—		—		13,381
Balances as of December 31, 2014
Aggregate goodwill acquired	287,667			43,405		19,307		350,379
Accumulated impairment loss	(259,732		)	—		—		(259,732		)
Goodwill, net of impairment loss	$	27,935		$	43,405	$	19,307	$	90,647

_______________

(a)

A non-cash pretax impairment charge of approximately $241.0 million 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 reporting unit. 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 and Allied Staffing acquisitions made through 2003. In addition, in the second quarter of 2012, a non-cash pretax impairment charge of approximately $18.7 million 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 Medical Staffing Network. See Note 3 - Acquisitions.

2014 annual impairment testing results

The Company performed its annual impairment test as of October 1, 2014. Upon completion of the impairment testing, the Company determined that the estimated fair value of its reporting units exceeded their respective carrying values. Accordingly, no goodwill impairment charges were warranted for these reporting units as of December 31, 2014.

Also, in conjunction with the annual impairment testing of trade names in the fourth quarter of 2014, the Company recorded a pretax non-cash impairment charge of $10.0 million related to the Physician Staffing segment. The Company reduced its long-term revenue forecast for the business segment 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 reduced long-term revenue forecast

5. Goodwill, Trade Names, and Other Identifiable Intangible Assets (continued)

was impacted by lower projected volume resulting from a delay in changing to a more scalable business model. The Company valued the trade name based on a discounted cash flow using projected cash flows of an estimated royalty fee. The royalty rate was determined by a blended rate using the Market Royalty Rate Method and the Apportionment of Profit Method and has been applied consistently since the date of acquisition. No additional impairments of indefinite-lived intangible assets were identified.

2013 annual impairment testing results

The Company performed its annual impairment test as of December 31, 2013. Upon completion of the impairment testing, the Company determined that the estimated fair value of its 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 pretax non-cash impairment charge of approximately $6.4 million of which $6.2 million related to the Physician Staffing reporting unit and $0.2 million related to the Nurse and Allied Staffing reporting unit. 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 Company valued the trade name based on a discounted cash flow using projected cash flows of an estimated royalty fee. The royalty rate was determined by a blended rate using the Market Royalty Rate Method and the Apportionment of Profit Method and has been applied consistently since the date of acquisition.

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 Nurse and Allied Staffing 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 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

5. Goodwill, Trade Names, and Other Identifiable Intangible Assets (continued)

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 pretax goodwill impairment charge of approximately $18.7 million 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.

- 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

Property and Equipment

12 Months Ended

Dec. 31, 2014

Property, Plant and Equipment [Abstract]

Property and Equipment

At December 31, 2014 and 2013, property and equipment consist of the following:



		December 31,
	Useful Lives	2014			2013
		(amounts in thousands)

Computer equipment	3-5 years	$	13,572		$	12,115
Computer software	3-5 years	34,100			30,059
Office equipment	5-7 years	3,846			3,307
Furniture and fixtures	5-7 years	3,562			1,752
Leasehold improvements	(a)	4,643			3,716
		59,723			50,949
Less accumulated depreciation and amortization		(47,590		)	(44,779		)
		$	12,133		$	6,170

_______________


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

Balance Sheet Details

12 Months Ended

Dec. 31, 2014

Balance Sheet Related Disclosures [Abstract]

Balance Sheet Details



	December 31,
	2014		2013
	(amounts in thousands)
Insurance recovery receivable:
Insurance recovery for workers’ compensation	$	3,316	$	2,093
Insurance recovery for professional liability	2,308		1,793
	$	5,624	$	3,886

Non-current insurance recovery receivable:
Insurance recovery for workers’ compensation – long-term	$	5,677	$	3,336
Insurance recovery for professional liability – long-term	11,148		7,578
	$	16,825	$	10,914

Accrued compensation and benefits:
Salaries and payroll taxes	$	8,406	$	6,875
Bonuses	4,050		2,200
Accrual for workers’ compensation claims	6,996		3,236
Accrual for health care benefits	2,206		1,385
Accrual for professional liability insurance	4,652		4,091
Accrual for vacation	2,421		1,361
	$	28,731	$	19,148

Long-term accrued claims:
Accrual for workers’ compensation claims	$	14,221	$	5,076
Accrual for professional liability insurance	17,847		13,227
	$	32,068	$	18,303

Other long-term liabilities:
Deferred compensation	$	1,510	$	1,638
Deferred rent	2,453		1,777
Other	47		—
	$	4,010	$	3,415

Long-Term Debt

12 Months Ended

Dec. 31, 2014

Debt Disclosure [Abstract]

Long-Term Debt

At December 31, 2014 and 2013, long-term debt consists of the following:



	December 31,
	2014			2013
	(amounts in thousands)
Senior Secured Asset-Based, interest 2.61% and 3.27% at December 31, 2014 and December 31, 2013, respectively	$	3,500		$	8,400
Second Lien Term Loan, net of unamortized discount of $1,011, interest 7.50% at December 31, 2014	28,989			—
Convertible Notes, net of unamortized discount of $7,053, interest 8.00% at December 31, 2014	17,947			—
Convertible Notes derivative liability	23,436			—
Capital lease obligations	202			176
Total debt	74,074			8,576
Less current portion	(3,607		)	(8,483		)
Long-term debt	$	70,467		$	93

As of December 31, 2014, the aggregate scheduled maturities of debt are as follows:



	Term Debt		Convertible Notes		Revolver		Capital Leases and Note Payable
	(amounts in thousands)
Through Years Ending December 31:
2015	$	—	$	—	3,500		107
2016	—		—		—		72
2017	—		—		—		13
2018	—		—		—		8
2019	30,000		—		—		2
Thereafter	—		25,000		—		—
Total	$	30,000	$	25,000	$	3,500	$	202

Senior Credit Facility

On January 9, 2013, the Company entered into a First Lien Loan Agreement, (the First Lien Loan Agreement or Senior Secured Asset-Based Loan), by and among the Company and certain of its subsidiaries, as borrowers, and Bank of America, N.A., as agent. The First Lien Loan Agreement was subsequently amended to allow for the sale of the Company's Clinical Trials Services business in February 2013 and for administrative matters.

The initial proceeds from the revolving credit facility were used to finance the repayment of existing indebtedness of the Company under its prior senior secured credit agreement and the payment of fees and expenses. The repayment of the term loan portion of the senior secured agreement 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 $0.3 million. The repayment of the revolver portion of the senior secured credit agreement was treated partially as extinguishment and partially as a modification. The fees related to the modified portion of $0.1 million relate to the continuation of credit provided by Bank of America, N.A. in its First Lien Loan Agreement. The Company wrote-off the remaining unamortized net debt issuance costs of approximately $1.1 million in the first quarter of 2013.

8. Long-Term Debt (continued)

On June 30, 2014, the Company and certain of its subsidiaries, as borrowers, entered into a third amendment (the Amendment) to the Company’s First Lien Loan Agreement with Bank of America, N.A., as agent, in order to, among other things, increase the Company’s borrowing capacity under the First Lien Loan Agreement and to consent to the consummation of the MSN acquisition and the incurrence by the Company of the indebtedness contemplated pursuant to the Second Lien Term Loan Agreement and the Note Purchase Agreement. The Amendment provided for, among other things, increasing the revolving credit facility under the First Lien Loan Agreement from $65.0 million to $85.0 million and increasing the letter of credit subline under the First Lien Loan Agreement from $20.0 million to $35.0 million. In addition, the termination date of the revolving credit facility under the First Lien Loan Agreement was extended to June 30, 2017.

The Company used the increased availability under the letter of credit subline to collateralize certain insurance obligations related to the MSN acquisition. The revolving credit facility and letter of credit subline will be used to provide ongoing working capital and for other general corporate purposes of the Company and its subsidiaries.

As of the June 30, 2014 amendment, the First Lien Loan Agreement provides for: a three-year senior secured asset-based revolving credit facility in the aggregate principal amount of up to $85.0 million, which includes a subfacility for swingline loans up to an amount equal to 10% of the aggregate Revolver Commitments, as defined in the agreement, and a $35.0 million subfacility for standby letters of credit. Swingline loans and letters of credit issued under the First Lien Loan Agreement reduce available revolving credit commitments on a dollar-for-dollar basis. Pursuant to the First Lien Loan Agreement, the aggregate amount of advances under the revolving credit facility (Borrowing Base) cannot exceed the lesser of (a) (i) $85.0 million, or (ii) 85% of eligible billed accounts receivable as defined in the First Lien Loan Agreement; plus (b) the lesser of (i) 85% of eligible unbilled accounts receivable and (ii) $18.0 million; minus (c) reserves as defined by the First Lien Loan Agreement, which include one week’s worth of W-2 payroll and fees payable to independent contractors.

The revolving credit facility can be used to provide ongoing working capital and for other general corporate purposes of the Company and its subsidiaries. As of December 31, 2014, the interest rate spreads and fees under the First Lien Loan Agreement are based on LIBOR plus 1.50% 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 could 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, 2014, was 0.375%.

The First Lien Loan Agreement contains customary representations, warranties, and affirmative covenants. The First Lien 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 availability under the revolving credit facility is less than the greater of (i) 12.5% of the Loan Cap, as defined, and (ii) $8.3 million, or availability is less than $4.0 million, the Company is required to meet a minimum fixed charge coverage ratio of 1.0, as defined in the First Lien Loan Agreement. The First Lien 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 First Lien 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 First Lien 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.

As of December 31, 2014, the Gross Availability, as defined in the First Lien Loan Agreement, was approximately $69.7 million based on the Company's November accounts receivable balance. The Company had $26.5 million letters of credit outstanding and $3.5 million drawn under its revolving credit facility, leaving $39.7 million available as of December 31, 2014. The letters of credit relate to the Company’s workers’ compensation and professional liability insurance policies.

Second Lien Term Loan

On June 30, 2014, the Company entered into a second lien loan and security agreement (the Second Lien Term Loan Agreement), by and among the Company, as borrower, certain of its domestic subsidiaries, as guarantors, and BSP Agency, LLC, as agent.

8. Long-Term Debt (continued)

The Second Lien Term Loan Agreement provides for a five-year senior secured term loan facility in an aggregate principal amount of $30.0 million (the loans thereunder, the Second Lien Term Loans). After deducting a debt discount of $1.1 million, the net proceeds of $28.9 million from the Second Lien Term Loan facility were used by the Company to pay a portion of the consideration for the MSN Acquisition and related fees and expenses. In connection with the financing, the Company incurred $0.4 million of debt issuance costs.

Amounts borrowed under the Second Lien Term Loan facility that are repaid or prepaid may not be re-borrowed. The Second Lien Term Loans bear interest at a rate equal to adjusted LIBOR (defined as the 3-month London interbank offered rate for U.S. dollars, adjusted for customary Eurodollar reserve requirements, if any, and subject to a floor of 1.00%) plus 6.50%. The interest rate would increase by 200 basis points if an event of default exists under the Second Lien Term Loan Agreement.

The Company may, at its option, elect to prepay the Second Lien Term Loans on or before June 30, 2015, subject to a prepayment premium in an amount equal to (i) the amount of the principal amount of the Second Lien Term Loans being repaid, plus (ii) the accrued but unpaid interest on the principal amount so prepaid, if any, to the date of the prepayment, plus (iii) any associated administrative amounts or charges owed to the lenders as a result of the redeployment of funds or fees payable to terminate matching deposits, plus (iv) a “make whole” amount equal to the excess, if any, of (a) the present value at the prepayment date of (1) 103% of the aggregate principal amount of the Second Lien Term Loans then being prepaid, plus (2) all remaining scheduled interest payments due on the principal amount of such Second Lien Term Loans being prepaid through June 30, 2015 (excluding accrued but unpaid interest to the date of such prepayment), computed using a discount rate equal to the Treasury rate as of such prepayment date plus 50 basis points over (b) the outstanding principal amount of such Second Lien Term Loans being prepaid. The Company may, at its option at any time after June 30, 2015, prepay the Second Lien Term Loans in whole or in part at the redemption prices set forth therein, which range from 103% of the principal amount thereof for prepayments during the period July 1, 2015 through June 30, 2016, 102% of the principal amount thereof for prepayments during the period July 1, 2016 through June 30, 2017, and 100% of the principal amount thereof for prepayments after such date.

Subject to certain exceptions, the Second Lien Term Loans are required to be prepaid with: (a) 50% of excess cash flow (as defined in the Second Lien Term Loan Agreement) above $5.0 million for each fiscal year of the Company (commencing with the fiscal year ending December 31, 2015), provided that voluntary prepayments of the Second Lien Term Loans made during such fiscal year will reduce the amount of excess cash flow prepayments required for such fiscal year on a dollar-for-dollar basis; (b) 100% of the net cash proceeds of all asset sales or other dispositions of property by the Company and its subsidiaries, as set forth in the agreement, in excess of a defined threshold and subject to the right of the Company to reinvest such proceeds within 12 months; (c) 100% of the net cash proceeds of issuances of debt offerings of the Company and its subsidiaries (except the net cash proceeds of any permitted debt); and (d) 50% of the net cash proceeds of equity offerings of the Company.

The Second Lien Term Loan Agreement contains customary representations, warranties, and affirmative covenants. Among other things, the agreement also includes a financial covenant limiting the Company’s maximum “debt” to “EBITDA” (each, as defined therein) ratio to no greater than 4.50:1.00, subject to customary equity cure rights. The financial covenant will be tested quarterly, commencing with the quarter ended June 30, 2015 and each quarter thereafter for so long as any Second Lien Term Loans are outstanding. The agreement also contains customary negative covenants; including covenants with respect to, among other things, (i) indebtedness, (ii) liens, (iii) investments, (iv) fundamental corporate changes, (v) dispositions, (vi) dividends, distributions and other restricted payments, (vii) transactions with affiliates, and (viii) restrictive agreements. The agreement 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 Second Lien Term Loan Facility documents.

The Company’s obligations under the Second Lien Term Loan Agreement are guaranteed by all material domestic subsidiaries of the Company (Subsidiary Guarantors). As collateral security for their obligations under the Second Lien Term Loan Agreement and guarantees thereof, the Company and the Subsidiary Guarantors have granted a second-priority security interest in substantially all their tangible and intangible assets.

Private Placement of Convertible Notes

On June 30, 2014, the Company and certain of its domestic subsidiaries entered into a Convertible Note Purchase Agreement (the Note Purchase Agreement), with certain note holders (collectively, the Noteholders). Pursuant to the Note Purchase

8. Long-Term Debt (continued)

Agreement, the Company sold to the Noteholders an aggregate of $25.0 million of convertible senior notes (the Convertible Notes). After deducting a debt discount of $0.9 million, the net proceeds of $24.1 million were used by the Company for the MSN Acquisition and related fees and expenses. In connection with the financing, the Company incurred $0.3 million of debt issuance costs. As a result of the conversion and redemption features, the Company recorded $6.8 million as additional discount for the fair value of these features.

The Convertible Notes are convertible at the option of the holders thereof at any time into shares of the Company’s common stock, par value $0.0001 per share (Common Stock), at an initial conversion price of $7.10 per share, or 3,521,126 shares of Common Stock. After three years, the Company has the right to force a conversion of the Convertible Notes if the volume-weighted average price (VWAP) per share of its Common Stock exceeds 125% of the then conversion price for 20 days of a 30 day trading period. The conversion price is subject to adjustment pursuant to customary weighted average anti-dilution provisions including adjustments for the following: Common Stock dividends or distributions; issuance of any rights, warrants of options to acquire Common Stock; distributions of property; tender offer or exchange offer payments; cash dividends; or certain issuances of Common Stock at less than the conversion price. Upon conversion of the Convertible Notes, the Company will exchange, for the applicable conversion amount thereof a number of shares of Common Stock, with no maximum, on amount, equal to the amount determined by dividing (i) such conversion amount by (ii) the conversion price in effect at the time of conversion. No fractional shares of Common Stock will be issued upon conversion of the Conversion Notes. In lieu of fractional shares, the Company shall pay cash in respect of each fractional share equal to such fractional amount multiplied by the Thirty Day VWAP as of the closing of business on the Business Day immediately preceding the conversion date as well as any unpaid accrued interest.

