S-1/A
1
y51181a3s-1a.txt
AMENDMENT NO. 3 TO FORM S-1
AS FILED WITH THE SECURITIES AND EXCHANGE COMMISSION ON OCTOBER 19, 2001
REGISTRATION NO. 333-65168
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SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
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AMENDMENT NO. 3
TO
FORM S-1
REGISTRATION STATEMENT
UNDER
THE SECURITIES ACT OF 1933
------------------------
AMN HEALTHCARE SERVICES, INC.
(EXACT NAME OF REGISTRANT AS SPECIFIED IN ITS CHARTER)
DELAWARE 8099 06-1500476
(STATE OR OTHER JURISDICTION OF (PRIMARY STANDARD INDUSTRIAL (IRS EMPLOYER
INCORPORATION OR ORGANIZATION) CLASSIFICATION CODE NUMBER) IDENTIFICATION NUMBER)
12235 EL CAMINO REAL, SUITE 200
SAN DIEGO, CALIFORNIA 92130
(800) 282-0300
(ADDRESS, INCLUDING ZIP CODE, AND TELEPHONE NUMBER, INCLUDING
AREA CODE, OF REGISTRANT'S PRINCIPAL EXECUTIVE OFFICES)
------------------------
STEVEN C. FRANCIS
PRESIDENT AND CHIEF EXECUTIVE OFFICER
AMN HEALTHCARE SERVICES, INC.
12235 EL CAMINO REAL, SUITE 200
SAN DIEGO, CALIFORNIA 92130
(800) 282-0300
(NAME, ADDRESS, INCLUDING ZIP CODE, AND TELEPHONE NUMBER,
INCLUDING AREA CODE, OF AGENT FOR SERVICE)
------------------------
COPIES TO:
JOHN C. KENNEDY, ESQ. IAN B. BLUMENSTEIN, ESQ.
PAUL, WEISS, RIFKIND, WHARTON & GARRISON LATHAM & WATKINS
1285 AVENUE OF THE AMERICAS 275 GROVE STREET, 4TH FLOOR
NEW YORK, NEW YORK 10019-6064 NEWTON, MASSACHUSETTS 02466
(212) 373-3000 (617) 663-5700
------------------------
APPROXIMATE DATE OF COMMENCEMENT OF PROPOSED SALE OF THE SECURITIES TO THE
PUBLIC: As soon as practicable after this Registration Statement becomes
effective.
If any of the securities being registered on this Form are to be offered on
a delayed or continuous basis pursuant to Rule 415 under the Securities Act of
1933, check the following box. [ ]
If this form is filed to register additional securities for an offering
pursuant to Rule 462(b) under the Securities Act, check the following box and
list the Securities Act registration statement number of the earlier effective
registration statement for the same offering: [ ] ------
If this form is a post-effective amendment filed pursuant to Rule 462(c)
under the Securities Act, check the following box and list the Securities Act
registration statement number of the earlier effective registration statement
for the same offering: [ ] ------
If this form is a post-effective amendment filed pursuant to Rule 462(d)
under the Securities Act, check the following box and list the Securities Act
registration statement number of the earlier effective registration statement
for the same offering: [ ] ------
If delivery of the prospectus is expected to be made pursuant to Rule 434,
please check the following box. [ ]
------------------------
THE REGISTRANT HEREBY AMENDS THIS REGISTRATION STATEMENT ON SUCH DATE OR
DATES AS MAY BE NECESSARY TO DELAY ITS EFFECTIVE DATE UNTIL THE REGISTRANT SHALL
FILE A FURTHER AMENDMENT WHICH SPECIFICALLY STATES THAT THIS REGISTRATION
STATEMENT SHALL THEREAFTER BECOME EFFECTIVE IN ACCORDANCE WITH SECTION 8(a) OF
THE SECURITIES ACT OF 1933, AS AMENDED, OR UNTIL THE REGISTRATION STATEMENT
SHALL BECOME EFFECTIVE ON SUCH DATE AS THE COMMISSION, ACTING PURSUANT TO SUCH
SECTION 8(a), MAY DETERMINE.
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THE INFORMATION IN THIS PROSPECTUS IS NOT COMPLETE AND MAY BE CHANGED WITHOUT
NOTICE. AMN HEALTHCARE SERVICES, INC. MAY NOT SELL THESE SECURITIES UNTIL THE
REGISTRATION STATEMENT FILED WITH THE SECURITIES AND EXCHANGE COMMISSION IS
EFFECTIVE. THIS PROSPECTUS IS NOT AN OFFER TO SELL THESE SECURITIES, AND AMN
HEALTHCARE SERVICES, INC. IS NOT SOLICITING OFFERS TO BUY THESE SECURITIES, IN
ANY STATE WHERE THE OFFER OR SALE OF THESE SECURITIES IS NOT PERMITTED.
Prospectus (Not Complete)
Issued October 19, 2001
10,000,000 SHARES
[AMN HEATHCARE SERVICES, INC. LOGO]
COMMON STOCK
------------------------------
AMN Healthcare Services, Inc. is offering 10,000,000 shares of common stock
in our initial public offering. We anticipate that the initial public offering
price for our shares will be between $14.00 and $16.00 per share. After this
offering, the market price for our shares may be outside of this range.
------------------------------
Our common stock has been approved for listing on the New York Stock
Exchange, subject to official notice of issuance, under the symbol "AHS."
------------------------------
INVESTING IN OUR COMMON STOCK INVOLVES A HIGH DEGREE OF RISK. SEE "RISK
FACTORS" BEGINNING ON PAGE 7.
------------------------------
Per Share Total
--------- --------
Offering Price............................................. $ $
Discounts and Commissions to Underwriters.................. $ $
Offering Proceeds to AMN Healthcare Services, Inc.......... $ $
NEITHER THE SECURITIES AND EXCHANGE COMMISSION NOR ANY STATE SECURITIES
COMMISSION HAS APPROVED OR DISAPPROVED OF THESE SECURITIES OR DETERMINED IF THIS
PROSPECTUS IS TRUTHFUL OR COMPLETE. ANY REPRESENTATION TO THE CONTRARY IS A
CRIMINAL OFFENSE.
We have granted the underwriters the right to purchase up to an additional
1,500,000 shares of our common stock to cover any over-allotments. The
underwriters can exercise this right at any time within thirty days after this
offering. Banc of America Securities LLC expects to deliver the shares of common
stock to investors on , 2001.
JOINT BOOK-RUNNING MANAGERS
BANC OF AMERICA SECURITIES LLC UBS WARBURG
JPMORGAN
------------------------------
, 2001
[ART WORK: COMPANY LOGO, SLOGAN ("A LEADER IN HEALTHCARE STAFFING") AND A FULL
PAGE PHOTO OF TWO NURSES WORKING IN A HOSPITAL HALLWAY.]
TABLE OF CONTENTS
PAGE
----
Prospectus Summary.......................................... 1
Risk Factors................................................ 7
Forward-Looking Statements.................................. 13
Use of Proceeds............................................. 14
Dividend Policy............................................. 15
Capitalization.............................................. 16
Dilution.................................................... 17
Selected Consolidated Financial and Operating Data.......... 18
Management's Discussion and Analysis of Financial Condition
and Results of Operations................................. 20
Business.................................................... 28
Management.................................................. 42
Related Party Transactions.................................. 51
Principal Stockholders...................................... 53
Description of Capital Stock................................ 55
Certain U.S. Federal Tax Considerations for Non-U.S.
