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Document and Entity Information - USD ($)	12 Months Ended
Document and Entity Information - USD ($)	Dec. 31, 2016	Feb. 28, 2017	Jun. 30, 2016
Document Documentand Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2016
Document Fiscal Year Focus	2016
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		32,984,000
Entity Public Float			$ 440,736,307

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Current assets:
Cash and cash equivalents	$ 20,630	$ 2,453
Accounts receivable, net of allowances of $3,245 in 2016 and $4,045 in 2015	173,620	146,873
Prepaid expenses	6,126	4,521
Insurance recovery receivable	3,037	2,866
Other current assets	2,198	2,032
Total current assets	205,611	158,745
Property and equipment	12,818	10,470
Trade names, indefinite-lived	35,402	36,101
Goodwill	79,648	95,096
Other intangible assets subject to amortization, net of accumulated amortization of $43,333 in 2016 and $38,419 in 2015	36,835	46,813
Debt issuance costs, net	929	376
Other non-current assets	17,135	17,994
Total assets	388,378	365,595
Current liabilities:
Accounts payable and accrued expenses	58,837	41,098
Accrued compensation and benefits	33,243	29,402
Current portion of long-term debt and capital lease obligations	2,263	8,071
Deferred purchase price	0	2,184
Other current liabilities	2,749	5,291
Total current liabilities	97,092	86,046
Long-term debt and capital lease obligations, less current portion	84,760	81,301
Non-current deferred tax liabilities	13,154	18,475
Long-term accrued claims	28,870	30,070
Contingent consideration	5,301	3,533
Other long-term liabilities	7,399	4,826
Total liabilities	236,576	224,251
Commitments and contingencies
Stockholders' equity:
Common stock—$0.0001 par value; 100,000,000 shares authorized; 32,339,285 and 31,951,960 shares issued and outstanding at December 31, 2016 and 2015, respectively	3	3
Additional paid-in capital	256,570	254,108
Accumulated other comprehensive loss	(1,241)	(1,207)
Accumulated deficit	(104,089)	(112,056)
Total Cross Country Healthcare, Inc. stockholders' equity	151,243	140,848
Noncontrolling interest	559	496
Total stockholders' equity	151,802	141,344
Total liabilities and stockholders' equity	$ 388,378	$ 365,595

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Accounts receivable, allowance for doubtful accounts	$ 3,245	$ 4,045
Other identifiable intangible assets, accumulated amortization	$ 43,333	$ 38,419
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	32,339,285	31,951,960
Common stock, shares outstanding	32,339,285	31,951,960
Other Intangible Assets
Other identifiable intangible assets, accumulated amortization	$ 43,333	$ 38,419

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Statement [Abstract]
Revenue from services	$ 833,537	$ 767,421	$ 617,825
Operating expenses:
Direct operating expenses	611,802	570,056	460,021
Selling, general, and administrative expenses	179,820	161,275	141,018
Bad debt expense	593	999	1,016
Depreciation	4,168	3,856	3,866
Amortization	5,014	4,210	3,575
Loss on sale of business	0	2,184	0
Acquisition-related contingent consideration	814	0	0
Acquisition and integration costs	78	902	7,957
Restructuring costs	753	1,274	840
Impairment charges	24,311	2,100	10,000
Total operating expenses	827,353	746,856	628,293
Income (loss) from operations	6,184	20,565	(10,468)
Other expenses (income):
Interest expense	6,106	6,810	4,160
(Gain) loss on derivative liability	(5,805)	9,901	16,671
Loss on early extinguishment of debt	1,568	0	0
Other (income) expense, net	(230)	(306)	19
Income (loss) before income taxes	4,545	4,160	(31,318)
Income tax (benefit) expense	(4,186)	(794)	216
Consolidated net income (loss)	8,731	4,954	(31,534)
Less: Net income attributable to noncontrolling interest in subsidiary	764	536	249
Net income (loss) attributable to common shareholders	$ 7,967	$ 4,418	$ (31,783)
Net income (loss) per share attributable to common shareholders - Basic (usd per share)	$ 0.25	$ 0.14	$ (1.02)
Net income (loss) per share attributable to common shareholders - Diluted (usd per share)	$ 0.15	$ 0.14	$ (1.02)
Weighted average common shares outstanding—basic (shares)	32,132	31,514	31,190
Weighted average common shares outstanding—diluted (shares)	36,246	32,162	31,190

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Statement of Comprehensive Income [Abstract]
Net income	$ 8,731	$ 4,954	$ (31,534)
Other comprehensive (loss) income, before income taxes:
Unrealized foreign currency translation (loss) gain	(34)	(89)	14
Other comprehensive (loss) income, before income taxes	(34)	(89)	14
Income tax expense related to items of other comprehensive (loss) income	0	0	162
Other comprehensive loss, net of taxes	(34)	(89)	(148)
Comprehensive income (loss)	8,697	4,865	(31,682)
Less: Net income attributable to noncontrolling interest in subsidiary	764	536	249
Comprehensive income (loss)	$ 7,933	$ 4,329	$ (31,931)

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-In Capital	Accumulated Other Total Comprehensive Loss, net	(Accumulated Deficit) Retained Earnings	Noncontrolling Interest in Subsidiary
Beginning Balance (in shares) at Dec. 31, 2013		31,085,000
Beginning 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)		66,000
Vesting of restricted stock and performance stock awards (in shares)		141,000
Vesting of restricted stock and performance stock awards	(245)		(245)
Equity compensation	1,387		1,387
Foreign currency translation adjustment, net of deferred taxes	(148)			(148)
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
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options (in shares)		119,000
Vesting of restricted stock and performance stock awards (in shares)		191,000
Vesting of restricted stock and performance stock awards	(543)		(543)
Equity compensation	2,460		2,460
Foreign currency translation adjustment, net of deferred taxes	(89)			(89)
Acquisition of Mediscan (in shares)		350,000
Acquisition of Mediscan	4,724		4,724
Distribution to noncontrolling shareholder	(494)					(494)
Net (loss) income	4,954				4,418	536
Ending Balance (in shares) at Dec. 31, 2015		31,952,000
Ending Balance at Dec. 31, 2015	$ 141,344	$ 3	254,108	(1,207)	(112,056)	496
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options (in shares)	195,312	103,000
Vesting of restricted stock and performance stock awards (in shares)		284,000
Vesting of restricted stock and performance stock awards	$ (917)		(917)
Equity compensation	3,379		3,379
Foreign currency translation adjustment, net of deferred taxes	(34)			(34)
Distribution to noncontrolling shareholder	(701)					(701)
Net (loss) income	8,731				7,967	764
Ending Balance (in shares) at Dec. 31, 2016		32,339,000
Ending Balance at Dec. 31, 2016	$ 151,802	$ 3	$ 256,570	$ (1,241)	$ (104,089)	$ 559

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Cash flows from operating activities
Consolidated net income (loss)	$ 8,731	$ 4,954	$ (31,534)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Depreciation and amortization	9,182	8,066	7,441
Amortization of debt discount and debt issuance costs	1,728	1,886	1,064
Provision for allowances	4,034	1,779	1,016
Deferred income tax benefit	(5,322)	(1,544)	(857)
(Gain) loss on derivative liability	(5,805)	9,901	16,671
Acquisition-related contingent consideration	769	0	0
Impairment charges	24,311	2,100	10,000
Loss on early extinguishment of debt	1,568	0	0
Equity compensation	3,379	2,460	1,387
Other noncash costs, including loss on sale of business	6	2,204	114
Changes in operating assets and liabilities:
Accounts receivable	(30,781)	(28,708)	(16,119)
Prepaid expenses and other assets	(1,882)	2,663	1,371
Income taxes	(497)	375	58
Accounts payable and accrued expenses	20,370	11,213	5,654
Other liabilities	354	886	(338)
Net cash provided by (used in) operating activities	30,145	18,235	(4,072)
Cash flows from investing activities
Proceeds from sale of business	500	7,500	3,750
Acquisitions, net of cash acquired	(1,900)	(28,721)	(44,631)
Acquisition-related settlements - Medical Staffing Network	(2,155)	(149)	0
Acquisition-related settlements - Mediscan	297	0	0
Transaction costs related to sale of business	0	(338)	0
Purchases of property and equipment	(6,522)	(2,362)	(4,571)
Net cash used in investing activities	(9,780)	(24,070)	(45,452)
Cash flows from financing activities
Proceeds from borrowing on Senior Credit Facility	40,000	0	0
Debt issuance costs	(1,182)	0	(1,093)
Principal payment on Senior Credit Facility	(500)	0	0
Principal payments on Second Lien Term Loan	(30,000)	0	0
Extinguishment fees	(641)	0	0
Borrowings under Senior Secured Asset-Based revolving credit facility	59,800	64,100	61,205
Repayments on Senior Secured Asset-Based revolving credit facility	(67,800)	(59,600)	(66,105)
Proceeds from borrowing on Second Lien Term Loan	0	0	28,875
Proceeds from borrowing on Convertible Note	0	0	24,063
Repayments of capital lease obligations	(71)	(108)	(122)
Cash paid for shares withheld for taxes	(917)	(543)	(245)
Payment of contingent consideration	(152)	0	0
Cash payments to noncontrolling shareholder	(701)	(494)	(119)
Net cash (used in) provided by financing activities	(2,164)	3,355	46,459
Effect of exchange rate changes on cash	(24)	(62)	5
Change in cash and cash equivalents	18,177	(2,542)	(3,060)
Cash and cash equivalents at beginning of year	2,453	4,995	8,055
Cash and cash equivalents at end of year	20,630	2,453	4,995
Supplemental disclosure of cash flow information:
Interest paid	3,893	5,052	2,512
Income taxes paid	$ 1,773	$ 1,035	$ 1,374

Organization and Basis of Presentation	12 Months Ended
Organization and Basis of Presentation	Dec. 31, 2016
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Basis of Presentation	Organization and Basis of Presentation Cross Country Healthcare, Inc. (the Company) was incorporated in Delaware on July 29, 1999 as a business providing travel nurse and allied health staffing services. As of December 31, 2016, the Company is a leading national provider of nurse and allied staffing, recruiting, and value-added workforce solution services, multi-specialty locum tenens (temporary physician staffing) services, as well as a provider of other human capital management services focused on healthcare. The consolidated financial statements include the accounts of the Company and its direct and indirect wholly-owned 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. All intercompany transactions and balances have been eliminated in consolidation. Certain prior year amounts have been reclassified to conform to the current year presentation. See consolidated balance sheets, Note 13 - Income Taxes and Note 17 - Segment Data.

Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2016

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

Use of Estimates

The preparation of consolidated financial statements in conformity with U.S. generally accepted accounting principles (U.S. GAAP), requires management to make estimates and assumptions that affect the reported amounts in the consolidated financial statements and accompanying notes. Significant estimates and assumptions are used for, but not limited to: (1) the valuation of accounts receivable; (2) goodwill, trade names, and other intangible assets; (3) other long-lived assets; (4) share-based compensation; (5) accruals for health, workers’ compensation and professional liability claims; (6) valuation of deferred tax assets; (7) purchase price allocation; (8) derivative liability; (9) legal contingencies; (10) contingent considerations; (11) income taxes; and (12) 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 significantly 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 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. In addition, the Company maintains a sales allowance for customer disputes which may arise in the ordinary course, which is recorded as contra-revenue. 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, 2016 and 2015, or revenue for the years ended December 31, 2016, 2015 and 2014.

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

The Company applies accounting in accordance with the Business Combinations Topic of the FASB ASC when it acquires control over a business. Business combinations are accounted for at fair value. The associated acquisition costs are expensed as incurred and recorded as acquisition and integration costs; noncontrolling interests, if any, are reflected at fair value at the acquisition date; restructuring costs associated with a business combination are expensed; contingent consideration is measured at fair value at the acquisition date, with changes in the fair value after the acquisition date affecting earnings; and goodwill is determined as the excess of the fair value of the consideration conveyed in the acquisition over the fair value of the net assets acquired. The accounting for business combinations requires estimates and judgments as to expectations for future cash flows of the acquired business, and the allocation of those cash flows to identifiable intangible assets, in determining the estimated fair value for assets and liabilities acquired. The fair values assigned to tangible and intangible assets acquired and liabilities assumed are based on management's estimates and assumptions, including valuations that utilize customary valuation procedures and techniques. If the actual results differ from the estimates and judgments used in these estimates, the amounts recorded in the financial statements could result in a possible impairment of the intangible assets and goodwill, or require acceleration of the amortization expense of finite-lived intangible assets. The results of the acquired businesses' operations are included in the consolidated statements of operations of the combined entity beginning on the date of acquisition. See Note 3 - Acquisitions.

Goodwill, Trade Names, and Other 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 1 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 statements 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 annual 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 did 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 was applied prospectively.

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 had four reporting units that it reviewed for impairment: 1) Nurse and Allied Staffing, 2) Physician Staffing, 3) Search, and 4) Education Seminars. The fourth reporting unit, Education Seminars, was divested August 31, 2015. See Note 4 - Disposal and Discontinued Operations.

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. 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 amount of the assets exceeds the fair value of the assets. See Note 5 – Goodwill, Trade Names, and Other Intangible Assets.

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 - 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 are capitalized and presented in the balance sheet as a direct deduction from the carrying amount of the debt liability. See Recently Adopted Accounting Pronouncements section. The deferred costs are amortized using the effective interest method. Deferred costs related to the issuance of the Company’s Revolving Credit Facility and Senior Secured Asset-Based Loan, as defined in Note 8 - 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 in accordance with the Derivatives and Hedging Topic of the FASB ASC 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 statements 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.

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.

Insurance Claims

The Company provides workers’ compensation insurance coverage, professional liability coverage, and healthcare 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 healthcare 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.

The Other Expenses/Insurance Costs Topic of the FASB ASC previously issued authoritative accounting guidance in the area of insurance contracts and related activity thereto. The Other Expenses/Insurance Costs Topic 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, 2016 and 2015 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, 2016 and 2015, the Company had outstanding approximately $20.2 million and $21.5 million, respectively, of 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 the Company and each working professional in its nurse and allied healthcare business with coverage. Until January 1, 2016, the Company had an occurrence-based professional liability policy for its independent contractor physicians and advanced practitioners which was insured by a wholly-owned subsidiary, Jamestown Indemnity, Ltd., a wholly-owned Cayman Island captive company (the Captive), until its voluntary liquidation in the third quarter of 2015. Beginning in March 2015, the Company's Physician subsidiary self-insured $0.5 million for each of its professional liability claims. Under the terms of the Captive’s reinsurance policy there was a requirement to guarantee the payment of claims to its insured party’s primary medical malpractice insurance carrier via a letter of credit. As a result of the Captive's liquidation, the letter of credit was reduced. As of both December 31, 2016 and 2015, the value of the letter of credit was $2.0 million. Effective January 1, 2016, the Company has a claims-made professional liability policy for its physicians and advanced practitioners.

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 advanced 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 reimbursable expenses in revenues, and the associated amounts of reimbursable expenses in cost of services.

Temporary Staffing Revenue

Revenue from services consists primarily of temporary staffing revenue. Revenues from temporary staffing, net of sales adjustments and discounts, are recognized when earned, based on hours worked by the Company’s healthcare professionals. Billings to customers are based on specific contract provisions which may include approval of submitted time by our customers. Accordingly, accounts receivable includes estimated revenue for employees’ and independent contractors’ time worked but not yet invoiced. At December 31, 2016 and 2015, the Company's estimate of amounts that had not been billed totaled $41.2 million and $18.4 million, respectively, and are included in accounts receivable on the consolidated balance sheets.

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.

Physician Staffing

The Physician Staffing business enters into contracts with its healthcare customers to provide temporary staffing services. The Company uses independent contractors for these services. The Company determined that it acts as a principal in this arrangement and, therefore, revenue is reported on a gross basis in the consolidated statements of operations.

Education Seminars

During the third quarter of 2015, the Company completed the sale of its education seminars business, Cross Country Education, LLC (CCE). See Note 4 - Disposal and Discontinued Operations. Prior to the sale of CCE, revenue from the Company’s Education Seminars services was recognized as the independent contractor-led seminars were performed. In the Company’s Education Seminars business, revenue was recorded in the consolidated statements of operations on a gross basis as a principal versus on a net basis as an agent.

Deferred Revenue

Amounts collected in advance of the services being substantially complete, related to our physician and executive search business, are recorded as deferred revenue in other current liabilities on the consolidated balance sheets. At December 31, 2016 and 2015, the Company had $0.9 million and $1.1 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 stock 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 used 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 stock awards by reference to its stock price on the date of grant.

The Company granted performance-based stock 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 vest are determined based on the level of attainment of the targets. If a minimum level of performance is attained for the awards, restricted stock is issued with a vesting date in the future, subject to the employee's continuing employment. 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 used historical data of options with similar characteristics to estimate pre-vesting option forfeitures, as it believed 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 $3.4 million, $2.5 million, and $1.4 million during the years ended December 31, 2016, 2015 and 2014, respectively. Because the Company had a full valuation allowance on its deferred tax assets, the granting and exercise of share-based payments during the years ended December 31, 2016, 2015 and 2014 had no impact on the income tax provision. See Note 14 - Stockholders’ Equity.

Advertising

The Company’s advertising expense consists primarily of online advertising, internet direct marketing, print media, promotional material and, prior to the sale of CCE, direct mail marketing. Advertising costs that were expensed as incurred totaled $10.2 million, $4.9 million, and $4.1 million for the years ended December 31, 2016, 2015 and 2014, respectively. Prior to the sale of CCE, direct mail marketing costs associated with the Company’s education seminars services were capitalized when the Company determined that there was a reasonable expectation that the cost of the incurred advertising would be recovered from the gross profit generated by the advertised event and expensed when the related event took place. There are no such costs included in prepaid expenses on the December 31, 2016 and 2015 consolidated balance sheets.

Restructuring Costs

The Company considers restructuring activities to be programs whereby it fundamentally changes its operations, such as closing and consolidating facilities, reducing headcount and realigning operations in response to changing market conditions. As a result, restructuring costs on the consolidated statements of operations include on-going benefit costs for its employees and exit costs.

Reconciliations of the beginning and ending total restructuring liability balances are presented below:



	Year Ended December 31,
	2016						2015
	(amounts in thousands)
	On-Going Benefit Costs			Exit Costs			On-Going Benefit Costs			Exit Costs
Balance at beginning of period	$	44		$	338		$	—		$	—
Charged to restructuring costs	563			190			633			641
Payments	(282		)	(255		)	(589		)	(303		)
Balance at end of period	$	325		$	273		$	44		$	338

During the year ended December 31, 2014, restructuring costs included in the consolidated statements of operations were primarily related to senior management employee severance pay.

Deferred Rent

Deferred rent consists of free rent, rent escalation, tenant improvement allowances, and other incentives received from landlords related to the operating leases for our facilities. Rent escalation represents the difference between actual operating lease payments due and straight-line rent expense, which we record over the term of the lease. The excess is recorded as a deferred credit in the early periods of the lease, when cash payments are generally lower than straight-line rent expense, and is reduced in the later periods of the lease when payments begin to exceed the straight-line expense. Tenant allowances from landlords for tenant improvements are generally comprised of cash received from the landlord or paid on our behalf as part of the negotiated terms of the lease. These tenant improvement allowances and other leasehold incentives are recorded when realizable as deferred rent and are amortized as a reduction of periodic rent expense, over the term of the applicable lease. See Note 12 - Commitments and Contingencies.

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.

The Company determines the need for a valuation allowance 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. See Note 13 - Income Taxes.

Comprehensive Income (Loss)

Total comprehensive income (loss) includes net income or loss and foreign currency translation adjustments, 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 $1.2 million at both December 31, 2016 and 2015.

There was no income tax impact related to foreign currency translation adjustments for the periods ended December 31, 2016 and 2015. During the period ended December 31, 2014, $0.2 million of income tax expense related to foreign currency translation adjustments was included on the Company's consolidated statements of comprehensive income (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. GAAP and expands disclosures about fair value measurements. As of December 31, 2016 and 2015, the Company’s financial assets and liabilities required to be measured on a recurring basis were its contingent consideration receivable, its deferred compensation liability, its convertible notes derivative liability, and its contingent purchase price liabilities. See Note 10 - Fair Value Measurements.

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 available to common shareholders (numerator) by the weighted average number of vested unrestricted common shares outstanding during the period (denominator). Diluted earnings per share gives effect to all dilutive potential common shares outstanding during the period including stock appreciation rights and options and unvested restricted stock, as calculated utilizing the treasury stock method, and Convertible Notes using the if-converted method.

Recently Adopted Accounting Pronouncements

In September 2015, the FASB issued Accounting Standards Update (ASU) No. 2015-16, Business Combinations (Topic 805), Simplifying the Accounting for Measurement-Period Adjustments. This ASU requires that an acquirer recognize adjustments to provisional amounts that are identified during the measurement period in the reporting period in which the adjustment amounts are determined. Prior to the issuance of the ASU, entities were required to retrospectively apply adjustments made to provisional amounts recognized in a business combination. The Company adopted this guidance in the first quarter of 2016, with no impact on its financial position and results of operations upon adoption. This new guidance may impact the Company for potential measurement adjustments related to its acquisitions.

In April 2015, the FASB issued ASU No. 2015-05, Intangibles-Goodwill and Other-Internal-Use Software (Subtopic 350-40), Customers Accounting for Fees Paid in a Cloud Computing Arrangement, to help entities evaluate the accounting for fees paid by a customer in a cloud computing arrangement. The amendment provides guidance to customers about whether a cloud computing arrangement includes a software license. If a cloud computing arrangement includes a software license element, then the customer should account for the software license element arrangement consistent with the acquisition of other software licenses. If a cloud computing arrangement does not include a software license, the customer should account for the arrangement as a service contract. The Company prospectively adopted this guidance in the first quarter of 2016, with no impact on its consolidated financial statements.

In April 2015, the FASB issued ASU No. 2015-03, Interest-Imputation of Interest (Subtopic 835-30), Simplifying the Presentation of Debt Issuance Costs. This guidance requires that debt issuance costs related to a recognized debt liability be presented in the balance sheet as a direct deduction from the carrying amount of that debt liability. The Company adopted this guidance in the first quarter of 2016, and reclassified $0.5 million of the Company's net debt issuance costs to long-term debt and capital lease obligations in its consolidated balance sheets as of December 31, 2015.

Recent Accounting Pronouncements

In January 2017, the FASB issued ASU No. 2017-04, Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment, to simplify how an entity is required to test goodwill for impairment by eliminating Step 2 from the goodwill impairment test. Under this guidance, an entity would perform its annual, or interim goodwill impairment test by comparing the fair value of a reporting unit with its carrying amount. An impairment charge would be recognized for the amount by which the carrying amount exceeds the reporting unit’s fair value; however, the loss recognized should not exceed the total amount of goodwill allocated to that reporting unit. Additionally, an entity would consider income tax effects from any tax deductible goodwill on the carrying amount of the reporting unit when measuring the goodwill impairment loss, if applicable. An entity still has the option to perform the qualitative assessment for a reporting unit to determine if the quantitative impairment test is necessary. ASU 2017-04 is effective for annual or any interim goodwill impairment tests in fiscal years beginning after December 15, 2019 and is to be applied prospectively. Early adoption is permitted for interim or annual goodwill impairment tests performed on testing dates after January 1, 2017. The Company expects to early adopt this standard in its first quarter of 2017, and does not expect this guidance to have a material impact on its consolidated financial statements.