The Convertible Notes bear interest at a rate of 8.00% per annum, payable in quarterly cash installments; provided, however, that, at the Company’s option, up to 4.00% of the interest payable may be “paid-in-kind” through a quarterly addition of such “paid-in-kind” interest amount to the principal amount of the Convertible Notes. The Convertible Notes will mature on June 30, 2020, unless earlier repurchased, redeemed or converted. Subject to certain exceptions, the Company is not permitted to redeem the Convertible Notes until June 30, 2017. If the Company redeems the Convertible Notes on or after June 30, 2017, the Company is required to pay a premium of 15% of the amount of principal of the Convertible Notes redeemed.

If the Convertible Notes are redeemed prior to June 30, 2017, pursuant to a Prohibited Transaction, as defined by the agreement, the Company is required to pay a premium equal to the greater of (i) the sum of (a) the amount of principal of the Convertible Notes redeemed, plus (b) the accrued but unpaid interests on the principal amount so redeemed to the date of the redemption, plus (c) a “make whole” amount (described below) and (ii) the sum of (x) the average thirty day VWAP per share of Common Stock multiplied by the number of shares of Common Stock that the redeemed Convertible Notes are then convertible into, with no maximum, and (y) the accrued but unpaid interest on the Convertible Notes. The “make whole” amount is equal to the excess, if any, of (1) the present value at the date of redemption of (A) 115% of the principal amount of the Convertible Notes redeemed, plus (B) all remaining scheduled interest due on the principal amount of the notes being redeemed through June 30, 2017 computed using a discount rate equal to the Treasury rate as of the date of redemption plus 50 basis points over (2) the outstanding principal amount of the Convertible Notes then redeemed.

The Company granted the Noteholders preemptive rights with respect to future equity issuances by the Company, subject to

customary exceptions.

In connection with the placement of the Convertible Notes, on June 30, 2014, the Company entered into a registration rights agreement (the Registration Rights Agreement) with the Noteholders, which sets forth the rights of the Noteholders to have the shares of Common Stock issuable upon conversion of the Convertible Notes registered with the Securities and Exchange Commission (the SEC) for public resale under the Securities Act of 1933, as amended. Pursuant to the Registration Rights Agreement, the Company was required to file a registration statement with the SEC (the Initial Registration Statement) registering the shares of Common Stock issuable upon conversion of the Convertible Notes. The Initial Registration Statement was filed with the SEC and became effective in the fourth quarter of 2014. In addition, the agreement gives the Noteholders the ability to exercise certain piggyback registration rights in connection with registered offerings by the Company.

Convertible Notes Derivative Liability

12 Months Ended

Dec. 31, 2014

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Convertible Notes Derivative Liability

Derivative financial instruments, as defined in ASC 815, Accounting for Derivative Financial Instruments and Hedging Activities, consist of financial instruments or other contracts that contain a notional amount and one or more underlyings (e.g. interest rate, security price or other variable), require no initial net investment and permit net settlement. Derivative financial instruments may be free-standing or embedded in other financial instruments. Further, derivative financial instruments are initially, and subsequently, measured at fair value and recorded as liabilities or, in rare instances, assets.

The Company does not use derivative financial instruments to hedge exposures to cash-flow, market or foreign-currency risks. However, the Company has issued Convertible Notes with features that are either (i) not afforded equity classification, (ii) embody risks not clearly and closely related to host contracts, or (iii) may be net-cash settled by the counterparty. As required by ASC 815, in certain instances, these instruments are required to be carried as derivative liabilities, at fair value, in our financial statements.

The Convertible Notes issued in conjunction with the MSN acquisition are subject to anti-dilution adjustments that allow for the reduction in the Conversion Price, as defined in the agreement, in the event the Company subsequently issues equity securities including Common Stock or any security convertible or exchangeable for shares of Common Stock for a price less than the current conversion price. In addition, the Convertible Notes allow the issuer to exercise optional redemption features and the holder to exercise an offer to purchase feature, under certain conditions. The Company accounted for the conversion option in accordance with ASC 815. Since this conversion feature is not considered to be solely indexed to the Company’s own stock the derivative was recorded as a liability.

The Company’s Convertible Notes derivative liability has been measured at fair value at December 31, 2014 using a

trinomial lattice model. The optional redemption features, along with the offer to purchase features are incorporated into the valuation model. Inputs into the model require estimates, including such items as estimated volatility of the Company’s stock, estimated probabilities of change of control and issuance of additional financing, risk-free interest rate, and the estimated life of the financial instruments being fair valued. In addition, since the conversion price contains an anti-dilution adjustment, the probability that the Conversion Price of the Notes would decrease as the share price decreased was also incorporated into the valuation calculation.

The inputs into the valuation model are as follows:



	December 31, 2014
Closing share price	$12.48
Conversion price	$7.10
Risk free rate	1.86%
Expected volatility	40%
Dividend yield	—%
Expected life	5.5 years

The fair value of this derivative liability is primarily determined by fluctuations in our stock price. As our stock price increases or decreases, the fair value of this derivative liability increases or decreases, resulting in a corresponding current period loss or gain to be recognized. As of December 31, 2014, a $1 decrease or increase in our stock price would have resulted in a change in the valuation of the embedded derivative by approximately $3.1 million and a 1% decrease or increase in interest rates would have resulted in a change in the valuation of the derivative of approximately $0.7 million.

Fair Value Measurements

12 Months Ended

Dec. 31, 2014

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.

10. Fair Value Measurements (continued)

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, 2014 and 2013, the Company’s financial assets/liabilities required to be measured on a recurring basis were its indemnity escrow receivable, deferred compensation liability included in other long-term liabilities, Convertible Notes derivative liability and contingent consideration receivable related to the sale of its Clinical Trial Services business.

Escrow receivable —The Company recorded the $3.8 million indemnity escrow funds related to the sale of its Clinical Trial Services business as an escrow receivable and adjusted the amount to the estimated fair value each reporting period based on any known information. The total escrow amount was released to the Company in August 2014 relieving the escrow receivable balance. See Note 4 - Discontinued Operations.

Contingent consideration receivable, performance earnout —The earn out related to the Company’s sale of its Clinical Trial Services business was treated as a contingent consideration receivable for accounting purposes. The Company utilized Level 3 inputs to value the contingent consideration receivable as significant unobservable inputs were used in the calculation of its fair value and related to the future performance of the disposed business. The fair value of the contingent consideration receivable was adjusted to its fair value on a quarterly basis with any 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 impacted the contingent consideration that could have been paid to the Company. The contingency was resolved during the third quarter of 2014 resulting in no additional consideration. See Note 4 - Discontinued Operations for further information.

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.

Convertible Notes derivative liability —The Company utilizes Level 3 inputs to value its Convertible Notes derivative liability. See Note 9 - Convertible Notes Derivative Liability and Note 2 - Summary of Significant Accounting Policies.

The table which follows summarizes the estimated fair value of the Company’s financial assets and liabilities measured on a recurring basis as of December 31, 2014 and 2013:

Fair Value Measurements



	December 31, 2014		December 31, 2013
Financial Assets:	(amounts in thousands)
(Level 3)
Escrow receivable	$	—	$	3,750

Financial Liabilities:
(Level 1)
Deferred compensation	$	1,510	$	1,638
(Level 3)
Convertible Notes derivative liability	$	23,436	$	—

10. Fair Value Measurements (continued)

The table which follows reconciles the opening balances to the closing balances for fair value measurements categorized within Level 3 of the fair value hierarchy:



	Escrow			Convertible Notes
	Receivable			Derivative Liability (a)
	(amounts in thousands)

December 31, 2012	$	—		$	—
Additions	3,750			—
December 31, 2013	3,750			—
Additions	—			6,765
Settlements	(3,750		)	—
Valuation loss for the period	—			16,671
December 31, 2014	$	—		$	23,436

_______________

(a)

Embedded derivative included in long-term debt on consolidated balance sheets. Embedded derivative of $6.8 million added as of June 30, 2014. Change in valuation of derivative for the year ended December 31, 2014 was $16.7 million and is included in other expenses (income) on the consolidated statement of operations. See Note 9 - Convertible Notes Derivative Liability and Note 2 - Summary of Significant Accounting Policies for further information.

Items Measured at Fair Value on a Nonrecurring Basis:

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.

As of October 1, 2014, in conjunction with the annual testing of indefinite-lived intangible assets not subject to amortization, the Company recorded a pretax non-cash impairment charge of approximately $10.0 million related to its MDA trade name. See Note 5 – Goodwill, Trade Names, and Other Identifiable Intangible Assets. The Company reduced its long-term revenue forecast for these businesses as part of its forecasting process 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.

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 pretax non-cash impairment charge of approximately $6.4 million related to its MDA acquisition (see Note 5 – 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, 2014 and 2013.

Fair Value Measurements



	December 31, 2014		December 31, 2013
	(amounts in thousands)
(Level 3)
MDA trade names	$	17,699	$	28,836

10. Fair Value Measurements (continued)

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



	December 31, 2014				December 31, 2013
	Carrying Amount		Fair Value		Carrying Amount		Fair Value
	(amounts in thousands)
Financial Liabilities:
(Level 2)
Second Lien Term Loan, net (a)	$	28,989	$	29,900	$	—	$	—
Convertible Notes, net (a)	$	17,948	$	19,200	$	—	$	—
Senior Secured Asset-Based Loan (b)	$	3,500	$	3,500	$	8,400	$	8,400

_______________


(a)	The Second Lien Term Loan and Convertible Notes are reported at their carrying value in the accompanying consolidated balance sheets. The Company determined their fair value, as presented in the table using an income approach, utilizing a discounted cash flow analysis based on current market interest rates for debt issuances with similar remaining years to maturity, adjusted for credit risk.


(b)	Carrying value of the Senior Secured Asset-Based Loan 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, 2014
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. 11. Employee Benefit Plans (continued) Contributions by the Company, net of forfeitures, under this plan amounted to $0.6 million the years ended December 31, 2014, 2013 and 2012, respectively. 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 $1.5 million and $1.6 million at December 31, 2014 and 2013, respectively.

Commitments and Contingencies

12 Months Ended

Dec. 31, 2014

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

Commitments:

Operating Leases

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.

Future minimum lease payments, as of December 31, 2014, associated with these agreements with terms of one year or more are as follows:



Through Year Ending December 31:	(amounts in thousands)
2015	$	7,202
2016	5,581
2017	3,884
2018	1,613
2019	486
Thereafter	2,146
	$	20,912

Total operating lease expense included in selling, general and administrative expenses was approximately $7.7 million, $5.5 million and $5.8 million for the years ending December 31, 2014, 2013 and 2012, respectively.

Contingencies:

Sales and 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. The expense is included in selling, general and administrative expenses on its consolidated statements of operations and the liability is reflected in sales tax payable as of December 31, 2014 and 2013, on its consolidated balance sheets.

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

12. Commitments and Contingencies (continued)

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 $0.5 million in the year ended December 31, 2011, of which approximately $0.4 million related to the 2008-2010 tax years. The Company accrued an additional pretax liability related to the non-income tax matters of approximately $1.0 million in the year ended December 31, 2012, of which approximately $0.3 million 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 $0.8 million, of which approximately $0.4 million related to the 2007-2012 tax years, and paid approximately $0.3 million to settle with certain states. For the year ended December 31, 2014, the Company accrued an additional pretax liability related to the non-income tax matters of approximately $0.2 million, and paid approximately $0.1 million to settle with certain states. The expenses are included in selling, general and administrative expenses on its consolidated statements of operations for the years ended December 31, 2014, 2013, and 2012 and the liability is reflected as sales tax payable as of December 31, 2014 and 2013, on its consolidated balance sheets. The Company is continuing to work with professional tax advisors and state authorities to resolve the remaining matters.

Legal Proceedings

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 alleged 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. In 2013, the parties agreed to settle this lawsuit for $0.8 million with the understanding that such settlement is not an admission by the Company of any liability, negligence or wrong doing. The Court granted final approval of the settlement in September 2014 and during the fourth quarter of 2014 the Company paid $0.8 million to the plaintiff.

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, 2014

Income Tax Disclosure [Abstract]

Income Taxes

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



	Year Ended December 31,
	2014			2013			2012
	(amounts in thousands)
United States	$	(33,574	)	$	(11,216	)	$	(28,599	)
Foreign	2,256			1,177			1,704
	$	(31,318	)	$	(10,039	)	$	(26,895	)

13. Income Taxes (continued)

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



	Year Ended December 31,
	2014			2013		2012
	(amounts in thousands)
Continuing operations:
Current
Federal	$	—		$	—	$	412
State	811			540		812
Foreign	262			416		1,561
Total	1,073			956		2,785

Deferred
Federal	(1,320		)	37,822		(4,048		)
State	68			5,134		(5,251		)
Foreign	395			299		364
Total	(857		)	43,255		(8,935		)
Total income tax expense (benefit) for continuing operations	$	216		$	44,211	$	(6,150	)

The total income tax provision is summarized as follows:
Continuing operations	$	216		$	44,211	$	(6,150	)
Discontinued operations	—			2,122		(9,497		)
	$	216		$	46,333	$	(15,647	)

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.

13. Income Taxes (continued)

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



	December 31,
	2014			2013
	(amounts in thousands)
Current deferred tax assets (liabilities):
Accrued other and prepaid expenses	$	2,823		$	2,592
Accrued settlement charge	—			283
Allowance for doubtful accounts	589			650
Other	822			468
Gross deferred tax assets	4,234			3,993
Valuation allowance	(6,215		)	(4,528		)
Deferred tax liabilities	(1,981		)	(535		)
Non-current deferred tax (liabilities) and assets:
Amortization	(5,967		)	(1,314		)
Depreciation	105			(384		)
Identifiable intangibles	—			(2,237		)
Net operating loss carryforwards	38,144			32,531
Derivative interest	6,370			—
Accrued professional liability	(92		)	(118		)
Accrued workers’ compensation	1,356			675
Tax on unrepatriated earnings	(336		)	(453		)
Share-based compensation	959			1,610
Other	(1,176		)	314
Gross deferred tax assets	39,363			30,624
Valuation allowance	(57,401		)	(47,473		)
Deferred tax liabilities	(18,038		)	(16,849		)
Net deferred taxes	$	(20,019	)	$	(17,384	)

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 $19.7 million and $17.4 million 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, 2014 and 2013, respectively. As of December 31, 2014 and 2013, the Company recorded valuation allowances of $63.6 million and $52.0 million, respectively. The December 31, 2014 and 2013 valuation allowances applied to all its deferred tax assets.

13. Income Taxes (continued)

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, 2014 and 2013, respectively, the Company had approximately $97.5 million and $78.1 million of federal, state, and foreign net operating loss carryforwards. The federal carryforwards expire between 2031 and 2034. The state carryforwards expire between 2014 and 2034. 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, 2014 and 2013, to reduce the Company’s deferred tax asset to an amount that is more likely than not to be realized. In the first quarter of 2014, the Company recorded a non-cash adjustment of $1.7 million primarily related to an overstatement of the valuation allowance established as of December 31, 2013. The out-of-period adjustment also decreased the net loss by the same amount or $0.06 per diluted share for the three months ended March 31, 2014 and the year ended December 31, 2014. Management concluded that the adjustment was not material to its prior period financial statements and is not expected to be material to the full year results for 2014.