Holders................................................... 57
Shares Eligible For Future Sale............................. 60
Underwriting................................................ 61
Legal Matters............................................... 63
Experts..................................................... 63
Change of Accountants....................................... 64
Where You Can Find More Information......................... 64
Index to Consolidated Financial Statements.................. F-1
Index to Pro Forma Condensed Consolidated Financial
Statements................................................ P-1
i
PROSPECTUS SUMMARY
This summary highlights information contained elsewhere in this prospectus. This
summary is not complete and does not contain all of the information that you
should consider before investing in the common stock. You should read the entire
prospectus carefully, especially the risks of investing in our common stock
discussed under "Risk Factors." Unless we state otherwise, the terms "we," "us"
and "our" refer to AMN Healthcare Services, Inc. and its subsidiaries. Some of
the statements in this "Prospectus Summary" are forward-looking statements. See
"Forward-Looking Statements."
THE COMPANY
We are a leading temporary healthcare staffing company and the largest
nationwide provider of travel nurse staffing services, one of the fastest
growing segments of the temporary healthcare staffing industry. We recruit
nurses and allied health professionals, our "temporary healthcare
professionals," and place them on temporary assignments, typically for 13 weeks
away from their permanent homes, at hospitals and healthcare facilities
throughout the United States. Approximately 90% of our temporary healthcare
professionals are nurses, while the remainder are technicians, therapists and
technologists. We are actively working with a pre-screened pool of over 25,000
prospective temporary healthcare professionals, of whom over 6,400 were on
assignment during September 2001. Additionally, in September 2001, we had over
17,000 open orders from our network of over 2,500 hospital and healthcare
facility clients.
In recent years our business has grown significantly, outpacing the growth
of the temporary healthcare staffing market. From 1996 to 2000, our revenue and
Adjusted EBITDA (as defined) increased at compound annual growth rates of 48%
and 58%, respectively. Approximately one-third of this growth was generated
through strategic acquisitions, while the remaining two-thirds was generated
through the organic growth of our operations. On a combined basis, assuming all
of our acquisitions had occurred on January 1, 1999, we would have generated
revenues of $467.3 million and Adjusted EBITDA of $54.5 million for the twelve
months ended September 30, 2001. This represents organic compound annual growth
rates of 50% and 76%, respectively, since 1999.
We market our services to two distinct customer bases: (1) temporary
healthcare professionals and (2) hospital and healthcare facility clients. To
enhance our ability to successfully attract temporary healthcare professionals,
we use a multi-brand recruiting strategy to recruit in the United States and
internationally under our five separate brand names: American Mobile Healthcare,
Medical Express, NursesRx, Preferred Healthcare Staffing and O'Grady-Peyton
International. Our large number of hospital and healthcare facility clients
allows us to offer traveling positions in all 50 states, and in a variety of
work environments. We believe that we attract temporary healthcare professionals
due to our long-standing reputation for providing a high level of service, our
numerous job opportunities and our most effective recruiting tool, word-of-mouth
referrals from our thousands of current and former temporary healthcare
professionals. As discussed further in "Risk Factors," our ability to remain
competitive in obtaining and retaining temporary healthcare professionals is
important to our future growth.
We have established a growing and diverse hospital and healthcare facility
client base, ranging from national healthcare providers to premier teaching and
regional hospitals. We currently hold contracts with approximately 42% of all
acute-care hospitals in the United States, where we place the vast majority of
our temporary healthcare professionals. Hospital and healthcare facilities
utilize our services to help cost-effectively manage staff shortages, new unit
openings, seasonal variations and other flexible staffing needs. As discussed
further in "Risk Factors," we operate in a highly competitive market and our
success also depends on our ability to remain competitive in obtaining and
retaining hospital and healthcare facility clients. In particular, our business
depends upon our ability to secure and fill new orders from our hospital and
healthcare facility clients because we do not have long-term agreements or
exclusive contracts with them.
1
MARKET OPPORTUNITY AND COMPETITIVE STRENGTHS
We believe that the following industry characteristics and competitive
strengths provide us an attractive opportunity to profitably grow our business:
- FAVORABLE INDUSTRY DYNAMICS. Favorable industry trends have increased
demand in the $7.2 billion temporary healthcare staffing industry, which
is projected to grow 21%, to $8.7 billion, in 2001. We believe these
trends will continue to grow demand for our services. Key industry
dynamics include:
-- Increasing Healthcare Expenditures. The Centers for Medicare &
Medicaid Services projects healthcare expenditures will increase by
approximately $1.3 trillion over the next decade, to $2.6 trillion.
This growth is expected to be fueled by an increasingly aging U.S.
population and by advances in medical technology.
-- Increasing Nurse Vacancies. Most regions of the United States are
experiencing a shortage of nurses. The American Hospital Association
estimates that up to 126,000 position vacancies currently exist for
registered nurses, representing approximately 10% of the current
hospital-based nursing workforce. A study published in the Journal of
the American Medical Association projects that the registered nurse
workforce will be nearly 20% below projected requirements by 2020.
-- Continuing Shift to Outsourced Services. In the current cost
containment environment, hospitals and healthcare facilities are
increasingly using flexible staffing models to more effectively
manage labor costs and fluctuations in demand for their services.
- CONSISTENT GROWTH OF REVENUE AND PROFITS. From 1996 to 2000, our revenue
and Adjusted EBITDA increased at compound annual growth rates of 48% and
58%, respectively. On a combined basis, assuming all of our acquisitions
had occurred on January 1, 1996, the compound annual growth rate of our
revenues from 1996 to 2000 would have been 30%. As discussed further in
"Risk Factors," if we are unable to attract qualified nurses and other
allied healthcare professionals for our healthcare staffing business at
reasonable costs, it could increase our operating costs and negatively
impact our revenue and profits.
- NATIONWIDE PRESENCE AND SCALE. Our broad client base helps us attract
potential temporary healthcare professionals, as we offer more employment
opportunities than our smaller competitors. Within our industry, we have
the largest number of working temporary healthcare professionals, which
generates a strong volume of word-of-mouth referrals. In addition, our
size provides us with economy of scale benefits in our administrative
areas, information systems, benefits and housing programs.
- PROVEN MULTI-BRAND RECRUITING STRATEGY. We have capitalized on our
multi-brand recruiting strategy by utilizing our five strong brand names,
complementary geographic concentrations and cross-selling opportunities
to successfully recruit temporary healthcare professionals. We believe
that each of our five brands has significant opportunity for growth
through leveraging our nationwide presence, extensive temporary
healthcare professional network and hospital client base.
- ESTABLISHED INTERNATIONAL RECRUITING BRAND. Our recent acquisition of
O'Grady-Peyton International (USA), Inc. expanded our traveler recruiting
capabilities beyond the United States. O'Grady-Peyton International is
the leading recruiter of registered nurses from English-speaking foreign
countries for placement in the United States, with approximately 20 years
of international recruiting experience.
- NO DIRECT REIMBURSEMENT RISK. We are not subject to direct reimbursement
risk from Medicare, Medicaid or any other federal or state healthcare
reimbursement programs. We contract with, and are paid directly by, our
hospital and healthcare facility clients.