In January 2017, the FASB issued ASU No. 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business, which clarifies the definition of a business, with the objective of adding guidance to assist entities with evaluating whether transactions should be accounted for as acquisitions (or disposals) of assets or businesses. This update provides a framework to assist entities in evaluating whether both an input and a substantive process are present, and narrows the definition of the term output so that the term is consistent with how outputs are described in the new revenue recognition standard. ASU 2017-01 is effective for annual periods beginning after December 15, 2017, and interim periods within those annual periods. Early adoption is permitted depending upon the date of the transaction. Entities should apply the guidance prospectively on or after the effective date. No disclosures are required at transition. The Company expects to adopt this standard in its first quarter of 2018, and does not expect this guidance to have a material impact on its consolidated financial statements.

In August 2016, the FASB issued ASU No. 2016-15, Statement of Cash Flows (Topic 230), Classification of Certain Cash Receipts and Cash Payments, which amends the guidance in ASC 230 on the classification of certain cash receipts and payments in the statement of cash flows. This update intends to reduce the diversity that has resulted from the lack of consistent principles on this topic by adding or clarifying guidance on eight cash flow issues, including: debt prepayment or debt extinguishment costs, contingent consideration payments made after a business combination, and separately identifiable cash flows and application of the predominance principle. ASU 2016-15 is effective for annual periods beginning after December 15, 2017, and interim periods within those annual periods. Early adoption is permitted. Entities must apply the guidance retrospectively to all periods presented but may apply it prospectively from the earliest date practicable if retrospective application would be impracticable. The Company expects to adopt this standard in its first quarter of 2018, and does not expect this guidance to have a material impact on its consolidated financial statements.

In March 2016, the FASB issued ASU No. 2016-09, Compensation-Stock Compensation (Topic 718), Improvements to Employee Share-Based Payment Accounting. The areas for simplification in this update involve several aspects of the accounting for share-based payment transactions, including the income tax consequences, classification of awards as either equity or liabilities, and classification on the statement of cash flows. This update revises the threshold to qualify for equity classification to permit withholding up to the employer's maximum statutory tax rates in the applicable jurisdictions. ASU 2016-09 is effective for annual periods beginning after December 15, 2016, and interim periods within those annual periods, and early adoption is permitted. There are various methods of adoption for each aspect. Upon adoption, the Company will recognize its previously unrecognized excess tax benefits using the modified retrospective transition method, which will result in a cumulative-effect adjustment to retained earnings and deferred tax assets. In addition, upon adoption, the Company no longer intends to calculate an estimate of expected forfeitures and will begin to recognize forfeitures as they occur, which will result in a cumulative-effect decrease to retained earnings and a corresponding increase to additional paid-in capital. The Company expects to adopt this standard in its first quarter of 2017.

In March 2016, the FASB issued ASU No. 2016-06, Derivatives and Hedging (Topic 815): Contingent Put and Call Options in Debt Instruments, to clarify the steps required to assess whether a call or put option meets the criteria for bifurcation as an embedded derivative. ASU 2016-06 is effective for interim and annual periods beginning after December 15, 2016, and requires a modified retrospective approach to adoption. Early adoption is permitted. The Company expects to adopt this standard in its first quarter of 2017, and does not expect this guidance to have an impact on its consolidated financial statements.

In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842), which will require, among other items, lessees to recognize most leases as assets and liabilities on the balance sheet. Qualitative and quantitative disclosures will be enhanced to better understand the amount, timing and uncertainty of cash flows arising from leases. ASU 2016-02 is effective for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years, with early adoption permitted. Entities are required to use a modified retrospective approach for leases that exist or are entered into after the beginning of the earliest comparative period in the financial statements. Full retrospective application is prohibited. The Company expects the valuation of right of use assets and lease liabilities, previously described as operating leases, to be the present value of our forecasted future lease commitments. The Company is continuing to assess the overall impacts of the new standard, including the discount rate to be applied in these valuations. See Note 12 - Commitments and Contingencies.

In May 2014, the FASB and the International Accounting Standards Board jointly issued ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606), that introduces a new five-step revenue recognition model in which 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 or services. This ASU also requires disclosures sufficient to enable users to understand the nature, amount, timing, and uncertainty of revenue and cash flows arising from contracts with customers, including qualitative and quantitative disclosures about contracts with customers, significant judgments and changes in judgments, and assets recognized from the costs to obtain or fulfill a contract. In March 2016, the FASB issued ASU 2016-08 which further clarifies the guidance on the principal versus agent considerations within ASU 2014-09. In April 2016, the FASB issued ASU 2016-10 to expand the guidance on identifying performance obligations and licensing within ASU 2014-09. In May 2016, the FASB issued ASU 2016-12 to improve revenue recognition in the areas of collectability, presentation of sales tax and other similar taxes collected from customers, non-cash consideration, contract modifications and completed contracts at transition. This update also amends the disclosure requirements within ASU 2014-09 for entities that retrospectively apply the guidance. The latest amendments are intended to address implementation issues that were raised by stakeholders and discussed by the Revenue Recognition Transition Resource Group, and provide additional practical expedients. These updates are effective for fiscal years beginning after December 15, 2017, including interim periods within that reporting period. The Company established a cross-functional implementation team consisting of representatives from across all of its business segments. Management is in the process of reviewing its contract portfolio and its existing accounting policies and practices to identify potential differences that would result from applying the requirements of the new standard to its contracts. Management expects this assessment will continue throughout the first half of 2017. Once this phase has been completed, if applicable, management intends to implement appropriate changes to its business processes, systems and controls to support the recognition and disclosure under the new standard. The Company is continuing to assess which transition method it will use to adopt this accounting standard and expects a full assessment by the fourth quarter of 2017.

Acquisitions

12 Months Ended

Dec. 31, 2016

Business Combinations [Abstract]

Acquisitions

US Resources Healthcare

On December 1, 2016, the Company completed the acquisition of a recruitment process outsourcing business, US Resources Healthcare, LLC (USR). This acquisition expands the Company's workforce solutions offerings to deliver financial and operating efficiencies through labor optimization services while enhancing the quality of care.

The acquisition was deemed immaterial and has been accounted for in accordance with the Business Combinations Topic of the FASB ASC, using the acquisition method of accounting. Acquisition-related expenses are included in the consolidated statements of operations. USR's results of operations are included in the consolidated statements of operations from December 1, 2016 and have been included in the Company's Nurse and Allied Staffing business segment. See Note 5 - Goodwill, Trade Names, and Other Intangible Assets and Note 10 - Fair Value Measurements.

Mediscan

On October 30, 2015, the Company completed the acquisition of all of the membership interests of New Mediscan II, LLC, Mediscan Diagnostic Services, LLC, and Mediscan Nursing Staffing, LLC (collectively Mediscan) for a purchase price of $29.9 million in cash ($28.0 million plus working capital estimate) and $4.7 million in shares (or 349,871 shares) of the Company's Common Stock, subject to a net working capital adjustment. The shares of Common Stock issued in connection with the acquisition were subject to a lockup period, which ended April 30, 2016. The Company financed the purchase price through a combination of cash-on-hand and borrowings under the Company's senior credit facility. The transaction has been treated as a purchase of assets for income tax purposes. In the first quarter of 2016, the net working capital adjustment was settled consistent with the receivable balance as of December 31, 2015.

The agreement also specified that the sellers were eligible to receive additional purchase price consideration of $7.0 million, with $3.5 million per year based on attainment of specific performance criteria in 2016 and 2017. As of December 31, 2016, the Company determined that the first year earnout was not achieved for 2016 and as a result, only $3.5 million remains as a potential earnout for 2017. As of December 31, 2016, the fair value of the remaining obligation was estimated at $0.7 million.

In connection with the Mediscan acquisition, the Company also assumed additional contingent purchase price liabilities for a previously acquired business that are payable annually based on specific performance criteria for the 2016 through 2019 years. Payments related to the 2016 through 2018 years are limited to $0.3 million per year and 2019 is uncapped. As of December 31, 2016, the fair value of the remaining obligations on an undiscounted basis was estimated at $3.6 million.

As of December 31, 2016, a total of $4.3 million was estimated as the fair value of these contingent consideration payments and is included in other current liabilities and contingent consideration on the condensed consolidated balance sheets. See Note 10 - Fair Value Measurements.

Mediscan provides temporary healthcare staffing and workforce solutions to both the healthcare and education markets - both public and charter schools. While largely concentrated in California, Mediscan provides services across 11 states to more than 300 clients through more than 70 specialties. The Mediscan acquisition provides the Company a new customer base in the healthcare staffing market for public schools and the workforce solutions arena for charter schools.

The acquisition has been accounted for in accordance with FASB ASC 805, Business Combinations, using the acquisition method of accounting. Mediscan's results of operations are included in the consolidated statements of operations from October 30, 2015 and have been included in the Company's Nurse and Allied Staffing business segment. As such, the associated goodwill related to the acquisition is fully allocated to Nurse and Allied Staffing.

The amounts of revenue and net income included in the Company's consolidated income statement from the acquisition date to the period ended December 31, 2015 were $6.7 million and $0.3 million, respectively.

The following is the estimated fair value of the purchase price for Mediscan on October 30, 2015:



	(amounts in thousands)
Cash purchase price paid at closing	$	28,000
Fair value of shares	4,723
Fair value of contingent consideration	3,686
Net working capital adjustment, including receivable	503
Total consideration	$	36,912

The purchase price was allocated to the assets acquired and the liabilities assumed based on the estimated fair value at the date of acquisition. The following is the estimated fair value of the assets acquired and liabilities assumed on October 30, 2015.



	(amounts in thousands)
Cash acquired	$	79
Accounts receivable	6,851
Other current assets	140
Property and equipment	20
Goodwill	14,338
Other intangible assets	17,200
Total assets acquired	38,628
Accounts payable and accrued expenses	306
Accrued employee compensation and benefits	1,410
Total liabilities assumed	1,716
Net assets acquired	$	36,912

The Company assigned the following values to other intangible assets: $3.2 million to trade names with a weighted average estimated useful life of 11 years, $5.2 million to customer relations with an estimated useful life of 10 years, and $8.8 million to a database with an estimated useful life of 10 years, for a total of $17.2 million in definite life intangible assets with a weighted average estimated useful life of 10 years.

The remaining excess purchase price over the fair value of net assets acquired of $14.3 million was recorded as goodwill, which is expected to be deductible for tax purposes. Associated acquisition costs incurred were $0.7 million and have been included in acquisition and integration costs on the Company's consolidated statement of operations for the year ended December 31, 2015.

Medical Staffing Network

On June 30, 2014, the Company acquired substantially all of the assets and certain liabilities of Medical Staffing Network Healthcare, LLC (MSN) for an aggregate purchase price of $47.1 million, net of $1.0 million cash acquired. 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. 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. An additional $2.5 million was deferred and due to the seller 21 months from the acquisition date, less any COBRA expenses incurred by the Company on behalf of former MSN employees over that period. The Company incurred $0.4 million in COBRA expenses since the MSN acquisition and, on April 1, 2016, released to the seller the remaining liability of $2.1 million.

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.

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 are included in the consolidated statements of operations from July 1, 2014. The acquisition results are substantially reported through the Company's Nurse and Allied Staffing business segment. As such, the associated goodwill related to the acquisition of MSN is fully allocated to Nurse and Allied Staffing.

The following table summarizes the fair value of the assets acquired and liabilities assumed. The Company used a third-party appraiser to assist with the determination of the fair value and estimated useful lives of acquired assets and liabilities assumed on June 30, 2014:



	(amounts in thousands)
Cash acquired	$	989
Accounts receivable	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

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.

The Company assigned the following values to other 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, including $2.2 million of costs directly attributable to the transaction (such as transaction and advisory fees) 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.

The Company has integrated the acquired businesses into its current operations. The MSN acquisition included the consolidation of branch and corporate offices and therefore, it is impracticable to separate their results. Integration costs for the years ended December 31, 2015 and 2014 include exit costs associated with redundant facilities and ongoing post-employment termination costs.

Total Acquisition and Integration Liabilities

Reconciliations of the beginning and ending total acquisition and integration liability balances are presented below:



	Year Ended December 31,
	2016						2015
	(amounts in thousands)
	On-Going Benefit Costs			Exit Costs			On-Going Benefit Costs			Exit Costs
Balance at beginning of period	$	47		$	46		$	762		$	868
Charged to acquisition and integration costs	—			—			17			88
Reclassifications (a)	—			—			—			(255		)
Payments	(47		)	(46		)	(732		)	(655		)
Balance at end of period	$	—		$	—		$	47		$	46


(a)	Exit liability has been reduced as a result of a lease amendment and has been reclassified to deferred rent, which will be amortized over the remaining lease term.

Pro Forma Financial Information

The following unaudited pro forma financial information approximates the consolidated results of operations of the Company as if the Mediscan and MSN acquisitions had occurred as of January 1, 2014, 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 $0.8 million for the year ended December 31, 2015 related to the Mediscan acquisition and $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 or an estimate of any impact on interest expense resulting from the operating cash flow of the acquired businesses, among other adjustments that could be made in the future but are not factually supportable on the date of the transaction.



	Year Ended December 31,
	2015		2014
	(unaudited, amounts in thousands except per share data)

Revenue from services	$	800,353	$	771,955

Net income (loss) attributable to common shareholders	$	5,436	$	(30,104	)

Net income (loss) per common share attributable to common shareholders - basic and diluted	$	0.17	$	(0.97	)

- Definition

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

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 10
-Section 50
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=65885119&loc=d3e1497-128463

Reference 2: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 10
-Section 50
-Paragraph 4
-URI http://asc.fasb.org/extlink&oid=65885119&loc=d3e1490-128463

Reference 3: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 10
-Section 50
-Paragraph 2
-URI http://asc.fasb.org/extlink&oid=65885119&loc=d3e1392-128463

Reference 4: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 30
-Section 50
-Paragraph 4
-URI http://asc.fasb.org/extlink&oid=35744584&loc=d3e7008-128479

Reference 5: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 10
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=65885119&loc=d3e1486-128463

Reference 6: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 30
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+ Details

Disposal and Discontinued Operations	12 Months Ended
Disposal and Discontinued Operations	Dec. 31, 2016
Discontinued Operations and Disposal Groups [Abstract]
Disposal and Discontinued Operations	Disposal and Discontinued Operations Cross Country Education On July 21, 2015, the Company's Board of Directors approved an agreement to sell the Company's education seminars business, CCE, which provided in-person seminars to healthcare professionals and was non-core to the Company’s business. The Company used the net proceeds from the transaction to finance, in part, the Mediscan acquisition in the fourth quarter of 2015. See Note 3 - Acquisitions. Since the disposal of the education seminars business did not represent a strategic shift that would have a major effect on the Company’s operations and financial results, it was not reflected as discontinued operations. On July 27, 2015, the Company entered into an Agreement and Plan of Merger to sell its wholly-owned subsidiary, CCE, to a third party (Buyer). On August 31, 2015, the Company completed the sale of CCE to the Buyer. The Company received $8.0 million in cash, subject to a net working capital adjustment, of which $0.5 million was held in escrow for a period of 12 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. In September 2016, the full amount of escrow, which had been reflected as an escrow receivable, was released to the Company. The purchase price also included an earnout of up to $0.5 million related to the performance of CCE for the year ended December 31, 2015, which was treated as contingent consideration. The Company assigned no fair value to this earnout as of December 31, 2015 as the performance-based milestones were not met. See Note 10 - Fair Value Measurements. The original escrow amount was released to the Buyer in the first quarter of 2016. The operating results of CCE were included in the Other Human Capital Management Services segment. See Note 17 - Segment Data for further information. The Company recognized a pre-tax loss of $2.2 million related to the sale of the business, which is included in income (loss) from operations in its consolidated statements of operations for the year ended December 31, 2015. In addition, the Company recorded a tax benefit of $3.5 million from the reversal of valuation allowances associated with this business, resulting in an after-tax gain on the sale of CCE of $1.3 million. Clinical Trial Services On February 15, 2013, the Company completed the sale of its clinical trial services business to a third party (Buyer) for an aggregate $52.0 million in cash, subject to certain adjustments. Of the $52.0 million purchase price paid at closing, $3.8 million was 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 total amount of the escrow was released to the Company in August 2014 and reported as additional proceeds from the sale in the investing activities on its consolidated statements of cash flows. The disposal of this business was previously presented as discontinued operations.

- Definition

The entire disclosure related to a disposal group. Includes, but is not limited to, a discontinued operation, disposal classified as held-for-sale or disposed of by means other than sale or disposal of an individually significant component.

+ References

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+ Details

Goodwill, Trade Names, and Other Intangible Assets

12 Months Ended

Dec. 31, 2016

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill, Trade Names, and Other Intangible Assets

As of December 31, 2016 and 2015, the Company had the following acquired intangible assets:



	December 31, 2016						December 31, 2015
	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	$	31,609	$	16,147	$	15,462	$	31,225	$	14,150	$	17,075
Customer relationships	41,724		23,316		18,408		47,204		20,734		26,470
Non-compete agreements	3,619		3,527		92		3,603		3,486		117
Trade names, definite-lived	3,216		343		2,873		3,200		49		3,151
	$	80,168	$	43,333	$	36,835	$	85,232	$	38,419	$	46,813
Intangible assets not subject to amortization:
Trade names					35,402						36,101
					$	72,237					$	82,914

As of December 31, 2016, estimated annual amortization expense is as follows:



Years Ending December 31:	(amounts in thousands)
2017	$	4,248
2018	4,148
2019	4,111
2020	4,007
2021	3,799
Thereafter	16,522
	$	36,835

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, 2015
Aggregate goodwill acquired	$	302,005		$	43,405		$	19,307		$	364,717
Sale of CCE (a)	—			—			(9,889		)	(9,889		)
Accumulated impairment loss	(259,732		)	—			—			(259,732		)
Goodwill, net of impairment loss	42,273			43,405			9,418			95,096

Changes to aggregate goodwill in 2016
Goodwill acquired (b)	2,272			—			—			2,272
Impairment charges	—			(17,720		)	—			(17,720		)

Balances as of December 31, 2016
Aggregate goodwill acquired	304,277			43,405			19,307			366,989
Sale of CCE (a)	—			—			(9,889		)	(9,889		)
Accumulated impairment loss	(259,732		)	(17,720		)	—			(277,452		)
Goodwill, net of impairment loss	$	44,545		$	25,685		$	9,418		$	79,648

_______________


(a)	See Note 4 - Disposal and Discontinued Operations.


(b)	Goodwill acquired from the acquisition of USR. See Note 3 - Acquisitions.

2016 Impairment Charges

During an evaluation of goodwill, trade names, and other intangible assets at June 30, 2016, the Company determined that indicators were present in the Physician Staffing reporting unit which would suggest the fair value of the reporting unit may have declined below the carrying value. The Physician Staffing reporting unit continued to under-perform relative to management’s expectations. The lower than expected revenue was driven by lower booking volumes partly due to the loss of customers, and margins that were negatively impacted from continued investments in the business all through the first half of 2016. The Company considered these factors to be impairment indicators that warranted impairment testing of goodwill, trade names, and other intangible assets.

As a result, an interim impairment test of goodwill, trade names, and other intangible assets was performed as of June 30, 2016 in accordance with the Intangibles-Goodwill and Other and Property, Plant, and Equipment Topics of the FASB ASC. The evaluation resulted in the carrying value of goodwill, trade names, and other intangible assets for Physician Staffing to exceed the estimated fair value. As a result, the Company recorded pre-tax impairment charges totaling $24.3 million: $17.7 million related to goodwill, $0.6 million related to trade names, and $6.0 million related to customer relationships.

Goodwill

In order to determine the fair value of the Physician Staffing reporting unit, the Company used a combination of an income and a market approach to calculate the fair value of the Physician Staffing reporting unit. The discounted cash flow that served as the primary basis for the income approach was based on the Company’s discrete financial forecast of revenue, gross profit margins, operating costs and cash flows. It also considered historical and estimated future results, general economic and market conditions, as well as the impact of planned business and operational strategies. The assumptions used in the income approach included a discount rate of 13.5% and a terminal value growth rate of 3.0% for cash flows beyond the discrete forecast period of ten years. Assumptions used in the market approach included valuation multiples based on an analysis of multiples for comparable public companies. The Company utilized total enterprise value/Earnings before Interest, Taxes, Depreciation, and Amortization (EBITDA) multiples ranging from 7.5 to 8.5. A 50% weighting was applied to the components of each approach to estimate the total fair value of goodwill. This weight is an estimate by management and was developed based on the specific characteristics, risks and uncertainties of the Physician Staffing reporting unit. As a result of the testing, the Company compared the implied fair value of goodwill to its carrying amount and recorded a non-cash pre-tax goodwill impairment charge of $17.7 million at June 30, 2016.

Trade Names

The Company valued the Physician Staffing trade names based on a Relief From Royalty methodology 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. The calculated value of the trade names was compared to its carrying amount and, as a result, the Company recorded a non-cash pre-tax impairment charge of $0.6 million at June 30, 2016.

Customer Relationships

The Company valued the Physician Staffing customer relationships based on the Multi-Period Excess Earnings Method (MPEEM). The MPEEM estimates the fair value based on the present value of the allocated future economic benefits. The inputs include the projected revenue and associated expenses from the customers, an estimated attrition rate, and a discount rate of 13.5%. The Company performed a recoverability test on the asset group which customers are a part of and deemed customer relationships to be impaired. As a result, the calculated value of customer relationships was compared to its carrying amount and the Company recorded a non-cash pre-tax impairment charge of $6.0 million at June 30, 2016.

2016 Annual Impairment Testing

The Company performed its annual impairment test as of October 1, 2016. Upon completion of the impairment testing, the Company determined that no additional impairment of goodwill, trade names, or other intangible assets was warranted.

2015 and 2014 Impairment Charges

The Company performed its annual impairment test as of October 1, 2015 and 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, 2015 and 2014.

However, in conjunction with the annual impairment testing of trade names in the fourth quarter of 2015 and 2014, the Company reduced its long-term revenue forecast for the business segment in the fourth quarter of each year and as a result, the calculation of estimated fair value was less than the carrying amount of the trade names. As a result, the Company recorded pre-tax non-cash impairment charges of $2.1 million and $10.0 million, respectively, related to the Physician Staffing segment.

The reduced long-term revenue forecast for 2015 was impacted by lower projected volume resulting from an under-investment in new revenue producers to keep pace with attrition. The reduced long-term revenue forecast for 2014 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 discounted cash flows 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.