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,
	2014			2013			2012
	(amounts in thousands)
Tax at U.S. statutory rate	$	(10,961	)	$	(3,514	)	$	(9,413	)
State taxes, net of federal benefit	219			(190		)	(1,226		)
Non-deductible meals and entertainment	1,425			450			962
Foreign tax expense	44			554			(222		)
Valuation allowances	12,038			48,556			(44		)
Uncertain tax positions	(996		)	(257		)	648
Deferred tax rate differential	—			—			150
Deferred tax write-offs (a)	—			221			—
Audit settlements	—			160			—
Tax on unrepatriated earnings	—			(1,465		)	2,005
Tax on repatriated earnings	—			—			519
Tax true ups and other	(1,553		)	(304		)	471
Total income tax expense (benefit) for continuing operations	$	216		$	44,211		$	(6,150	)

The tax years of 2004, 2005, and 2008 through 2013 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.

In the fourth quarter of 2012, the Company changed its position regarding permanent reinvestment and accrued approximately $1.4 million of U.S. tax and $0.6 million of India tax on earnings of approximately $9.5 million. During the fourth quarter of 2012, the company repatriated approximately $3.3 million 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 U.S. in the UK during 2013 resulted in write-offs of the investment in those subsidiaries and offset the amount of U.S. taxes that would need to be accrued on the India earnings to zero. During 2014, the Company accrued $0.2 million of India tax on earnings of approximately $0.6 million. India withholding taxes on a dividend of India earnings are not affected by the calculation of U.S. taxes due and continue to be accrued.

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.

13. Income Taxes (continued)

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



	2014			2013
	(amounts in thousands)
Balance at January 1	$	4,986		$	5,204
Additions based on tax positions related to the current year	709			496
Additions based on tax positions related to prior years	91			681
Reductions based on settlements of tax positions related to the prior year	(344		)	(292		)
Reductions for tax positions as a result of a lapse of the applicable statute of limitations	(1,578		)	(1,076		)
Other	(87		)	(27		)
Balance at December 31	$	3,777		$	4,986

Short-term unrecognized tax benefits are included in other current liabilities on the consolidated balance sheets and were approximately $0.6 million and $1.0 million as of December 31, 2014 and 2013, respectively. As of December 31, 2014 and 2013, the Company had unrecognized tax benefits, which would affect the effective tax rate if recognized of approximately $3.3 million and $4.4 million, respectively. During 2014, the Company had gross increases of $0.8 million to its current year unrecognized tax benefits, related to federal and state tax issues. In addition, the Company had gross decreases of $2.0 million 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 year ended December 31, 2014, the Company recognized a reduction on interest and penalties of $0.2 million. During the years ended December 31, 2013 and 2012, the Company recognized interest and penalties of $0.1 million. The Company had accrued approximately $0.8 million and $1.0 million for the payment of interest and penalties at December 31, 2014 and 2013, respectively.

Stockholders' Equity

12 Months Ended

Dec. 31, 2014

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 years ended December 31, 2014 and 2013, the Company did not repurchase any shares of its Common Stock under its February 2008 Board authorization.

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 $0.4 million. All of the common stock was retired.

At December 31, 2014, the Company may purchase up to an additional 942,443 shares of Common Stock under the February 2008 Board authorization, subject to certain conditions in the Company's First Lien Loan Agreement and Second Lien Term Loan 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.

14. Stockholders’ Equity (continued)

Share-Based Payments

2014 Omnibus Incentive Plan

On March 11, 2014, the Board of Directors approved an amendment and restatement of the Company's 2007 Stock Incentive Plan (amended and restated effective March 20, 2013), which was renamed the 2014 Omnibus Incentive Plan. The term of the Amended Plan was extended until March 10, 2024 (the 2007 Stock Incentive Plan was scheduled to expire on April 5, 2017). The 2014 Omnibus Plan approval was subject to, and became effective upon, stockholder approval at the Annual Meeting held on May 13, 2014. The 2014 Omnibus Plan provides for the issuance of stock options, stock appreciation rights, restricted stock, performance shares, performance-based cash awards that may be granted with the intent to comply with the “performance-based compensation” exception under Section 162(m) of the Internal Revenue Code, and other stock-based awards, all as defined by The 2014 Omnibus 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 4,100,000 shares, which may be either authorized and unissued common stock or common stock held in or acquired for the treasury of the Company.

Under The 2014 Omnibus 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.

Restricted stock awards granted under the Company’s 2014 Omnibus 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 three to four year period ending on the anniversary date of the grant. There is no partial vesting and any unvested portion is forfeited.

Pursuant to the 2014 Omnibus Plan the number of target shares that are issued for performance-based stock awards are determined based on the level of attainment of the targets. Pursuant to the 2014 grants, if the minimum level of performance is attained, restricted stock will be issued with a vesting date of December 31, 2016, subject to the employee’s continuing employment. Subject to Board of Director approval, as of December 31, 2014, the Company estimated it achieved a minimum level of performance and accordingly, share-based compensation was recognized during the year ended December 31, 2014 relating to the performance stock awards.

The following table summarizes restricted stock awards and performance-based stock awards activity issued under the 2014 Omnibus Plan (including awards issued prior to the restatement and amendment) for the year ended December 31, 2014:



	Restricted Stock Awards				Performance Stock Awards
	Number of Shares		Weighted Average Grant Date Fair Value		Number of Target Shares		Weighted Average Grant Date Fair Value
Unvested restricted stock awards, January 1, 2014	552,231		$	5.37	—		$	—
Granted	377,308		$	6.18	239,585		$	5.81
Vested	(181,354	)	$	5.77	—		$	—
Forfeited	(88,535	)	$	5.39	(21,410	)	$	5.77
Unvested restricted stock awards, December 31, 2014	659,650		$	5.72	218,175		$	5.82

As of December 31, 2014, the Company had approximately$2.4 million 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

14. Stockholders’ Equity (continued)

recognize such cost over a weighted average period of 2.22 years. The fair value of shares vested was approximately $2.3 million, $2.4 million, and $0.9 million for the years ended December 31, 2014, 2013, and 2012, respectively.

As of December 31, 2014, the Company had approximately $0.3 million pretax of total unrecognized compensation cost related to performance 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 years, the remaining service period.

The following table represents information about stock options and stock appreciation rights granted and exercised in each year. During the years ended December 31, 2014, 2013 and 2012, the Company issued options and stock appreciation rights at market price.



	Year Ended December 31,
	2014		2013		2012
Share option grants	—		324,000		344,500
Weighted average grant date fair value of options granted during the period	—		$	1.77	$	1.65
Total intrinsic value of options exercised	$	695,286	$	12,465	$	—

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 equally over a 3 to 4 year period on each 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.

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. During the year ended December 31, 2014, no stock options were 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
Expected dividend yield		—	%	—	%
Expected volatility		48.00	%	47.00	%
Risk-free interest rate		0.79	%	0.58	%
Expected life		4.2 years		4.3 years

Due to the adoption of the 2007 Stock Incentive Plan, no further grants have been 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.

14. Stockholders’ Equity (continued)

The following table summarizes the Company’s activities with respect to all of its share option plans for the year ended December 31, 2014:



	Shares		Option Price	Weighted Average Exercise Price	Weighted- Average Remaining Contractual Life (in years)	Aggregate Intrinsic Value
Share options outstanding at beginning of year	1,546,299		$4.16-$22.50	$8.93
Granted	—		—	—
Exercised	(228,500	)	$4.35-$8.56	$7.47
Forfeited/expired	(382,704	)	$4.35-$22.50	$11.41
Share options outstanding at end of year	935,095		$4.16-$22.50	$8.27	2.94	$	4,464,160
Share options exercisable at end of year	655,468		$4.16-$22.50	$9.58	2.07	$	2,430,566
Share options unvested at end of year	279,627		$4.16-$7.44	$5.21	4.96	$	2,033,594

As of December 31, 2014, the Company had 935,095 share options outstanding of which 864,671 were vested or expected to vest at a weighted average exercise price of $8.52, intrinsic value of $4.0 million and a weighted average contractual life of 2.78 years. As of December 31, 2014, the Company had approximately $0.3 million 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 2.08 years.

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, 2014

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 2014, 2013 and 2012 per share calculations because their effect would have been anti-dilutive. Such shares amounted to 559,064; 1,547,814 and 2,033,632, during the years ended December 31, 2014, 2013 and 2012, respectively. For purposes of calculating net income (loss) per common share - diluted for the years ending December 31, 2014 and 2013, the Company excluded potentially dilutive shares of 334,828, and 149,453, respectively, as their effect would have been anti-dilutive, due to the Company’s net loss from continuing operations in the respective years.

Contingently issuable shares of 3,521,126 as of December 31, 2014, related to Convertible Notes, as defined in Note 8 - Long-Term Debt, if converted, would have had an anti-dilutive effect, and as such, have been excluded from the per share calculations for the year ended December 31, 2014.

15. Earnings Per Share (continued)

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,
	2014			2013			2012
	(amounts in thousands, except per share data)
Loss from continuing operations	$	(31,534	)	$	(54,250	)	$	(20,745	)
Less: Income attributable to noncontrolling interest in subsidiary	249			—			—
Loss from continuing operations attributable to common shareholders	(31,783		)	(54,250		)	(20,745		)
Income (loss) from discontinued operations, net of income taxes	—			2,281			(21,476		)
Net loss attributable to common shareholders	$	(31,783	)	$	(51,969	)	$	(42,221	)

Basic (loss) income per share attributable to common shareholders
Continuing operations	$	(1.02	)	$	(1.75	)	$	(0.67	)
Discontinued operations	—			0.07			(0.70		)
Net loss	$	(1.02	)	$	(1.68	)	$	(1.37	)

Diluted (loss) income per share attributable to common shareholders
Continuing operations	$	(1.02	)	$	(1.75	)	$	(0.67	)
Discontinued operations	—			0.07			(0.70		)
Net loss	$	(1.02	)	$	(1.68	)	$	(1.37	)

Weighted-average number of shares outstanding-basic	31,190			31,009			30,843
Plus dilutive equity awards	—			—			—
Weighted-average number of shares outstanding-diluted	31,190			31,009			30,843

Related Party Transactions	12 Months Ended
Related Party Transactions	Dec. 31, 2014
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 was $17.8 million, $3.9 million and $3.8 million in 2014, 2013 and 2012, respectively. Accounts receivable due from these hospitals at December 31, 2014 and 2013 were $2.0 million and $0.8 million, respectively. In connection with the acquisition of MSN, the Company acquired a 68% ownership interest in InteliStaf of Oklahoma, LLC, a joint venture between the Company and a hospital system. The Company provides staffing services to the hospital system. Revenue related to these services was $4.7 million during the period of July 1, 2014 through December 31, 2014. At December 31, 2014, the Company had a receivable balance of $0.9 million and a payable balance of $0.1 million relating to these staffing services.

- 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, 2014

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. The Company manages and segments its business based on the services it offers to its customers as described below:


•	Nurse and Allied Staffing - Nurse and Allied Staffing 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,

17. Segment Information (continued)

ambulatory care facilities, retailers, and many other healthcare providers throughout the U.S. The Company aggregates its various brands that it markets to its customers in this business segment.

•

Physician Staffing – Physician Staffing provides physicians in many specialties, certified registered nurse anesthetists (CRNAs), nurse practitioners (NPs), and physician assistants (PAs) under the Company's Medical Doctor Associates (MDA) and Saber-Salisbury brands 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. The Physician Staffing business also provides certain other employees on a temporary basis to its customers.


•	Other Human Capital Management Services - Other Human Capital Management Services provides education and training programs to the healthcare industry and retained and contingent 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. 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 from continuing operations for the periods indicated are as follows:



	Year Ended December 31,
	2014			2013 (a)			2012 (a)
	(amounts in thousands)
Revenue from unaffiliated customers:
Nurse and Allied Staffing	$	457,034		$	271,563		$	272,136
Physician Staffing	123,306			128,781			129,162
Other Human Capital Management Services	37,485			37,967			41,337
	$	617,825		$	438,311		$	442,635
Contribution income: (b)
Nurse and Allied Staffing	$	36,326		$	18,424		$	10,277
Physician Staffing	6,700			8,939			10,863
Other Human Capital Management Services	514			746			1,943
	43,540			28,109			23,083

Unallocated corporate overhead	27,770			21,844			21,701
Depreciation	3,866			3,886			4,905
Amortization	3,575			2,294			2,263
Acquisition and integration costs	7,957			473			—
Restructuring costs	840			484			—
Legal settlement charge	—			750			—
Impairment charges (c)	10,000			6,400			18,732
Loss from operations	$	(10,468	)	$	(8,022	)	$	(24,518	)

_______________


(a)	In 2014, the Company reclassified the revenue and contribution income of certain higher level staffing professionals previously included with Nurse and Allied Staffing to Physician Staffing. In addition, in 2014, the Company refined its methodology for allocating certain corporate overhead expenses to its Nurse and Allied Staffing segment to more

17. Segment Information (continued)

accurately reflect the segment’s profitability. Prior year information has been reclassified to conform to current year presentation.

(b)

The Company defines contribution income as loss from operations before depreciation, amortization, acquisition and integration costs, restructuring costs, legal settlement charges, impairment charges, and corporate expenses not specifically identified to a reporting segment. Contribution income is a financial measure used by management when assessing segment performance and is provided in accordance with ASC 280, Segment Reporting Topic of the FASB ASC.


(c)	During the years ended December 31, 2014 and 2013, the Company recorded trade names impairment charges of $10.0 million and $6.4 million, respectively. During the year ended December 31, 2012, the Company recorded pretax impairment charges in its continuing operations of $18.7 million. See Note 5 - Goodwill, Trade Names, and Other Identifiable Intangible Assets for further information.

- 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
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Reference 4: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
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Reference 5: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 6: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 7: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
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-SubTopic 10
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-Paragraph 26
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Reference 8: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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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
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-SubTopic 10
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-Paragraph 42
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-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
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Reference 12: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 13: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
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Reference 14: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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+ Details

Quarterly Financial Data (Unaudited)

12 Months Ended

Dec. 31, 2014

Quarterly Financial Information Disclosure [Abstract]

Quarterly Financial Data (Unaudited)



	First Quarter (a)			Second Quarter (b)			Third Quarter (c)			Fourth Quarter (d)
2014	(amounts in thousands)
Revenue from services	$	118,091		$	122,656		$	188,944		$	188,134
Gross profit	30,450			32,436			47,277			47,641

Loss from continuing operations, net of tax	(782		)	(3,181		)	(7,484		)	(20,087		)
Income (loss) from discontinued operations, net of tax	—			—			—			—
Consolidated net loss	(782		)	(3,181		)	(7,484		)	(20,087		)
Less: Net income attributable to noncontrolling interest in subsidiary	—			—			118			131
Net loss attributable to common shareholders	(782		)	(3,181		)	(7,602		)	(20,218		)

Basic (loss) income per share attributable to common shareholders
Continuing operations	$	(0.03	)	$	(0.10	)	$	(0.24	)	$	(0.65	)
Discontinuing operations	—			—			—			—
Net loss	$	(0.03	)	$	(0.10	)	$	(0.24	)	$	(0.65	)

Diluted (loss) income per share attributable to common shareholders
Continuing operations	$	(0.03	)	$	(0.10	)	$	(0.24	)	$	(0.65	)
Discontinuing operations	—			—			—			—
Net loss	$	(0.03	)	$	(0.10	)	$	(0.24	)	$	(0.65	)



	First Quarter (e)			Second Quarter			Third Quarter			Fourth Quarter (f)
2013	(amounts in thousands)
Revenue from services	$	110,316		$	110,768		$	108,048		$	109,179
Gross profit	28,876			27,838			28,184			28,562

(Loss) income from continuing operations, net of tax	(1,346		)	(1,435		)	1,453			(52,922		)
Income (loss) from discontinued operations, net of tax	2,504			(22		)	(539		)	338
Consolidated net income (loss)	1,158			(1,457		)	914			(52,584		)
Less: Net income attributable to noncontrolling interest in subsidiary	—			—			—			—
Net income (loss) attributable to common shareholders	1,158			(1,457		)	914			(52,584		)

Basic (loss) income per share attributable to common shareholders
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 (loss) income per share attributable to common shareholders
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	)

________________

18. Quarterly Financial Data (Unaudited) (continued)


(a)	During the first quarter of 2014, the Company recorded acquisition and integration costs of 0.3 million. See Note 3 - Acquisitions.