- EXPERIENCED MANAGEMENT. We have an experienced management team, which
has successfully expanded our business, grown our revenues and Adjusted
EBITDA, and integrated strategic acquisitions. Our six senior operating
officers have worked an average of 12 years in the temporary
2
healthcare staffing industry. Steven Francis, our President and CEO,
co-founded our company in 1985, and has been instrumental in shaping the
growth of the travel nurse staffing sector.
For a discussion of risks and uncertainties related to our business and an
investment in our common stock, see "Risk Factors."
We were incorporated in Delaware on November 10, 1997. Our corporate
headquarters is located at 12235 El Camino Real, Suite 200, San Diego,
California 92130. Our telephone number is (800) 282-0300 and our corporate
website is www.amnhealthcare.com. The information on our website is not part of
this prospectus.
THE OFFERING
Common stock offered............... 10,000,000 shares
Common stock outstanding after the
offering........................... 40,714,643 shares
Use of proceeds.................... We intend to use the net proceeds from
this offering to repay indebtedness under
our credit facility and our senior
subordinated notes. The remaining net
proceeds, if any, will be used for
working capital and general corporate
purposes. See "Use of Proceeds."
New York Stock Exchange Symbol..... "AHS"
Unless we indicate otherwise, the number of shares of common stock to be
outstanding after this offering is based on the number of shares outstanding as
of , 2001 and excludes 7,710,936 shares of common stock reserved
for issuance under our stock option plans, of which 5,727,955 shares are subject
to options outstanding at a weighted average exercise price of $4.98 per share.
Unless we indicate otherwise, the information in this prospectus assumes:
- that the underwriters will not exercise their over-allotment option; and
- the exercise of an outstanding warrant resulting in the issuance of
1,879,628 shares immediately prior to this offering (assuming a cashless
exercise of the warrant with a fair market valuation based upon an
initial offering price of $15.00 per share, the mid-point of the range
shown on the cover page of this prospectus).
------------------------
YOU SHOULD RELY ONLY ON THE INFORMATION CONTAINED IN THIS PROSPECTUS. WE HAVE
NOT AUTHORIZED ANYONE TO PROVIDE YOU WITH DIFFERENT INFORMATION. WE ARE NOT
MAKING AN OFFER TO SELL THESE SECURITIES IN ANY JURISDICTION WHERE THE OFFER OR
SALE IS NOT PERMITTED. YOU SHOULD ASSUME THAT THE INFORMATION APPEARING IN THIS
PROSPECTUS IS ACCURATE AS OF THE DATE ON THE FRONT COVER OF THIS PROSPECTUS
ONLY. OUR BUSINESS, FINANCIAL CONDITION, RESULTS OF OPERATIONS AND PROSPECTS MAY
HAVE CHANGED SINCE THAT DATE.
3
SUMMARY CONSOLIDATED FINANCIAL AND OPERATING DATA
You should read the following summary consolidated financial and operating
data in conjunction with "Selected Consolidated Financial and Operating Data,"
"Management's Discussion and Analysis of Financial Condition and Results of
Operations," our pro forma financial statements, our historical financial
statements and the historical financial statements of Nurses RX, Inc., Preferred
Healthcare Staffing, Inc., and O'Grady-Peyton International (USA), Inc. and the
related notes appearing elsewhere in this prospectus.
The following table summarizes our consolidated financial and operating
data as of September 30, 2001, for the years ended December 31, 1998, 1999 and
2000 and for the nine months ended September 30, 2000 and 2001, prepared from
our historical accounting records. The pro forma consolidated statements of
operations and other financial and operating data for the year ended December
31, 2000 and for the nine months ended September 30, 2000 give effect to the
acquisitions of NursesRx, Preferred Healthcare Staffing and O'Grady-Peyton
International, as well as this offering, as if these events had occurred on
January 1, 2000. The pro forma consolidated statements of operations and other
financial and operating data for the nine months ended September 30, 2001 give
effect to the acquisition of O'Grady-Peyton International, as well as this
offering, as if these events had occurred on January 1, 2000. The as adjusted
consolidated balance sheet data as of September 30, 2001 gives effect to this
offering as of such date. The pro forma information is not necessarily
indicative of the actual results of operations that would have occurred had the
acquisitions of NursesRx, Preferred Healthcare Staffing and O'Grady-Peyton
International and this offering occurred on the assumed dates nor do they
represent any indication of future performance.
4
YEARS ENDED DECEMBER 31, NINE MONTHS ENDED SEPTEMBER 30,
------------------------------------------- -----------------------------------------------------
2000 2000 2001
1998 1999 2000 PRO FORMA 2000 2001 PRO FORMA PRO FORMA
------- -------- -------- ----------- ----------- ----------- ----------- -----------
(UNAUDITED) (UNAUDITED) (UNAUDITED) (UNAUDITED) (UNAUDITED)
(DOLLARS AND SHARES IN THOUSANDS, EXCEPT PER SHARE DATA)
CONSOLIDATED STATEMENTS OF
OPERATIONS:
Revenue..................... $87,718 $146,514 $230,766 $326,355 $151,713 $357,108 $226,733 $367,690
Cost of revenue............. 67,244 111,784 170,608 241,984 112,729 267,333 167,515 274,706
------- -------- -------- -------- -------- -------- -------- --------
Gross profit................ 20,474 34,730 60,158 84,371 38,984 89,775 59,218 92,984
------- -------- -------- -------- -------- -------- -------- --------
Expenses:
Selling, general and
administrative
(excluding non-cash
stock-based
compensation)........... 12,804 20,677 30,728 44,599 19,770 49,750 32,489 51,568
Non-cash stock-based
compensation(1)......... -- -- 22,379 54,150 15,901 13,096 54,150 --
Amortization.............. 1,163 1,721 2,387 5,735 1,504 4,128 4,301 4,296
Depreciation.............. 171 325 916 1,207 605 1,484 846 1,509
Transaction costs(2)...... -- 12,404 1,500 1,500 -- -- -- --
------- -------- -------- -------- -------- -------- -------- --------
Total expenses.............. 14,138 35,127 57,910 107,191 37,780 68,458 91,786 57,373
------- -------- -------- -------- -------- -------- -------- --------
Income (loss) from
operations................ 6,336 (397) 2,248 (22,820) 1,204 21,317 (32,568) 35,611
Interest income (expense),
net....................... (2,476) (4,030) (10,006) 31 (7,043) (11,780) (5) (47)
------- -------- -------- -------- -------- -------- -------- --------
Income (loss) before
minority interest, income
taxes and extraordinary
item...................... 3,860 (4,427) (7,758) (22,789) (5,839) 9,537 (32,573) 35,564
Minority interest in
earnings of
subsidiary(3)............. (657) (1,325) -- -- -- -- -- --
Income tax (expense)
benefit................... (1,571) 872 2,560 7,520 1,927 (4,959) 10,749 (18,493)
------- -------- -------- -------- -------- -------- -------- --------
Income (loss) before
extraordinary item........ 1,632 (4,880) (5,198) (15,269) (3,912) 4,578 (21,824) 17,071
Extraordinary loss on early
extinguishment of debt,
net of income tax
benefit................... -- (730) -- N/A -- -- N/A N/A
------- -------- -------- -------- -------- -------- -------- --------
Net income (loss)........... $ 1,632 $ (5,610) $ (5,198) $(15,269) $ (3,912) $ 4,578 $(21,824) $ 17,071
======= ======== ======== ======== ======== ======== ======== ========
Net income (loss) per common
share:
Basic..................... $ 0.09 $ (0.26) $ (0.23) $ (0.38) $ (0.18) $ 0.16 $ (0.54) $ 0.42