The Company based its fair value estimates on assumptions it believed to be reasonable, but such assumptions are subject to inherent uncertainty. Actual results may differ from those estimates.

- 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, 2016

Property, Plant and Equipment [Abstract]

Property and Equipment

At December 31, 2016 and 2015, property and equipment consist of the following:



		December 31,
	Useful Lives	2016			2015
		(amounts in thousands)

Computer equipment	3-5 years	$	13,584		$	12,335
Computer software	3-5 years	28,752			27,565
Office equipment	5-7 years	2,397			2,241
Furniture and fixtures	5-7 years	3,969			3,411
Leasehold improvements	(a)	7,257			4,286
		55,959			49,838
Less accumulated depreciation and amortization		(43,141		)	(39,368		)
		$	12,818		$	10,470

_______________


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

Balance Sheet Details

12 Months Ended

Dec. 31, 2016

Balance Sheet Related Disclosures [Abstract]

Balance Sheet Details



	December 31,
	2016		2015
	(amounts in thousands)
Insurance recovery receivable:
Insurance recovery for health	$	279	$	—
Insurance recovery for workers’ compensation	1,271		1,403
Insurance recovery for professional liability	1,487		1,463
	$	3,037	$	2,866

Other non-current assets:
Insurance recovery for workers’ compensation – long-term	$	5,857	$	6,281
Insurance recovery for professional liability – long-term	10,353		10,722
Non-current security deposits	925		991
	$	17,135	$	17,994

Accrued compensation and benefits:
Salaries and payroll taxes	$	15,480	$	11,976
Bonuses	3,915		4,584
Accrual for workers’ compensation claims	5,266		5,151
Accrual for professional liability insurance	2,433		2,516
Accrual for health care benefits	4,053		3,009
Accrual for vacation	2,096		2,166
	$	33,243	$	29,402

Long-term accrued claims:
Accrual for workers’ compensation claims	$	12,817	$	14,014
Accrual for professional liability insurance	16,053		16,056
	$	28,870	$	30,070

Other long-term liabilities:
Deferred compensation	$	1,472	$	1,412
Deferred rent	5,011		2,473
Long-term unrecognized tax benefits	874		819
Other	42		122
	$	7,399	$	4,826

Debt

12 Months Ended

Dec. 31, 2016

Debt Disclosure [Abstract]

Debt

At December 31, 2016 and 2015, long-term debt consists of the following:



	December 31, 2016						December 31, 2015
	Principal			Unamortized Discount and Debt Issuance Costs			Principal			Unamortized Discount and Debt Issuance Costs
	(amounts in thousands)

Term Loan, interest 2.62%	$	39,500		$	(363	)	$	—		$	—
Senior Secured Asset-Based, weighted average interest 2.41%	—			—			8,000			—
Second Lien Term Loan, interest 5.75%	—			—			30,000			(1,052		)
Convertible Notes, fixed rate interest of 8.00%	25,000			(4,669		)	25,000			(6,007		)
Convertible Notes derivative liability	27,532			—			33,337			—
Capital lease obligations	23			—			94			—
Total debt	92,055			(5,032		)	96,431			(7,059		)
Less current portion	(2,263		)	—			(8,071		)	—
Long-term debt	$	89,792		$	(5,032	)	$	88,360		$	(7,059	)

As of December 31, 2016, the aggregate scheduled maturities of debt are as follows:



	Term Loan		Convertible Notes		Capital Leases
	(amounts in thousands)
Through Years Ending December 31:
2017	$	2,250	$	—	$	13
2018	3,750		—		8
2019	3,500		—		2
2020	4,000		25,000		—
2021	26,000		—		—
Thereafter	—		—		—
Total	$	39,500	$	25,000	$	23

At December 31, 2015, the Company had a senior secured asset-based revolving credit facility (First Lien Loan), with a termination date of June 30, 2017, in the aggregate principal amount of up to $85.0 million, which included 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. The Company also had a five-year second lien term loan facility (Second Lien Term Loan) in an aggregate principal amount of $30.0 million. The Company had the ability, at its option at any time, to prepay the Second Lien Term Loan in whole or in part at the redemption prices set forth therein, which ranged 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 June 30, 2017.

2016 Senior Credit Facilities

On June 22, 2016, the Company entered into a senior credit agreement (Credit Agreement), which provides a term loan of $40.0 million (Term Loan) and a revolving credit facility of up to $100.0 million (Revolving Credit Facility) (together with the Term Loan, the Senior Credit Facilities) both of which mature in five years. The Revolving Credit Facility includes a subfacility for swingline loans up to an amount not to exceed $15.0 million, and a $35.0 million sublimit for the issuance of standby letters of credit. The Credit Agreement also includes a provision permitting the Company, subject to certain conditions, to increase the aggregate amount of the commitments under the Revolving Credit Facility or establish one or more additional term loans in an aggregate amount of up to $50.0 million with optional additional commitments from existing lenders or new commitments from additional lenders. The Term Loan is payable in quarterly installments, with the first payment made September 30, 2016, and each such installment being in the aggregate principal amount (subject to adjustment as a result of prepayments) equal to 1.25% of the principal amount for the first four installments, 1.875% for the next eight installments and 2.50% of the principal amount for the remaining installments.

Proceeds of the Senior Credit Facilities were used primarily to refinance the Company’s First Lien Loan and Second Lien Term Loan and to pay related transaction fees and expenses, including a prepayment penalty of $0.6 million. In addition, as of June 22, 2016, $23.1 million of standby letters of credit issued under the First Lien Loan have been rolled into and been deemed issued under the Revolving Credit Facility. The Revolving Credit Facility can be used to provide ongoing working capital, fund permitted acquisitions and for other general corporate purposes of the Company and its subsidiaries.

The repayment of the Second Lien Term Loan was treated as extinguishment of debt and, as a result, the Company recognized a loss on extinguishment of debt of approximately $1.6 million in the second quarter of 2016, related to the write-off of unamortized net debt discount and issuance costs as well as transaction fees and expenses.

Subject to the Credit Agreement, the Company pays interest on (i) each Base Rate Loan at the Base Rate (as defined therein) plus the Applicable Margin in effect from time to time, (ii) each LIBOR Index Rate Loan at the One Month LIBOR Index Rate (as defined therein) plus the Applicable Margin in effect from time to time and (iii) each Eurodollar Loan at the Adjusted LIBOR for the applicable Interest Period (as defined therein) in effect for such Loan plus the Applicable Margin in effect from time to time. The Applicable Margin, as of any date, is a percentage per annum determined by reference to the applicable Consolidated Net Leverage Ratio (as defined by the agreement) in effect on such date as set forth in the table below.



Level	Consolidated Net Leverage Ratio	Eurodollar Loans, LIBOR Index Rate Loans and Letter of Credit Fee	Base Rate Loans	Commitment Fee
I	Less than 1.50:1.00	1.75%	0.75%	0.25%
II	Greater than or equal to 1.50:1.00 but less than 2.00:1.00	2.00%	1.00%	0.30%
III	Greater than or equal to 2.00:1.00 but less than 2.50:1.00	2.25%	1.25%	0.30%
IV	Greater than or equal to 2.50:1.00 but less than 3.00:1.00	2.50%	1.50%	0.35%
V	Greater than or equal to 3.00:1.00	2.75%	1.75%	0.40%

As of December 31, 2016, the Term Loan and Revolving Credit Facility bore interest at a rate equal to One Month LIBOR plus 200 basis points. The interest rate is subject to an increase of 200 basis points if an event of default exists under the Credit Agreement. The Company is required to pay a commitment fee on the average daily unused portion of the Revolving Credit Facility, based on the Applicable Margin which was 0.30% as of December 31, 2016.

The Company has the right at any time and from time to time to prepay any borrowing, in whole or in part, without premium or penalty, by giving irrevocable written notice (or telephonic notice promptly confirmed in writing) except that such notice shall be revocable if a prepayment is being made in anticipation of concluding a financing arrangement, and the Company is ultimately unable to secure such financing arrangement. The Company is required to prepay the Senior Credit Facilities under certain circumstances including from net cash proceeds from asset sales or dispositions in excess of certain thresholds, as well as from net cash proceeds from the issuance of certain debt by the Company.

The Credit Agreement contains customary representations, warranties, and affirmative covenants. The Credit Agreement also contains customary negative covenants, subject to some exceptions, on (i) indebtedness and preferred equity, (ii) liens, (iii) fundamental changes, (iv) investments, (v) restricted payments, and (vi) sale of assets and certain other restrictive agreements. The Credit 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 the negative covenants and other covenants related to the operation of the Company’s business. See Note 14 - Stockholders' Equity.

The Credit Agreement also includes two financial covenants, commencing with the fiscal quarter ending September 30, 2016: (i) limiting a maximum Consolidated Total Leverage ratio (as defined therein) to be no greater than 3.50:1.00 for the fiscal quarters ending September 30, 2016 through June 30, 2017, 3.25:1.00 for the fiscal quarters ending September 30, 2017 through June 30, 2018, and 3.00:1.00 for each fiscal quarter ending thereafter and as adjusted pursuant to a Qualified Permitted Acquisition (as defined therein); and (ii) requiring a minimum Consolidated Fixed Charge Coverage ratio (as defined therein) as of the end of each fiscal quarter of 1.50:1.00. As of December 31, 2016, the Company was in compliance with the financial covenants and other covenants contained in the Credit Agreement.

The obligations under the Credit Agreement are guaranteed by all of the Company’s domestic wholly-owned subsidiaries. The obligations under the Credit Agreement are secured by a first-priority security interest in the Collateral (as defined therein).

As of December 31, 2016, the Company had $22.2 million letters of credit outstanding and $77.8 million available under the Revolving Credit Facility. The letters of credit relate to the Company’s workers’ compensation and professional liability insurance policies.

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 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.

As of December 31, 2016, 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 from the issuance date, 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 equal to the amount determined by dividing (i) such conversion amount by (ii) the conversion price in effect at the time of conversion provided that the number of shares of Common Stock issued upon conversion, when aggregated with the aggregate number of shares of Common Stock previously issued upon conversion cannot exceed 6,244,650 shares of Common Stock. If this share cap results in the issuance of fewer shares of Common Stock, the Company will pay to the holders of the Convertible Notes an amount in cash equal to the product of (i) the number of shares not delivered as a result of the cap and (ii) the 30-day VWAP as of the close of business on the Business Day immediately preceding the conversion date. 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 multiplied by the 30-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 30-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.

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.

First Lien Loan Agreement (Terminated June 22, 2016)

The First Lien Loan was used to provide ongoing working capital and for other general corporate purposes of the Company and its subsidiaries. As of December 31, 2015, the interest rate spreads and fees under the First Lien Loan Agreement were based on LIBOR plus 1.50% or Base Rate plus 0.50%. The LIBOR and Base Rate margins were subject to performance pricing adjustments, pursuant to a pricing matrix based on the Company’s excess availability under the revolving credit facility. The Company was required to pay a monthly commitment fee on the average daily unused portion of the revolving loan facility, which, as of December 31, 2015, was 0.375%.

As of December 31, 2015, the Gross Availability, as defined in the First Lien Loan Agreement, was approximately $71.6 million based on the Company's accounts receivable balance as of November 30, 2015. The Company had $23.5 million letters of credit outstanding and $8.0 million drawn under its revolving credit facility, leaving $40.1 million available as of December 31, 2015. The letters of credit related to the Company’s workers’ compensation and professional liability insurance policies.

Second Lien Term Loan (Terminated June 22, 2016)

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.

The Second Lien Term Loan Agreement provided 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 Loan). 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.

On July 22, 2015, the Company entered into an amendment to its Second Lien Term Loan. Under the terms of the amendment, the interest rate on the Second Lien Term Loan was modified at no cost from 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 1% floor) plus 6.50% to LIBOR (1% floor) plus a rate based on the Company's total net leverage ratio. As of December 31, 2015, the Second Lien Term Loan bore interest at a rate equal to adjusted LIBOR (1% floor) plus 4.75%. The interest rate was subject to an increase by 200 basis points if an event of default exists under the Second Lien Term Loan Agreement. As of December 31, 2015, the Company was in compliance with the financial covenants and other covenants contained in the agreement.

Convertible Notes Derivative Liability

12 Months Ended

Dec. 31, 2016

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Convertible Notes Derivative Liability

Derivative financial instruments, as defined in the Accounting for Derivative Financial Instruments and Hedging Activities Topic of the FASB ASC, 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 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 the Accounting for Derivative Financial Instruments and Hedging Activities Topic, in certain instances, these instruments are required to be carried as derivative liabilities, at fair value, in our financial statements.

The Convertible Notes 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 the Accounting for Derivative Financial Instruments and Hedging Activities Topic. Since this conversion feature is not considered to be solely indexed to the Company’s own stock the derivative was recorded as a liability in the line item long-term debt on the Company's consolidated balance sheets. See Note 8 - Debt.

The Company’s Convertible Notes derivative liability is measured at fair value 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 credit risk of the Company, 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 is incorporated into the valuation calculation.

The inputs into the valuation model are as follows:



	December 31, 2016
Closing share price	$15.61
Conversion price	$7.10
Risk free rate	1.76%
Expected volatility	40%
Dividend yield	—%
Expected life	3.5 years

The fair value of this derivative liability is primarily determined by fluctuations in our stock price. In addition, changes in our credit risk profile impact the fair value determination. As of December 31, 2016, a $1 increase or decrease in our stock price would result in a corresponding increase or decrease of approximately $3.5 million in the fair value of the derivative liability, and a 1% increase or decrease in interest rates would result in a corresponding increase or decrease of approximately $0.8 million in the fair value of the derivative liability. These fluctuations result in a current period gain or loss that is presented on the consolidated statements of operations as (gain) loss on derivative liability.

Fair Value Measurements

12 Months Ended

Dec. 31, 2016

Fair Value Disclosures [Abstract]

Fair Value Measurements

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

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

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

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

Items Measured at Fair Value on a Recurring Basis:

At December 31, 2016 and 2015, the Company’s financial assets/liabilities required to be measured on a recurring basis were: contingent consideration receivable, deferred compensation liability included in other long-term liabilities, convertible notes derivative liability included in long-term debt and capital lease obligations, and contingent purchase price liabilities included in other current liabilities and contingent consideration on the consolidated balance sheets.

Contingent consideration receivable—In connection with the sale of CCE, the Company treated the related performance-based earnout as a contingent consideration receivable for accounting purposes. The Company assigned no fair value to this earnout as of December 31, 2015 as the performance milestones were not met. The amount escrowed for this earnout was released to the buyer in the first quarter of 2016.

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.

Contingent purchase price liabilities—Potential earnout payments related to the acquisition of Mediscan and USR are contingent upon meeting certain performance requirements through 2019. See Note 3 - Acquisitions. The long-term portion of these liabilities is included in contingent consideration, and the short-term portion is included in other current liabilities on the consolidated balance sheets. The Company utilized Level 3 inputs to value these contingent purchase price liabilities as significant unobservable inputs were used in the calculation of their fair value. The Mediscan contingent consideration is recorded as a liability and measured at fair value using a discounted cash flow model in a Monte Carlo simulation setting, utilizing significant unobservable inputs, including the expected volatility of the acquisitions' gross profits and an estimated discount rate commensurate with the risks of the expected gross profit stream. The USR contingent consideration is recorded as a liability and measured at fair value using a discounted cash flow model utilizing significant unobservable inputs, including the probability of achieving each of the potential milestones and an estimated discount rate commensurate with the risks of the expected cash flows attributable to the milestones.

The fair value of contingent consideration and the associated liabilities will be adjusted to fair value at each reporting date until actual settlement occurs, with the changes in fair value and related accretion reflected as acquisition-related contingent consideration on the consolidated statements of operations. Significant increases (decreases) in the volatility or in any of the probabilities of success, or decreases (increases) in the discount rate would result in a significantly higher (lower) fair value, respectively, and commensurate changes to these liabilities.

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, 2016 and 2015:

Fair Value Measurements



	December 31, 2016		December 31, 2015
Financial Liabilities:	(amounts in thousands)
(Level 1)
Deferred compensation	$	1,472	$	1,412
(Level 3)
Convertible Notes derivative liability	$	27,532	$	33,337
Contingent purchase price liabilities	$	5,603	$	3,686

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:



	Contingent Purchase			Convertible Notes
	Price Liabilities (a)			Derivative Liability
	(amounts in thousands)

December 31, 2014	$	—		$	23,436
Additions	3,686			—
Valuation loss for the period	—			9,901
December 31, 2015	3,686			33,337
Additions	1,300			—
Payments	(152		)	—
Accretion expense	887			—
Valuation gain for the period	(118		)	(5,805		)
December 31, 2016	$	5,603		$	27,532

_______________

(a) Related to the Mediscan acquisition on October 30, 2015 and the USR acquisition on December 1, 2016. See Note 3 - Acquisitions. Valuation gain and accretion expense is included as acquisition-related contingent consideration on the consolidated statements of operations.

Items Measured at Fair Value on a Non-recurring Basis:

The Company's non-financial assets, such as goodwill, trade names, other intangible assets and property and equipment, are measured at fair value when there is an indicator of impairment and are recorded at fair value only when an impairment charge is recognized. During an evaluation of goodwill, trade names, and other intangible assets during the years ended December 31, 2016, 2015, and 2014, the carrying value of goodwill, trade names, and other intangible assets in the Physician Staffing reporting unit exceeded their fair values. As a result, the Company recorded impairment charges that incorporates fair value measurements based on Level 3 inputs. For further discussion on measuring the Company's non-financial assets, specifically goodwill and trade names, and customer relationships. See Note 5 - Goodwill, Trade Names, and Other Intangible Assets.

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 estimated fair value of the Company’s debt was calculated using a discounted cash flow analysis and appropriate valuation methodologies using Level 2 inputs from 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, 2016				December 31, 2015
	Carrying Amount		Fair Value		Carrying Amount		Fair Value
	(amounts in thousands)
Financial Liabilities:
(Level 2)
Second Lien Term Loan, net	$	—	$	—	$	28,948	$	30,600
Term Loan, net	$	39,137	$	41,500	$	—	$	—
Convertible Notes, net	$	20,331	$	27,250	$	18,993	$	23,250
Senior Secured Asset-Based Loan	$	—	$	—	$	8,000	$	8,000

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, 2016
Compensation and Retirement Disclosure [Abstract]
Employee Benefit Plans	Employee Benefit Plans The Company maintains a voluntary defined contribution 401(k) profit-sharing plan covering all eligible employees as defined in the plan documents. The plan provides for a discretionary matching contribution, which is equal to a percentage of each eligible contributing participant’s elective deferral, which the Company, at its sole discretion, determines from year to year. Contributions by the Company, net of forfeitures, under this plan amounted to $0.8 million, $0.7 million, and $0.6 million for the years ended December 31, 2016, 2015, and 2014, 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 to $1.5 million and $1.4 million at December 31, 2016 and 2015, respectively.

Commitments and Contingencies

12 Months Ended

Dec. 31, 2016

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 premises reductions, 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, 2016, associated with these agreements with terms of one year or more are as follows:



Years Ending December 31:	(amounts in thousands)
2017	$	7,249
2018	6,240
2019	4,826
2020	4,145
2021	3,843
Thereafter	13,191
	$	39,494

Total operating lease expense included in selling, general, and administrative expenses was approximately $8.4 million, $8.1 million, and $7.7 million for the years ending December 31, 2016, 2015, and 2014, 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 within other current liabilities as of December 31, 2016 and 2015, 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 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. For the year ended December 31, 2014, the Company accrued an additional pre-tax liability related to the non-income tax matters of approximately $0.2 million, and paid approximately $0.1 million to settle with certain states. In 2016, the Company paid approximately $1.4 million to settle with certain states, which was fully reserved for at December 31, 2015. For the year ended December 31, 2016, the Company recognized a pre-tax benefit of $0.8 million related to non-income tax matters. The expenses are included in selling, general, and administrative expenses on the consolidated statements of operations for the years ended December 31, 2016, 2015, and 2014 and the liability is included in other current liabilities on the consolidated balance sheets as of December 31, 2016 and 2015.

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 filed in the United States District Court, Northern District of California. 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. The Company does not believe the outcome of these other matters will have a material adverse effect on the Company’s business, financial condition, results of operations or cash flows.

Income Taxes

12 Months Ended

Dec. 31, 2016

Income Tax Disclosure [Abstract]

Income Taxes

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



	Year Ended December 31,
	2016		2015		2014
	(amounts in thousands)
United States	$	3,309	$	3,565	$	(33,574	)
Foreign	1,236		595		2,256
Income (loss) before income taxes	$	4,545	$	4,160	$	(31,318	)

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



	Year Ended December 31,
	2016			2015			2014
	(amounts in thousands)
Current:
Federal	$	227		$	551		$	—
State	587			(21		)	811
Foreign	322			220			262
Total	1,136			750			1,073

Deferred:
Federal	(4,114		)	(1,819		)	(1,320		)
State	(866		)	8			68
Foreign	(342		)	267			395
Total	(5,322		)	(1,544		)	(857		)
Total income tax (benefit) expense	$	(4,186	)	$	(794	)	$	216

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

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



	December 31,
	2016			2015
	(amounts in thousands)
Deferred Tax Assets:
Accrued other and prepaid expenses	$	3,494		$	2,973
Allowance for doubtful accounts	704			1,278
Intangible Assets	10,725			11,365
Net operating loss carryforwards	17,228			22,662
Derivative interest	7,940			10,144
Accrued professional liability	2,632			2,536
Accrued workers’ compensation	3,439			3,061
Share-based compensation	—			891
Credit carryforwards	1,055			797
Other	584			595
Gross deferred tax assets	47,801			56,302
Valuation allowance	(46,454		)	(55,336		)
	1,347			966
Deferred Tax Liabilities:
Depreciation	(70		)	(123		)
Indefinite intangibles	(13,971		)	(18,714		)
Tax on unrepatriated earnings	(263		)	(604		)
Share-based compensation	(197		)	—
	(14,501		)	(19,441		)
Net deferred taxes	$	(13,154	)	$	(18,475	)

The Company's cumulative loss position was significant negative evidence in assessing the need for a valuation allowance on its deferred tax assets. 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. Due to the historical losses from the Company's operations, it has recorded a full valuation allowance on its deferred tax assets. 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 the Income Taxes Topic of the FASB ASC. The Company had $14.0 million and $18.7 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, 2016 and 2015, respectively. As of December 31, 2016 and 2015, the Company recorded valuation allowances of $46.5 million and $55.3 million, respectively.

The Company believes it is necessary to see further positive evidence, such as sustained achievement of cumulative profits, before these valuation allowances can be released. If such positive evidence develops, the Company may release all or a portion of the remaining valuation allowances, but at this point in time cannot determine in which period they would reverse. The Company will continue to assess the realizability of its deferred tax assets.

As of December 31, 2016 and 2015, respectively, the Company had approximately $53.2 million and $65.2 million of federal, state, and foreign net operating loss carryforwards. The federal carryforwards expire between 2031 and 2034. The state carryforwards expire between 2016 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, 2016 and 2015, 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.