(b)	During the second quarter of 2014, the Company recorded acquisition and integration costs of $2.7 million. See Note 3 - Acquisitions.

(c)

On June 30, 2014, the Company acquired substantially all of the assets and certain liabilities of Medical Staffing Network Healthcare, LLC. The acquisition has been accounted for in accordance with FASB ASC 805, Business Combinations, using the acquisition method. The results of the acquisition's operations have been included in the consolidated statements of operations from July 1, 2014 due to their immaterial impact on June 30, 2014, the date of the acquisition. See Note 3 - Acquisitions. During the third quarter of 2014, the Company recorded acquisition and integration costs of $2.4 million and a change in fair value of convertible notes derivative liability of $7.3 million. See Note 3 - Acquisitions and Note 9 - Convertible Notes Derivative Liability.


(d)	During the fourth quarter of 2014, the Company recorded acquisition and integration costs of $2.5 million, a trade name impairment charge of $10.0 million, and a change in fair value of convertible notes derivative liability of $9.4 million. See Note 3 - Acquisitions, Note 5 - Goodwill, Trade Names, and Other Identifiable Intangible Assets, and Note 9 - Convertible Notes Derivative Liability.


(e)	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 $4.0 million pretax, or $2.1 million after tax. See Note 4 – Discontinued Operations.

(f)

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 acquisition method. The results of these allied healthcare staffing operations have been included in the Company's consolidated statements of operations since December 2, 2013, the date of the acquisition. See Note 3 - Acquisitions. During the fourth quarter of 2013, the Company recorded a deferred tax assets valuation allowance of approximately $48.4 million and a trade names impairment charge of $6.4 million. See Note 13 - Income Taxes and Note 5 - Goodwill, Trade Names, and Other Identifiable Intangible Assets.

Schedule II - Valuation and Qualifying Accounts

12 Months Ended

Dec. 31, 2014

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, 2014, 2013, AND 2012



	Balance at Beginning of Period		Charged to Costs and Expenses			Write-offs			Recoveries		Other Changes				Balance at End of Period
	(amounts in thousands)
Allowance for Doubtful Accounts
Year ended December 31, 2014	$	1,651	$	1,016		$	(1,257	)	$	15	$	—			$	1,425
Year ended December 31, 2013	$	1,841	$	1,078		$	(1,324	)	$	56	$	—			$	1,651
Year ended December 31, 2012	$	2,180	$	786		$	(913	)	$	16	$	(228	)	(a)	$	1,841

Valuation Allowance for Deferred Tax Assets
Year ended December 31, 2014	$	52,001	$	12,038	(b)	$	—		$	—	$	(423	)	(c)	$	63,616
Year ended December 31, 2013	$	4,033	$	48,406	(d)	$	(438	)	$	—	$	—			$	52,001
Year ended December 31, 2012	$	3,678	$	355	(e)	$	—		$	—	$	—			$	4,033

________________


(a)	Represents the reclassification of the allowance for doubtful accounts related to Assets Held for Sale. See Note 4 – Discontinued Operations.


(b)	Related to deferred tax assets.


(c)	Related to foreign valuation allowance adjustment.


(d)	Related to deferred tax assets, Cyprus NOL's, and reversal of deferred tax assets related to the Clinical Trial Services business.


(e)	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, 2014

Accounting Policies [Abstract]

Use of Estimates

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, Allowance for Doubtful Accounts, and Concentration of Credit Risk

2. Summary of Significant Accounting Policies (continued)

Prepaid Rent and Deposits

Property and Equipment

Goodwill, Trade Names, and Other Identifiable Intangible Assets

2. Summary of Significant Accounting Policies (continued)

Debt Discount and Debt Issuance Costs

Derivative Financial Instruments

Sales and Other State Non-income Tax Liabilities

Reserves for Claims

Revenue Recognition

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

2. Summary of Significant Accounting Policies (continued)

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.

2. Summary of Significant Accounting Policies (continued)


•	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 Costs

Restructuring costs included in the consolidated statements of operations are primarily related to senior management employee severance pay.

Operating Leases

Income Taxes

Comprehensive Loss

2. Summary of Significant Accounting Policies (continued)

Fair Value Measurements

Recent Accounting Pronouncements

Acquisitions Acquisitions (Tables)

12 Months Ended

Dec. 31, 2014

Business Acquisition [Line Items]

Business Acquisition, Pro Forma Information

The following unaudited pro forma financial information approximates the consolidated results of operations of the Company as if the MSN and allied staffing business acquisitions had occurred as of January 1, 2013, after giving effect to certain adjustments, including additional interest expense on the amount the Company borrowed on the date of the transaction, the amortization of acquired intangible assets, and the elimination of certain expenses that will not be recurring in post-acquisition periods, net of an estimated income tax impact. These adjustments include removing transaction-related expenses of approximately $6.2 million for the year ended December 31, 2014, related to the MSN acquisition. These results are not necessarily indicative of future results as they do not include incremental investments in support functions, elimination of costs for integration or operating synergies, estimates of the changes in the fair value of the embedded derivative in our Convertible Notes or 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.

3. Acquisitions (continued)



	Year Ended December 31,
	2014			2013
	(unaudited, amounts in thousands except per share data)

Revenue from services	$	739,895		$	705,477

Net loss attributable to common shareholders	$	(29,797	)	$	(66,232	)

Net loss per common share attributable to common shareholders - basic	$	(0.96	)	$	(2.14	)

Net loss per common share attributable to common shareholders - diluted	$	(0.96	)	$	(2.14	)

Medical Staffing Network [Member]

Business Acquisition [Line Items]

Schedule of Recognized Identified Assets Acquired and Liabilities Assumed [Table Text Block]



	(amounts in thousands)
Other current assets	$	62
Property and equipment	161
Goodwill	14,554
Other intangible assets	14,000
Other assets	52
Total assets acquired	28,829

Accrued employee compensation and benefits	112
Total liabilities assumed	112

Net assets acquired	$	28,717

The following table is an estimate of the fair value of the assets acquired and liabilities assumed.



	(amounts in thousands)
Cash acquired	$	989
Accounts receivable, net	37,275
Other current assets	3,378
Property and equipment	5,329
Goodwill	13,381
Other intangible assets	17,100
Other assets	2,325
Total assets acquired	79,777

Accounts payable	6,736
Accrued employee compensation and benefits	14,731
Other liabilities	9,867
Total liabilities assumed	31,334

Noncontrolling interest	324

Net assets acquired	$	48,119

Discontinued Operations (Tables)

12 Months Ended

Dec. 31, 2014

Discontinued Operations and Disposal Groups [Abstract]

Revenues and Components of Discontinued Operations, Net of Tax

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



	Years Ended December 31,
		2013			2012
	(amounts in thousands)

Revenue		$	7,939		$	67,627

Income (loss) from discontinued operations before gain on sale and income taxes		434			(30,973		)
Gain on sale of discontinued operations		3,969			—
Income tax (expense) benefit		(2,122		)	9,497
Income (loss) from discontinued operations, net of income taxes		$	2,281		$	(21,476	)

- 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, 2014

Goodwill and Intangible Assets Disclosure [Abstract]

Acquired Intangible Assets

As of December 31, 2014 and 2013, the Company had the following acquired intangible assets:



	December 31, 2014						December 31, 2013
	Gross Carrying Amount		Accumulated Amortization		Net Carrying Amount		Gross Carrying Amount		Accumulated Amortization		Net Carrying Amount
	(amounts in thousands)
Intangible assets subject to amortization:
Databases	$	22,425	$	12,893	$	9,532	$	15,925	$	12,103	$	3,822
Customer relationships	42,004		17,870		24,134		37,304		15,125		22,179
Non-compete agreements	3,603		3,446		157		3,603		3,406		197
	$	68,032	$	34,209	$	33,823	$	56,832	$	30,634	$	26,198

Intangible assets not subject to amortization:
Goodwill					$	90,647					$	77,266
Trade names					38,201						42,301
					$	128,848					$	119,567

Estimated Annual Amortization Expense

As of December 31, 2014, estimated annual amortization expense for continuing operations is as follows:



Years Ending December 31:	(amounts in thousands)
2015	$	3,929
2016	3,929
2017	3,885
2018	3,800
2019	3,763
Thereafter	14,517
	$	33,823

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
	(amounts in thousands)
Balances as of December 31, 2013
Aggregate goodwill acquired	$	274,286		$	43,405	$	19,307	$	336,998
Accumulated impairment loss (a)	(259,732		)	—		—		(259,732		)
Goodwill, net of impairment loss	14,554			43,405		19,307		77,266
Changes to aggregate goodwill in 2014
Goodwill acquired (b)	13,381			—		—		13,381
Balances as of December 31, 2014
Aggregate goodwill acquired	287,667			43,405		19,307		350,379
Accumulated impairment loss	(259,732		)	—		—		(259,732		)
Goodwill, net of impairment loss	$	27,935		$	43,405	$	19,307	$	90,647

_______________

(a)


(b)	Goodwill acquired from the acquisition of Medical Staffing Network. See Note 3 - Acquisitions.

Property and Equipment (Tables)

12 Months Ended

Dec. 31, 2014

Property, Plant and Equipment [Abstract]

Property and Equipment

At December 31, 2014 and 2013, property and equipment consist of the following:



		December 31,
	Useful Lives	2014			2013
		(amounts in thousands)

Computer equipment	3-5 years	$	13,572		$	12,115
Computer software	3-5 years	34,100			30,059
Office equipment	5-7 years	3,846			3,307
Furniture and fixtures	5-7 years	3,562			1,752
Leasehold improvements	(a)	4,643			3,716
		59,723			50,949
Less accumulated depreciation and amortization		(47,590		)	(44,779		)
		$	12,133		$	6,170

_______________


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

Balance Sheet Details (Tables)

12 Months Ended

Dec. 31, 2014

Balance Sheet Related Disclosures [Abstract]

Balance Sheet Details



	December 31,
	2014		2013
	(amounts in thousands)
Insurance recovery receivable:
Insurance recovery for workers’ compensation	$	3,316	$	2,093
Insurance recovery for professional liability	2,308		1,793
	$	5,624	$	3,886

Non-current insurance recovery receivable:
Insurance recovery for workers’ compensation – long-term	$	5,677	$	3,336
Insurance recovery for professional liability – long-term	11,148		7,578
	$	16,825	$	10,914

Accrued compensation and benefits:
Salaries and payroll taxes	$	8,406	$	6,875
Bonuses	4,050		2,200
Accrual for workers’ compensation claims	6,996		3,236
Accrual for health care benefits	2,206		1,385
Accrual for professional liability insurance	4,652		4,091
Accrual for vacation	2,421		1,361
	$	28,731	$	19,148

Long-term accrued claims:
Accrual for workers’ compensation claims	$	14,221	$	5,076
Accrual for professional liability insurance	17,847		13,227
	$	32,068	$	18,303

Other long-term liabilities:
Deferred compensation	$	1,510	$	1,638
Deferred rent	2,453		1,777
Other	47		—
	$	4,010	$	3,415

Long-Term Debt (Tables)

12 Months Ended

Dec. 31, 2014

Debt Disclosure [Abstract]

Long-term Debt

At December 31, 2014 and 2013, long-term debt consists of the following:



	December 31,
	2014			2013
	(amounts in thousands)
Senior Secured Asset-Based, interest 2.61% and 3.27% at December 31, 2014 and December 31, 2013, respectively	$	3,500		$	8,400
Second Lien Term Loan, net of unamortized discount of $1,011, interest 7.50% at December 31, 2014	28,989			—
Convertible Notes, net of unamortized discount of $7,053, interest 8.00% at December 31, 2014	17,947			—
Convertible Notes derivative liability	23,436			—
Capital lease obligations	202			176
Total debt	74,074			8,576
Less current portion	(3,607		)	(8,483		)
Long-term debt	$	70,467		$	93

Aggregate Scheduled Maturities of Debt

As of December 31, 2014, the aggregate scheduled maturities of debt are as follows:



	Term Debt		Convertible Notes		Revolver		Capital Leases and Note Payable
	(amounts in thousands)
Through Years Ending December 31:
2015	$	—	$	—	3,500		107
2016	—		—		—		72
2017	—		—		—		13
2018	—		—		—		8
2019	30,000		—		—		2
Thereafter	—		25,000		—		—
Total	$	30,000	$	25,000	$	3,500	$	202

Convertible Notes Derivative Liability (Tables)

12 Months Ended

Dec. 31, 2014

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Fair Value Measurements, Recurring and Nonrecurring, Valuation Techniques

The inputs into the valuation model are as follows:



	December 31, 2014
Closing share price	$12.48
Conversion price	$7.10
Risk free rate	1.86%
Expected volatility	40%
Dividend yield	—%
Expected life	5.5 years

Fair Value Measurements (Tables)

12 Months Ended

Dec. 31, 2014

Fair Value Disclosures [Abstract]

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

The table which follows summarizes the estimated fair value of the Company’s financial assets and liabilities measured on a recurring basis as of December 31, 2014 and 2013:

Fair Value Measurements



	December 31, 2014		December 31, 2013
Financial Assets:	(amounts in thousands)
(Level 3)
Escrow receivable	$	—	$	3,750

Financial Liabilities:
(Level 1)
Deferred compensation	$	1,510	$	1,638
(Level 3)
Convertible Notes derivative liability	$	23,436	$	—

Fair Value, Assets and Liabilities Measured on recurring Basis, Unobservable Input Reconciliation

The table which follows reconciles the opening balances to the closing balances for fair value measurements categorized within Level 3 of the fair value hierarchy:



	Escrow			Convertible Notes
	Receivable			Derivative Liability (a)
	(amounts in thousands)

December 31, 2012	$	—		$	—
Additions	3,750			—
December 31, 2013	3,750			—
Additions	—			6,765
Settlements	(3,750		)	—
Valuation loss for the period	—			16,671
December 31, 2014	$	—		$	23,436

_______________

(a)

Fair Value of Goodwill Measured On Non-Recurring Basis

The table below presents the fair value of the MDA trade names as of December 31, 2014 and 2013.