======= ======== ======== ======== ======== ======== ======== ========
Diluted................... $ 0.09 $ (0.26) $ (0.23) $ (0.38) $ (0.18) $ 0.15 $ (0.54) $ 0.39
======= ======== ======== ======== ======== ======== ======== ========
Weighted average common
shares outstanding:
Basic..................... 17,751 21,715 22,497 40,715 21,491 28,835 40,715 40,715
======= ======== ======== ======== ======== ======== ======== ========
Diluted................... 17,751 21,715 22,497 40,715 21,491 31,431 40,715 44,325
======= ======== ======== ======== ======== ======== ======== ========
OTHER FINANCIAL AND
OPERATING DATA:
Revenue growth.............. N/A 67% 58% N/A N/A 135% N/A 62%
======= ======== ======== ======== ======== ======== ======== ========
Average temporary healthcare
professionals on
assignment................ 1,444 2,289 3,166 4,402 2,870 5,654 4,203 5,811
======= ======== ======== ======== ======== ======== ======== ========
Growth in average temporary
healthcare professionals
on assignment............. N/A 59% 38% N/A N/A 97% N/A 38%
======= ======== ======== ======== ======== ======== ======== ========
Capital expenditures........ $ 690 $ 1,656 $ 2,358 $ 3,067 $ 1,865 $ 2,880 $ 2,400 $ 3,019
======= ======== ======== ======== ======== ======== ======== ========
Adjusted EBITDA(4).......... $ 7,670 $ 14,053 $ 29,430 $ 39,772 $ 19,214 $ 40,025 $ 26,729 $ 41,416
======= ======== ======== ======== ======== ======== ======== ========
Adjusted EBITDA growth...... N/A 83% 109% N/A N/A 108% N/A 55%
======= ======== ======== ======== ======== ======== ======== ========
5
AS OF SEPTEMBER 30, 2001
---------------------------
ACTUAL AS ADJUSTED(5)
-------- ---------------
(UNAUDITED)
(IN THOUSANDS)
CONSOLIDATED BALANCE SHEET DATA:
Cash and cash equivalents................................... $ 3,953 $ 3,953
Working capital............................................. 52,653 65,778
Total assets................................................ 256,214 256,214
Total long-term debt, including current portion............. 135,842 3,541
Total stockholders' equity.................................. 84,266 222,131
---------------
(1) Non-cash stock-based compensation represents compensation expense related to
our performance-based stock option plans to reflect the difference between
the fair market value and the exercise price of stock options previously
issued to our officers. See Note 8 of Notes to Consolidated Financial
Statements for AMN Healthcare Services, Inc. Upon consummation of this
offering, options to purchase 5,181,642 shares of our common stock will be
vested and will have an average exercise price $10.45 below the assumed
initial offering price of $15.00 per share. As a result, based upon an
assumed initial offering price of $15.00 per share, we expect to record an
additional non-cash stock-based compensation charge of $18.7 million in the
quarter in which this offering occurs. Following the quarter in which this
offering occurs, we do not expect to incur additional non-cash stock-based
compensation charges in excess of $250,000 per quarter.
(2) Transaction costs represent non-capitalized costs incurred in connection
with our 1999 recapitalization and our acquisition of Preferred Healthcare
Staffing.
(3) On October 18, 1999, the minority stockholder of one of our subsidiaries
exchanged his shares of the subsidiary for our shares. As a result, no
minority interest is reflected after that date.
(4) Adjusted EBITDA represents income (loss) from operations plus depreciation,
amortization, transaction costs and non-cash stock-based compensation
expense. Adjusted EBITDA is presented because we believe that it is a widely
accepted financial indicator used by certain investors and securities
analysts to analyze and compare companies on the basis of operating
performance. Adjusted EBITDA is not intended to represent cash flows for the
period, nor has it been presented as an alternative to operating income as
an indicator of operating performance and should not be considered in
isolation or as a substitute for measures of performance prepared in
accordance with generally accepted accounting principles. Adjusted EBITDA,
as we define it, is not necessarily comparable to other similarly titled
captions of other companies due to potential inconsistencies in the method
of calculation. See our historical and unaudited pro forma financial
statements and the related notes appearing elsewhere in this prospectus.
(5) As adjusted to reflect our receipt of the net proceeds from this offering at
an assumed initial public offering price of $15.00 per share, after
deducting estimated underwriting discounts and commissions and estimated
offering expenses, and application of such proceeds as set forth under "Use
of Proceeds."
6
RISK FACTORS
An investment in our common stock involves a high degree of risk. You should
consider carefully the following information about these risks, together with
the other information contained in this prospectus, before buying shares of our
common stock. Any of the risk factors we describe below could severely harm our
business, financial condition and results of operations. The market price of our
common stock could decline if one or more of these risks and uncertainties
develop into actual events. You may lose all or part of the money you paid to
buy our common stock. Some of the statements in "Risk Factors" are
forward-looking statements. See "Forward-Looking Statements."
IF WE ARE UNABLE TO ATTRACT QUALIFIED NURSES AND OTHER ALLIED HEALTHCARE
PROFESSIONALS FOR OUR HEALTHCARE STAFFING BUSINESS AT REASONABLE COSTS, IT COULD
INCREASE OUR OPERATING COSTS AND NEGATIVELY IMPACT OUR BUSINESS.
We rely significantly on our ability to attract and retain nurses and other
allied healthcare professionals who possess the skills, experience and licenses
necessary to meet the requirements of our hospital and healthcare facility
clients. We compete for healthcare staffing personnel with other temporary
healthcare staffing companies and with hospitals and healthcare facilities. We
must continually evaluate and expand our temporary healthcare professional
network to keep pace with our hospital and healthcare facility clients' needs.
Currently, there is a shortage of qualified nurses in most areas of the United
States, competition for nursing personnel is increasing, and salaries and
benefits have risen. We may be unable to continue to increase the number of
temporary healthcare professionals that we recruit, decreasing the potential for
growth of our business. Our ability to attract and retain temporary healthcare
professionals depends on several factors, including our ability to provide
temporary healthcare professionals with assignments that they view as attractive
and to provide them with competitive benefits and wages. We cannot assure you
that we will be successful in any of these areas. The cost of attracting
temporary healthcare professionals and providing them with attractive benefit
packages may be higher than we anticipate and, as a result, if we are unable to
pass these costs on to our hospital and healthcare facility clients, our
profitability could decline. Moreover, if we are unable to attract and retain
temporary healthcare professionals, the quality of our services to our hospital
and healthcare facility clients may decline and, as a result, we could lose
clients.
WE OPERATE IN A HIGHLY COMPETITIVE MARKET AND OUR SUCCESS DEPENDS ON OUR ABILITY
TO REMAIN COMPETITIVE IN OBTAINING AND RETAINING HOSPITAL AND HEALTHCARE
FACILITY CLIENTS AND TEMPORARY HEALTHCARE PROFESSIONALS.