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



	Year Ended December 31,
	2016			2015			2014
	(amounts in thousands)
Tax at U.S. statutory rate	$	1,591		$	1,456		$	(10,961	)
State taxes, net of federal benefit	344			611			219
Noncontrolling interest	(260		)	—			—
Non-deductible meals and entertainment	1,546			1,510			1,425
Foreign tax expense	(5		)	(6		)	44
Valuation allowances	(8,379		)	(5,078		)	12,038
Uncertain tax positions	1,090			917			(996		)
Audit settlements	—			(624		)	—
Other	(113		)	420			(1,553		)
Total income tax (benefit) expense	$	(4,186	)	$	(794	)	$	216

The tax years of 2004, 2005, and 2008 through 2015 remain open to examination by certain taxing jurisdictions to which the Company is subject to tax, other than certain states in which the statute of limitations has been extended.

During 2016, the Company accrued $0.2 million of India tax on earnings of approximately $0.5 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.

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



	2016		2015
	(amounts in thousands)
Balance at January 1	$	4,071	$	3,777
Additions based on tax positions related to the current year	1,054		861
Additions based on tax positions related to prior years	55		62
Reductions based on settlements of tax positions related to prior years	—		(624		)
Other	—		(5		)
Balance at December 31	$	5,180	$	4,071

Short-term unrecognized tax benefits are included in other current liabilities on the consolidated balance sheets and were approximately $0.1 million as of December 31, 2016 and 2015. Long-term unrecognized tax benefits are included in other long-term liabilities on the consolidated balance sheets and were approximately $0.9 million and $0.8 million as of December 31, 2016 and 2015, respectively. See Note 7 - Balance Sheet Details. As of December 31, 2016 and 2015, the Company had unrecognized tax benefits, which would affect the effective tax rate if recognized, of approximately $4.9 million and $3.8 million, respectively. During 2016, the Company had gross increases of $1.1 million to its current year unrecognized tax benefits, related to federal and state tax positions.

The Company recognizes interest and penalties related to unrecognized tax benefits in the provision for income taxes. During the year ended December 31, 2016, the Company recognized interest and penalties of $0.1 million. During the years ended December 31, 2015 and 2014, the Company recognized a reduction on interest and penalties of $0.2 million. The Company had accrued approximately $0.5 million and $0.4 million for the payment of interest and penalties at December 31, 2016 and 2015, respectively.

Stockholders' Equity

12 Months Ended

Dec. 31, 2016

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, 2016, 2015 and 2014, the Company did not repurchase any shares of its Common Stock under its February 2008 Board authorization.

As of December 31, 2016, 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 new Credit Agreement. The Company may repurchase up to an aggregate amount not to exceed $2.5 million in any fiscal year, or an unlimited amount if the Company meets certain conditions as described in its new Credit Agreement.

Share-Based Payments

2014 Omnibus Incentive Plan

The Company's 2014 Omnibus Incentive Plan (2014 Plan) provides for the issuance of stock options, stock appreciation rights, restricted stock, performance shares, and 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 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 2014 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 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 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.

During the year ended December 31, 2016, 246,020 of restricted stock awards and 202,442 of performance stock awards were granted under the 2014 Plan to the Company's non-employee Directors and management team. In 2015, the Company changed the timing of its annual grants to management from June to March. Pursuant to the 2014 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. If the minimum level of performance is attained for the 2016 awards, restricted stock will be issued with a vesting date of December 31, 2018, subject to the employee’s continuing employment. During the first quarter of 2016, the Committee approved a 100% level of attainment for the 2015 performance-based share awards, resulting in the issuance of 148,178 performance shares that will vest on December 31, 2017.

The following table summarizes restricted stock awards and performance stock awards activity issued under the 2014 Plan for the year ended December 31, 2016:



	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, 2016	586,488		$	7.82	234,138		$	9.81
Granted	246,020		$	12.01	202,442		$	11.63
Vested	(272,597	)	$	7.06	(79,636	)	$	5.82
Forfeited	(27,617	)	$	11.11	(24,852	)	$	11.75
Unvested restricted stock awards, December 31, 2016	532,294		$	9.98	332,092		$	11.73

As of December 31, 2016, the Company had approximately $3.0 million pre-tax of total unrecognized compensation cost related to non-vested restricted stock awards which may be adjusted for future changes in forfeitures. The Company expects to recognize such cost over a weighted average period of 1.82 years. The fair value of shares vested was approximately $4.3 million, $3.9 million, and $2.3 million for the years ended December 31, 2016, 2015, and 2014, respectively.

As of December 31, 2016, the Company had approximately $1.0 million pre-tax 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 1.54 years, the remaining service period. The fair value of shares vested was approximately $1.2 million for the year ended December 31, 2016, the first year these awards began to vest.

During the years ended December 31, 2016, 2015, and 2014, the Company did not issue stock options or stock appreciation rights. The following table represents information about stock options and stock appreciation rights exercised in each year.



	Year Ended December 31,
	2016		2015		2014
	(amounts in thousands)
Total intrinsic value of options exercised	$	1,323	$	1,610	$	695

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 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 recorded 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. Due to the adoption of the 2014 Plan (previously titled 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.

The following table summarizes the Company’s activities with respect to all of its share option plans (issued under the 2014 Plan and the 1999 Plan) for the year ended December 31, 2016:



	Number of Shares		Option Price	Weighted Average Exercise Price	Weighted- Average Remaining Contractual Life (in years)	Aggregate Intrinsic Value (amounts in thousands)
Share options outstanding at beginning of year	395,625		$4.16-$22.50	$6.28
Granted	—		—	—
Exercised	(195,312	)	$4.35-$8.56	$6.08
Forfeited/expired	(12,100	)	$5.21-$22.50	$17.97
Share options outstanding at end of year	188,213		$4.16-$22.50	$5.72	2.62	$	1,870
Share options exercisable at end of year	137,087		$4.16-$22.50	$5.90	2.33	$	1,341
Share options unvested at end of year	51,126		$4.92-$5.61	$5.26	3.40	$	529

As of December 31, 2016, the Company had 188,213 share options outstanding of which 173,457 were vested or expected to vest at a weighted average exercise price of $5.76, intrinsic value of $1.7 million and a weighted average contractual life of 2.55 years. As of December 31, 2016, the Company had less than $0.1 million pre-tax 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 0.42 years.

Earnings Per Share

12 Months Ended

Dec. 31, 2016

Earnings Per Share [Abstract]

Earnings Per Share

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



	Year Ended December 31,
	2016			2015		2014
	(amounts in thousands, except per share data)
Numerator:
Net income (loss) attributable to common shareholders - Basic	$	7,967		$	4,418	$	(31,783	)
Interest on Convertible Notes	3,383			*		*
(Gain) loss on derivative liability	(5,805		)	*		*
Net income (loss) attributable to common shareholders - Diluted	$	5,545		$	4,418	$	(31,783	)

Denominator:
Weighted average common shares - Basic	32,132			31,514		31,190
Effective of diluted shares:
Share-based awards	593			648		—
Convertible Notes	3,521			—		—
Weighted average common shares - Diluted	36,246			32,162		31,190

Net income (loss) per share attributable to common shareholders - Basic	$	0.25		$	0.14	$	(1.02	)

Net income (loss) per share attributable to common shareholders - Diluted	$	0.15		$	0.14	$	(1.02	)

* For the years 2015 and 2014, the Convertible Notes would have been anti-dilutive if converted at the beginning of the respective periods and therefore, amounts are not applicable.

For the periods presented, no tax benefits have been assumed in the weighted average share calculation due to a full valuation allowance on the Company's deferred tax assets.

The following table represents the securities that could potentially dilute net income per share attributable to common shareholders in the future that were not included in the computation of diluted net income per share attributable to common shareholders because to do so would have been anti-dilutive for the periods presented.



	Year Ended December 31,
	2016	2015	2014
	(amounts in thousands)
Convertible notes and share-based awards	—	3,521	3,856

Related Party Transactions	12 Months Ended
Related Party Transactions	Dec. 31, 2016
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 services with related parties were conducted on terms equivalent to those prevailing in an arm's-length transaction. Revenue related to these transactions was $5.0 million, $11.8 million, and $17.8 million in 2016, 2015, and 2014, respectively. Accounts receivable due from these hospitals at December 31, 2016 and 2015 were approximately $1.0 million and $0.6 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 generated revenue providing staffing services to the hospital system of $12.6 million and $10.0 million in 2016 and 2015, respectively, and $4.7 million for the six months ended December 31, 2014. At December 31, 2016 and 2015, the Company had a receivable balance of $1.5 million and $1.4 million, respectively, and a payable balance of $0.2 million. Subsequent to the Company's acquisition of Mediscan on October 30, 2015, Mediscan continued to operate at premises owned, in part, by the founding members of Mediscan. The Company paid $0.4 million for rent for these premises in 2016 and $0.1 million for the two months ended December 31, 2015.

Segment Data

12 Months Ended

Dec. 31, 2016

Segment Reporting [Abstract]

Segment Data

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, recruiting, and value-added workforce solutions including: temporary and permanent placement of travel and local branch-based nurse and allied professionals, MSP services, education healthcare services, and outsourcing services. Its clients include: public and private acute care and non-acute care hospitals, government facilities, public schools and charter schools, outpatient clinics, ambulatory care facilities, physician practice groups, retailers, and many other healthcare providers throughout the U.S. The results of the Mediscan acquisition have been aggregated with the Company's Nurse and Allied Staffing business segment. See Note 3 - Acquisitions.

•

Physician Staffing - Physician Staffing provides physicians in many specialties, certified registered nurse anesthetists (CRNAs), nurse practitioners (NPs), and physician assistants (PAs) as independent contractors on temporary assignments throughout the U.S. at various healthcare facilities, such as acute and non-acute care facilities, medical group practices, government facilities, and managed care organizations.


•	Other Human Capital Management Services - Subsequent to the sale of CCE on August 31, 2015, Other Human Capital Management Services includes retained and contingent search services for physicians, healthcare executives and other healthcare professionals within the U.S.

The Company’s management evaluates performance of each segment primarily based on revenue and contribution income. The Company defines contribution income as income or loss from operations before depreciation, amortization, loss on sale of business, acquisition and integration costs, acquisition-related contingent consideration, restructuring costs, 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 the Segment Reporting Topic of the FASB ASC. 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 to income (loss) from operations for the periods indicated are as follows:



	Year Ended December 31,
	2016			2015		2014
	(amounts in thousands)
Revenue from services:
Nurse and Allied Staffing (a)	$	721,486		$	621,258	$	459,195
Physician Staffing	98,283			115,336		121,145
Other Human Capital Management Services	13,768			30,827		37,485
	$	833,537		$	767,421	$	617,825
Contribution income (loss):
Nurse and Allied Staffing (a)	$	71,992		$	55,718	$	36,486
Physician Staffing	8,265			10,213		6,540
Other Human Capital Management Services	(535		)	1,863		514
	79,722			67,794		43,540

Unallocated corporate overhead (a)	38,400			32,703		27,770
Depreciation	4,168			3,856		3,866
Amortization	5,014			4,210		3,575
Loss on sale of business (b)	—			2,184		—
Acquisition and integration costs	78			902		7,957
Acquisition-related contingent consideration	814			—		—
Restructuring costs	753			1,274		840
Impairment charges (c)	24,311			2,100		10,000
Income (loss) from operations	$	6,184		$	20,565	$	(10,468	)

_______________

(a)

The Company has been centralizing administrative functions to gain efficiencies and, as a result, certain prior periods have been restated for comparability purposes. For the year ended December 31, 2015, $1.2 million of expenses were reclassified from Nurse and Allied Staffing to unallocated corporate overhead to conform to the current period presentation. It was not practicable to reclassify these amounts for the year ended December 31, 2014.


(b)	On August 31, 2015, the Company completed the sale of CCE, and recognized a pre-tax loss of $2.2 million related to the divestiture of the business. See Note 4 - Disposal and Discontinued Operations.


(c)	During the years ended December 31, 2016, 2015, and 2014, the Company recorded impairment charges of $24.3 million, $2.1 million, and $10.0 million, respectively. See Note 5 - Goodwill, Trade Names, and Other Intangible Assets.

- 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
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Reference 2: http://www.xbrl.org/2003/role/presentationRef
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-Topic 280
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Reference 3: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 4: http://www.xbrl.org/2003/role/presentationRef
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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
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Reference 7: http://www.xbrl.org/2003/role/presentationRef
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Reference 8: http://www.xbrl.org/2003/role/presentationRef
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-URI http://asc.fasb.org/extlink&oid=68060357&loc=d3e8984-108599

Reference 9: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 40
-URI http://asc.fasb.org/extlink&oid=68060357&loc=d3e9031-108599

Reference 10: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
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Reference 11: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
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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
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-URI http://asc.fasb.org/extlink&oid=68060357&loc=d3e8924-108599

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, 2016

Quarterly Financial Information Disclosure [Abstract]

Quarterly Financial Data (Unaudited)



	First Quarter		Second Quarter			Third Quarter		Fourth Quarter
2016	(amounts in thousands, except per share data)
Revenue from services	$	196,583	$	199,443		$	214,988	$	222,523

Gross profit	51,046		54,846			58,210		57,633

Consolidated net income (loss)	19,186		(17,095		)	14,289		(7,649		)

Net income (loss) attributable to common shareholders	19,022		(17,237		)	14,066		(7,884		)

Net income (loss) per share attributable to common shareholders - Basic	$	0.60	$	(0.54	)	$	0.44	$	(0.24	)

Net income (loss) per share attributable to common shareholders - Diluted	$	0.09	$	(0.54	)	$	0.22	$	(0.24	)



	First Quarter		Second Quarter		Third Quarter		Fourth Quarter
2015	(amounts in thousands, except per share data)
Revenue from services	$	185,964	$	192,617	$	195,692	$	193,148

Gross profit	47,037		48,363		51,486		50,479

Consolidated net income (loss)	3,050		2,680		5,151		(5,927		)

Net income (loss) attributable to common shareholders	2,934		2,573		5,009		(6,098		)

Net income (loss) per share attributable to common shareholders - Basic	$	0.09	$	0.08	$	0.16	$	(0.19	)

Net income (loss) per share attributable to common shareholders - Diluted	$	0.05	$	0.08	$	0.16	$	(0.19	)

________________

The following items impact the comparability and presentation of our consolidated data:

•

The Company recorded changes in the fair value of convertible notes derivative liability, recording a gain in the first and third quarters of 2016 of $16.4 million and $7.1 million, respectively, and a loss in the second and fourth quarters of 2016 of $3.6 million and $14.2 million, respectively. The Company also recorded a gain in the first and second quarters of 2015 of $2.1 million and $0.4 million, respectively, and a loss in the third and fourth quarters of 2015 of $2.9 million and $9.5 million, respectively. See Note 9 - Convertible Notes Derivative Liability.


•	During the second quarter of 2016 and the fourth quarter of 2015, the Company recorded impairment charges of $24.3 million and $2.1 million, respectively. See Note 5 - Goodwill, Trade Names, and Other Intangible Assets.


•	During the second quarter of 2016, the Company repaid its Second Lien Term Loan and recognized a loss on extinguishment of debt of $1.6 million. See Note 8 - Debt.

•

On August 31, 2015, the Company completed the sale of its education seminars business, CCE. Since the disposal did not represent a strategic shift that will have a major effect on the Company's operations and financial results, it was not reflected as discontinued operations. The transaction resulted in a pre-tax loss of $2.2 million, and an after-tax gain on the sale of CCE of $1.3 million. See Note 4 - Disposals and Discontinued Operations.


•	On October 30, 2015, the Company acquired all of the membership interests of Mediscan. 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 its date of acquisition. See Note 3 - Acquisitions.


•	In 2016, the Company recorded acquisition-related contingent consideration expense primarily related to the Mediscan acquisition, recording $0.3 million in the first quarter, $0.2 million in the second and third quarters, and $0.1 million in the fourth quarter. There were no similar costs recorded in 2015. See Note 3 - Acquisitions and Note 10 - Fair Value Measurements.

•

In the third and fourth quarters of 2016, the Company recorded restructuring costs of $0.6 million and $0.2 million, respectively, primarily related to the centralization of corporate functions. In the second, third, and fourth quarters of 2015, the Company recorded restructuring costs of $1.0 million, $0.2 million, and $0.1 million, respectively. See Note 2 - Summary of Significant Accounting Policies.

Schedule II - Valuation and Qualifying Accounts

12 Months Ended

Dec. 31, 2016

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, 2016, 2015, AND 2014



	Balance at Beginning of Period		Charged to Operations				Write-Offs			Recoveries		Other Changes				Balance at End of Period
	(amounts in thousands)
Allowances for Accounts Receivable
Year Ended December 31, 2016	$	4,045	$	4,034			$	(5,149	)	$	315	$	—			$	3,245
Year Ended December 31, 2015	$	1,425	$	2,414			$	(923	)	$	1,129	$	—			$	4,045
Year Ended December 31, 2014	$	1,651	$	1,016			$	(1,257	)	$	15	$	—			$	1,425

Valuation Allowance for Deferred Tax Assets
Year Ended December 31, 2016	$	55,336	$	(8,894	)		$	—		$	—	$	12			$	46,454
Year Ended December 31, 2015	$	63,616	$	(7,518	)	(a)	$	—		$	—	$	(762	)	(b)	$	55,336
Year Ended December 31, 2014	$	52,001	$	12,038			$	—		$	—	$	(423	)	(c)	$	63,616

________________


(a)	Includes a reversal of valuation allowance related to CCE.


(b)	Valuation allowance on deferred tax asset related to share-based compensation.


(c)	Related to foreign valuation allowance adjustment.