Fair Value Measurements



	December 31, 2014		December 31, 2013
	(amounts in thousands)
(Level 3)
MDA trade names	$	17,699	$	28,836

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 value of the Company’s significant financial instruments that were not measured at fair value:



	December 31, 2014				December 31, 2013
	Carrying Amount		Fair Value		Carrying Amount		Fair Value
	(amounts in thousands)
Financial Liabilities:
(Level 2)
Second Lien Term Loan, net (a)	$	28,989	$	29,900	$	—	$	—
Convertible Notes, net (a)	$	17,948	$	19,200	$	—	$	—
Senior Secured Asset-Based Loan (b)	$	3,500	$	3,500	$	8,400	$	8,400

_______________


(a)	The Second Lien Term Loan and Convertible Notes are reported at their carrying value in the accompanying consolidated balance sheets. The Company determined their fair value, as presented in the table using an income approach, utilizing a discounted cash flow analysis based on current market interest rates for debt issuances with similar remaining years to maturity, adjusted for credit risk.


(b)	Carrying value of the Senior Secured Asset-Based Loan 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, 2014

Commitments and Contingencies Disclosure [Abstract]

Future Minimum Lease Payments

Future minimum lease payments, as of December 31, 2014, associated with these agreements with terms of one year or more are as follows:



Through Year Ending December 31:	(amounts in thousands)
2015	$	7,202
2016	5,581
2017	3,884
2018	1,613
2019	486
Thereafter	2,146
	$	20,912

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2014

Income Tax Disclosure [Abstract]

Components of Income (Loss) Before Income Taxes

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



	Year Ended December 31,
	2014			2013			2012
	(amounts in thousands)
United States	$	(33,574	)	$	(11,216	)	$	(28,599	)
Foreign	2,256			1,177			1,704
	$	(31,318	)	$	(10,039	)	$	(26,895	)

Components of Income Tax Expense (Benefit)

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



	Year Ended December 31,
	2014			2013		2012
	(amounts in thousands)
Continuing operations:
Current
Federal	$	—		$	—	$	412
State	811			540		812
Foreign	262			416		1,561
Total	1,073			956		2,785

Deferred
Federal	(1,320		)	37,822		(4,048		)
State	68			5,134		(5,251		)
Foreign	395			299		364
Total	(857		)	43,255		(8,935		)
Total income tax expense (benefit) for continuing operations	$	216		$	44,211	$	(6,150	)

The total income tax provision is summarized as follows:
Continuing operations	$	216		$	44,211	$	(6,150	)
Discontinued operations	—			2,122		(9,497		)
	$	216		$	46,333	$	(15,647	)

Significant Components of Deferred Tax Assets and Liabilities

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



	December 31,
	2014			2013
	(amounts in thousands)
Current deferred tax assets (liabilities):
Accrued other and prepaid expenses	$	2,823		$	2,592
Accrued settlement charge	—			283
Allowance for doubtful accounts	589			650
Other	822			468
Gross deferred tax assets	4,234			3,993
Valuation allowance	(6,215		)	(4,528		)
Deferred tax liabilities	(1,981		)	(535		)
Non-current deferred tax (liabilities) and assets:
Amortization	(5,967		)	(1,314		)
Depreciation	105			(384		)
Identifiable intangibles	—			(2,237		)
Net operating loss carryforwards	38,144			32,531
Derivative interest	6,370			—
Accrued professional liability	(92		)	(118		)
Accrued workers’ compensation	1,356			675
Tax on unrepatriated earnings	(336		)	(453		)
Share-based compensation	959			1,610
Other	(1,176		)	314
Gross deferred tax assets	39,363			30,624
Valuation allowance	(57,401		)	(47,473		)
Deferred tax liabilities	(18,038		)	(16,849		)
Net deferred taxes	$	(20,019	)	$	(17,384	)

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,
	2014			2013			2012
	(amounts in thousands)
Tax at U.S. statutory rate	$	(10,961	)	$	(3,514	)	$	(9,413	)
State taxes, net of federal benefit	219			(190		)	(1,226		)
Non-deductible meals and entertainment	1,425			450			962
Foreign tax expense	44			554			(222		)
Valuation allowances	12,038			48,556			(44		)
Uncertain tax positions	(996		)	(257		)	648
Deferred tax rate differential	—			—			150
Deferred tax write-offs (a)	—			221			—
Audit settlements	—			160			—
Tax on unrepatriated earnings	—			(1,465		)	2,005
Tax on repatriated earnings	—			—			519
Tax true ups and other	(1,553		)	(304		)	471
Total income tax expense (benefit) for continuing operations	$	216		$	44,211		$	(6,150	)

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:



	2014			2013
	(amounts in thousands)
Balance at January 1	$	4,986		$	5,204
Additions based on tax positions related to the current year	709			496
Additions based on tax positions related to prior years	91			681
Reductions based on settlements of tax positions related to the prior year	(344		)	(292		)
Reductions for tax positions as a result of a lapse of the applicable statute of limitations	(1,578		)	(1,076		)
Other	(87		)	(27		)
Balance at December 31	$	3,777		$	4,986

Stockholders' Equity (Tables)

12 Months Ended

Dec. 31, 2014

Equity [Abstract]

Summary of Restricted Stock Award Activity



	Restricted Stock Awards				Performance Stock Awards
	Number of Shares		Weighted Average Grant Date Fair Value		Number of Target Shares		Weighted Average Grant Date Fair Value
Unvested restricted stock awards, January 1, 2014	552,231		$	5.37	—		$	—
Granted	377,308		$	6.18	239,585		$	5.81
Vested	(181,354	)	$	5.77	—		$	—
Forfeited	(88,535	)	$	5.39	(21,410	)	$	5.77
Unvested restricted stock awards, December 31, 2014	659,650		$	5.72	218,175		$	5.82

Stock Options and Stock Appreciation Rights Granted and Exercised



	Year Ended December 31,
	2014		2013		2012
Share option grants	—		324,000		344,500
Weighted average grant date fair value of options granted during the period	—		$	1.77	$	1.65
Total intrinsic value of options exercised	$	695,286	$	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
Expected dividend yield		—	%	—	%
Expected volatility		48.00	%	47.00	%
Risk-free interest rate		0.79	%	0.58	%
Expected life		4.2 years		4.3 years

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 December 31, 2014:



	Shares		Option Price	Weighted Average Exercise Price	Weighted- Average Remaining Contractual Life (in years)	Aggregate Intrinsic Value
Share options outstanding at beginning of year	1,546,299		$4.16-$22.50	$8.93
Granted	—		—	—
Exercised	(228,500	)	$4.35-$8.56	$7.47
Forfeited/expired	(382,704	)	$4.35-$22.50	$11.41
Share options outstanding at end of year	935,095		$4.16-$22.50	$8.27	2.94	$	4,464,160
Share options exercisable at end of year	655,468		$4.16-$22.50	$9.58	2.07	$	2,430,566
Share options unvested at end of year	279,627		$4.16-$7.44	$5.21	4.96	$	2,033,594

Earnings Per Share (Tables)

12 Months Ended

Dec. 31, 2014

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,
	2014			2013			2012
	(amounts in thousands, except per share data)
Loss from continuing operations	$	(31,534	)	$	(54,250	)	$	(20,745	)
Less: Income attributable to noncontrolling interest in subsidiary	249			—			—
Loss from continuing operations attributable to common shareholders	(31,783		)	(54,250		)	(20,745		)
Income (loss) from discontinued operations, net of income taxes	—			2,281			(21,476		)
Net loss attributable to common shareholders	$	(31,783	)	$	(51,969	)	$	(42,221	)

Basic (loss) income per share attributable to common shareholders
Continuing operations	$	(1.02	)	$	(1.75	)	$	(0.67	)
Discontinued operations	—			0.07			(0.70		)
Net loss	$	(1.02	)	$	(1.68	)	$	(1.37	)

Diluted (loss) income per share attributable to common shareholders
Continuing operations	$	(1.02	)	$	(1.75	)	$	(0.67	)
Discontinued operations	—			0.07			(0.70		)
Net loss	$	(1.02	)	$	(1.68	)	$	(1.37	)

Weighted-average number of shares outstanding-basic	31,190			31,009			30,843
Plus dilutive equity awards	—			—			—
Weighted-average number of shares outstanding-diluted	31,190			31,009			30,843

Segment Information (Tables)

12 Months Ended

Dec. 31, 2014

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 from continuing operations for the periods indicated are as follows:



	Year Ended December 31,
	2014			2013 (a)			2012 (a)
	(amounts in thousands)
Revenue from unaffiliated customers:
Nurse and Allied Staffing	$	457,034		$	271,563		$	272,136
Physician Staffing	123,306			128,781			129,162
Other Human Capital Management Services	37,485			37,967			41,337
	$	617,825		$	438,311		$	442,635
Contribution income: (b)
Nurse and Allied Staffing	$	36,326		$	18,424		$	10,277
Physician Staffing	6,700			8,939			10,863
Other Human Capital Management Services	514			746			1,943
	43,540			28,109			23,083

Unallocated corporate overhead	27,770			21,844			21,701
Depreciation	3,866			3,886			4,905
Amortization	3,575			2,294			2,263
Acquisition and integration costs	7,957			473			—
Restructuring costs	840			484			—
Legal settlement charge	—			750			—
Impairment charges (c)	10,000			6,400			18,732
Loss from operations	$	(10,468	)	$	(8,022	)	$	(24,518	)

_______________


(a)	In 2014, the Company reclassified the revenue and contribution income of certain higher level staffing professionals previously included with Nurse and Allied Staffing to Physician Staffing. In addition, in 2014, the Company refined its methodology for allocating certain corporate overhead expenses to its Nurse and Allied Staffing segment to more

17. Segment Information (continued)

accurately reflect the segment’s profitability. Prior year information has been reclassified to conform to current year presentation.

(b)


(c)	During the years ended December 31, 2014 and 2013, the Company recorded trade names impairment charges of $10.0 million and $6.4 million, respectively. During the year ended December 31, 2012, the Company recorded pretax impairment charges in its continuing operations of $18.7 million. See Note 5 - Goodwill, Trade Names, and Other Identifiable Intangible Assets for further information.

Quarterly Financial Data (Unaudited) (Tables)

12 Months Ended

Dec. 31, 2014

Quarterly Financial Information Disclosure [Abstract]

Quarterly Financial Data



	First Quarter (a)			Second Quarter (b)			Third Quarter (c)			Fourth Quarter (d)
2014	(amounts in thousands)
Revenue from services	$	118,091		$	122,656		$	188,944		$	188,134
Gross profit	30,450			32,436			47,277			47,641

Loss from continuing operations, net of tax	(782		)	(3,181		)	(7,484		)	(20,087		)
Income (loss) from discontinued operations, net of tax	—			—			—			—
Consolidated net loss	(782		)	(3,181		)	(7,484		)	(20,087		)
Less: Net income attributable to noncontrolling interest in subsidiary	—			—			118			131
Net loss attributable to common shareholders	(782		)	(3,181		)	(7,602		)	(20,218		)

Basic (loss) income per share attributable to common shareholders
Continuing operations	$	(0.03	)	$	(0.10	)	$	(0.24	)	$	(0.65	)
Discontinuing operations	—			—			—			—
Net loss	$	(0.03	)	$	(0.10	)	$	(0.24	)	$	(0.65	)

Diluted (loss) income per share attributable to common shareholders
Continuing operations	$	(0.03	)	$	(0.10	)	$	(0.24	)	$	(0.65	)
Discontinuing operations	—			—			—			—
Net loss	$	(0.03	)	$	(0.10	)	$	(0.24	)	$	(0.65	)



	First Quarter (e)			Second Quarter			Third Quarter			Fourth Quarter (f)
2013	(amounts in thousands)
Revenue from services	$	110,316		$	110,768		$	108,048		$	109,179
Gross profit	28,876			27,838			28,184			28,562

(Loss) income from continuing operations, net of tax	(1,346		)	(1,435		)	1,453			(52,922		)
Income (loss) from discontinued operations, net of tax	2,504			(22		)	(539		)	338
Consolidated net income (loss)	1,158			(1,457		)	914			(52,584		)
Less: Net income attributable to noncontrolling interest in subsidiary	—			—			—			—
Net income (loss) attributable to common shareholders	1,158			(1,457		)	914			(52,584		)

Basic (loss) income per share attributable to common shareholders
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 (loss) income per share attributable to common shareholders
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	)

________________

18. Quarterly Financial Data (Unaudited) (continued)


(a)	During the first quarter of 2014, the Company recorded acquisition and integration costs of 0.3 million. See Note 3 - Acquisitions.


(b)	During the second quarter of 2014, the Company recorded acquisition and integration costs of $2.7 million. See Note 3 - Acquisitions.

(c)


(d)	During the fourth quarter of 2014, the Company recorded acquisition and integration costs of $2.5 million, a trade name impairment charge of $10.0 million, and a change in fair value of convertible notes derivative liability of $9.4 million. See Note 3 - Acquisitions, Note 5 - Goodwill, Trade Names, and Other Identifiable Intangible Assets, and Note 9 - Convertible Notes Derivative Liability.


(e)	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 $4.0 million pretax, or $2.1 million after tax. See Note 4 – Discontinued Operations.

(f)

Summary of Significant Accounting Policies - Narrative (Detail) - USD ($) $ in Thousands	3 Months Ended					12 Months Ended
	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Mar. 31, 2013	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Significant Accounting Policies [Line Items]
Outstanding standby letters of credit as collateral	$ 21,500					$ 21,500	$ 6,400
Accrued revenue	21,900					21,900	11,000
Equity compensation						1,400	2,100	$ 2,600
Deferred tax benefits related to share based compensation								1,000
Advertising costs						4,100	3,200	3,200
Prepaid expenses, advertising	1,000					1,000	1,300
Acquisition and integration costs	2,500	$ 2,400	$ 2,700	$ 300		7,957	473	0
Acquisition costs						2,200	500
Restructuring liabilities assumed	1,900					1,900	0
Cumulative impact of currency fluctuations	1,100					1,100	1,100
Reclassification of currency translation adjustments related to sale of clinical trial services business					$ 2,300	0	2,336	0
Income tax expense (benefit) related to items of other comprehensive income						162	(162)	$ 15
Ongoing Postemployment Benefits [Member]
Significant Accounting Policies [Line Items]
Integration costs						1,600
Restructuring liabilities assumed	800					800	0
Facility Closing [Member]
Significant Accounting Policies [Line Items]
Integration costs						1,100
Exit Costs [Member]
Significant Accounting Policies [Line Items]
Restructuring liabilities assumed	900					900	0
Occurrence-Based Professional Liability Insurance [Member] \| MDA Holdings Inc [Member]
Significant Accounting Policies [Line Items]
Letter of credit for malpractice claims	5,000					5,000	5,000
Other Current Liabilities [Member]
Significant Accounting Policies [Line Items]
Deferred revenue	$ 1,200					$ 1,200	$ 1,300
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