The temporary healthcare staffing business is highly competitive. We
compete in national, regional and local markets with full-service staffing
companies and with specialized temporary staffing agencies. Some of our
competitors in the temporary nurse staffing sector include Cross Country,
InteliStaf, Medical Staffing Network and RehabCare Group. Some of these
companies may have greater marketing and financial resources than us. We believe
that the primary competitive factors in obtaining and retaining hospital and
healthcare facility clients are identifying qualified healthcare professionals
for specific job requirements, providing qualified employees in a timely manner,
pricing services competitively and effectively monitoring employees' job
performance. We compete for temporary healthcare professionals based on the
quantity, diversity and quality of assignments offered, compensation packages
and the benefits that we provide. Competition for hospital and healthcare
facility clients and temporary healthcare professionals may increase in the
future and, as a result, we may not be able to remain competitive. To the extent
competitors seek to gain or retain market share by reducing prices or increasing
marketing expenditures, we could lose revenues or hospital and healthcare
facility clients and our margins could decline, which could seriously harm our
operating results and cause the price of our stock to decline. In addition, the
development of alternative recruitment channels could lead our hospital and
healthcare facility clients to bypass our services, which would also cause our
revenues and margins to decline.
7
OUR BUSINESS DEPENDS UPON OUR ABILITY TO SECURE AND FILL NEW ORDERS FROM OUR
HOSPITAL AND HEALTHCARE FACILITY CLIENTS BECAUSE WE DO NOT HAVE LONG-TERM
AGREEMENTS OR EXCLUSIVE CONTRACTS WITH THEM.
We do not have long-term agreements or exclusive guaranteed order contracts
with our hospital and healthcare facility clients. The success of our business
is dependent upon our ability to continually secure new orders from hospitals
and other healthcare facilities and to fill those orders with our temporary
healthcare professionals. Our hospital and healthcare facility clients are free
to place orders with our competitors and choose to use temporary healthcare
professionals that our competitors offer them. Therefore, we must maintain
positive relationships with our hospital and healthcare facility clients. If we
fail to maintain positive relationships with our hospital and healthcare
facility clients, we may be unable to generate new temporary healthcare
professional orders and our business may be adversely affected.
FLUCTUATIONS IN PATIENT OCCUPANCY AT THE HOSPITAL AND HEALTHCARE FACILITIES OF
OUR CLIENTS MAY ADVERSELY AFFECT THE DEMAND FOR OUR SERVICES AND THEREFORE THE
PROFITABILITY OF OUR BUSINESS.
Demand for our temporary healthcare staffing services is significantly
affected by the general level of patient occupancy at our hospital and
healthcare clients' facilities. When occupancy increases, temporary employees
are often added before full-time employees are hired. As occupancy decreases,
hospital and healthcare facility clients typically will reduce their use of
temporary employees before undertaking layoffs of their regular employees. In
addition, we may experience more competitive pricing pressure during periods of
occupancy downturn. Occupancy at our healthcare clients' facilities also
fluctuates due to the seasonality of some elective procedures. We are unable to
predict the level of patient occupancy at any particular time and its effect on
our revenues and earnings.
HEALTHCARE REFORM COULD NEGATIVELY IMPACT OUR BUSINESS OPPORTUNITIES, REVENUES
AND MARGINS.
The U.S. government has undertaken efforts to control growing healthcare
costs through legislation, regulation and voluntary agreements with medical care
providers and drug companies. In the recent past, the U.S. Congress has
considered several comprehensive healthcare reform proposals. The proposals were
generally intended to expand healthcare coverage for the uninsured and reduce
the growth of total healthcare expenditures. While the U.S. Congress did not
adopt any comprehensive reform proposals, members of Congress may raise similar
proposals in the future. If any of these proposals are approved, hospitals and
other healthcare facilities may react by spending less on healthcare staffing,
including nurses. If this were to occur, we would have fewer business
opportunities, which could have a material adverse effect on our business.
State governments have also attempted to control the growth of healthcare
costs. For example, the state of Massachusetts has recently implemented a
regulation that limits the hourly rate paid to temporary nursing agencies for
registered nurses, licensed practical nurses and certified nurses aides. While
the current regulation does not apply to us, if similar regulations were to be
applied to longer term contracts in states in which we operate, our revenues and
margins could decrease.
Furthermore, third party payors, such as health maintenance organizations,
increasingly challenge the prices charged for medical care. Failure by hospitals
and other healthcare facilities to obtain full reimbursement from those third
party payors could reduce the demand or the price paid for our services.
WE OPERATE IN A REGULATED INDUSTRY AND CHANGES IN REGULATIONS OR VIOLATIONS OF
REGULATIONS MAY RESULT IN INCREASED COSTS OR SANCTIONS THAT COULD REDUCE OUR
REVENUES AND PROFITABILITY.
The healthcare industry is subject to extensive and complex federal and
state laws and regulations related to professional licensure, conduct of
operations, payment for services and payment for referrals. If we fail to comply
with the laws and regulations that are directly applicable to our business, we
could suffer civil and/or criminal penalties or be subject to injunctions or
cease and desist orders.
Our business is generally not subject to the extensive and complex laws
that apply to our hospital and healthcare facility clients, including laws
related to Medicare, Medicaid and other federal and state healthcare programs.
However, these laws and regulations could indirectly affect the demand or the
prices paid for our
8
services. For example, our hospital and healthcare facility clients could suffer
civil and/or criminal penalties and/or be excluded from participating in
Medicare, Medicaid and other healthcare programs if they fail to comply with the
laws and regulations applicable to their businesses. In addition, our hospital
and healthcare facility clients could receive reduced reimbursements, or be
excluded from coverage, because of a change in the rates or conditions set by
federal or state governments. In turn, violations of or changes to these laws
and regulations that adversely affect our hospital and healthcare facility
clients could also adversely affect the prices that these clients are willing or
able to pay for our services.
SIGNIFICANT LEGAL ACTIONS COULD SUBJECT US TO SUBSTANTIAL LIABILITIES.
In recent years, our hospital and healthcare facility clients have become
subject to an increasing number of legal actions alleging malpractice or related
legal theories. Because our temporary healthcare professionals provide medical
care, claims may be brought against our temporary healthcare professionals and
us relating to the quality of medical care provided by our temporary healthcare
professionals while on assignment at our hospital and healthcare facility
clients. We and our temporary healthcare professionals are at times named in
these lawsuits regardless of our contractual obligations or the standard of care
provided by our temporary healthcare professionals. In some instances, we are
required to indemnify hospital and healthcare facility clients contractually
against some or all of these potential legal actions. Also, because most of our
temporary healthcare professionals are our employees, we may be subject to
various employment claims and contractual disputes regarding the terms of a
temporary healthcare professional's employment. We maintain a policy of $10
million for employment practices coverage with an additional excess coverage of
$10 million. We also have two layers of professional and general liability
coverage. The professional and general liability coverage consists of primary
coverage with limits of $1 million per occurrence and $3 million in the
aggregate and an umbrella policy with limits of $20 million. However, our
insurance coverage may not cover all claims against us or continue to be
available to us at a reasonable cost. Also, we may not be able to pass on all or
any portion of increased insurance costs to our hospital and healthcare facility
clients. If we are unable to maintain adequate insurance coverage or if any
claims are not covered by insurance, we may be exposed to substantial
liabilities.
WE MAY BE LEGALLY LIABLE FOR DAMAGES RESULTING FROM OUR HOSPITAL AND HEALTHCARE
FACILITY CLIENTS' MISTREATMENT OF OUR TRAVELING HEALTHCARE PERSONNEL.