Summary of Significant Accounting Policies (Policies)	12 Months Ended
Summary of Significant Accounting Policies (Policies)	Dec. 31, 2016
Accounting Policies [Abstract]
Use of Estimates	Use of Estimates The preparation of consolidated financial statements in conformity with U.S. generally accepted accounting principles (U.S. GAAP), requires management to make estimates and assumptions that affect the reported amounts in the consolidated financial statements and accompanying notes. Significant estimates and assumptions are used for, but not limited to: (1) the valuation of accounts receivable; (2) goodwill, trade names, and other intangible assets; (3) other long-lived assets; (4) share-based compensation; (5) accruals for health, workers’ compensation and professional liability claims; (6) valuation of deferred tax assets; (7) purchase price allocation; (8) derivative liability; (9) legal contingencies; (10) contingent considerations; (11) income taxes; and (12) 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 significantly differ from those estimates.
Cash and Cash Equivalents	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, 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 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. In addition, the Company maintains a sales allowance for customer disputes which may arise in the ordinary course, which is recorded as contra-revenue. 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.
Prepaid Rent and Deposits	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 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	Business Combinations The Company applies accounting in accordance with the Business Combinations Topic of the FASB ASC when it acquires control over a business. Business combinations are accounted for at fair value. The associated acquisition costs are expensed as incurred and recorded as acquisition and integration costs; noncontrolling interests, if any, are reflected at fair value at the acquisition date; restructuring costs associated with a business combination are expensed; contingent consideration is measured at fair value at the acquisition date, with changes in the fair value after the acquisition date affecting earnings; and goodwill is determined as the excess of the fair value of the consideration conveyed in the acquisition over the fair value of the net assets acquired. The accounting for business combinations requires estimates and judgments as to expectations for future cash flows of the acquired business, and the allocation of those cash flows to identifiable intangible assets, in determining the estimated fair value for assets and liabilities acquired. The fair values assigned to tangible and intangible assets acquired and liabilities assumed are based on management's estimates and assumptions, including valuations that utilize customary valuation procedures and techniques. If the actual results differ from the estimates and judgments used in these estimates, the amounts recorded in the financial statements could result in a possible impairment of the intangible assets and goodwill, or require acceleration of the amortization expense of finite-lived intangible assets. The results of the acquired businesses' operations are included in the consolidated statements of operations of the combined entity beginning on the date of acquisition.
Goodwill, Trade Names, and Other Intangible Assets	Goodwill, Trade Names, and Other 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 1 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 statements 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 annual 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 did 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 was applied prospectively. 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 had four reporting units that it reviewed for impairment: 1) Nurse and Allied Staffing, 2) Physician Staffing, 3) Search, and 4) Education Seminars. The fourth reporting unit, Education Seminars, was divested August 31, 2015. See Note 4 - Disposal and Discontinued Operations. 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. 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 amount of the assets exceeds the fair value of the assets.
Debt Discount and Debt Issuance Costs	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 - 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 are capitalized and presented in the balance sheet as a direct deduction from the carrying amount of the debt liability. See Recently Adopted Accounting Pronouncements section. The deferred costs are amortized using the effective interest method. Deferred costs related to the issuance of the Company’s Revolving Credit Facility and Senior Secured Asset-Based Loan, as defined in Note 8 - Debt, have been capitalized and amortized using the straight line method, over the term of the related credit agreement.
Derivative Financial Instruments	Derivative Financial Instruments The Company evaluates embedded conversion features within convertible debt in accordance with the Derivatives and Hedging Topic of the FASB ASC 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 statements 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.
Sales and Other State Non-income Tax Liabilities	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.
Insurance Claims	Insurance Claims The Company provides workers’ compensation insurance coverage, professional liability coverage, and healthcare 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 healthcare 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. The Other Expenses/Insurance Costs Topic of the FASB ASC previously issued authoritative accounting guidance in the area of insurance contracts and related activity thereto. The Other Expenses/Insurance Costs Topic 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, 2016 and 2015 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, 2016 and 2015, the Company had outstanding approximately $20.2 million and $21.5 million, respectively, of 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 the Company and each working professional in its nurse and allied healthcare business with coverage. Until January 1, 2016, the Company had an occurrence-based professional liability policy for its independent contractor physicians and advanced practitioners which was insured by a wholly-owned subsidiary, Jamestown Indemnity, Ltd., a wholly-owned Cayman Island captive company (the Captive), until its voluntary liquidation in the third quarter of 2015. Beginning in March 2015, the Company's Physician subsidiary self-insured $0.5 million for each of its professional liability claims. Under the terms of the Captive’s reinsurance policy there was a requirement to guarantee the payment of claims to its insured party’s primary medical malpractice insurance carrier via a letter of credit. As a result of the Captive's liquidation, the letter of credit was reduced. As of both December 31, 2016 and 2015, the value of the letter of credit was $2.0 million. Effective January 1, 2016, the Company has a claims-made professional liability policy for its physicians and advanced practitioners. 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 advanced practitioners, it does cover claims brought against all of the Company’s subsidiaries for non-patient general liability.
Revenue Recognition	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 reimbursable expenses in revenues, and the associated amounts of reimbursable expenses in cost of services. Temporary Staffing Revenue Revenue from services consists primarily of temporary staffing revenue. Revenues from temporary staffing, net of sales adjustments and discounts, are recognized when earned, based on hours worked by the Company’s healthcare professionals. Billings to customers are based on specific contract provisions which may include approval of submitted time by our customers. Accordingly, accounts receivable includes estimated revenue for employees’ and independent contractors’ time worked but not yet invoiced. At December 31, 2016 and 2015, the Company's estimate of amounts that had not been billed totaled $41.2 million and $18.4 million, respectively, and are included in accounts receivable on the consolidated balance sheets. 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. Physician Staffing The Physician Staffing business enters into contracts with its healthcare customers to provide temporary staffing services. The Company uses independent contractors for these services. The Company determined that it acts as a principal in this arrangement and, therefore, revenue is reported on a gross basis in the consolidated statements of operations. Education Seminars During the third quarter of 2015, the Company completed the sale of its education seminars business, Cross Country Education, LLC (CCE). See Note 4 - Disposal and Discontinued Operations. Prior to the sale of CCE, revenue from the Company’s Education Seminars services was recognized as the independent contractor-led seminars were performed. In the Company’s Education Seminars business, revenue was recorded in the consolidated statements of operations on a gross basis as a principal versus on a net basis as an agent. Deferred Revenue Amounts collected in advance of the services being substantially complete, related to our physician and executive search business, are recorded as deferred revenue in other current liabilities on the consolidated balance sheets.
Share-Based Compensation	Share-Based Compensation The Company has, from time to time, granted stock options, stock appreciation rights, performance-based stock 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 used 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 stock awards by reference to its stock price on the date of grant. The Company granted performance-based stock 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 vest are determined based on the level of attainment of the targets. If a minimum level of performance is attained for the awards, restricted stock is issued with a vesting date in the future, subject to the employee's continuing employment. 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 used historical data of options with similar characteristics to estimate pre-vesting option forfeitures, as it believed 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 $3.4 million, $2.5 million, and $1.4 million during the years ended December 31, 2016, 2015 and 2014, respectively. Because the Company had a full valuation allowance on its deferred tax assets, the granting and exercise of share-based payments during the years ended December 31, 2016, 2015 and 2014 had no impact on the income tax provision. See Note 14 - Stockholders’ Equity.
Advertising	Advertising The Company’s advertising expense consists primarily of online advertising, internet direct marketing, print media, promotional material and, prior to the sale of CCE, direct mail marketing. Advertising costs that were expensed as incurred totaled $10.2 million, $4.9 million, and $4.1 million for the years ended December 31, 2016, 2015 and 2014, respectively. Prior to the sale of CCE, direct mail marketing costs associated with the Company’s education seminars services were capitalized when the Company determined that there was a reasonable expectation that the cost of the incurred advertising would be recovered from the gross profit generated by the advertised event and expensed when the related event took place.
Restructuring Costs	Restructuring Costs The Company considers restructuring activities to be programs whereby it fundamentally changes its operations, such as closing and consolidating facilities, reducing headcount and realigning operations in response to changing market conditions. As a result, restructuring costs on the consolidated statements of operations include on-going benefit costs for its employees and exit costs.
Deferred Rent	Deferred Rent Deferred rent consists of free rent, rent escalation, tenant improvement allowances, and other incentives received from landlords related to the operating leases for our facilities. Rent escalation represents the difference between actual operating lease payments due and straight-line rent expense, which we record over the term of the lease. The excess is recorded as a deferred credit in the early periods of the lease, when cash payments are generally lower than straight-line rent expense, and is reduced in the later periods of the lease when payments begin to exceed the straight-line expense. Tenant allowances from landlords for tenant improvements are generally comprised of cash received from the landlord or paid on our behalf as part of the negotiated terms of the lease. These tenant improvement allowances and other leasehold incentives are recorded when realizable as deferred rent and are amortized as a reduction of periodic rent expense, over the term of the applicable lease. See Note 12 - Commitments and Contingencies.
Income Taxes	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. The Company determines the need for a valuation allowance 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. See Note 13 - Income Taxes.
Comprehensive Income (Loss)	Comprehensive Income (Loss) Total comprehensive income (loss) includes net income or loss and foreign currency translation adjustments, 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 $1.2 million at both December 31, 2016 and 2015. There was no income tax impact related to foreign currency translation adjustments for the periods ended December 31, 2016 and 2015. During the period ended December 31, 2014, $0.2 million of income tax expense related to foreign currency translation adjustments was included on the Company's consolidated statements of comprehensive income (loss).
Fair Value Measurements	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. GAAP and expands disclosures about fair value measurements. As of December 31, 2016 and 2015, the Company’s financial assets and liabilities required to be measured on a recurring basis were its contingent consideration receivable, its deferred compensation liability, its convertible notes derivative liability, and its contingent purchase price liabilities. See Note 10 - Fair Value Measurements.
Earnings Per Share	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 available to common shareholders (numerator) by the weighted average number of vested unrestricted common shares outstanding during the period (denominator). Diluted earnings per share gives effect to all dilutive potential common shares outstanding during the period including stock appreciation rights and options and unvested restricted stock, as calculated utilizing the treasury stock method, and Convertible Notes using the if-converted method.
Recent Accounting Pronouncements	Recently Adopted Accounting Pronouncements In September 2015, the FASB issued Accounting Standards Update (ASU) No. 2015-16, Business Combinations (Topic 805), Simplifying the Accounting for Measurement-Period Adjustments. This ASU requires that an acquirer recognize adjustments to provisional amounts that are identified during the measurement period in the reporting period in which the adjustment amounts are determined. Prior to the issuance of the ASU, entities were required to retrospectively apply adjustments made to provisional amounts recognized in a business combination. The Company adopted this guidance in the first quarter of 2016, with no impact on its financial position and results of operations upon adoption. This new guidance may impact the Company for potential measurement adjustments related to its acquisitions. In April 2015, the FASB issued ASU No. 2015-05, Intangibles-Goodwill and Other-Internal-Use Software (Subtopic 350-40), Customers Accounting for Fees Paid in a Cloud Computing Arrangement, to help entities evaluate the accounting for fees paid by a customer in a cloud computing arrangement. The amendment provides guidance to customers about whether a cloud computing arrangement includes a software license. If a cloud computing arrangement includes a software license element, then the customer should account for the software license element arrangement consistent with the acquisition of other software licenses. If a cloud computing arrangement does not include a software license, the customer should account for the arrangement as a service contract. The Company prospectively adopted this guidance in the first quarter of 2016, with no impact on its consolidated financial statements. In April 2015, the FASB issued ASU No. 2015-03, Interest-Imputation of Interest (Subtopic 835-30), Simplifying the Presentation of Debt Issuance Costs. This guidance requires that debt issuance costs related to a recognized debt liability be presented in the balance sheet as a direct deduction from the carrying amount of that debt liability. The Company adopted this guidance in the first quarter of 2016, and reclassified $0.5 million of the Company's net debt issuance costs to long-term debt and capital lease obligations in its consolidated balance sheets as of December 31, 2015. Recent Accounting Pronouncements In January 2017, the FASB issued ASU No. 2017-04, Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment, to simplify how an entity is required to test goodwill for impairment by eliminating Step 2 from the goodwill impairment test. Under this guidance, an entity would perform its annual, or interim goodwill impairment test by comparing the fair value of a reporting unit with its carrying amount. An impairment charge would be recognized for the amount by which the carrying amount exceeds the reporting unit’s fair value; however, the loss recognized should not exceed the total amount of goodwill allocated to that reporting unit. Additionally, an entity would consider income tax effects from any tax deductible goodwill on the carrying amount of the reporting unit when measuring the goodwill impairment loss, if applicable. An entity still has the option to perform the qualitative assessment for a reporting unit to determine if the quantitative impairment test is necessary. ASU 2017-04 is effective for annual or any interim goodwill impairment tests in fiscal years beginning after December 15, 2019 and is to be applied prospectively. Early adoption is permitted for interim or annual goodwill impairment tests performed on testing dates after January 1, 2017. The Company expects to early adopt this standard in its first quarter of 2017, and does not expect this guidance to have a material impact on its consolidated financial statements. In January 2017, the FASB issued ASU No. 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business, which clarifies the definition of a business, with the objective of adding guidance to assist entities with evaluating whether transactions should be accounted for as acquisitions (or disposals) of assets or businesses. This update provides a framework to assist entities in evaluating whether both an input and a substantive process are present, and narrows the definition of the term output so that the term is consistent with how outputs are described in the new revenue recognition standard. ASU 2017-01 is effective for annual periods beginning after December 15, 2017, and interim periods within those annual periods. Early adoption is permitted depending upon the date of the transaction. Entities should apply the guidance prospectively on or after the effective date. No disclosures are required at transition. The Company expects to adopt this standard in its first quarter of 2018, and does not expect this guidance to have a material impact on its consolidated financial statements. In August 2016, the FASB issued ASU No. 2016-15, Statement of Cash Flows (Topic 230), Classification of Certain Cash Receipts and Cash Payments, which amends the guidance in ASC 230 on the classification of certain cash receipts and payments in the statement of cash flows. This update intends to reduce the diversity that has resulted from the lack of consistent principles on this topic by adding or clarifying guidance on eight cash flow issues, including: debt prepayment or debt extinguishment costs, contingent consideration payments made after a business combination, and separately identifiable cash flows and application of the predominance principle. ASU 2016-15 is effective for annual periods beginning after December 15, 2017, and interim periods within those annual periods. Early adoption is permitted. Entities must apply the guidance retrospectively to all periods presented but may apply it prospectively from the earliest date practicable if retrospective application would be impracticable. The Company expects to adopt this standard in its first quarter of 2018, and does not expect this guidance to have a material impact on its consolidated financial statements. In March 2016, the FASB issued ASU No. 2016-09, Compensation-Stock Compensation (Topic 718), Improvements to Employee Share-Based Payment Accounting. The areas for simplification in this update involve several aspects of the accounting for share-based payment transactions, including the income tax consequences, classification of awards as either equity or liabilities, and classification on the statement of cash flows. This update revises the threshold to qualify for equity classification to permit withholding up to the employer's maximum statutory tax rates in the applicable jurisdictions. ASU 2016-09 is effective for annual periods beginning after December 15, 2016, and interim periods within those annual periods, and early adoption is permitted. There are various methods of adoption for each aspect. Upon adoption, the Company will recognize its previously unrecognized excess tax benefits using the modified retrospective transition method, which will result in a cumulative-effect adjustment to retained earnings and deferred tax assets. In addition, upon adoption, the Company no longer intends to calculate an estimate of expected forfeitures and will begin to recognize forfeitures as they occur, which will result in a cumulative-effect decrease to retained earnings and a corresponding increase to additional paid-in capital. The Company expects to adopt this standard in its first quarter of 2017. In March 2016, the FASB issued ASU No. 2016-06, Derivatives and Hedging (Topic 815): Contingent Put and Call Options in Debt Instruments, to clarify the steps required to assess whether a call or put option meets the criteria for bifurcation as an embedded derivative. ASU 2016-06 is effective for interim and annual periods beginning after December 15, 2016, and requires a modified retrospective approach to adoption. Early adoption is permitted. The Company expects to adopt this standard in its first quarter of 2017, and does not expect this guidance to have an impact on its consolidated financial statements. In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842), which will require, among other items, lessees to recognize most leases as assets and liabilities on the balance sheet. Qualitative and quantitative disclosures will be enhanced to better understand the amount, timing and uncertainty of cash flows arising from leases. ASU 2016-02 is effective for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years, with early adoption permitted. Entities are required to use a modified retrospective approach for leases that exist or are entered into after the beginning of the earliest comparative period in the financial statements. Full retrospective application is prohibited. The Company expects the valuation of right of use assets and lease liabilities, previously described as operating leases, to be the present value of our forecasted future lease commitments. The Company is continuing to assess the overall impacts of the new standard, including the discount rate to be applied in these valuations. See Note 12 - Commitments and Contingencies. In May 2014, the FASB and the International Accounting Standards Board jointly issued ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606), that introduces a new five-step revenue recognition model in which 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 or services. This ASU also requires disclosures sufficient to enable users to understand the nature, amount, timing, and uncertainty of revenue and cash flows arising from contracts with customers, including qualitative and quantitative disclosures about contracts with customers, significant judgments and changes in judgments, and assets recognized from the costs to obtain or fulfill a contract. In March 2016, the FASB issued ASU 2016-08 which further clarifies the guidance on the principal versus agent considerations within ASU 2014-09. In April 2016, the FASB issued ASU 2016-10 to expand the guidance on identifying performance obligations and licensing within ASU 2014-09. In May 2016, the FASB issued ASU 2016-12 to improve revenue recognition in the areas of collectability, presentation of sales tax and other similar taxes collected from customers, non-cash consideration, contract modifications and completed contracts at transition. This update also amends the disclosure requirements within ASU 2014-09 for entities that retrospectively apply the guidance. The latest amendments are intended to address implementation issues that were raised by stakeholders and discussed by the Revenue Recognition Transition Resource Group, and provide additional practical expedients. These updates are effective for fiscal years beginning after December 15, 2017, including interim periods within that reporting period. The Company established a cross-functional implementation team consisting of representatives from across all of its business segments. Management is in the process of reviewing its contract portfolio and its existing accounting policies and practices to identify potential differences that would result from applying the requirements of the new standard to its contracts. Management expects this assessment will continue throughout the first half of 2017. Once this phase has been completed, if applicable, management intends to implement appropriate changes to its business processes, systems and controls to support the recognition and disclosure under the new standard. The Company is continuing to assess which transition method it will use to adopt this accounting standard and expects a full assessment by the fourth quarter of 2017.

Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2016

Accounting Policies [Abstract]

Schedule of restructuring costs

Reconciliations of the beginning and ending total restructuring liability balances are presented below:



	Year Ended December 31,
	2016						2015
	(amounts in thousands)
	On-Going Benefit Costs			Exit Costs			On-Going Benefit Costs			Exit Costs
Balance at beginning of period	$	44		$	338		$	—		$	—
Charged to restructuring costs	563			190			633			641
Payments	(282		)	(255		)	(589		)	(303		)
Balance at end of period	$	325		$	273		$	44		$	338

Acquisitions (Tables)

12 Months Ended

Dec. 31, 2016

Business Acquisition [Line Items]

Reconciliation of acquisition and integration liability

Reconciliations of the beginning and ending total acquisition and integration liability balances are presented below:



	Year Ended December 31,
	2016						2015
	(amounts in thousands)
	On-Going Benefit Costs			Exit Costs			On-Going Benefit Costs			Exit Costs
Balance at beginning of period	$	47		$	46		$	762		$	868
Charged to acquisition and integration costs	—			—			17			88
Reclassifications (a)	—			—			—			(255		)
Payments	(47		)	(46		)	(732		)	(655		)
Balance at end of period	$	—		$	—		$	47		$	46


(a)	Exit liability has been reduced as a result of a lease amendment and has been reclassified to deferred rent, which will be amortized over the remaining lease term.

Schedule of unaudited pro forma information



	Year Ended December 31,
	2015		2014
	(unaudited, amounts in thousands except per share data)

Revenue from services	$	800,353	$	771,955

Net income (loss) attributable to common shareholders	$	5,436	$	(30,104	)

Net income (loss) per common share attributable to common shareholders - basic and diluted	$	0.17	$	(0.97	)

Mediscan

Business Acquisition [Line Items]

Schedule of estimated fair value of purchase price

The following is the estimated fair value of the purchase price for Mediscan on October 30, 2015:



	(amounts in thousands)
Cash purchase price paid at closing	$	28,000
Fair value of shares	4,723
Fair value of contingent consideration	3,686
Net working capital adjustment, including receivable	503
Total consideration	$	36,912

Summary of fair value of assets acquired and liabilities assumed

The following is the estimated fair value of the assets acquired and liabilities assumed on October 30, 2015.



	(amounts in thousands)
Cash acquired	$	79
Accounts receivable	6,851
Other current assets	140
Property and equipment	20
Goodwill	14,338
Other intangible assets	17,200
Total assets acquired	38,628
Accounts payable and accrued expenses	306
Accrued employee compensation and benefits	1,410
Total liabilities assumed	1,716
Net assets acquired	$	36,912

Medical Staffing Network

Business Acquisition [Line Items]

Summary of fair value of assets acquired and liabilities assumed

The Company used a third-party appraiser to assist with the determination of the fair value and estimated useful lives of acquired assets and liabilities assumed on June 30, 2014:



	(amounts in thousands)
Cash acquired	$	989
Accounts receivable	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

Goodwill, Trade Names, and Other Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2016

Goodwill and Intangible Assets Disclosure [Abstract]

Acquired Intangible Assets

As of December 31, 2016 and 2015, the Company had the following acquired intangible assets:



	December 31, 2016						December 31, 2015
	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	$	31,609	$	16,147	$	15,462	$	31,225	$	14,150	$	17,075
Customer relationships	41,724		23,316		18,408		47,204		20,734		26,470
Non-compete agreements	3,619		3,527		92		3,603		3,486		117
Trade names, definite-lived	3,216		343		2,873		3,200		49		3,151
	$	80,168	$	43,333	$	36,835	$	85,232	$	38,419	$	46,813
Intangible assets not subject to amortization:
Trade names					35,402						36,101
					$	72,237					$	82,914

Estimated Annual Amortization Expense

As of December 31, 2016, estimated annual amortization expense is as follows:



Years Ending December 31:	(amounts in thousands)
2017	$	4,248
2018	4,148
2019	4,111
2020	4,007
2021	3,799
Thereafter	16,522
	$	36,835

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, 2015
Aggregate goodwill acquired	$	302,005		$	43,405		$	19,307		$	364,717
Sale of CCE (a)	—			—			(9,889		)	(9,889		)
Accumulated impairment loss	(259,732		)	—			—			(259,732		)
Goodwill, net of impairment loss	42,273			43,405			9,418			95,096

Changes to aggregate goodwill in 2016
Goodwill acquired (b)	2,272			—			—			2,272
Impairment charges	—			(17,720		)	—			(17,720		)

Balances as of December 31, 2016
Aggregate goodwill acquired	304,277			43,405			19,307			366,989
Sale of CCE (a)	—			—			(9,889		)	(9,889		)
Accumulated impairment loss	(259,732		)	(17,720		)	—			(277,452		)
Goodwill, net of impairment loss	$	44,545		$	25,685		$	9,418		$	79,648

_______________


(a)	See Note 4 - Disposal and Discontinued Operations.


(b)	Goodwill acquired from the acquisition of USR. See Note 3 - Acquisitions.

Property and Equipment (Tables)

12 Months Ended

Dec. 31, 2016

Property, Plant and Equipment [Abstract]

Property and Equipment

At December 31, 2016 and 2015, property and equipment consist of the following:



		December 31,
	Useful Lives	2016			2015
		(amounts in thousands)

Computer equipment	3-5 years	$	13,584		$	12,335
Computer software	3-5 years	28,752			27,565
Office equipment	5-7 years	2,397			2,241
Furniture and fixtures	5-7 years	3,969			3,411
Leasehold improvements	(a)	7,257			4,286
		55,959			49,838
Less accumulated depreciation and amortization		(43,141		)	(39,368		)
		$	12,818		$	10,470

_______________


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

Balance Sheet Details (Tables)

12 Months Ended

Dec. 31, 2016

Balance Sheet Related Disclosures [Abstract]

Balance Sheet Details



	December 31,
	2016		2015
	(amounts in thousands)
Insurance recovery receivable:
Insurance recovery for health	$	279	$	—
Insurance recovery for workers’ compensation	1,271		1,403
Insurance recovery for professional liability	1,487		1,463
	$	3,037	$	2,866

Other non-current assets:
Insurance recovery for workers’ compensation – long-term	$	5,857	$	6,281
Insurance recovery for professional liability – long-term	10,353		10,722
Non-current security deposits	925		991
	$	17,135	$	17,994

Accrued compensation and benefits:
Salaries and payroll taxes	$	15,480	$	11,976
Bonuses	3,915		4,584
Accrual for workers’ compensation claims	5,266		5,151
Accrual for professional liability insurance	2,433		2,516
Accrual for health care benefits	4,053		3,009
Accrual for vacation	2,096		2,166
	$	33,243	$	29,402

Long-term accrued claims:
Accrual for workers’ compensation claims	$	12,817	$	14,014
Accrual for professional liability insurance	16,053		16,056
	$	28,870	$	30,070

Other long-term liabilities:
Deferred compensation	$	1,472	$	1,412
Deferred rent	5,011		2,473
Long-term unrecognized tax benefits	874		819
Other	42		122
	$	7,399	$	4,826

Debt (Tables)

12 Months Ended

Dec. 31, 2016

Debt Disclosure [Abstract]

Long-term Debt

At December 31, 2016 and 2015, long-term debt consists of the following:



	December 31, 2016						December 31, 2015
	Principal			Unamortized Discount and Debt Issuance Costs			Principal			Unamortized Discount and Debt Issuance Costs
	(amounts in thousands)

Term Loan, interest 2.62%	$	39,500		$	(363	)	$	—		$	—
Senior Secured Asset-Based, weighted average interest 2.41%	—			—			8,000			—
Second Lien Term Loan, interest 5.75%	—			—			30,000			(1,052		)
Convertible Notes, fixed rate interest of 8.00%	25,000			(4,669		)	25,000			(6,007		)
Convertible Notes derivative liability	27,532			—			33,337			—
Capital lease obligations	23			—			94			—
Total debt	92,055			(5,032		)	96,431			(7,059		)
Less current portion	(2,263		)	—			(8,071		)	—
Long-term debt	$	89,792		$	(5,032	)	$	88,360		$	(7,059	)

The Applicable Margin, as of any date, is a percentage per annum determined by reference to the applicable Consolidated Net Leverage Ratio (as defined by the agreement) in effect on such date as set forth in the table below.