Acquisitions - Narrative (Detail)		1 Months Ended	3 Months Ended								12 Months Ended
Acquisitions - Narrative (Detail)	Jun. 30, 2014 USD ($) location $ / shares	Dec. 31, 2013 USD ($) branch specialty	Dec. 31, 2014 USD ($)	Sep. 30, 2014 USD ($)	Jun. 30, 2014 USD ($) location $ / shares	Mar. 31, 2014 USD ($)	Dec. 31, 2013 USD ($)	Sep. 30, 2013 USD ($)	Jun. 30, 2013 USD ($)	Mar. 31, 2013 USD ($)	Dec. 31, 2014 USD ($)	Dec. 31, 2013 USD ($)	Dec. 31, 2012 USD ($)	Jan. 09, 2013 USD ($)
Business Acquisition, Contingent Consideration [Line Items]
Acquisition of assets of Medical Staffing Network, net of cash acquired											$ 44,631,000	$ 0	$ 0
Noncontrolling interest fair value assessment, discounted cash flow method, utilization percentage	80.00%
Noncontrolling interest fair value assessment, guideline public company method, utilization percentage	10.00%
Noncontrolling interest fair value assessment, mergers and acquisition method, utilization percentage	10.00%
Goodwill		$ 77,266,000	$ 90,647,000				$ 77,266,000				90,647,000	77,266,000
Acquisition and integration costs			2,500,000	$ 2,400,000	$ 2,700,000	$ 300,000					7,957,000	473,000	0
Acquisition costs											2,200,000	500,000
Adjustment for nonrecurring costs in Net Loss			(20,087,000)	$ (7,484,000)	(3,181,000)	$ (782,000)	(52,584,000)	$ 914,000	$ (1,457,000)	$ 1,158,000	(31,534,000)	(51,969,000)	$ (42,221,000)
Medical Staffing Network [Member]
Business Acquisition, Contingent Consideration [Line Items]
Consideration transferred	$ 48,100,000
Acquisition of assets of Medical Staffing Network, net of cash acquired	44,600,000
Business combination, amount deposited in escrow, working capital adjustment	1,000,000				1,000,000
Consideration deferred	$ 2,500,000				$ 2,500,000
Period of deferred consideration (in months)	21 months
Business combination, amount received from escrow, working capital adjustment			200,000
Number of locations of operations \| location	55				55
Gross accounts receivable	$ 38,100,000				$ 38,100,000
Receivables not expected to be collected	800,000				800,000
Claim attached	2,300,000				2,300,000
Policy limit	5,000,000				5,000,000
Estimated fair value of professional liabilities related to stop loss policy	5,600,000				5,600,000
Estimated recovery receivable related to stop loss policy	400,000				400,000
Policy, coverage per occurrence	1,000,000				1,000,000
Policy coverage	5,000,000				5,000,000
Excess layer limit per occurrence	1,000,000				1,000,000
Excess layer limit	6,000,000				6,000,000
Other intangible assets	17,100,000				17,100,000
Finite-lived intangible assets	$ 11,200,000				11,200,000
Weighted average useful life (in years)	11 years
Noncontrolling interest	$ 324,000				324,000
Goodwill	13,381,000				13,381,000
Acquisition and integration costs											7,300,000
On Assignment [Member]
Business Acquisition, Contingent Consideration [Line Items]
Consideration transferred		28,700,000
Other intangible assets		14,000,000					14,000,000					14,000,000
Finite-lived intangible assets		$ 14,000,000					14,000,000					14,000,000
Weighted average useful life (in years)		14 years
Goodwill		$ 14,554,000					14,554,000					14,554,000
Acquisition and integration costs											700,000	500,000
Acquisition costs		500,000
Cash		$ 24,700,000					24,700,000					24,700,000
Number of branch-based employees \| branch		84
Number of staffing specialties acquired \| specialty		125
Number of branch offices acquired \| branch		23
MDA Holdings Inc [Member]
Business Acquisition, Contingent Consideration [Line Items]
Escrow deposit balance		$ 3,600,000	3,600,000				3,600,000				3,600,000	3,600,000
Acquisition-related Costs [Member]
Business Acquisition, Contingent Consideration [Line Items]
Adjustment for nonrecurring costs in Net Loss											6,200,000
Subordinated Debt [Member] \| Medical Staffing Network [Member]
Business Acquisition, Contingent Consideration [Line Items]
Long-term Debt	55,000,000				55,000,000
Term Loan Facility [Member]
Business Acquisition, Contingent Consideration [Line Items]
Long-term Debt		0	28,989,000				0				28,989,000	0
Term Loan Facility [Member] \| Medical Staffing Network [Member]
Business Acquisition, Contingent Consideration [Line Items]
Long-term Debt	$ 30,000,000				30,000,000
Term (in years)	5 years
Convertible Notes Payable [Member]
Business Acquisition, Contingent Consideration [Line Items]
Long-term Debt		0	17,947,000				0				17,947,000	0
Convertible Notes Payable [Member] \| Medical Staffing Network [Member]
Business Acquisition, Contingent Consideration [Line Items]
Long-term Debt	$ 25,000,000				$ 25,000,000
Term (in years)	6 years
Debt conversion price \| $ / shares	$ 7.10				$ 7.10
Revolving Credit Facility [Member]
Business Acquisition, Contingent Consideration [Line Items]
Long-term Debt			$ 3,500,000								$ 3,500,000
Revolving Credit Facility [Member] \| Line of Credit [Member] \| On Assignment [Member]
Business Acquisition, Contingent Consideration [Line Items]
Long-term Debt		4,500,000					4,500,000					4,500,000
First Lien Loan Agreement [Member] \| Revolving Credit Facility [Member]
Business Acquisition, Contingent Consideration [Line Items]
Term (in years)	3 years
Credit facility borrowing capacity	$ 85,000,000.0				$ 85,000,000.0									$ 65,000,000.0
Trade Names [Member] \| Medical Staffing Network [Member]
Business Acquisition, Contingent Consideration [Line Items]
Other intangible assets	5,900,000				5,900,000
Customer Relationships [Member] \| Medical Staffing Network [Member]
Business Acquisition, Contingent Consideration [Line Items]
Other intangible assets	$ 4,700,000				4,700,000
Intangible assets- useful life	13 years
Customer Relationships [Member] \| On Assignment [Member]
Business Acquisition, Contingent Consideration [Line Items]
Other intangible assets		$ 10,400,000					10,400,000					10,400,000
Intangible assets- useful life		16 years
Customer Lists [Member] \| Medical Staffing Network [Member]
Business Acquisition, Contingent Consideration [Line Items]
Other intangible assets	$ 6,500,000				$ 6,500,000
Intangible assets- useful life	10 years
Customer Lists [Member] \| On Assignment [Member]
Business Acquisition, Contingent Consideration [Line Items]
Other intangible assets		$ 3,400,000					3,400,000					3,400,000
Intangible assets- useful life		10 years
Noncompete Agreements [Member] \| On Assignment [Member]
Business Acquisition, Contingent Consideration [Line Items]
Other intangible assets		$ 200,000					$ 200,000					$ 200,000
Intangible assets- useful life		5 years

Acquisitions Schedule of Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Thousands	Dec. 31, 2014	Jun. 30, 2014	Dec. 31, 2013
Business Acquisition [Line Items]
Goodwill	$ 90,647		$ 77,266
On Assignment [Member]
Business Acquisition [Line Items]
Other current assets			62
Property and equipment			161
Goodwill			14,554
Other intangible assets			14,000
Other assets			52
Total assets acquired			28,829
Accrued employee compensation and benefits			112
Total liabilities assumed			112
Net assets acquired			$ 28,717
Medical Staffing Network [Member]
Business Acquisition [Line Items]
Cash acquired		$ 989
Accounts receivable, net		37,275
Other current assets		3,378
Property and equipment		5,329
Goodwill		13,381
Other intangible assets		17,100
Other assets		2,325
Total assets acquired		79,777
Accounts payable		6,736
Accrued employee compensation and benefits		14,731
Other liabilities		9,867
Total liabilities assumed		31,334
Noncontrolling interest		324
Net assets acquired		$ 48,119

Acquisitions Schedule of Pro-forma Information (Details) - On Assignment [Member] - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013
Business Acquisition [Line Items]
Revenue from services	$ 739,895	$ 705,477
Net loss attributable to common shareholders	$ (29,797)	$ (66,232)
Net loss per common share - basic (usd per share)	$ (0.96)	$ (2.14)
Net loss per common share - diluted (usd per share)	$ (0.96)	$ (2.14)

Discontinued Operations -Narrative (Detail) - USD ($) $ in Thousands		1 Months Ended	3 Months Ended		12 Months Ended
	Feb. 15, 2013	Jul. 31, 2014	Dec. 31, 2013	Jun. 30, 2013	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Indemnity escrow receivable	$ 3,800		$ 3,750		$ 0	$ 3,750
Trademark impairment charge					$ 10,000	$ 6,400	$ 18,732
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							34,000
Income from operations							4,400
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
Clinical Trial Services [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Aggregate amount of selling prices	52,000
Adjustment to reflect additional gain (loss) on disposal	100		$ 200
Earn-out related to certain performance-based milestones	3,800
Release of escrow to the buyer		$ 2,300		$ 1,500
Indemnity escrow receivable	$ 3,800
Escrow deposit term (in years)	18 months

Discontinued Operations (Detail) - USD ($) $ in Thousands	12 Months Ended
Discontinued Operations (Detail) - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Income tax (expense) benefit	$ 0	$ (2,122)	$ 9,497
Clinical Trial Services [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenue		7,939	67,627
Income (loss) from discontinued operations before gain on sale and income taxes		434	(30,973)
Gain on sale of discontinued operations		3,969	0
Income tax (expense) benefit		(2,122)	9,497
Income (loss) from discontinued operations, net of income taxes		$ 2,281	$ (21,476)

Acquired Intangible Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, gross carrying amount	$ 68,032	$ 56,832
Intangible assets subject to amortization, accumulated amortization	34,209	30,634
Intangible assets subject to amortization, net carrying amount	33,823	26,198
Goodwill	90,647	77,266
Trade names	38,201	42,301
Intangible assets not subject to amortization, net	128,848	119,567
Database Rights [Member]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, gross carrying amount	22,425	15,925
Intangible assets subject to amortization, accumulated amortization	12,893	12,103
Intangible assets subject to amortization, net carrying amount	9,532	3,822
Customer Relationships [Member]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, gross carrying amount	42,004	37,304
Intangible assets subject to amortization, accumulated amortization	17,870	15,125
Intangible assets subject to amortization, net carrying amount	24,134	22,179
Noncompete Agreements [Member]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, gross carrying amount	3,603	3,603
Intangible assets subject to amortization, accumulated amortization	3,446	3,406
Intangible assets subject to amortization, net carrying amount	$ 157	$ 197

Estimated Annual Amortization Expense (Detail) - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013
Goodwill and Intangible Assets Disclosure [Abstract]
2015	$ 3,929
2016	3,929
2017	3,885
2018	3,800
2019	3,763
Thereafter	14,517
Intangible assets subject to amortization, net carrying amount	$ 33,823	$ 26,198

Changes in Carrying Amount of Goodwill by Segment (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013
Goodwill balances
Aggregate goodwill acquired	$ 350,379	$ 336,998
Accumulated impairment loss	(259,732)	(259,732)
Goodwill, net of impairment loss	90,647	77,266
Changes to aggregate goodwill in 2014
Goodwill acquired	13,381
Nurse and allied staffing [Member]
Goodwill balances
Aggregate goodwill acquired	287,667	274,286
Accumulated impairment loss	(259,732)	(259,732)
Goodwill, net of impairment loss	27,935	14,554
Changes to aggregate goodwill in 2014
Goodwill acquired	13,381
Physician staffing [Member]
Goodwill balances
Aggregate goodwill acquired	43,405	43,405
Accumulated impairment loss	0	0
Goodwill, net of impairment loss	43,405	43,405
Changes to aggregate goodwill in 2014
Goodwill acquired	0
Other human capital management services [Member]
Goodwill balances
Aggregate goodwill acquired	19,307	19,307
Accumulated impairment loss	0	0
Goodwill, net of impairment loss	19,307	$ 19,307
Changes to aggregate goodwill in 2014
Goodwill acquired	$ 0

Changes in Carrying Amount of Goodwill by Segment - Additional (Detail) - USD ($) $ in Millions	3 Months Ended
	Jun. 30, 2012	Dec. 31, 2008
Nurse and allied staffing [Member]
Goodwill [Line Items]
Goodwill impairment charge	$ 18.7	$ 241.0

Goodwill and Other Identifiable Intangible Assets - Narrative (Detail) - USD ($) $ in Millions	3 Months Ended				12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Jun. 30, 2012	Dec. 31, 2008	Dec. 31, 2012
Income Approach Valuation Technique [Member]
Goodwill and Intangible Assets Disclosure [Line Items]
Forecast period used to calculate discounted cash flows (in years)					10 years
Terminal value growth rate (as a percentage)					2.50%
Income Approach Valuation Technique [Member] \| Minimum [Member]
Goodwill and Intangible Assets Disclosure [Line Items]
Cash flow discount rates (as a percentage)					11.00%
Income Approach Valuation Technique [Member] \| Maximum [Member]
Goodwill and Intangible Assets Disclosure [Line Items]
Cash flow discount rates (as a percentage)					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		$ 6.2
Nurse and allied staffing [Member]
Goodwill and Intangible Assets Disclosure [Line Items]
Impairment of intangibles		0.2
Goodwill impairment charge			$ 18.7	$ 241.0
Education And Training [Member] \| Market Approach Valuation Technique [Member]
Goodwill and Intangible Assets Disclosure [Line Items]
Percentage assumed - weighting to EBITDA multiples					100.00%
Trade Names [Member]
Goodwill and Intangible Assets Disclosure [Line Items]
Impairment of intangibles	$ 10.0	$ 6.4
Trade Names [Member] \| Physician staffing [Member]
Goodwill and Intangible Assets Disclosure [Line Items]
Impairment of intangibles	$ 10.0

Property and Equipment (Detail) - USD ($) $ in Thousands	12 Months Ended
Property and Equipment (Detail) - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013
Property, Plant and Equipment [Line Items]
Property and equipment	$ 59,723	$ 50,949
Less accumulated depreciation and amortization	(47,590)	(44,779)
Property and equipment, net of accumulated depreciation and amortization	$ 12,133	6,170
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	$ 13,572	12,115
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	$ 34,100	30,059
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	$ 3,846	3,307
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	$ 3,562	1,752
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	$ 4,643	$ 3,716

Balance Sheet Details (Detail) - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013
Balance Sheet Related Disclosures [Abstract]
Insurance recovery for workers’ compensation	$ 3,316	$ 2,093
Insurance recovery for professional liability	2,308	1,793
Insurance recovery receivable	5,624	3,886
Insurance recovery for workers’ compensation – long-term	5,677	3,336
Insurance recovery for professional liability – long-term	11,148	7,578
Non-current insurance recovery receivable	16,825	10,914
Salaries and payroll taxes	8,406	6,875
Bonuses	4,050	2,200
Accrual for workers’ compensation claims	6,996	3,236
Accrual for health care benefits	2,206	1,385
Accrual for professional liability insurance	4,652	4,091
Accrual for vacation	2,421	1,361
Accrued compensation and benefits	28,731	19,148
Accrual for workers’ compensation claims	14,221	5,076
Accrual for professional liability insurance	17,847	13,227
Long-term accrued claims	32,068	18,303
Deferred compensation	1,510	1,638
Deferred rent	2,453	1,777
Other	47	0
Other long-term liabilities	$ 4,010	$ 3,415

Long- Term Debt (Detail) - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013
Debt Instrument [Line Items]
Capital lease obligations	$ 202	$ 176
Total debt	74,074	8,576
Less current portion	(3,607)	(8,483)
Long-term debt and capital lease obligations, less current portion	70,467	93
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Debt	3,500	8,400
Term Loan Facility [Member]
Debt Instrument [Line Items]
Debt	28,989	0
Convertible Notes Payable [Member]
Debt Instrument [Line Items]
Debt	17,947	0
Convertible Note Derivative Liability [Member]
Debt Instrument [Line Items]
Debt	$ 23,436	$ 0

Long- Term Debt (Additional Information) (Detail) - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013
Debt Instrument [Line Items]
Revolver credit facility, interest rate	2.61%	3.27%
Convertible Notes Payable [Member]
Debt Instrument [Line Items]
Unamortized discount	$ 7,053
Interest rate	8.00%
Term Loan Facility [Member]
Debt Instrument [Line Items]
Unamortized discount	$ 1,011
Interest rate	7.50%