Because we are in the business of placing our temporary healthcare
professionals in the workplaces of other companies, we are subject to possible
claims by our temporary healthcare professionals alleging discrimination, sexual
harassment, negligence and other similar activities by our hospital and
healthcare facility clients. The cost of defending such claims, even if
groundless, could be substantial and the associated negative publicity could
adversely affect our ability to attract and retain qualified individuals in the
future.
WE CANNOT ASSURE YOU THAT WE WILL BE ABLE TO SUCCESSFULLY COMPLETE THE
INTEGRATION OF OUR RECENT ACQUISITIONS.
During the last year, we acquired two companies in the temporary healthcare
staffing industry: Preferred Healthcare Staffing and O'Grady-Peyton
International. These acquisitions involve significant risks and uncertainties,
including difficulties integrating acquired personnel and other corporate
cultures into our business, the potential loss of key employees or customers of
acquired companies, the assumption of liabilities and exposure to unforeseen
liabilities of acquired companies and the diversion of management attention from
existing operations. We may not be able to fully integrate the operations of the
acquired businesses with our own in an efficient and cost-effective manner. In
addition, through our most recent acquisition, O'Grady-Peyton International, we
are now involved in new international temporary healthcare professional
recruitment markets where we have limited or no experience. Our failure to
effectively integrate either of these businesses could have an adverse effect on
our financial condition and results of operations.
9
DIFFICULTIES IN MAINTAINING OUR MANAGEMENT INFORMATION AND COMMUNICATIONS
SYSTEMS MAY RESULT IN INCREASED COSTS THAT REDUCE OUR PROFITABILITY.
Our ability to deliver our staffing services to our hospital and healthcare
facility clients and manage our internal systems depends to a large extent upon
the performance of our management information and communications systems. If
these systems do not adequately support our operations, or if we are required to
incur significant additional costs to maintain or expand these systems, our
business and financial results could be materially adversely affected.
OUR OPERATIONS MAY DETERIORATE IF WE ARE UNABLE TO CONTINUE TO ATTRACT, DEVELOP
AND RETAIN OUR SALES PERSONNEL.
Our success is dependent upon the performance of our sales personnel,
especially regional client service directors, hospital account managers and
recruiters. The number of individuals who meet our qualifications for these
positions is limited and we may experience difficulty in attracting qualified
candidates. In addition, we commit substantial resources to the training,
development and support of these individuals. Competition for qualified sales
personnel in the line of business in which we operate is strong and there is a
risk that we may not be able to retain our sales personnel after we have
expended the time and expense to recruit and train them.
THE LOSS OF KEY SENIOR MANAGEMENT PERSONNEL COULD ADVERSELY AFFECT OUR ABILITY
TO REMAIN COMPETITIVE.
We believe that the success of our business strategy and our ability to
operate profitably depends on the continued employment of our senior management
team, led by Steven Francis, Susan Nowakowski and Donald Myll. Other than Steven
Francis, none of our senior management team has an employment contract with us.
If Steven Francis or other members of our senior management team become unable
or unwilling to continue in their present positions, our business and financial
results could be materially adversely affected.
THE CALIFORNIA ENERGY CRISIS MAY ADVERSELY AFFECT OUR BUSINESS.
Our corporate headquarters is located in San Diego, California. Southern
California has been and is expected to continue to be subject to periodic power
outages. Interruption of power may cause our computer systems, phone lines and
other communications systems to become inoperable for unknown periods of time.
Our inability to successfully conduct our temporary healthcare professional
recruiting efforts and other back-office functions from our headquarters
location due to power outages in California could have an adverse effect on our
operations.
OUR EXISTING STOCKHOLDERS WILL CONTINUE TO CONTROL US AFTER THIS OFFERING, AND
THEY MAY MAKE DECISIONS WITH WHICH YOU DISAGREE.
Upon consummation of this offering, HWH Capital Partners, L.P. and some of
its affiliates, whom we refer to collectively as the "HWP stockholders," will
own approximately 64.9% of the outstanding shares of our common stock, or 62.6%
if the underwriters' over-allotment option is exercised in full. As a result,
the HWP stockholders will be able to control us and direct our affairs,
including the election of directors and approval of significant corporate
transactions. This concentration of ownership also may delay, defer or even
prevent a change in control of our company, and make some transactions more
difficult or impossible without the support of these stockholders. These
transactions might include proxy contests, tender offers, mergers or other
purchases of common stock that could give you the opportunity to realize a
premium over the then-prevailing market price for shares of our common stock.
10
WE HAVE A SUBSTANTIAL AMOUNT OF GOODWILL ON OUR BALANCE SHEET. OUR LEVEL OF
GOODWILL MAY HAVE THE EFFECT OF DECREASING OUR EARNINGS OR INCREASING OUR
LOSSES.
As of September 30, 2001, we had $125.9 million of unamortized goodwill on
our balance sheet, which represents the excess of the total purchase price of
our acquisitions over the fair value of the net assets acquired. At September
30, 2001, goodwill represented 49% of our total assets.
Currently, we amortize goodwill on a straight-line basis over the estimated
period of future benefit of 25 years. In July 2001, the Financial Accounting
Standards Board issued SFAS No. 141, Business Combinations, and SFAS No. 142,
Goodwill and Other Intangible Assets. SFAS No. 141 requires that the purchase
method of accounting be used for all business combinations initiated after June
30, 2001, as well as all purchase method business combinations completed after
June 30, 2001. SFAS No. 142 requires that, subsequent to January 1, 2002,
goodwill not be amortized but rather that it be reviewed annually for
impairment. In the event impairment is identified, a charge to earnings would be
recorded. We are required to adopt the provisions of SFAS No. 141 immediately
and SFAS No. 142 effective January 1, 2002. Although it does not affect our cash
flow, amortization of goodwill or an impairment charge to earnings has the
effect of decreasing our earnings or increasing our losses, as the case may be.
If we are required to amortize a substantial amount of goodwill or take a charge
to earnings, our stock price could be adversely affected.
WE WILL INCUR CHARGES AGAINST OUR FUTURE EARNINGS IN THE QUARTER IN WHICH THIS
OFFERING IS CONSUMMATED.
Upon consummation of this offering, options to purchase 5,181,642 shares of
our common stock that we granted to members of our management will be vested.
Because these options have an average exercise price of $10.45 below an assumed
initial offering price of $15.00 per share, we will record a non-cash charge
against earnings of approximately $18.7 million in the quarter in which this
offering occurs. In addition, upon consummation of this offering, we will take a
charge against earnings of approximately $5.2 million, net of income tax
benefits, related to the write-off of unamortized discount on the senior
subordinated notes and unamortized deferred financing costs resulting from the
early extinguishment of our existing indebtedness, the termination of our
existing interest rate swap agreements, and a prepayment premium resulting from
the early extinguishment of the senior subordinated notes.
YOU WILL INCUR IMMEDIATE AND SUBSTANTIAL DILUTION OF THE BOOK VALUE OF YOUR
INVESTMENT IN OUR COMMON STOCK.
The initial public offering price of our common stock is substantially
greater than the book value per share of our common stock. As a result, if you
purchase our common stock in this offering, you will incur immediate dilution.