Level	Consolidated Net Leverage Ratio	Eurodollar Loans, LIBOR Index Rate Loans and Letter of Credit Fee	Base Rate Loans	Commitment Fee
I	Less than 1.50:1.00	1.75%	0.75%	0.25%
II	Greater than or equal to 1.50:1.00 but less than 2.00:1.00	2.00%	1.00%	0.30%
III	Greater than or equal to 2.00:1.00 but less than 2.50:1.00	2.25%	1.25%	0.30%
IV	Greater than or equal to 2.50:1.00 but less than 3.00:1.00	2.50%	1.50%	0.35%
V	Greater than or equal to 3.00:1.00	2.75%	1.75%	0.40%

Aggregate Scheduled Maturities of Debt

As of December 31, 2016, the aggregate scheduled maturities of debt are as follows:



	Term Loan		Convertible Notes		Capital Leases
	(amounts in thousands)
Through Years Ending December 31:
2017	$	2,250	$	—	$	13
2018	3,750		—		8
2019	3,500		—		2
2020	4,000		25,000		—
2021	26,000		—		—
Thereafter	—		—		—
Total	$	39,500	$	25,000	$	23

Convertible Notes Derivative Liability (Tables)

12 Months Ended

Dec. 31, 2016

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, 2016
Closing share price	$15.61
Conversion price	$7.10
Risk free rate	1.76%
Expected volatility	40%
Dividend yield	—%
Expected life	3.5 years

Fair Value Measurements (Tables)

12 Months Ended

Dec. 31, 2016

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, 2016 and 2015:

Fair Value Measurements



	December 31, 2016		December 31, 2015
Financial Liabilities:	(amounts in thousands)
(Level 1)
Deferred compensation	$	1,472	$	1,412
(Level 3)
Convertible Notes derivative liability	$	27,532	$	33,337
Contingent purchase price liabilities	$	5,603	$	3,686

Fair Value, 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:



	Contingent Purchase			Convertible Notes
	Price Liabilities (a)			Derivative Liability
	(amounts in thousands)

December 31, 2014	$	—		$	23,436
Additions	3,686			—
Valuation loss for the period	—			9,901
December 31, 2015	3,686			33,337
Additions	1,300			—
Payments	(152		)	—
Accretion expense	887			—
Valuation gain for the period	(118		)	(5,805		)
December 31, 2016	$	5,603		$	27,532

_______________

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, 2016				December 31, 2015
	Carrying Amount		Fair Value		Carrying Amount		Fair Value
	(amounts in thousands)
Financial Liabilities:
(Level 2)
Second Lien Term Loan, net	$	—	$	—	$	28,948	$	30,600
Term Loan, net	$	39,137	$	41,500	$	—	$	—
Convertible Notes, net	$	20,331	$	27,250	$	18,993	$	23,250
Senior Secured Asset-Based Loan	$	—	$	—	$	8,000	$	8,000

Commitments and Contingencies (Tables)

12 Months Ended

Dec. 31, 2016

Commitments and Contingencies Disclosure [Abstract]

Future Minimum Lease Payments

Future minimum lease payments, as of December 31, 2016, associated with these agreements with terms of one year or more are as follows:



Years Ending December 31:	(amounts in thousands)
2017	$	7,249
2018	6,240
2019	4,826
2020	4,145
2021	3,843
Thereafter	13,191
	$	39,494

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2016

Income Tax Disclosure [Abstract]

Components of Income (Loss) Before Income Taxes

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



	Year Ended December 31,
	2016		2015		2014
	(amounts in thousands)
United States	$	3,309	$	3,565	$	(33,574	)
Foreign	1,236		595		2,256
Income (loss) before income taxes	$	4,545	$	4,160	$	(31,318	)

Components of Income Tax Expense (Benefit)

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



	Year Ended December 31,
	2016			2015			2014
	(amounts in thousands)
Current:
Federal	$	227		$	551		$	—
State	587			(21		)	811
Foreign	322			220			262
Total	1,136			750			1,073

Deferred:
Federal	(4,114		)	(1,819		)	(1,320		)
State	(866		)	8			68
Foreign	(342		)	267			395
Total	(5,322		)	(1,544		)	(857		)
Total income tax (benefit) expense	$	(4,186	)	$	(794	)	$	216

Significant Components of Deferred Tax Assets and Liabilities

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



	December 31,
	2016			2015
	(amounts in thousands)
Deferred Tax Assets:
Accrued other and prepaid expenses	$	3,494		$	2,973
Allowance for doubtful accounts	704			1,278
Intangible Assets	10,725			11,365
Net operating loss carryforwards	17,228			22,662
Derivative interest	7,940			10,144
Accrued professional liability	2,632			2,536
Accrued workers’ compensation	3,439			3,061
Share-based compensation	—			891
Credit carryforwards	1,055			797
Other	584			595
Gross deferred tax assets	47,801			56,302
Valuation allowance	(46,454		)	(55,336		)
	1,347			966
Deferred Tax Liabilities:
Depreciation	(70		)	(123		)
Indefinite intangibles	(13,971		)	(18,714		)
Tax on unrepatriated earnings	(263		)	(604		)
Share-based compensation	(197		)	—
	(14,501		)	(19,441		)
Net deferred taxes	$	(13,154	)	$	(18,475	)

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 (benefit) expense is as follows:



	Year Ended December 31,
	2016			2015			2014
	(amounts in thousands)
Tax at U.S. statutory rate	$	1,591		$	1,456		$	(10,961	)
State taxes, net of federal benefit	344			611			219
Noncontrolling interest	(260		)	—			—
Non-deductible meals and entertainment	1,546			1,510			1,425
Foreign tax expense	(5		)	(6		)	44
Valuation allowances	(8,379		)	(5,078		)	12,038
Uncertain tax positions	1,090			917			(996		)
Audit settlements	—			(624		)	—
Other	(113		)	420			(1,553		)
Total income tax (benefit) expense	$	(4,186	)	$	(794	)	$	216

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:



	2016		2015
	(amounts in thousands)
Balance at January 1	$	4,071	$	3,777
Additions based on tax positions related to the current year	1,054		861
Additions based on tax positions related to prior years	55		62
Reductions based on settlements of tax positions related to prior years	—		(624		)
Other	—		(5		)
Balance at December 31	$	5,180	$	4,071

Stockholders' Equity (Tables)

12 Months Ended

Dec. 31, 2016

Equity [Abstract]

Summary of Restricted Stock Award Activity

The following table summarizes restricted stock awards and performance stock awards activity issued under the 2014 Plan for the year ended December 31, 2016:



	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, 2016	586,488		$	7.82	234,138		$	9.81
Granted	246,020		$	12.01	202,442		$	11.63
Vested	(272,597	)	$	7.06	(79,636	)	$	5.82
Forfeited	(27,617	)	$	11.11	(24,852	)	$	11.75
Unvested restricted stock awards, December 31, 2016	532,294		$	9.98	332,092		$	11.73

Stock Options and Stock Appreciation Rights Granted and Exercised

The following table represents information about stock options and stock appreciation rights exercised in each year.



	Year Ended December 31,
	2016		2015		2014
	(amounts in thousands)
Total intrinsic value of options exercised	$	1,323	$	1,610	$	695

Summary of Share Option Plans Activities

The following table summarizes the Company’s activities with respect to all of its share option plans (issued under the 2014 Plan and the 1999 Plan) for the year ended December 31, 2016:



	Number of Shares		Option Price	Weighted Average Exercise Price	Weighted- Average Remaining Contractual Life (in years)	Aggregate Intrinsic Value (amounts in thousands)
Share options outstanding at beginning of year	395,625		$4.16-$22.50	$6.28
Granted	—		—	—
Exercised	(195,312	)	$4.35-$8.56	$6.08
Forfeited/expired	(12,100	)	$5.21-$22.50	$17.97
Share options outstanding at end of year	188,213		$4.16-$22.50	$5.72	2.62	$	1,870
Share options exercisable at end of year	137,087		$4.16-$22.50	$5.90	2.33	$	1,341
Share options unvested at end of year	51,126		$4.92-$5.61	$5.26	3.40	$	529

Earnings Per Share (Tables)

12 Months Ended

Dec. 31, 2016

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 the basic and diluted earnings per share:



	Year Ended December 31,
	2016			2015		2014
	(amounts in thousands, except per share data)
Numerator:
Net income (loss) attributable to common shareholders - Basic	$	7,967		$	4,418	$	(31,783	)
Interest on Convertible Notes	3,383			*		*
(Gain) loss on derivative liability	(5,805		)	*		*
Net income (loss) attributable to common shareholders - Diluted	$	5,545		$	4,418	$	(31,783	)

Denominator:
Weighted average common shares - Basic	32,132			31,514		31,190
Effective of diluted shares:
Share-based awards	593			648		—
Convertible Notes	3,521			—		—
Weighted average common shares - Diluted	36,246			32,162		31,190

Net income (loss) per share attributable to common shareholders - Basic	$	0.25		$	0.14	$	(1.02	)

Net income (loss) per share attributable to common shareholders - Diluted	$	0.15		$	0.14	$	(1.02	)

* For the years 2015 and 2014, the Convertible Notes would have been anti-dilutive if converted at the beginning of the respective periods and therefore, amounts are not applicable.

Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share



	Year Ended December 31,
	2016	2015	2014
	(amounts in thousands)
Convertible notes and share-based awards	—	3,521	3,856

Segment Data (Tables)

12 Months Ended

Dec. 31, 2016

Segment Reporting [Abstract]

Information on Operating Segments and Reconciliation to Income From Operations

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



	Year Ended December 31,
	2016			2015		2014
	(amounts in thousands)
Revenue from services:
Nurse and Allied Staffing (a)	$	721,486		$	621,258	$	459,195
Physician Staffing	98,283			115,336		121,145
Other Human Capital Management Services	13,768			30,827		37,485
	$	833,537		$	767,421	$	617,825
Contribution income (loss):
Nurse and Allied Staffing (a)	$	71,992		$	55,718	$	36,486
Physician Staffing	8,265			10,213		6,540
Other Human Capital Management Services	(535		)	1,863		514
	79,722			67,794		43,540

Unallocated corporate overhead (a)	38,400			32,703		27,770
Depreciation	4,168			3,856		3,866
Amortization	5,014			4,210		3,575
Loss on sale of business (b)	—			2,184		—
Acquisition and integration costs	78			902		7,957
Acquisition-related contingent consideration	814			—		—
Restructuring costs	753			1,274		840
Impairment charges (c)	24,311			2,100		10,000
Income (loss) from operations	$	6,184		$	20,565	$	(10,468	)

_______________

(a)


(b)	On August 31, 2015, the Company completed the sale of CCE, and recognized a pre-tax loss of $2.2 million related to the divestiture of the business. See Note 4 - Disposal and Discontinued Operations.


(c)	During the years ended December 31, 2016, 2015, and 2014, the Company recorded impairment charges of $24.3 million, $2.1 million, and $10.0 million, respectively. See Note 5 - Goodwill, Trade Names, and Other Intangible Assets.

Quarterly Financial Data (Unaudited) (Tables)

12 Months Ended

Dec. 31, 2016

Quarterly Financial Information Disclosure [Abstract]

Quarterly Financial Data



	First Quarter		Second Quarter			Third Quarter		Fourth Quarter
2016	(amounts in thousands, except per share data)
Revenue from services	$	196,583	$	199,443		$	214,988	$	222,523

Gross profit	51,046		54,846			58,210		57,633

Consolidated net income (loss)	19,186		(17,095		)	14,289		(7,649		)

Net income (loss) attributable to common shareholders	19,022		(17,237		)	14,066		(7,884		)

Net income (loss) per share attributable to common shareholders - Basic	$	0.60	$	(0.54	)	$	0.44	$	(0.24	)

Net income (loss) per share attributable to common shareholders - Diluted	$	0.09	$	(0.54	)	$	0.22	$	(0.24	)



	First Quarter		Second Quarter		Third Quarter		Fourth Quarter
2015	(amounts in thousands, except per share data)
Revenue from services	$	185,964	$	192,617	$	195,692	$	193,148

Gross profit	47,037		48,363		51,486		50,479

Consolidated net income (loss)	3,050		2,680		5,151		(5,927		)

Net income (loss) attributable to common shareholders	2,934		2,573		5,009		(6,098		)

Net income (loss) per share attributable to common shareholders - Basic	$	0.09	$	0.08	$	0.16	$	(0.19	)

Net income (loss) per share attributable to common shareholders - Diluted	$	0.05	$	0.08	$	0.16	$	(0.19	)

________________

The following items impact the comparability and presentation of our consolidated data:

•


•	During the second quarter of 2016 and the fourth quarter of 2015, the Company recorded impairment charges of $24.3 million and $2.1 million, respectively. See Note 5 - Goodwill, Trade Names, and Other Intangible Assets.


•	During the second quarter of 2016, the Company repaid its Second Lien Term Loan and recognized a loss on extinguishment of debt of $1.6 million. See Note 8 - Debt.

•


•	On October 30, 2015, the Company acquired all of the membership interests of Mediscan. 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 its date of acquisition. See Note 3 - Acquisitions.


•	In 2016, the Company recorded acquisition-related contingent consideration expense primarily related to the Mediscan acquisition, recording $0.3 million in the first quarter, $0.2 million in the second and third quarters, and $0.1 million in the fourth quarter. There were no similar costs recorded in 2015. See Note 3 - Acquisitions and Note 10 - Fair Value Measurements.


•	In the third and fourth quarters of 2016, the Company recorded restructuring costs of $0.6 million and $0.2 million, respectively, primarily related to the centralization of corporate functions. In the second, third, and fourth quarters of 2015, the Company recorded restructuring costs of $1.0 million, $0.2 million, and $0.1 million, respectively.

Summary of Significant Accounting Policies - Narrative (Detail)	1 Months Ended	12 Months Ended
	Mar. 31, 2015 USD ($)	Dec. 31, 2016 USD ($) reporting_unit	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)
Significant Accounting Policies [Line Items]
Number of reporting units \| reporting_unit		4
Outstanding standby letters of credit as collateral		$ 20,200,000	$ 21,500,000
Accrued revenue		41,200,000	18,400,000
Equity compensation		3,400,000	2,500,000	$ 1,400,000
Advertising costs		10,200,000	4,900,000	4,100,000
Prepaid expenses, advertising		0	0
Cumulative impact of currency fluctuations		1,200,000	1,200,000
Income tax expense (benefit) related to items of other comprehensive (loss) income		0	0	$ 162,000
Claims-Based Liability Insurance \| MDA Holdings Inc
Significant Accounting Policies [Line Items]
Letter of credit for malpractice claims		2,000,000
Occurrence-Based Professional Liability Insurance \| MDA Holdings Inc
Significant Accounting Policies [Line Items]
Coverage for professional liability claims	$ 500,000.0
Letter of credit for malpractice claims			2,000,000
Other Current Liabilities
Significant Accounting Policies [Line Items]
Deferred revenue		$ 900,000	1,100,000
Minimum
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		1 year
Minimum \| Computer software
Significant Accounting Policies [Line Items]
Estimated useful life of assets		3 years
Maximum
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 \| Computer software
Significant Accounting Policies [Line Items]
Estimated useful life of assets		5 years
ASU 2015-03 \| Long-term Debt and Capital Lease Obligations
Significant Accounting Policies [Line Items]
Debt issuance costs, net			$ 500,000

Summary of Significant Accounting Policies - Reconciliation of Restructuring Liabilities (Details) - USD ($) $ in Thousands	3 Months Ended			12 Months Ended
	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Restructuring Reserve [Roll Forward]
Charged to restructuring costs				$ 753	$ 1,274	$ 840
On-Going Benefit Costs
Restructuring Reserve [Roll Forward]
Balance at beginning of period				47	762
Charged to restructuring costs				0	17
Payments				(47)	(732)
Balance at end of period	$ 47			0	47	762
Exit Costs
Restructuring Reserve [Roll Forward]
Balance at beginning of period				46	868
Charged to restructuring costs				0	88
Payments				(46)	(655)
Balance at end of period	46			0	46	868
Cost Optimization Project
Restructuring Reserve [Roll Forward]
Charged to restructuring costs	100	$ 200	$ 1,000
Cost Optimization Project \| On-Going Benefit Costs
Restructuring Reserve [Roll Forward]
Balance at beginning of period				44	0
Charged to restructuring costs				563	633
Payments				(282)	(589)
Balance at end of period	44			325	44	0
Cost Optimization Project \| Exit Costs
Restructuring Reserve [Roll Forward]
Balance at beginning of period				338	0
Charged to restructuring costs				190	641
Payments				(255)	(303)
Balance at end of period	$ 338			$ 273	$ 338	$ 0

Acquisitions - Narrative (Detail)			2 Months Ended	3 Months Ended									12 Months Ended			30 Months Ended
Acquisitions - Narrative (Detail)	Oct. 30, 2015 USD ($) shares	Jun. 30, 2014 USD ($) location $ / shares	Dec. 31, 2015 USD ($)	Dec. 31, 2016 USD ($) state client specialty	Sep. 30, 2016 USD ($)	Jun. 30, 2016 USD ($)	Mar. 31, 2016 USD ($)	Dec. 31, 2015 USD ($)	Sep. 30, 2015 USD ($)	Jun. 30, 2015 USD ($)	Mar. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)	Dec. 31, 2016 USD ($) state client specialty	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)	Dec. 31, 2016 USD ($) state client specialty	Apr. 01, 2016 USD ($)
Business Acquisition, Contingent Consideration [Line Items]
Cash purchase price paid at closing													$ 2,155,000	$ 149,000	$ 0
Goodwill			$ 95,096,000	$ 79,648,000				$ 95,096,000					79,648,000	95,096,000		$ 79,648,000
Acquisition costs													78,000	902,000	7,957,000
Acquisition of assets of Medical Staffing Network, net of cash acquired													1,900,000	28,721,000	44,631,000
Acquisition-related contingent consideration													(769,000)	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%
Net (loss) income				$ (7,649,000)	$ 14,289,000	$ (17,095,000)	$ 19,186,000	$ (5,927,000)	$ 5,151,000	$ 2,680,000	$ 3,050,000		$ 8,731,000	4,954,000	(31,534,000)
Mediscan
Business Acquisition, Contingent Consideration [Line Items]
Cash purchase price paid at closing	$ 29,900,000
Cash consideration plus working capital estimate	28,000,000
Fair value of shares	$ 4,723,000
Fair value of shares (in shares) \| shares	349,871
Contingent consideration, range of outcomes, high	$ 7,000,000
Number of states \| state				11									11			11
Number of clients (more than) \| client				300									300			300
Number of specialties (more than) \| specialty				70									70			70
Revenues			6,700,000
Net income			$ 300,000
Finite-lived intangible assets	$ 17,200,000
Weighted average useful life	10 years
Goodwill	$ 14,338,000
Acquisition costs														700,000
Consideration transferred	36,912,000
Other intangible assets	17,200,000
Medical Staffing Network
Business Acquisition, Contingent Consideration [Line Items]
Contingent liability		$ 2,500,000															$ 2,100,000
Finite-lived intangible assets		$ 11,200,000
Weighted average useful life		11 years
Goodwill		$ 13,381,000
Acquisition costs															2,200,000
Consideration transferred		47,100,000
Cash acquired from acquisition		1,000,000
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
Business combination, amount received from escrow, working capital adjustment												$ 200,000
Period of deferred consideration		21 months
Acquisition-related contingent consideration																$ 400,000
Number of locations of operations \| location		55
Gross accounts receivable		$ 38,100,000
Receivables not expected to be collected		800,000
Claim attached		2,300,000
Policy limit		5,000,000.0
Estimated fair value of professional liabilities related to stop loss policy		5,600,000
Estimated recovery receivable related to stop loss policy		400,000
Policy, coverage per occurrence		1,000,000
Policy coverage		5,000,000
Excess layer limit per occurrence		1,000,000.0
Excess layer limit		6,000,000.0
Other intangible assets		17,100,000
Noncontrolling interest		324,000
Acquisition and integration costs															7,300,000
Acquisition-related Costs \| Mediscan
Business Acquisition, Contingent Consideration [Line Items]
Net (loss) income														$ 800,000
Acquisition-related Costs \| Medical Staffing Network
Business Acquisition, Contingent Consideration [Line Items]
Net (loss) income															$ 6,200,000
Subordinated Debt \| Medical Staffing Network
Business Acquisition, Contingent Consideration [Line Items]
Long-term Debt		55,000,000
Term Loan Facility \| Medical Staffing Network
Business Acquisition, Contingent Consideration [Line Items]
Long-term Debt		$ 30,000,000
Term		5 years
Convertible Notes Payable \| Medical Staffing Network
Business Acquisition, Contingent Consideration [Line Items]
Long-term Debt		$ 25,000,000
Term		6 years
Debt conversion price (usd per share) \| $ / shares		$ 7.10
Trade Names \| Medical Staffing Network
Business Acquisition, Contingent Consideration [Line Items]
Other intangible assets		$ 5,900,000
Trade Names \| Mediscan
Business Acquisition, Contingent Consideration [Line Items]
Finite-lived intangible assets	$ 3,200,000
Intangible assets- useful life	11 years
Customer Relationships \| Mediscan
Business Acquisition, Contingent Consideration [Line Items]
Finite-lived intangible assets	$ 5,200,000
Intangible assets- useful life	10 years
Customer Relationships \| Medical Staffing Network
Business Acquisition, Contingent Consideration [Line Items]
Intangible assets- useful life		13 years
Other intangible assets		$ 4,700,000
Database Rights \| Mediscan
Business Acquisition, Contingent Consideration [Line Items]
Finite-lived intangible assets	$ 8,800,000
Intangible assets- useful life	10 years
Database Rights \| Medical Staffing Network
Business Acquisition, Contingent Consideration [Line Items]
Intangible assets- useful life		10 years
Other intangible assets		$ 6,500,000
Other Current Liabilities \| Mediscan
Business Acquisition, Contingent Consideration [Line Items]
Contingent liability				$ 4,300,000									$ 4,300,000			4,300,000
Potential Earnout, Attainment of Specific Performance Criteria in 2016 \| Mediscan
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration, range of outcomes, high	$ 3,500,000
Potential Earnout, Attainment of Specific Performance Criteria in 2017 \| Mediscan
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration, range of outcomes, high	$ 3,500,000
Potential Earnout \| Mediscan
Business Acquisition, Contingent Consideration [Line Items]
Maximum payment liability each year for contingent liabilities acquired				300,000									300,000			300,000
Remaining liability at undiscounted basis				3,600,000									3,600,000			3,600,000
Contingent liability				$ 700,000									$ 700,000			$ 700,000

Acquisitions - Estimated Fair Value of Purchase Price (Detail) - Mediscan $ in Thousands	Oct. 30, 2015 USD ($)
Business Acquisition [Line Items]
Cash purchase price paid at closing	$ 28,000
Fair value of shares	4,723
Fair value of contingent consideration	3,686
Net working capital adjustment, including receivable	503
Total consideration	$ 36,912

Acquisitions - Schedule of Assets Acquired and Liabilities Assumed (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015	Oct. 30, 2015	Jun. 30, 2014
Business Acquisition [Line Items]
Goodwill	$ 79,648	$ 95,096
Mediscan
Business Acquisition [Line Items]
Cash acquired			$ 79
Accounts receivable, net			6,851
Other current assets			140
Property and equipment			20
Goodwill			14,338
Other intangible assets			17,200
Total assets acquired			38,628
Accounts payable			306
Accrued employee compensation and benefits			1,410
Total liabilities assumed			1,716
Net assets acquired			$ 36,912
Medical Staffing Network
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 - Reconciliation of Acquisition and Integration Liabilities (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Restructuring Reserve [Roll Forward]
Charged to acquisition and integration costs	$ 753	$ 1,274	$ 840
On-Going Benefit Costs
Restructuring Reserve [Roll Forward]
Balance at beginning of period	47	762
Charged to acquisition and integration costs	0	17
Reclassifications	0	0
Payments	(47)	(732)
Balance at end of period	0	47	762
Exit Costs
Restructuring Reserve [Roll Forward]
Balance at beginning of period	46	868
Charged to acquisition and integration costs	0	88
Reclassifications	0	(255)
Payments	(46)	(655)
Balance at end of period	$ 0	$ 46	$ 868

Acquisitions - Schedule of Pro-forma Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Business Combinations [Abstract]
Revenue from services	$ 800,353	$ 771,955
Net income (loss) attributable to common shareholders	$ 5,436	$ (30,104)
Net income (loss) per common share attributable to common shareholders - basic (usd per share)	$ 0.17	$ (0.97)
Net income (loss) per common share attributable to common shareholders - diluted (usd per share)	$ 0.17	$ (0.97)