Aggregate Scheduled Maturities of Debt (Detail) $ in Thousands	Dec. 31, 2014 USD ($)
Term Loan Facility [Member]
Debt Instrument [Line Items]
2015	$ 0
2016	0
2017	0
2018	0
2019	30,000
Thereafter	0
Total	30,000
Convertible Notes Payable [Member]
Debt Instrument [Line Items]
2015	0
2016	0
2017	0
2018	0
2019	0
Thereafter	25,000
Total	25,000
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
2015	3,500
2016	0
2017	0
2018	0
2019	0
Thereafter	0
Total	3,500
Capital Lease and Note Payable [Member]
Debt Instrument [Line Items]
2015	107
2016	72
2017	13
2018	8
2019	2
Thereafter	0
Total	$ 202

Long-Term Debt - Narrative (Detail)		3 Months Ended	12 Months Ended
Long-Term Debt - Narrative (Detail)	Jun. 30, 2014 USD ($) instrument d $ / shares	Mar. 31, 2013 USD ($)	Dec. 31, 2014 USD ($) $ / shares	Dec. 31, 2013 USD ($) $ / shares	Dec. 31, 2012 USD ($)	Jan. 09, 2013 USD ($)
Debt Instrument [Line Items]
Debt covenant, availability threshold			$ 4,000,000.0
Debt issuance costs			$ (1,093,000)	$ (506,000)	$ (1,377,000)
Unamortized discount, conversion and redemption features	$ 6,800,000
Common stock, par value (usd per share) \| $ / shares			$ 0.0001	$ 0.0001
First Lien Loan Agreement [Member]
Debt Instrument [Line Items]
Quarterly commitment fee on the average daily unused portion			0.375%
Term Loan Facility [Member]
Debt Instrument [Line Items]
Write off debt issuance cost		$ 300,000
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Write off debt issuance cost		1,100,000
Interest rate increase			2.00%
Revolving Credit Facility [Member] \| Debt Modifications [Member]
Debt Instrument [Line Items]
Debt financing costs		$ 100,000
Standby Letters of Credit [Member]
Debt Instrument [Line Items]
Letters of credit outstanding			$ 26,500,000
Second Lien Term Loan [Member]
Debt Instrument [Line Items]
Debt financing costs	400,000
Credit facility borrowing capacity	$ 30,000,000.0
Term (in years)	5 years
Interest margin	6.50%
Unamortized discount	$ 1,100,000
Proceeds from debt, net	$ 28,900,000
Basis spread, floor	1.00%
Percent of aggregate principal	103.00%
Mandatory prepayment in excess cash flow, percent	50.00%
Mandatory prepayments in excess of cash flow, threshold	$ 5,000,000.0
Percent of net cash proceeds of asset sales	100.00%
Percent of net cash proceeds of issuances of debt offerings	100.00%
Percent of net cash proceeds of equity offerings	50.00%
Debt/EBITDA ratio	4.50
Second Lien Term Loan [Member] \| Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Interest rate increase	2.00%
Basis spread on discount	0.50%
First Lien Loan Agreement [Member] \| Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Credit facility borrowing capacity	$ 85,000,000.0					$ 65,000,000.0
Term (in years)	3 years
Aggregate amount of advances under the line of credit (borrowing base)	$ 85,000,000.0
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	$ 18,000,000.0
Debt covenant, loan cap threshold			12.50%
Debt covenant, threshold			$ 8,300,000
Fixed charge coverage ratio, minimum			1.0
Current borrowing capacity			$ 69,700,000
Amount drawn under credit facility			3,500,000
Remaining borrowing capacity			$ 39,700,000
First Lien Loan Agreement [Member] \| Revolving Credit Facility [Member] \| LIBOR [Member]
Debt Instrument [Line Items]
Interest margin			1.50%
Interest rate description			LIBOR
First Lien Loan Agreement [Member] \| Revolving Credit Facility [Member] \| Base Rate [Member]
Debt Instrument [Line Items]
Interest margin			0.50%
Interest rate description			Base Rate
First Lien Loan Agreement [Member] \| Standby Letters of Credit [Member] \| Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Line of credit, subfacility for standby letters of credit	$ 35,000,000.0					$ 20,000,000.0
First Lien Loan Agreement [Member] \| Swingline loans [Member] \| Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Subfacility loans percentage up to aggregate revolver commitments	10.00%
Debt Instrument, Redemption, Period One [Member] \| Second Lien Term Loan [Member]
Debt Instrument [Line Items]
Percent of principal redeemed	103.00%
Debt Instrument, Redemption, Period Two [Member] \| Second Lien Term Loan [Member]
Debt Instrument [Line Items]
Percent of principal redeemed	102.00%
Debt Instrument, Redemption, Period Three [Member] \| Second Lien Term Loan [Member]
Debt Instrument [Line Items]
Percent of principal redeemed	100.00%
Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Debt financing costs	$ 300,000
Proceeds from debt, net	24,100,000
Long-term Debt	25,000,000.0
Unamortized discount, interest rate portion	$ 900,000
Common stock, par value (usd per share) \| $ / shares	$ 0.0001
Debt conversion price \| $ / shares	$ 7.10
Number of convertible shares of common stock \| instrument	3,521,126
Percent of conversion price threshold	125.00%
Trading days threshold \| d	20
Consecutive trading days period	30 days
Interest rate	8.00%
Interest rate that may be paid-in-kind	4.00%
Percent of principal of Convertible Notes redeemed for required premium payment	15.00%
Percent of principal amount of Convertible Notes redeemed	115.00%
Treasury Rate [Member] \| Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Basis spread on discount rate	0.50%

Convertible Notes Derivative Liability (Details) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2014 USD ($) $ / shares
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Closing share price	$ 12.48
Conversion price	$ 7.10
Risk free rate	1.86%
Expected volatility	40.00%
Dividend yield	0.00%
Expected life	5 years 6 months
Change in valuation of embedded derivative liability due to dollar change in stock price \| $	$ 3.1
Change in valuation of embedded derivative liability due to percentage change in interest rates \| $	$ 0.7
Embedded Derivative Liability [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Change in stock price (usd per share)	$ 1
Change in interest rates (as a percentage)	1.00%

Fair Value Measurements - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2014	Feb. 15, 2013
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Indemnity escrow receivable	$ 0	$ 3,750	$ 0	$ 3,800
Clinical Trial Services [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Indemnity escrow receivable				$ 3,800
Trade Names [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Impairment of intangibles	10,000	6,400
Minimum [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Threshold period, past due for payment of services provided (in days)			15 days
Maximum [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Threshold period, past due for payment of services provided (in days)			60 days
Physician staffing [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Impairment of intangibles		$ 6,200
Physician staffing [Member] \| Trade Names [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Impairment of intangibles	$ 10,000

Estimated Fair values Assets and Liabilities Measured on Recurring Basis (Detail) - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013
Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Escrow receivable	$ 0	$ 3,750
Deferred Compensation [Member] \| Fair Value, Inputs, Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Deferred compensation	1,510	1,638
Convertible Notes, Net [Member] \| Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Convertible Notes derivative liability	$ 23,436	$ 0

Fair Value Measurements Schedule of reconciliation of opening and closing balances for fair value measurements categorized within Level 3 (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012	Jun. 30, 2014
Convertible Notes Derivative Liability
Embedded derivative				$ 6,800
Change in fair value of convertible note derivatives liability	$ (16,671)	$ 0	$ 0
Escrow Receivable [Member]
Escrow Receivable
Beginning balance	3,750	0
Additions	0		3,750
Settlements	(3,750)
Valuation loss for the period	0
Ending balance	0	3,750	0
Derivative Financial Instruments, Liabilities [Member]
Convertible Notes Derivative Liability
Beginning balance	0	0
Additions	6,765		0
Settlements	0
Valuation loss for the period	16,671
Ending balance	$ 23,436	$ 0	$ 0

Estimated Fair Value of Goodwill Measured On Nonrecurring Basis (Detail) - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013
Fair Value, Measurements, Nonrecurring [Member] \| Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Indefinite-lived intangible assets (excluding goodwill), fair value disclosure	$ 17,699	$ 28,836

Fair Value Measurements Financial Instruments that were not Measured at Fair Value (Details) - Fair Value, Inputs, Level 2 [Member] - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013
Second Lien Term Loan [Member] \| Reported Value Measurement [Member]
Fair Value, Option, Quantitative Disclosures [Line Items]
Long-term Debt	$ 28,989	$ 0
Second Lien Term Loan [Member] \| Estimate of Fair Value Measurement [Member]
Fair Value, Option, Quantitative Disclosures [Line Items]
Fair value	29,900	0
Convertible Notes, Net [Member] \| Reported Value Measurement [Member]
Fair Value, Option, Quantitative Disclosures [Line Items]
Long-term Debt	17,948	0
Convertible Notes, Net [Member] \| Estimate of Fair Value Measurement [Member]
Fair Value, Option, Quantitative Disclosures [Line Items]
Fair value	19,200	0
First Lien Term Loan [Member] \| Reported Value Measurement [Member]
Fair Value, Option, Quantitative Disclosures [Line Items]
Long-term Debt	3,500	8,400
First Lien Term Loan [Member] \| Estimate of Fair Value Measurement [Member]
Fair Value, Option, Quantitative Disclosures [Line Items]
Fair value	$ 3,500	$ 8,400

Employee Benefit Plans - Narrative (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Compensation and Retirement Disclosure [Abstract]
Company contribution net of forfeitures	$ 600	$ 600	$ 600
Deferred compensation liabilities	$ 1,510	$ 1,638

Future Minimum Lease Payments (Detail) $ in Thousands	Dec. 31, 2014 USD ($)
Commitments and Contingencies Disclosure [Abstract]
2015	$ 7,202
2016	5,581
2017	3,884
2018	1,613
2019	486
Thereafter	2,146
Operating Leases, Future Minimum Payments Due, Total	$ 20,912

Commitment and Contingencies - Narrative (Detail) - USD ($) $ in Millions	3 Months Ended	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Loss Contingencies [Line Items]
Operating lease expense		$ 7.7	$ 5.5	$ 5.8
Pretax liability related to the non-income tax matters		0.2	0.8	1.0	$ 0.5
Taxes paid to settle with certain states		$ 0.1	0.3
Settlement			0.8
Payments for legal settlement	$ 0.8
Tax Years 2008 to 2010 [Member]
Loss Contingencies [Line Items]
Pretax liability related to the non-income tax matters					$ 0.4
Tax Years 2005 to 2011 [Member]
Loss Contingencies [Line Items]
Pretax liability related to the non-income tax matters				$ 0.3
Tax Years 2007 to 2012 [Member]
Loss Contingencies [Line Items]
Pretax liability related to the non-income tax matters			$ 0.4

Components of Income (Loss) Before Income Taxes (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Income Tax Disclosure [Abstract]
United States	$ (33,574)	$ (11,216)	$ (28,599)
Foreign	2,256	1,177	1,704
Loss from continuing operations before income taxes	$ (31,318)	$ (10,039)	$ (26,895)

Components of Income Tax Expense (Benefit) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Current
Federal	$ 0	$ 0	$ 412
State	811	540	812
Foreign	262	416	1,561
Current Income Tax Expense (Benefit), Total	1,073	956	2,785
Deferred
Federal	(1,320)	37,822	(4,048)
State	68	5,134	(5,251)
Foreign	395	299	364
Total	(857)	43,255	(8,935)
Total income tax expense (benefit) for continuing operations	216	44,211	(6,150)
Continuing operations	216	44,211	(6,150)
Discontinued operations	0	2,122	(9,497)
Income tax expense (benefit), continuing operations, discontinued operations, total	$ 216	$ 46,333	$ (15,647)

Significant Components of Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2014	Dec. 31, 2013
Current deferred tax assets (liabilities):
Accrued other and prepaid expenses	$ 2,823	$ 2,592
Accrued settlement charge	0	283
Allowance for doubtful accounts	589	650
Other	822	468
Gross deferred tax assets	4,234	3,993
Valuation allowance	(6,215)	(4,528)
Deferred tax assets (liabilities), net, current	(1,981)	(535)
Non-current deferred tax (liabilities) and assets:
Amortization	(5,967)	(1,314)
Depreciation	105	(384)
Identifiable intangibles	0	(2,237)
Net operating loss carryforwards	38,144	32,531
Derivative interest	6,370	0
Accrued professional liability	(92)	(118)
Accrued workers’ compensation	1,356	675
Tax on unrepatriated earnings	(336)	(453)
Share-based compensation	959	1,610
Other	(1,176)	314
Gross deferred tax assets	39,363	30,624
Valuation allowance	(57,401)	(47,473)
Deferred tax asset (liabilities), net, noncurrent	(18,038)	(16,849)
Deferred tax assets (liabilities), net	$ (20,019)	$ (17,384)

Income Taxes - Narrative (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended			12 Months Ended
	Mar. 31, 2014	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Income Tax Contingency [Line Items]
Deferred tax liabilities relating to indefinite lived intangible assets		$ 2,237		$ 0	$ 2,237
Valuation allowance		52,000		63,600	52,000
Federal, state and foreign net operating loss carryforwards		78,100		97,500	78,100
Change in valuation allowance		(48,400)
Deferred liabilities on undistributed foreign earnings		453		336	453
Undistributed foreign earnings			$ 9,500			$ 9,500
Unrecognized tax benefits		4,986	5,204	3,777	4,986	5,204
Unrecognized tax benefits, which would affect the effective tax rate		4,400		3,300	4,400
Gross increases in current year unrecognized tax				800
Gross decreases in current year unrecognized tax related to prior year uncertain positions and the closure of tax years				2,000
Recognized interest and penalties				(200)	100	100
Unrecognized tax benefit accrued interest and penalties		1,000		800	1,000
United States Tax Authority [Member]
Income Tax Contingency [Line Items]
Deferred liabilities on undistributed foreign earnings			1,400			1,400
India [Member]
Income Tax Contingency [Line Items]
Deferred liabilities on undistributed foreign earnings			600	200		$ 600
Repatriated amount of foreign earnings			$ 3,300	600
Indefinite-lived Intangible Assets [Member]
Income Tax Contingency [Line Items]
Deferred tax liabilities relating to indefinite lived intangible assets		17,400		$ 19,700	17,400
Prior Period Adjustment [Member]
Income Tax Contingency [Line Items]
Change in valuation allowance	$ 1,700
Out-or-period adjustment, decrease in net loss per diluted share (usd per share)	$ 0.06			$ 0.06
Other Current Liabilities [Member]
Income Tax Contingency [Line Items]
Unrecognized tax benefits		$ 1,000		$ 600	$ 1,000

Reconciliation of Income Tax Computed At U. S. Federal Statutory Rate to Income Tax (Benefit) Expense (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Income Tax Disclosure [Abstract]
Tax at U.S. statutory rate	$ (10,961)	$ (3,514)	$ (9,413)
State taxes, net of federal benefit	219	(190)	(1,226)
Non-deductible meals and entertainment	1,425	450	962
Foreign tax expense	44	554	(222)
Valuation allowances	12,038	48,556	(44)
Uncertain tax positions	(996)	(257)	648
Deferred tax rate differential	0	0	150
Deferred tax write-offs	0	221	0
Audit settlements	0	160	0
Tax on unrepatriated earnings	0	(1,465)	2,005
Tax on repatriated earnings	0	0	519
Tax true ups and other	(1,553)	(304)	471
Total income tax expense (benefit) for continuing operations	$ 216	$ 44,211	$ (6,150)