This means that you will pay a price per share that substantially exceeds the
per share book value of our assets immediately following this offering after
subtracting our liabilities. In addition, all of the purchasers in this offering
will have contributed 54.4% of the total consideration received for our common
stock (assuming an initial public offering price of $15.00 per share) but
collectively will own only 24.6% of our outstanding shares. The exercise of
outstanding options with an exercise price less than the initial public offering
price of this offering and the issuance of common stock with a purchase price
less than the initial public offering price of this offering will each result in
further dilution to you. See "Dilution."
11
OUR STOCK PRICE MAY BE VOLATILE AND YOU MAY BE UNABLE TO RESELL YOUR SHARES AT
OR ABOVE THE OFFERING PRICE.
Prior to this offering, there has not been a public market for our common
stock. We cannot predict whether a liquid trading market will develop. The
initial public offering price will be determined by negotiations between us and
the representatives of the underwriters and may not be indicative of prices that
will prevail in the trading market. The market price of our common stock could
be subject to wide fluctuations as a result of many factors, including those
listed in this "Risk Factors" section of the prospectus.
In recent years, the stock market has experienced significant price and
volume fluctuations that are often unrelated to the operating performance of
specific companies. Our market price may fluctuate based on a number of factors,
including:
- our operating performance and the performance of other similar
companies;
- news announcements relating to us, our industry or our competitors;
- changes in earnings estimates or recommendations by research analysts;
- changes in general economic conditions;
- the number of shares to be publicly traded after this offering;
- actions of our current stockholders; and
- other developments affecting us, our industry or our competitors.
A LARGE NUMBER OF OUR SHARES ARE OR WILL BE ELIGIBLE FOR FUTURE SALE WHICH COULD
DEPRESS OUR STOCK PRICE.
Sales of substantial amounts of common stock, or the perception that a
large number of shares will be sold, could depress the market price of our
common stock. After this offering, our current stockholders will own
beneficially approximately 75.4% of the outstanding shares of our common stock,
or approximately 72.8% if the underwriters' over-allotment option is exercised
in full. After expiration of a 180-day "lock-up" period to which all of our
current stockholders, directors, executive officers and option holders are
subject, these holders will be entitled to dispose of their shares, although the
shares of common stock held by our affiliates will continue to be subject to the
volume and other restrictions of Rule 144 under the Securities Act. In addition,
Banc of America Securities LLC may, in its sole discretion and at any time
without notice, release all or any portion of the shares subject to the lock-up.
After this offering, the holders of approximately 33,218,195 shares of our
common stock (including shares issuable upon the exercise of outstanding
options) will have rights, subject to some conditions, to require us to file
registration statements covering their shares or to include their shares in
registration statements that we may file for ourselves or other stockholders. By
exercising their registration rights and selling a large number of shares, these
holders could cause the price of our common stock to decline.
12
FORWARD-LOOKING STATEMENTS
This prospectus includes forward-looking statements. We based these
forward-looking statements on our current expectations and projections about
future events. Our actual results could differ materially from those discussed
in, or implied by, these forward-looking statements. Forward-looking statements
are identified by words such as "believe," "anticipate," "expect," "intend,"
"plan," "will," "may" and other similar expressions. In addition, any statements
that refer to expectations, projections or other characterizations of future
events or circumstances are forward-looking statements. The following factors
could cause our actual results to differ from those implied by the
forward-looking statements in this prospectus:
- our ability to continue to recruit and retain qualified temporary
healthcare professionals and ability to attract and retain operational
personnel;
- our ability to enter into contracts with hospitals and other
healthcare facility clients on terms attractive to us;
- the general level of patient occupancy at our hospital and healthcare
facility clients' facilities;
- our ability to successfully implement our acquisition and integration
strategies;
- the effect of existing or future government regulation of the
healthcare industry, and our ability to comply with these regulations;
- the impact of medical malpractice and other claims asserted against
us; and
- our ability to carry out our business strategy.
Other factors that could cause actual results to differ from those implied
by the forward-looking statements in this prospectus are more fully described in
the "Risk Factors" section and elsewhere in this prospectus.
13
USE OF PROCEEDS
Based on an assumed initial offering price of $15.00 per share, our net
proceeds from this offering are estimated to be $135.4 million, or approximately
$156.3 million if the underwriters' over-allotment option is exercised in full,
after deducting estimated underwriting discounts and commissions and other
offering expenses payable by us. We intend to use the net proceeds from this
offering to repay indebtedness outstanding under our credit facility and our
senior subordinated notes. We will use the remaining proceeds, if any, for
working capital and general corporate purposes.
As of September 30, 2001, we had an aggregate of $113.0 million outstanding
under our existing credit facility. Our existing credit facility consists of a
revolving loan and term loans. Because our working capital fluctuates, the
borrowings under our revolving loan may vary. If the proceeds of this offering
are not sufficient to repay all of our indebtedness, then we will repay all of
the term loans under our credit facility and our senior subordinated notes and
we will use the remaining net proceeds to repay a substantial portion of the
revolving loan under our existing credit facility.
Each of the facilities under our existing credit facility bears interest at
a variable rate based upon LIBOR, federal funds or prime lending rates, at our
option. At September 30, 2001, the weighted average interest rate on our
borrowings under the credit facility was 7.6%. Our existing credit facility has
a final maturity date of March 31, 2005. We used a portion of the proceeds from
our borrowings under the credit facility to acquire Preferred Healthcare
Staffing in November 2000 and O'Grady-Peyton International in May 2001.
We issued our senior subordinated notes on November 19, 1999 in connection
with our recapitalization. The senior subordinated notes had an aggregate
outstanding principal amount of $24.9 million at September 30, 2001. The senior
subordinated notes have a maturity date of November 19, 2005 and bear interest
at an annual rate of 12%. Interest is payable quarterly in cash or through the
issuance of additional notes, at our option.
14
DIVIDEND POLICY
We have not paid any dividends in the past and currently do not expect to
pay cash dividends or make any other distributions in the future. We expect to
retain our future earnings, if any, for use in the operation and expansion of
our business. Any future determination to pay dividends will be at the
discretion of our board of directors and will depend upon our financial
condition, results of operations, capital requirements and such other factors as
our board deems relevant. In addition, our ability to declare and pay dividends
on our common stock is expected to be restricted by covenants in our revolving
credit facility.
15
CAPITALIZATION
The following table sets forth our capitalization as of September 30, 2001,
on an actual basis and as adjusted to reflect this offering at an assumed
initial public offering price of $15.00 per share, the mid-point of the range
shown on the cover page of this prospectus, and the application of the net
proceeds of this offering, as described under "Use of Proceeds."
You should read this information in conjunction with "Selected Consolidated
Financial and Operating Data," "Management's Discussion and Analysis of
Financial Condition and Results of Operations," our consolidated financial
statements and the related notes and our pro forma financial statements
appearing elsewhere in this prospectus.
AS OF SEPTEMBER 30, 2001
-------------------------
ACTUAL AS ADJUSTED
--------- ------------
(UNAUDITED)
(IN THOUSANDS, EXCEPT
SHARE DATA)
Long-term debt, including current portion................... $122,694(1) $ --
Revolving credit facility(2)................................ 13,148 3,541
Stockholders' equity:
Common stock, $.01 par value; 200,000,000 shares authorized;
30,714,643 shares issued and outstanding on an actual
basis; 40,714,643 shares issued and outstanding on an as
adjusted basis(3)......................................... 288 407
Additional paid-in capital.................................. 149,831 303,803
Accumulated deficit......................................... (65,375) (82,079)
Accumulated other comprehensive loss........................ (478) --
-------- --------
Total capitalization................................... $220,108 $225,672
======== ========
---------------
(1) Long-term debt includes senior subordinated notes of $22.8 million, which is
net of an unamortized discount of $2.1 million.