Disposal and Discontinued Operations - Narrative (Detail) - USD ($) $ in Thousands			12 Months Ended
	Aug. 31, 2015	Feb. 15, 2013	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Loss on sale of business			$ 0	$ 2,184	$ 0
Disposal Group, Disposed of by Sale, Not Discontinued Operations \| Cross Country Education, LLC
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Aggregate amount of selling prices	$ 8,000
Escrow deposit	$ 500
Earn-out held in escrow, term (in months)	12 months
Earnout (up to)	$ 500
Loss on sale of business	$ 2,200			2,200
Recorded tax benefit related to sale of business				3,500
Gain on sale of discontinued operations, net of tax				$ 1,300
Discontinued Operations \| Clinical Trial Services
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Aggregate amount of selling prices		$ 52,000
Escrow deposit		$ 3,800
Held in escrow, term (in months)		18 months

Goodwill, Trade Names, and Other Intangible Assets - Acquired Intangible Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, gross carrying amount	$ 80,168	$ 85,232
Other identifiable intangible assets, accumulated amortization	43,333	38,419
Intangible assets subject to amortization, net carrying amount	36,835	46,813
Trade names	35,402	36,101
Intangible assets not subject to amortization, net	72,237	82,914
Database Rights
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, gross carrying amount	31,609	31,225
Other identifiable intangible assets, accumulated amortization	16,147	14,150
Intangible assets subject to amortization, net carrying amount	15,462	17,075
Customer Relationships
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, gross carrying amount	41,724	47,204
Other identifiable intangible assets, accumulated amortization	23,316	20,734
Intangible assets subject to amortization, net carrying amount	18,408	26,470
Noncompete Agreements
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, gross carrying amount	3,619	3,603
Other identifiable intangible assets, accumulated amortization	3,527	3,486
Intangible assets subject to amortization, net carrying amount	92	117
Trade Names
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, gross carrying amount	3,216	3,200
Other identifiable intangible assets, accumulated amortization	343	49
Intangible assets subject to amortization, net carrying amount	$ 2,873	$ 3,151

Goodwill, Trade Names, and Other Intangible Assets - Estimated Annual Amortization Expense (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Goodwill and Intangible Assets Disclosure [Abstract]
2017	$ 4,248
2018	4,148
2019	4,111
2020	4,007
2021	3,799
Thereafter	16,522
Intangible assets subject to amortization, net carrying amount	$ 36,835	$ 46,813

Goodwill, Trade Names, and Other Intangible Assets - Changes in Carrying Amount of Goodwill by Segment (Detail) - USD ($)	3 Months Ended	12 Months Ended
	Jun. 30, 2016	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Goodwill balances
Goodwill, net of impairment loss, beginning of period		$ 95,096,000
Goodwill, Translation and Purchase Accounting Adjustments [Abstract]
Impairment charges			$ 0	$ 0
Goodwill, net of impairment loss, end of period		79,648,000	95,096,000
Physician Staffing Segment
Goodwill, Translation and Purchase Accounting Adjustments [Abstract]
Impairment charges	$ (17,700,000)
Operating Segments
Goodwill balances
Goodwill, net of impairment loss, beginning of period		95,096,000
Accumulated impairment loss, beginning of period		(259,732,000)
Sale of CCE		(9,889,000)	(9,889,000)
Aggregate goodwill acquired, beginning of period		364,717,000
Goodwill, Translation and Purchase Accounting Adjustments [Abstract]
Goodwill acquired		2,272,000
Impairment charges		(17,720,000)
Aggregate goodwill acquired, end of period		366,989,000	364,717,000
Accumulated impairment loss, end of period		277,452,000	259,732,000
Goodwill, net of impairment loss, end of period		79,648,000	95,096,000
Operating Segments \| Nurse and Allied Staffing Segment
Goodwill balances
Goodwill, net of impairment loss, beginning of period		42,273,000
Accumulated impairment loss, beginning of period		(259,732,000)
Sale of CCE		0	0
Aggregate goodwill acquired, beginning of period		302,005,000
Goodwill, Translation and Purchase Accounting Adjustments [Abstract]
Goodwill acquired		2,272,000
Impairment charges		0
Aggregate goodwill acquired, end of period		304,277,000	302,005,000
Accumulated impairment loss, end of period		259,732,000	259,732,000
Goodwill, net of impairment loss, end of period		44,545,000	42,273,000
Operating Segments \| Physician Staffing Segment
Goodwill balances
Goodwill, net of impairment loss, beginning of period		43,405,000
Accumulated impairment loss, beginning of period		0
Sale of CCE		0	0
Aggregate goodwill acquired, beginning of period		43,405,000
Goodwill, Translation and Purchase Accounting Adjustments [Abstract]
Goodwill acquired		0
Impairment charges		(17,720,000)
Aggregate goodwill acquired, end of period		43,405,000	43,405,000
Accumulated impairment loss, end of period		17,720,000	0
Goodwill, net of impairment loss, end of period		25,685,000	43,405,000
Operating Segments \| Other Human Capital Management Services Segment
Goodwill balances
Goodwill, net of impairment loss, beginning of period		9,418,000
Accumulated impairment loss, beginning of period		0
Sale of CCE		(9,889,000)	(9,889,000)
Aggregate goodwill acquired, beginning of period		19,307,000
Goodwill, Translation and Purchase Accounting Adjustments [Abstract]
Goodwill acquired		0
Impairment charges		0
Aggregate goodwill acquired, end of period		19,307,000	19,307,000
Accumulated impairment loss, end of period		0	0
Goodwill, net of impairment loss, end of period		$ 9,418,000	$ 9,418,000

Goodwill, Trade Names, and Other Intangible Assets - Narrative (Detail)	3 Months Ended			12 Months Ended
	Jun. 30, 2016 USD ($)	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)	Dec. 31, 2016 USD ($)	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)
Goodwill and Intangible Assets Disclosure [Line Items]
Impairment charges	$ 24,300,000	$ 2,100,000		$ 24,311,000	$ 2,100,000	$ 10,000,000
Goodwill impairment charge					$ 0	$ 0
Physician Staffing Segment
Goodwill and Intangible Assets Disclosure [Line Items]
Impairment charges	24,300,000
Goodwill impairment charge	17,700,000
Trade Names \| Physician Staffing Segment
Goodwill and Intangible Assets Disclosure [Line Items]
Impairment of intangibles indefinite lived	600,000
Customer Relationships \| Physician Staffing Segment
Goodwill and Intangible Assets Disclosure [Line Items]
Impairment of intangibles finite lived	$ 6,000,000
Income Approach Valuation Technique \| Physician Staffing Segment
Goodwill and Intangible Assets Disclosure [Line Items]
Discount rate percentage	13.50%
Terminal value growth rate percentage	3.00%
Income Approach Valuation Technique \| Customer Relationships \| Physician Staffing Segment
Goodwill and Intangible Assets Disclosure [Line Items]
Discount rate percentage	13.50%
Income and Market Approach Valuation Technique \| Physician Staffing Segment
Goodwill and Intangible Assets Disclosure [Line Items]
Forecast period	10 years
Minimum \| Income and Market Approach Valuation Technique \| Physician Staffing Segment
Goodwill and Intangible Assets Disclosure [Line Items]
Weighted applied percentage	50.00%
Minimum \| Market Approach Valuation Technique \| Physician Staffing Segment
Goodwill and Intangible Assets Disclosure [Line Items]
Ratio of total enterprise value by EBITDA	7.5
Maximum \| Market Approach Valuation Technique \| Physician Staffing Segment
Goodwill and Intangible Assets Disclosure [Line Items]
Ratio of total enterprise value by EBITDA	8.5
Trade Names \| Physician Staffing Segment
Goodwill and Intangible Assets Disclosure [Line Items]
Impairment of intangibles indefinite lived		$ 2,100,000	$ 10,000,000

Property and Equipment (Detail) - USD ($) $ in Thousands	12 Months Ended
Property and Equipment (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Property, Plant and Equipment [Line Items]
Property and equipment	$ 55,959	$ 49,838
Less accumulated depreciation and amortization	(43,141)	(39,368)
Property and equipment, net of accumulated depreciation and amortization	12,818	10,470
Computer equipment
Property, Plant and Equipment [Line Items]
Property and equipment	13,584	12,335
Computer software
Property, Plant and Equipment [Line Items]
Property and equipment	28,752	27,565
Office equipment
Property, Plant and Equipment [Line Items]
Property and equipment	2,397	2,241
Furniture and fixtures
Property, Plant and Equipment [Line Items]
Property and equipment	3,969	3,411
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment	$ 7,257	$ 4,286
Minimum
Property, Plant and Equipment [Line Items]
Estimated useful life	3 years
Minimum \| Computer equipment
Property, Plant and Equipment [Line Items]
Estimated useful life	3 years
Minimum \| Computer software
Property, Plant and Equipment [Line Items]
Estimated useful life	3 years
Minimum \| Office equipment
Property, Plant and Equipment [Line Items]
Estimated useful life	5 years
Minimum \| Furniture and fixtures
Property, Plant and Equipment [Line Items]
Estimated useful life	5 years
Maximum
Property, Plant and Equipment [Line Items]
Estimated useful life	7 years
Maximum \| Computer equipment
Property, Plant and Equipment [Line Items]
Estimated useful life	5 years
Maximum \| Computer software
Property, Plant and Equipment [Line Items]
Estimated useful life	5 years
Maximum \| Office equipment
Property, Plant and Equipment [Line Items]
Estimated useful life	7 years
Maximum \| Furniture and fixtures
Property, Plant and Equipment [Line Items]
Estimated useful life	7 years

Balance Sheet Details (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Balance Sheet Related Disclosures [Abstract]
Insurance recovery for health	$ 279	$ 0
Insurance recovery for workers’ compensation	1,271	1,403
Insurance recovery for professional liability	1,487	1,463
Insurance recovery receivable	3,037	2,866
Insurance recovery for workers’ compensation – long-term	5,857	6,281
Insurance recovery for professional liability – long-term	10,353	10,722
Non-current security deposits	925	991
Other non-current assets	17,135	17,994
Salaries and payroll taxes	15,480	11,976
Bonuses	3,915	4,584
Accrual for workers’ compensation claims	5,266	5,151
Accrual for professional liability insurance	2,433	2,516
Accrual for health care benefits	4,053	3,009
Accrual for vacation	2,096	2,166
Accrued compensation and benefits	33,243	29,402
Accrual for workers’ compensation claims	12,817	14,014
Accrual for professional liability insurance	16,053	16,056
Long-term accrued claims	28,870	30,070
Deferred compensation	1,472	1,412
Deferred rent	5,011	2,473
Long-term unrecognized tax benefits	874	819
Other	42	122
Other long-term liabilities	$ 7,399	$ 4,826

Debt - Long- Term Debt (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Debt Instrument [Line Items]
Capital lease obligations	$ 23	$ 94
Total debt	92,055	96,431
Less current portion	(2,263)	(8,071)
Long-term Debt and Capital Lease Obligations	89,792	88,360
Unamortized Discount and Debt Issuance Costs	(5,032)	(7,059)
Revolving Credit Facility \| Senior Secured Asset-Backed
Debt Instrument [Line Items]
Debt	0	8,000
Unamortized Discount and Debt Issuance Costs	0	$ 0
Weighted average interest rate		2.41%
Senior Debt \| Term Loan
Debt Instrument [Line Items]
Debt	39,500	$ 0
Unamortized Discount and Debt Issuance Costs	$ (363)	0
Interest Rate	2.62%
Subordinated Debt \| Second Lien Term Loan
Debt Instrument [Line Items]
Debt	$ 0	30,000
Unamortized Discount and Debt Issuance Costs	0	$ (1,052)
Interest Rate		5.75%
Convertible Notes \| 8% Convertible Notes
Debt Instrument [Line Items]
Debt	25,000	$ 25,000
Unamortized Discount and Debt Issuance Costs	$ (4,669)	(6,007)
Interest Rate	8.00%
Convertible Notes \| Convertible Note Derivative Liability
Debt Instrument [Line Items]
Debt	$ 27,532	33,337
Unamortized Discount and Debt Issuance Costs	$ 0	$ 0

Debt - Aggregate Scheduled Maturities of Debt (Detail) $ in Thousands	Dec. 31, 2016 USD ($)
Capital Leases
2017	$ 13
2018	8
2019	2
2020	0
2021	0
Thereafter	0
Total	23
Term Loan Facility
Long-term Debt, Fiscal Year Maturity
2017	2,250
2018	3,750
2019	3,500
2020	4,000
2021	26,000
Thereafter	0
Total	39,500
Convertible Notes
Long-term Debt, Fiscal Year Maturity
2017	0
2018	0
2019	0
2020	25,000
2021	0
Thereafter	0
Total	$ 25,000

Debt - Narrative (Detail)				3 Months Ended	12 Months Ended
Debt - Narrative (Detail)	Jun. 22, 2016 USD ($)	Jul. 22, 2015	Jun. 30, 2014 USD ($)	Jun. 30, 2016 USD ($)	Dec. 31, 2016 USD ($) financial_covenant	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)
Debt Instrument [Line Items]
Prepayment penalty	$ 600,000
Loss on early extinguishment of debt					$ 1,568,000	$ 0	$ 0
First Lien Loan Agreement
Debt Instrument [Line Items]
Credit facility maximum borrowing capacity						$ 71,600,000
Quarterly commitment fee on the average daily unused portion (percent)						0.375%
Available borrowing capacity, gross						$ 40,100,000
Letters of credit outstanding						23,500,000
Draw under revolving credit facility						$ 8,000,000
Second Lien Term Loan
Debt Instrument [Line Items]
Interest rate increase (decrease) (percent)					2.00%
Convertible Senior Notes
Debt Instrument [Line Items]
Face amount			$ 25,000,000.0
Proceeds from debt, net			24,100,000
Debt issuance costs, net			$ 300,000
LIBOR \| First Lien Loan Agreement
Debt Instrument [Line Items]
Interest margin						1.50%
Base Rate \| First Lien Loan Agreement
Debt Instrument [Line Items]
Interest margin						0.50%
Credit Agreement
Debt Instrument [Line Items]
Interest rate increase (decrease) (percent)					2.00%
Quarterly commitment fee on the average daily unused portion (percent)					0.30%
Number of financial covenants \| financial_covenant					2
Credit Agreement \| Senior Debt
Debt Instrument [Line Items]
Credit facility maximum borrowing capacity	$ 40,000,000.0
Percentage of principal payment for first four installments	1.25%
Percentage of principal payment for next eight installments	1.875%
Percentage of principal payment for remaining installments	2.50%
Credit Agreement \| Minimum
Debt Instrument [Line Items]
Consolidated Fixed Charge Coverage Ratio					1.50
Credit Agreement \| LIBOR \| Senior Debt
Debt Instrument [Line Items]
Interest margin					2.00%
Second Lien Term Loan
Debt Instrument [Line Items]
Loss on early extinguishment of debt				$ 1,600,000
Second Lien Term Loan \| Subordinated Debt
Debt Instrument [Line Items]
Loss on early extinguishment of debt				$ 1,600,000
Second Lien Term Loan \| Junior subordinated debt
Debt Instrument [Line Items]
Line of credit facility, term			5 years
Interest margin			6.50%
Face amount			$ 30,000,000.0
Unamortized discount			1,100,000
Proceeds from debt, net			28,900,000
Debt issuance costs, net			$ 400,000
Basis spread, floor (percent)			1.00%
Second Lien Term Loan \| LIBOR \| Junior subordinated debt
Debt Instrument [Line Items]
Interest margin					4.75%
Variable rate, floor (percent)		1.00%			1.00%
Revolving Credit Facility \| Credit Agreement
Debt Instrument [Line Items]
Credit facility maximum borrowing capacity	$ 100,000,000.0
Line of credit, subfacility for standby letters of credit	35,000,000.0
Sub facility for swingline loans	15,000,000.0
Additional capacity	50,000,000.0
Line of credit outstanding					$ 77,800,000
Letters of credit outstanding					$ 22,200,000
Revolving Credit Facility \| Credit Agreement \| LIBOR
Debt Instrument [Line Items]
Interest margin					2.00%
Revolving Credit Facility \| First Lien Loan Agreement
Debt Instrument [Line Items]
Credit facility maximum borrowing capacity						$ 85,000,000.0
Subfacility loans percentage up to aggregate revolver commitments (percent)						10.00%
Line of credit, subfacility for standby letters of credit						$ 35,000,000.0
Letters of credit rolled and issued under new facility	$ 23,100,000
Revolving Credit Facility \| Second Lien Term Loan \| Subordinated Debt
Debt Instrument [Line Items]
Credit facility maximum borrowing capacity						$ 30,000,000.0
Line of credit facility, term						5 years
Revolving Credit Facility \| Second Lien Term Loan \| Period July 1, 2015 through June 30, 2016 \| Subordinated Debt
Debt Instrument [Line Items]
Percentage of principal amount redeemed						103.00%
Revolving Credit Facility \| Second Lien Term Loan \| Period July 1, 2016 through June 30, 2017 \| Subordinated Debt
Debt Instrument [Line Items]
Percentage of principal amount redeemed						102.00%
Revolving Credit Facility \| Second Lien Term Loan \| After June 30, 2017 \| Subordinated Debt
Debt Instrument [Line Items]
Percentage of principal amount redeemed						100.00%
Fiscal Quarters Ending September 30, 2016 through June 30, 2017 \| Credit Agreement \| Maximum
Debt Instrument [Line Items]
Consolidated Net Leverage Ratio					3.50
Fiscal Quarters Ending September 30, 2017 through June 30, 2018 \| Credit Agreement \| Maximum
Debt Instrument [Line Items]
Consolidated Net Leverage Ratio					3.25
Each Fiscal Quarter Ending Thereafter \| Credit Agreement \| Maximum
Debt Instrument [Line Items]
Consolidated Net Leverage Ratio					3.00

Debt - Consolidated Net Leverage Ratio (Detail) - Credit Agreement	12 Months Ended
	Dec. 31, 2016
Covenant Term 1
Line of Credit Facility [Line Items]
Commitment fee percentage	0.25%
Covenant Term 1 \| Eurodollar Loans
Line of Credit Facility [Line Items]
Interest margin	1.75%
Covenant Term 1 \| LIBOR
Line of Credit Facility [Line Items]
Interest margin	1.75%
Covenant Term 1 \| Letter of Credit Fee
Line of Credit Facility [Line Items]
Interest margin	1.75%
Covenant Term 1 \| Base Rate
Line of Credit Facility [Line Items]
Interest margin	0.75%
Covenant Term 1 \| Maximum
Line of Credit Facility [Line Items]
Consolidated Net Leverage Ratio	1.50
Covenant Term 2
Line of Credit Facility [Line Items]
Commitment fee percentage	0.30%
Covenant Term 2 \| Eurodollar Loans
Line of Credit Facility [Line Items]
Interest margin	2.00%
Covenant Term 2 \| LIBOR
Line of Credit Facility [Line Items]
Interest margin	2.00%
Covenant Term 2 \| Letter of Credit Fee
Line of Credit Facility [Line Items]
Interest margin	2.00%
Covenant Term 2 \| Base Rate
Line of Credit Facility [Line Items]
Interest margin	1.00%
Covenant Term 2 \| Minimum
Line of Credit Facility [Line Items]
Consolidated Net Leverage Ratio	1.50
Covenant Term 2 \| Maximum
Line of Credit Facility [Line Items]
Consolidated Net Leverage Ratio	2.00
Covenant Term 3
Line of Credit Facility [Line Items]
Commitment fee percentage	0.30%
Covenant Term 3 \| Eurodollar Loans
Line of Credit Facility [Line Items]
Interest margin	2.25%
Covenant Term 3 \| LIBOR
Line of Credit Facility [Line Items]
Interest margin	2.25%
Covenant Term 3 \| Letter of Credit Fee
Line of Credit Facility [Line Items]
Interest margin	2.25%
Covenant Term 3 \| Base Rate
Line of Credit Facility [Line Items]
Interest margin	1.25%
Covenant Term 3 \| Minimum
Line of Credit Facility [Line Items]
Consolidated Net Leverage Ratio	2.00
Covenant Term 3 \| Maximum
Line of Credit Facility [Line Items]
Consolidated Net Leverage Ratio	2.50
Covenant Term 4
Line of Credit Facility [Line Items]
Commitment fee percentage	0.35%
Covenant Term 4 \| Eurodollar Loans
Line of Credit Facility [Line Items]
Interest margin	2.50%
Covenant Term 4 \| LIBOR
Line of Credit Facility [Line Items]
Interest margin	2.50%
Covenant Term 4 \| Letter of Credit Fee
Line of Credit Facility [Line Items]
Interest margin	2.50%
Covenant Term 4 \| Base Rate
Line of Credit Facility [Line Items]
Interest margin	1.50%
Covenant Term 4 \| Minimum
Line of Credit Facility [Line Items]
Consolidated Net Leverage Ratio	2.50
Covenant Term 4 \| Maximum
Line of Credit Facility [Line Items]
Consolidated Net Leverage Ratio	3.00
Covenant Term 5
Line of Credit Facility [Line Items]
Commitment fee percentage	0.40%
Covenant Term 5 \| Eurodollar Loans
Line of Credit Facility [Line Items]
Interest margin	2.75%
Covenant Term 5 \| LIBOR
Line of Credit Facility [Line Items]
Interest margin	2.75%
Covenant Term 5 \| Letter of Credit Fee
Line of Credit Facility [Line Items]
Interest margin	2.75%
Covenant Term 5 \| Base Rate
Line of Credit Facility [Line Items]
Interest margin	1.75%
Covenant Term 5 \| Minimum
Line of Credit Facility [Line Items]
Consolidated Net Leverage Ratio	3.00

Debt - Private Placement of Convertible Notes Narrative (Detail)		12 Months Ended
	Jun. 30, 2014 USD ($)	Dec. 31, 2016 instrument d $ / shares shares	Dec. 31, 2015 $ / shares
Debt Instrument [Line Items]
Unamortized discount, conversion and redemption features	$ 6,800,000
Common stock, par value (usd per share) \| $ / shares		$ 0.0001	$ 0.0001
Convertible Senior Notes
Debt Instrument [Line Items]
Face amount	25,000,000.0
Unamortized discount, interest rate portion	900,000
Proceeds from debt, net	24,100,000
Debt issuance costs, net	$ 300,000
Common stock, par value (usd per share) \| $ / shares		0.0001
Debt conversion price (usd per share) \| $ / shares		$ 7.10
Debt instrument, convertible, number of equity instruments \| instrument		3,521,126
Debt Instrument, convertible, threshold period following issuance date (in years)		3 years
Debt instrument, convertible, threshold percentage of stock price trigger		125.00%
Debt instrument, convertible, threshold trading days \| d		20
Debt instrument, convertible, threshold consecutive trading days		30 days
Debt Instrument, Convertible, Number of Shares Not to Be Exceeded, Aggregate Number of Shares Previously Converted \| shares		6,244,650
Interest rate (percent)		8.00%
Debt instrument, interest, percent paid in kind, maximum		4.00%
Convertible debt redeemed after permissible date, redemption premium, percent of principal		15.00%
Convertible debt redeemed before permissible date, redemption premium, percent of principal		115.00%
Convertible Senior Notes \| Treasury Rate [Member]
Debt Instrument [Line Items]
Convertible debt, basis spread on discount rate on redemption, percentage		0.50%