Reconciliation of Beginning and Ending Balance of Unrecognized Tax Benefits (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013
Income Tax Disclosure [Abstract]
Balance at January 1	$ 4,986	$ 5,204
Additions based on tax positions related to the current year	709	496
Additions based on tax positions related to prior years	91	681
Reductions based on settlements of tax positions related to the prior year	(344)	(292)
Reductions for tax positions as a result of a lapse of the applicable statute of limitations	(1,578)	(1,076)
Other	(87)	(27)
Balance at December 31	$ 3,777	$ 4,986

Stockholders' Equity- Narrative (Detail) - USD ($)	12 Months Ended
Stockholders' Equity- Narrative (Detail) - USD ($)	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012	Jan. 09, 2013	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
Shares repurchased, average price per share (usd per share)			$ 5.22
Stock repurchase and retirement			$ (374,000)
Common stock left remaining to repurchase under the plan (in shares)	942,443
Aggregate stock repurchase amount				$ 5,000,000
Pretax total unrecognized compensation cost related to share options- period	2 years 1 month
Pretax total unrecognized compensation cost related to share options	$ 300,000
Share options outstanding at end of year	935,095	1,546,299
Shares options outstanding vested or expected to vest	864,671
Shares options outstanding vested or expected to vest -weighted average exercise price	$ 8.52
Shares options outstanding vested or expected to vest ,intrinsic value	$ 4,000,000
Shares options outstanding vested or expected to vest -weighted average contractual life	2 years 9 months 10 days
Registration of common stock held by three existing shareholders						11,403,455
Public offering shares			8,172,868
Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Pretax of total unrecognized compensation cost related to non-vested restricted stock awards	$ 2,400,000
Pretax total unrecognized compensation cost related to share options- period	2 years 2 months 19 days
Fair value of shares vested	$ 2,300,000	$ 2,400,000	$ 900,000
Performance Shares [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Pretax of total unrecognized compensation cost related to non-vested restricted stock awards	$ 300,000
Pretax total unrecognized compensation cost related to share options- period	2 years
2014 Omnibus Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate number of common stock shares authorized for issuance	4,100,000
2014 Omnibus 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%
2014 Omnibus Incentive Plan [Member] \| Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock expiration period	10 years
2014 Omnibus 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%
2014 Omnibus 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] \| Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock vesting percentage per year	25.00%
2007 Stock Incentive Plan [Member] \| Restricted Stock [Member] \| Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock vesting period	3 years
2007 Stock Incentive Plan [Member] \| Restricted Stock [Member] \| Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
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 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

Summary of Restricted Stock Award Activity and Performance Stock Awards (Detail)	12 Months Ended
	Dec. 31, 2014 $ / shares shares
Restricted Stock [Member]
Number of Shares
Unvested restricted stock awards, beginning balance \| shares	552,231
Granted (in shares) \| shares	377,308
Vested (in shares) \| shares	(181,354)
Forfeited (in shares) \| shares	(88,535)
Unvested restricted stock awards, ending balance \| shares	659,650
Weighted average grant date fair value
Unvested restricted stock awards, beginning balance \| $ / shares	$ 5.37
Granted (usd per share) \| $ / shares	6.18
Vested (usd per share) \| $ / shares	5.77
Forfeited (usd per share) \| $ / shares	5.39
Unvested restricted stock awards, ending balance \| $ / shares	$ 5.72
Performance Shares [Member]
Number of Shares
Unvested restricted stock awards, beginning balance \| shares	0
Granted (in shares) \| shares	239,585
Vested (in shares) \| shares	0
Forfeited (in shares) \| shares	(21,410)
Unvested restricted stock awards, ending balance \| shares	218,175
Weighted average grant date fair value
Unvested restricted stock awards, beginning balance \| $ / shares	$ 0.00
Granted (usd per share) \| $ / shares	5.81
Vested (usd per share) \| $ / shares	0.00
Forfeited (usd per share) \| $ / shares	5.77
Unvested restricted stock awards, ending balance \| $ / shares	$ 5.82

Stock Options and Stock Appreciation Rights Granted and Exercised (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Equity [Abstract]
Share option grants	0	324,000	344,500
Weighted average grant date fair value of options granted during the period	$ 0.00	$ 1.77	$ 1.65
Total intrinsic value of options exercised	$ 695,286	$ 12,465	$ 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
Equity [Abstract]
Expected dividend yield (as a percentage)	0.00%	0.00%
Expected volatility (as a percentage)	48.00%	47.00%
Risk-free interest rate (as a percentage)	0.79%	0.58%
Expected life (in years)	4 years 2 months	4 years 3 months 18 days

Summary of Company's Share Option Plans Activities (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding [Roll Forward]
Share options outstanding at beginning of year	1,546,299
Granted (in shares)	0	324,000	344,500
Exercised (in shares)	(228,500)
Forfeited/expired (in shares)	(382,704)
Share options outstanding at end of year	935,095	1,546,299
Share options exercisable at end of year	655,468
Share options unvested at end of year	279,627
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)	$ 8.93
Granted, weighted average exercise price (usd per share)	0.00
Exercised, weighted average exercise price (usd per share)	7.47
Forfeited/expired, weighted average exercise price (usd per share)	11.41
Share options outstanding at end of year, weighted average exercise price (usd per share)	8.27	$ 8.93
Share options exercisable at end of year, weighted average exercise price (usd per share)	9.58
Share options unvested at end of year, weighted average exercise price (usd per share)	$ 5.21
Share options outstanding at end of year, weighted-average remaining contractual life (in years)	2 years 11 months 8 days
Share options exercisable at end of year, weighted-average remaining contractual life (in years)	2 years 27 days
Share options unvested at end of year, weighted-average remaining contractual life (in years)	4 years 11 months 17 days
Share options outstanding at end of year	$ 4,464,160
Share options exercisable at end of year	2,430,566
Share options unvested at end of year	$ 2,033,594
Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract]
Exercised, weighted average exercise price (usd per share)	$ 4.35
Forfeited/expired, weighted average exercise price (usd per share)	4.35
Share options outstanding at end of year, weighted average exercise price (usd per share)	4.16
Share options exercisable at end of year, weighted average exercise price (usd per share)	4.16
Share options unvested at end of year, weighted average exercise price (usd per share)	4.16
Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract]
Exercised, weighted average exercise price (usd per share)	8.56
Forfeited/expired, weighted average exercise price (usd per share)	22.50
Share options outstanding at end of year, weighted average exercise price (usd per share)	22.50
Share options exercisable at end of year, weighted average exercise price (usd per share)	22.50
Share options unvested at end of year, weighted average exercise price (usd per share)	$ 7.44

Earnings Per Share - Narrative (Detail) - shares	12 Months Ended
Earnings Per Share - Narrative (Detail) - shares	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Common stock shares that have been excluded from the per share calculation	559,064	1,547,814	2,033,632
Dilutive shares excluded due to net loss	334,828	149,453
Convertible Debt Securities [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Common stock shares that have been excluded from the per share calculation	3,521,126

Components of Numerator and Denominator for Computation of Basic and Diluted Earnings per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Earnings Per Share [Abstract]
Loss from continuing operations including portion attributable to noncontrolling interest	$ (20,087)	$ (7,484)	$ (3,181)	$ (782)	$ (52,922)	$ 1,453	$ (1,435)	$ (1,346)	$ (31,534)	$ (54,250)	$ (20,745)
Less: Income attributable to noncontrolling interest in subsidiary									249	0	0
Loss from continuing operations attributable to common shareholders									(31,783)	(54,250)	(20,745)
Income (loss) from discontinued operations, net of income taxes	0	0	0	0	338	(539)	(22)	2,504	0	2,281	(21,476)
Net loss attributable to common shareholders	$ (20,218)	$ (7,602)	$ (3,181)	$ (782)	$ (52,584)	$ 914	$ (1,457)	$ 1,158	$ (31,783)	$ (51,969)	$ (42,221)
Basic (loss) income per share attributable to common shareholders
Continuing operations (usd per share)	$ (0.65)	$ (0.24)	$ (0.10)	$ (0.03)	$ (1.70)	$ 0.05	$ (0.05)	$ (0.04)	$ (1.02)	$ (1.75)	$ (0.67)
Discontinued operations (usd per share)	0.00	0.00	0.00	0.00	0.01	(0.02)	0.00	0.08	0.00	0.07	(0.70)
Net (loss) income (usd per share)	(0.65)	(0.24)	(0.10)	(0.03)	(1.69)	0.03	(0.05)	0.04	(1.02)	(1.68)	(1.37)
Diluted (loss) income per share attributable to common shareholders
Continuing operations (usd per share)	(0.65)	(0.24)	(0.10)	(0.03)	(1.70)	0.05	(0.05)	(0.04)	(1.02)	(1.75)	(0.67)
Discontinued operations (usd per share)	0.00	0.00	0.00	0.00	0.01	(0.02)	0.00	0.08	0.00	0.07	(0.70)
Net (loss) income (usd per share)	$ (0.65)	$ (0.24)	$ (0.10)	$ (0.03)	$ (1.69)	$ 0.03	$ (0.05)	$ 0.04	$ (1.02)	$ (1.68)	$ (1.37)
Weighted-average number of shares outstanding-basic (shares)									31,190	31,009	30,843
Plus dilutive equity awards										0
Weighted-average number of shares outstanding-diluted (shares)									31,190	31,009	30,843

Related Party Transactions - Narrative (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Related Party Transaction [Line Items]
Revenue from related parties	$ 17.8	$ 3.9	$ 3.8
Account receivable due from related parties	2.0	$ 0.8
InteliStaf [Member]
Related Party Transaction [Line Items]
Revenue from related parties	$ 4.7
Percent ownership in joint venture	68.00%
Receivable balance with joint venture	$ 0.9
Payable balance with joint venture	$ 0.1

- Definition

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

+ References + Details

Information on Operating Segments and Reconciliation to Income From Operations (Detail) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2014 USD ($)	Sep. 30, 2014 USD ($)	Jun. 30, 2014 USD ($)	Mar. 31, 2014 USD ($)	Dec. 31, 2013 USD ($)	Sep. 30, 2013 USD ($)	Jun. 30, 2013 USD ($)	Mar. 31, 2013 USD ($)	Dec. 31, 2014 USD ($) segment	Dec. 31, 2013 USD ($)	Dec. 31, 2012 USD ($)
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Number of Operating Segments \| segment									3
Revenue from unaffiliated customers	$ 188,134	$ 188,944	$ 122,656	$ 118,091	$ 109,179	$ 108,048	$ 110,768	$ 110,316	$ 617,825	$ 438,311	$ 442,635
Contribution income									43,540	28,109	23,083
Unallocated corporate overhead									27,770	21,844	21,701
Depreciation									3,866	3,886	4,905
Amortization									3,575	2,294	2,263
Acquisition and integration costs	2,500	$ 2,400	$ 2,700	$ 300					7,957	473	0
Restructuring costs									840	484	0
Legal settlement charge									0	750	0
Impairment charges									10,000	6,400	18,732
(Loss) income from continuing operations									(10,468)	(8,022)	(24,518)
Nurse and allied staffing [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Revenue from unaffiliated customers									457,034	271,563	272,136
Contribution income									36,326	18,424	10,277
Impairment of intangibles					200
Physician staffing [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Revenue from unaffiliated customers									123,306	128,781	129,162
Contribution income									6,700	8,939	10,863
Impairment of intangibles					6,200
Other human capital management services [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Revenue from unaffiliated customers									37,485	37,967	41,337
Contribution income									514	746	1,943
Segment, Continuing Operations [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Depreciation									3,866	3,886	4,905
Amortization									3,575	2,294	2,263
Impairment charges									$ 10,000	$ 6,400	$ 18,732
Trade Names [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Impairment of intangibles	10,000				$ 6,400
Trade Names [Member] \| Physician staffing [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Impairment of intangibles	$ 10,000

Quarterly Financial Data (Unaudited) (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Quarterly Financial Information Disclosure [Abstract]
Revenue from services	$ 188,134	$ 188,944	$ 122,656	$ 118,091	$ 109,179	$ 108,048	$ 110,768	$ 110,316	$ 617,825	$ 438,311	$ 442,635
Gross profit	47,641	47,277	32,436	30,450	28,562	28,184	27,838	28,876
Loss from continuing operations	(20,087)	(7,484)	(3,181)	(782)	(52,922)	1,453	(1,435)	(1,346)	(31,534)	(54,250)	(20,745)
Income (loss) from discontinued operations, net of tax	0	0	0	0	338	(539)	(22)	2,504	0	2,281	(21,476)
Consolidated net loss	(20,087)	(7,484)	(3,181)	(782)	(52,584)	914	(1,457)	1,158	(31,534)	(51,969)	(42,221)
Less: Net income attributable to noncontrolling interest in subsidiary	131	118	0	0	0	0	0	0	249	0	0
Net loss attributable to common shareholders	$ (20,218)	$ (7,602)	$ (3,181)	$ (782)	$ (52,584)	$ 914	$ (1,457)	$ 1,158	$ (31,783)	$ (51,969)	$ (42,221)
Basic (loss) income per share attributable to common shareholders
Continuing operations (usd per share)	$ (0.65)	$ (0.24)	$ (0.10)	$ (0.03)	$ (1.70)	$ 0.05	$ (0.05)	$ (0.04)	$ (1.02)	$ (1.75)	$ (0.67)
Discontinuing operations (usd per share)	0.00	0.00	0.00	0.00	0.01	(0.02)	0.00	0.08	0.00	0.07	(0.70)
Net (loss) income (usd per share)	(0.65)	(0.24)	(0.10)	(0.03)	(1.69)	0.03	(0.05)	0.04	(1.02)	(1.68)	(1.37)
Diluted (loss) income per share attributable to common shareholders
Continuing operations (usd per share)	(0.65)	(0.24)	(0.10)	(0.03)	(1.70)	0.05	(0.05)	(0.04)	(1.02)	(1.75)	(0.67)
Discontinuing operations (usd per share)	0.00	0.00	0.00	0.00	0.01	(0.02)	0.00	0.08	0.00	0.07	(0.70)
Net (loss) income (usd per share)	$ (0.65)	$ (0.24)	$ (0.10)	$ (0.03)	$ (1.69)	$ 0.03	$ (0.05)	$ 0.04	$ (1.02)	$ (1.68)	$ (1.37)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Acquisition and integration costs	$ 2,500	$ 2,400	$ 2,700	$ 300					$ 7,957	$ 473	$ 0
Net increase (decrease) in favor value of embedded derivative	9,400	$ 7,300
Change in valuation allowance					$ 48,400
Clinical Trial Services [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain on sale of discontinued operations										3,969	$ 0
Gain on sale of discontinued operations, net of tax										$ 2,100
Trade Names [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Impairment of intangibles	$ 10,000				$ 6,400

Schedule II - Valuation and Qualifying Accounts(Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Allowance for Doubtful Accounts [Member]
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	$ 1,651	$ 1,841	$ 2,180
Charged to Costs and Expenses	1,016	1,078	786
Write-offs	(1,257)	(1,324)	(913)
Recoveries	15	56	16
Other Changes	0	0	(228)
Balance at End of Period	1,425	1,651	1,841
Valuation Allowance of Deferred Tax Assets [Member]
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	52,001	4,033	3,678
Charged to Costs and Expenses	12,038	48,406	355
Write-offs	0	(438)	0
Recoveries	0	0	0
Other Changes	(423)	0	0
Balance at End of Period	$ 63,616	$ 52,001	$ 4,033