Convertible Notes Derivative Liability (Details) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2016 USD ($) $ / shares
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Closing share price (usd per share)	$ 15.61
Conversion price (usd per share)	$ 7.10
Risk free rate	1.76%
Expected volatility	40.00%
Dividend yield	0.00%
Expected life	3 years 6 months
Change in valuation of embedded derivative liability due to dollar change in stock price \| $	$ 3.5
Change in valuation of embedded derivative liability due to percentage change in interest rates \| $	$ 0.8
Embedded derivative liability
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 - Estimated Fair values Assets and Liabilities Measured on Recurring Basis (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent purchase price liabilities	$ 5,603	$ 3,686
Convertible Notes derivative liability \| Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Convertible Notes derivative liability	27,532	33,337
Deferred compensation \| Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Deferred compensation	$ 1,472	$ 1,412

Fair Value Measurements - Schedule of reconciliation of opening and closing balances for fair value measurements categorized within Level 3 (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Contingent Purchase Price Liabilities
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance	$ 3,686	$ 0
Additions	1,300	3,686
Payments	(152)
Accretion expense	887
Valuation (gain) loss for the period	(118)	0
Ending balance	5,603	3,686
Convertible Notes Derivative Liability
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance	33,337	23,436
Additions	0	0
Payments	0
Accretion expense	0
Valuation (gain) loss for the period	(5,805)	9,901
Ending balance	$ 27,532	$ 33,337

Fair Value Measurements - Narrative (Detail)	12 Months Ended
Fair Value Measurements - Narrative (Detail)	Dec. 31, 2016
Minimum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Threshold period, past due for payment of services provided	15 days
Maximum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Threshold period, past due for payment of services provided	60 days

Fair Value Measurements - Financial Instruments that were not Measured at Fair Value (Detail) - Level 2 - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Second Lien Term Loan, net \| Carrying Amount
Fair Value, Option, Quantitative Disclosures [Line Items]
Carrying Amount	$ 0	$ 28,948
Second Lien Term Loan, net \| Fair Value
Fair Value, Option, Quantitative Disclosures [Line Items]
Fair Value	0	30,600
Term Loan, net \| Carrying Amount
Fair Value, Option, Quantitative Disclosures [Line Items]
Carrying Amount	39,137	0
Term Loan, net \| Fair Value
Fair Value, Option, Quantitative Disclosures [Line Items]
Fair Value	41,500	0
Convertible Notes, net \| Carrying Amount
Fair Value, Option, Quantitative Disclosures [Line Items]
Carrying Amount	20,331	18,993
Convertible Notes, net \| Fair Value
Fair Value, Option, Quantitative Disclosures [Line Items]
Fair Value	27,250	23,250
Senior Secured Asset-Based Loan \| Carrying Amount
Fair Value, Option, Quantitative Disclosures [Line Items]
Carrying Amount	0	8,000
Senior Secured Asset-Based Loan \| Fair Value
Fair Value, Option, Quantitative Disclosures [Line Items]
Fair Value	$ 0	$ 8,000

Employee Benefit Plans - Narrative (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Compensation and Retirement Disclosure [Abstract]
Company contribution net of forfeitures	$ 800	$ 700	$ 600
Deferred compensation liabilities	$ 1,472	$ 1,412

Commitments and Contingencies - Future Minimum Lease Payments (Detail) $ in Thousands	Dec. 31, 2016 USD ($)
Commitments and Contingencies Disclosure [Abstract]
2017	$ 7,249
2018	6,240
2019	4,826
2020	4,145
2021	3,843
Thereafter	13,191
Operating Leases, Future Minimum Payments Due, Total	$ 39,494

Commitments and Contingencies - Narrative (Detail) - USD ($) $ in Millions	3 Months Ended	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Commitments and Contingencies Disclosure [Abstract]
Operating lease expense		$ 8.4	$ 8.1	$ 7.7
Pretax liability expense (benefit) related to the non-income tax matters		(0.8)		0.2
Taxes paid to settle with certain states		$ 1.4		$ 0.1
Settlement					$ 0.8
Payments for legal settlement	$ 0.8

Income Taxes - Components of Income (Loss) Before Income Taxes (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Tax Disclosure [Abstract]
United States	$ 3,309	$ 3,565	$ (33,574)
Foreign	1,236	595	2,256
Income (loss) before income taxes	$ 4,545	$ 4,160	$ (31,318)

Income Taxes - Components of Income Tax Expense (Benefit) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Current:
Federal	$ 227	$ 551	$ 0
State	587	(21)	811
Foreign	322	220	262
Total	1,136	750	1,073
Deferred:
Federal	(4,114)	(1,819)	(1,320)
State	(866)	8	68
Foreign	(342)	267	395
Total	(5,322)	(1,544)	(857)
Total income tax (benefit) expense	$ (4,186)	$ (794)	$ 216

Income Taxes - Significant Components of Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Deferred Tax Assets:
Accrued other and prepaid expenses	$ 3,494	$ 2,973
Allowance for doubtful accounts	704	1,278
Intangible Assets	10,725	11,365
Net operating loss carryforwards	17,228	22,662
Derivative interest	7,940	10,144
Accrued professional liability	2,632	2,536
Accrued workers’ compensation	3,439	3,061
Share-based compensation	0	891
Credit carryforwards	1,055	797
Other	584	595
Gross deferred tax assets	47,801	56,302
Valuation allowance	(46,454)	(55,336)
Deferred tax assets, net	1,347	966
Deferred Tax Liabilities:
Depreciation	(70)	(123)
Indefinite intangibles	(13,971)	(18,714)
Tax on unrepatriated earnings	(263)	(604)
Share-based compensation	(197)	0
Deferred tax liabilities, gross	(14,501)	(19,441)
Net deferred taxes	$ (13,154)	$ (18,475)

Income Taxes - Narrative (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2014	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Tax Contingency [Line Items]
Deferred tax liabilities relating to indefinite lived intangible assets		$ 13,971	$ 18,714
Valuation allowance		46,454	55,336
Federal, state and foreign net operating loss carryforwards		53,200	65,200
Deferred liabilities on undistributed foreign earnings		263	604
Unrecognized tax benefits		5,180	4,071	$ 3,777
Unrecognized tax benefits, which would affect the effective tax rate		4,900	3,800
Gross increases in current year unrecognized tax		1,100
Increase (decrease) in recognized interest and penalties		100	(200)	$ (200)
Unrecognized tax benefit accrued interest and penalties		500	400
India
Income Tax Contingency [Line Items]
Deferred liabilities on undistributed foreign earnings		200
Repatriated amount of foreign earnings		500
Other Current Liabilities
Income Tax Contingency [Line Items]
Unrecognized tax benefits		100	100
Other Noncurrent Liabilities
Income Tax Contingency [Line Items]
Unrecognized tax benefits		900	800
Indefinite-lived Intangible Assets
Income Tax Contingency [Line Items]
Deferred tax liabilities relating to indefinite lived intangible assets		$ 14,000	$ 18,700
Adjustment for Error Correction of Overstatement of Valuation Allowance
Income Tax Contingency [Line Items]
Reduction in valuation allowance	$ 1,700
Out-or-period adjustment, decrease in net loss per diluted share (usd per share)	$ 0.06			$ 0.06

Income Taxes - 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, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Tax Disclosure [Abstract]
Tax at U.S. statutory rate	$ 1,591	$ 1,456	$ (10,961)
State taxes, net of federal benefit	344	611	219
Noncontrolling interest	(260)	0	0
Non-deductible meals and entertainment	1,546	1,510	1,425
Foreign tax expense	(5)	(6)	44
Valuation allowances	(8,379)	(5,078)	12,038
Uncertain tax positions	1,090	917	(996)
Audit settlements	0	(624)	0
Other	(113)	420	(1,553)
Total income tax (benefit) expense	$ (4,186)	$ (794)	$ 216

Income Taxes - Reconciliation of Beginning and Ending Balance of Unrecognized Tax Benefits (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Balance at January 1	$ 4,071	$ 3,777
Additions based on tax positions related to the current year	1,054	861
Additions based on tax positions related to prior years	55	62
Reductions based on settlements of tax positions related to prior years	0	(624)
Other	0	(5)
Balance at December 31	$ 5,180	$ 4,071

Stockholders' Equity - Narrative (Detail) - USD ($)	3 Months Ended		12 Months Ended
Stockholders' Equity - Narrative (Detail) - USD ($)	Mar. 31, 2016	Mar. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014	Feb. 28, 2008	Oct. 25, 2001
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Common stock authorized for stock repurchase program (in shares)						1,500,000
Common stock left remaining to repurchase under the plan (in shares)			942,443
Aggregate stock repurchase amount			$ 2,500,000.0
Pretax total unrecognized compensation cost related to share options- period			5 months 2 days
Share options outstanding at end of year (in shares)			188,213	395,625
Shares options outstanding vested or expected to vest (in shares)			173,457
Shares options outstanding vested or expected to vest -weighted average exercise price (usd per share)			$ 5.76
Shares options outstanding vested or expected to vest ,intrinsic value			$ 1,700,000
Shares options outstanding vested or expected to vest -weighted average contractual life			2 years 6 months 20 days
Pretax total unrecognized compensation cost related to share options, less than			$ 100,000
Restricted Stock Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)			246,020
Pretax of total unrecognized compensation cost related to non-vested restricted stock awards			$ 3,000,000
Pretax total unrecognized compensation cost related to share options- period			1 year 9 months 26 days
Fair value of shares vested			$ 4,300,000	$ 3,900,000	$ 2,300,000
Performance Stock Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)			202,442
Pretax of total unrecognized compensation cost related to non-vested restricted stock awards			$ 1,000,000
Pretax total unrecognized compensation cost related to share options- period			1 year 6 months 15 days
Fair value of shares vested			$ 1,200,000
2014 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate number of common stock shares authorized for issuance (in shares)			4,100,000
2014 Plan \| Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exercise price percentage of the fair market value of common stock			100.00%
2014 Plan \| Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock expiration period			10 years
2014 Plan \| Ten Percent Or More Stockholders \| Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exercise price percentage of the fair market value of common stock			110.00%
2014 Plan \| Ten Percent Or More Stockholders \| Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock expiration period			5 years
2014 Plan \| Restricted Stock Awards \| Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock vesting period			3 years
2014 Plan \| Restricted Stock Awards \| Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock vesting period			4 years
Omnibus Plan \| Performance Stock Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of performance attained		100.00%
Shares issued (in shares)	148,178
2007 Stock Incentive Plan \| Stock Appreciation Rights
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock expiration period			7 years
Stock vesting period			4 years
Stock vesting percentage per year			25.00%
The 1999 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate number of common stock shares authorized for issuance (in shares)							4,398,001

Stockholders' Equity - Summary of Restricted Stock Award Activity and Performance Stock Awards (Detail)	12 Months Ended
	Dec. 31, 2016 $ / shares shares
Restricted Stock Awards
Number of Shares
Unvested restricted stock awards, beginning balance (in shares) \| shares	586,488
Granted (in shares) \| shares	246,020
Vested (in shares) \| shares	(272,597)
Forfeited (in shares) \| shares	(27,617)
Unvested restricted stock awards, ending balance (in shares) \| shares	532,294
Weighted average grant date fair value
Unvested restricted stock awards, beginning balance (usd per share) \| $ / shares	$ 7.82
Granted (usd per share) \| $ / shares	12.01
Vested (usd per share) \| $ / shares	7.06
Forfeited (usd per share) \| $ / shares	11.11
Unvested restricted stock awards, ending balance (usd per share) \| $ / shares	$ 9.98
Performance Stock Awards
Number of Shares
Unvested restricted stock awards, beginning balance (in shares) \| shares	234,138
Granted (in shares) \| shares	202,442
Vested (in shares) \| shares	(79,636)
Forfeited (in shares) \| shares	(24,852)
Unvested restricted stock awards, ending balance (in shares) \| shares	332,092
Weighted average grant date fair value
Unvested restricted stock awards, beginning balance (usd per share) \| $ / shares	$ 9.81
Granted (usd per share) \| $ / shares	11.63
Vested (usd per share) \| $ / shares	5.82
Forfeited (usd per share) \| $ / shares	11.75
Unvested restricted stock awards, ending balance (usd per share) \| $ / shares	$ 11.73

Stockholders' Equity - Stock Options and Stock Appreciation Rights Granted and Exercised (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Equity [Abstract]
Total intrinsic value of options exercised	$ 1,323	$ 1,610	$ 695

Stockholders' Equity - Summary of Company's Share Option Plans Activities (Detail) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2016 USD ($) $ / shares shares
Number of Shares
Share options outstanding at beginning of year (in shares) \| shares	395,625
Granted (in shares) \| shares	0
Exercised (in shares) \| shares	(195,312)
Forfeited/expired (in shares) \| shares	(12,100)
Share options outstanding at end of year (in shares) \| shares	188,213
Share options exercisable at end of year (in shares) \| shares	137,087
Share options unvested at end of year (in shares) \| shares	51,126
Weighted Average Exercise Price
Share options outstanding at beginning of year, weighted average exercise price (usd per share)	$ 6.28
Granted, weighted average exercise price (usd per share)	0.00
Exercised, weighted average exercise price (usd per share)	6.08
Forfeited/expired, weighted average exercise price (usd per share)	17.97
Share options outstanding at end of year, weighted average exercise price (usd per share)	5.72
Share options exercisable at end of year, weighted average exercise price (usd per share)	5.90
Share options unvested at end of year, weighted average exercise price (usd per share)	$ 5.26
Share options outstanding at end of year, weighted-average remaining contractual life	2 years 7 months 14 days
Share options exercisable at end of year, weighted-average remaining contractual life	2 years 4 months
Share options unvested at end of year, weighted-average remaining contractual life	3 years 4 months 26 days
Share options outstanding at end of year \| $	$ 1,870
Share options exercisable at end of year \| $	1,341
Share options unvested at end of year \| $	$ 529
Exercise Price Range One
Number of Shares
Exercise Price, Lower Limit (usd per share)	$ 4.16
Exercise Price, Upper Limit (usd pre share)	22.50
Exercise Price Range Two
Number of Shares
Exercise Price, Lower Limit (usd per share)	4.35
Exercise Price, Upper Limit (usd pre share)	8.56
Exercise Price Range Three
Number of Shares
Exercise Price, Lower Limit (usd per share)	5.21
Exercise Price, Upper Limit (usd pre share)	22.50
Exercise Price Range Four
Number of Shares
Exercise Price, Lower Limit (usd per share)	4.16
Exercise Price, Upper Limit (usd pre share)	22.50
Exercise Price Range Five
Number of Shares
Exercise Price, Lower Limit (usd per share)	4.16
Exercise Price, Upper Limit (usd pre share)	22.50
Exercise Price Range Six
Number of Shares
Exercise Price, Lower Limit (usd per share)	4.92
Exercise Price, Upper Limit (usd pre share)	$ 5.61

Earnings Per Share - 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, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Earnings Per Share [Abstract]
Net income (loss) attributable to common shareholders - Basic									$ 7,967	$ 4,418	$ (31,783)
Interest on Convertible Notes									3,383
(Gain) loss on derivative liability									5,805	(9,901)	(16,671)
Net income (loss) attributable to common shareholders - Diluted									$ 5,545	$ 4,418	$ (31,783)
Weighted average common shares - Basic (shares)									32,132	31,514	31,190
Share-based awards (shares)									593	648	0
Convertible Notes (shares)									3,521	0	0
Weighted average common shares - Diluted (shares)									36,246	32,162	31,190
Net income (loss) per share attributable to common shareholders - Basic (usd per share)	$ (0.24)	$ 0.44	$ (0.54)	$ 0.60	$ (0.19)	$ 0.16	$ 0.08	$ 0.09	$ 0.25	$ 0.14	$ (1.02)
Net income (loss) per share attributable to common shareholders - Diluted (usd per share)	$ (0.24)	$ 0.22	$ (0.54)	$ 0.09	$ (0.19)	$ 0.16	$ 0.08	$ 0.05	$ 0.15	$ 0.14	$ (1.02)

Earnings Per Share - Antidilutive Securities (Detail) - shares shares in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Convertible notes and share-based awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities	0	3,521	3,856

Related Party Transactions (Detail) - USD ($) $ in Millions	2 Months Ended	6 Months Ended	12 Months Ended
Related Party Transactions (Detail) - USD ($) $ in Millions	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Related Party Transaction [Line Items]
Revenue from related parties			$ 5.0	$ 11.8	$ 17.8
Account receivable due from related parties	$ 0.6		1.0	0.6
InteliStaf
Related Party Transaction [Line Items]
Revenue from related parties		$ 4.7	$ 12.6	10.0
Percent ownership in joint venture			68.00%
Receivable balance with joint venture	1.4		$ 1.5	1.4
Payable balance with joint venture	0.2		0.2	$ 0.2
Affiliated Entity
Related Party Transaction [Line Items]
Rent expense	$ 0.1		$ 0.4

Segment Data (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
Segment Data (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Revenue from services	$ 222,523	$ 214,988	$ 199,443	$ 196,583	$ 193,148	$ 195,692	$ 192,617	$ 185,964	$ 833,537	$ 767,421	$ 617,825
Contribution income									79,722	67,794	43,540
Unallocated corporate overhead									38,400	32,703	27,770
Depreciation									4,168	3,856	3,866
Amortization									5,014	4,210	3,575
Loss on sale of business									0	2,184	0
Acquisition and integration costs									78	902	7,957
Acquisition-related contingent consideration									814	0	0
Restructuring costs									753	1,274	840
Impairment charges			24,300		$ 2,100				24,311	2,100	10,000
Income (loss) from operations									6,184	20,565	(10,468)
Physician Staffing Segment
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Impairment charges			$ 24,300
Operating Segments \| Nurse and Allied Staffing Segment
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Revenue from services									721,486	621,258	459,195
Contribution income									71,992	55,718	36,486
Operating Segments \| Physician Staffing Segment
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Revenue from services									98,283	115,336	121,145
Contribution income									8,265	10,213	6,540
Operating Segments \| Other Human Capital Management Services Segment
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Revenue from services									13,768	30,827	37,485
Contribution income									$ (535)	$ 1,863	$ 514

Segment Data - Additional Information (Details) $ in Thousands		3 Months Ended		12 Months Ended
	Aug. 31, 2015 USD ($)	Jun. 30, 2016 USD ($)	Dec. 31, 2015 USD ($)	Dec. 31, 2016 USD ($) segment	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)
Segment Reporting Information [Line Items]
Number of operating segments \| segment				3
Increase (decrease) in contribution income				$ 79,722	$ 67,794	$ 43,540
Loss on sale of business				0	2,184	0
Impairment charges		$ 24,300	$ 2,100	$ 24,311	2,100	$ 10,000
Adjustment \| Contribution Income, Nurse and Allied Staffing
Segment Reporting Information [Line Items]
Increase (decrease) in contribution income					(1,200)
Adjustment \| Unallocated Corporate Overhead
Segment Reporting Information [Line Items]
Increase (decrease) in contribution income					1,200
Cross Country Education, LLC \| Disposal Group, Disposed of by Sale, Not Discontinued Operations
Segment Reporting Information [Line Items]
Loss on sale of business	$ 2,200				$ 2,200

Quarterly Financial Data (Unaudited) (Detail) - USD ($) $ / shares in Units, $ in Thousands		3 Months Ended								12 Months Ended
	Aug. 31, 2015	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Quarterly Financial Information Disclosure [Abstract]
Revenue from services		$ 222,523	$ 214,988	$ 199,443	$ 196,583	$ 193,148	$ 195,692	$ 192,617	$ 185,964	$ 833,537	$ 767,421	$ 617,825
Gross profit		57,633	58,210	54,846	51,046	50,479	51,486	48,363	47,037
Consolidated net income (loss)		(7,649)	14,289	(17,095)	19,186	(5,927)	5,151	2,680	3,050	8,731	4,954	(31,534)
Net income (loss) attributable to common shareholders		$ (7,884)	$ 14,066	$ (17,237)	$ 19,022	$ (6,098)	$ 5,009	$ 2,573	$ 2,934	$ 7,967	$ 4,418	$ (31,783)
Net income (loss) per share attributable to common shareholders - Basic (usd per share)		$ (0.24)	$ 0.44	$ (0.54)	$ 0.60	$ (0.19)	$ 0.16	$ 0.08	$ 0.09	$ 0.25	$ 0.14	$ (1.02)
Net income (loss) per share attributable to common shareholders - Diluted (usd per share)		$ (0.24)	$ 0.22	$ (0.54)	$ 0.09	$ (0.19)	$ 0.16	$ 0.08	$ 0.05	$ 0.15	$ 0.14	$ (1.02)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Changes in the fair value of convertible notes derivative liability		$ (14,200)	$ 7,100	$ (3,600)	$ 16,400	$ (9,500)	$ (2,900)	$ 400	$ 2,100
Impairment charges				24,300		2,100				$ 24,311	$ 2,100	$ 10,000
Loss on extinguishment of debt										1,568	0	0
Pre-tax loss on sale of the business										0	2,184	0
Acquisition-related contingent consideration										814	0	0
Restructuring costs										$ 753	1,274	$ 840
Disposal Group, Disposed of by Sale, Not Discontinued Operations \| Cross Country Education, LLC
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Pre-tax loss on sale of the business	$ 2,200										2,200
Gain on sale of discontinued operations, net of tax											$ 1,300
Second Lien Term Loan, net
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Loss on extinguishment of debt				1,600
Second Lien Term Loan, net \| Subordinated Debt
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Loss on extinguishment of debt				1,600
Mediscan
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Acquisition-related contingent consideration		100	200	$ 200	$ 300	0	0	0	$ 0
Centralization of Corporate Functions
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Restructuring costs		$ 200	$ 600
Cost Optimization Project
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Restructuring costs						$ 100	$ 200	$ 1,000

Schedule II - Valuation and Qualifying Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Allowances for Accounts Receivable
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	$ 4,045	$ 1,425	$ 1,651
Charged to Operations	4,034	2,414	1,016
Write-Offs	(5,149)	(923)	(1,257)
Recoveries	315	1,129	15
Other Changes	0	0	0
Balance at End of Period	3,245	4,045	1,425
Valuation Allowance for Deferred Tax Assets
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	55,336	63,616	52,001
Charged to Operations	(8,894)	(7,518)	12,038
Write-Offs	0	0	0
Recoveries	0	0	0
Other Changes	12	(762)	(423)
Balance at End of Period	$ 46,454	$ 55,336	$ 63,616