(2) We expect to amend and restate our existing credit facility in order to
eliminate all of our term loans and to provide for a $50.0 million revolving
credit facility upon the consummation of this offering. See "Management's
Discussion and Analysis of Financial Condition and Results of
Operations -- Liquidity and Capital Resources."
(3) As adjusted share amounts assume a cashless exercise of an outstanding
warrant but do not include the following shares:
- 7,710,936 shares of common stock reserved for issuance under our stock
option plans, of which 5,727,955 shares are subject to options
outstanding at a weighted average exercise price of $4.98 per share;
and
- 1,500,000 shares of our common stock issuable by us if the
underwriters' over-allotment option is exercised in full.
16
DILUTION
The net tangible book value per share of our common stock is the difference
between our tangible assets and our liabilities, divided by the number of shares
of common stock outstanding. For investors in the common stock, dilution is the
per share difference between an assumed $15.00 per share initial offering price
of the common stock in this offering and the net tangible book value of common
stock immediately after completing this offering. Dilution results from the fact
that the per share offering price of the common stock is substantially in excess
of the book value per share attributable to the existing stockholders for the
presently outstanding stock.
On September 30, 2001, our net tangible book value prior to this offering
was a deficit of approximately $47.7 million, or a deficit of approximately
$1.55 per share, based on 30,714,643 shares of common stock outstanding
(assuming a cashless exercise of an outstanding warrant with a fair market
valuation based upon an initial offering price of $15.00 per share).
As of September 30, 2001, without taking into account any changes in our
net tangible book value subsequent to that date other than the sale of the
common stock in this offering at the assumed offering price of $15.00 per share,
less the estimated offering expenses, the net tangible book value of each of the
outstanding shares of common stock would have been $2.22 after this offering.
Therefore, investors in the common stock would have paid $15.00 for a share of
common stock having a pro forma net tangible book value of approximately $2.22
per share after this offering. That is, their investment would have been diluted
by approximately $12.78 per share. At the same time, existing stockholders would
have realized an increase in pro forma net tangible book value of $3.77 per
share after this offering without further cost or risk to themselves. The
following table illustrates this per share dilution:
Assumed initial public offering price per share of common
stock..................................................... $15.00
Net tangible book value per share of common stock before the
offering.................................................. (1.55)
Increase in pro forma net tangible book value per share of
common stock attributable to investors in the offering.... 3.77
-----
Net tangible book value per share of common stock after the
offering(1)(2)............................................ 2.22
------
Dilution per share to new investors......................... $12.78
======
---------------
(1) After deduction of the estimated offering expenses payable by us (including
the underwriting discounts and commissions).
(2) Does not give effect to the 1,500,000 shares subject to the underwriters'
over-allotment option.
The following table summarizes, as of September 30, 2001, the differences
between existing stockholders and the new investors with respect to the number
of shares of common stock purchased from us, the total consideration paid and
the average price per share paid before deducting the underwriting discounts and
commissions and our estimated offering expenses.
SHARES PURCHASED TOTAL CONSIDERATION
--------------------- ----------------------- AVERAGE PRICE
NUMBER PERCENT AMOUNT PERCENT PER SHARE
---------- ------- ------------ ------- -------------
Existing Stockholders............ 30,714,643 75.4% $125,553,103 45.6% $ 4.09
New Investors.................... 10,000,000 24.6% 150,000,000 54.4% 15.00
---------- ----- ------------ -----
Total............................ 40,714,643 100.0% $275,553,103 100.0% 6.77
========== ===== ============ =====
The discussion and tables above assume no exercise of stock options
outstanding as of September 30, 2001. As of the consummation of this offering,
we expect to have options outstanding to purchase a total of 5,727,955 shares of
common stock, with a weighted average exercise price of $4.98 per share. To the
extent that any of these options are exercised, there will be further dilution
to new investors. See "Description of Capital Stock" and Note 8 of Notes to
Consolidated Financial Statements for AMN Healthcare Services, Inc.
17
SELECTED CONSOLIDATED FINANCIAL AND OPERATING DATA
The selected consolidated financial data set forth below as of December 31,
1999 and 2000 and for the three years ended December 31, 2000 have been derived
from our audited consolidated financial statements that appear elsewhere in this
prospectus. The selected consolidated financial data as of December 31, 1996,
1997 and 1998 and for the two years ended December 31, 1997 have been derived
from our audited consolidated financial statements not included in this
prospectus. The selected consolidated financial data as of and for the nine
months ended September 30, 2000 and September 30, 2001 have been derived from
our unaudited consolidated financial statements for these periods, which, in the
opinion of our management, reflect all adjustments, consisting of normal
recurring adjustments, necessary for a fair presentation of this data. The
results for any interim period are not necessarily indicative of the results
that may be expected for the full year.
You should read the selected financial and operating data presented below
in conjunction with "Management's Discussion and Analysis of Financial Condition
and Results of Operations" and our financial statements and their related notes
appearing elsewhere in this prospectus.
PREDECESSOR(1)
--------------------------
PERIOD FROM PERIOD FROM NINE MONTHS
JANUARY 1, DECEMBER 4, ENDED
YEAR ENDED THROUGH THROUGH YEARS ENDED DECEMBER 31, SEPTEMBER 30,
DECEMBER 31, DECEMBER 3, DECEMBER 31, ----------------------------- -------------------
1996 1997 1997(2) 1998 1999 2000 2000 2001
------------ ----------- ------------ ------- -------- -------- -------- --------
(UNAUDITED)
(DOLLARS AND SHARES IN THOUSANDS, EXCEPT PER SHARE DATA)
CONSOLIDATED STATEMENTS OF
OPERATIONS:
Revenue......................... $47,987 $63,570 $5,209 $87,718 $146,514 $230,766 $151,713 $357,108
Cost of revenue................. 36,316 49,510 4,118 67,244 111,784 170,608 112,729 267,333
------- ------- ------ ------- -------- -------- -------- --------
Gross profit.................... 11,671 14,060 1,091 20,474 34,730 60,158 38,984 89,775
------- ------- ------ ------- -------- -------- -------- --------
Expenses:
Selling, general and
administrative (excluding
non-cash stock-based
compensation)............... 6,972 9,560 845 12,804 20,677 30,728 19,770 49,750
Non-cash stock-based
compensation(3)............. -- -- -- -- -- 22,379 15,901 13,096
Amortization.................. -- -- 90 1,163 1,721 2,387 1,504 4,128
Depreciation.................. 55 68 7 171 325 916 605 1,484
Transaction costs(4).......... -- -- -- -- 12,404 1,500 -- --
------- ------- ------ ------- -------- -------- -------- --------
Total expenses.................. 7,027 9,628 942 14,138 35,127 57,910 37,780 68,458
------- ------- ------ ------- -------- -------- -------- --------
Income (loss) from operations... 4,644 4,432 149 6,336 (397) 2,248 1,204 21,317
Interest income (expense),
net........................... 23 (174) (183) (2,476) (4,030) (10,006) (7,043) (11,780)
------- ------- ------ ------- -------- -------- -------- --------
Income (loss) before minority
interest, income taxes and
extraordinary item............ 4,667 4,258 (34) 3,860 (4,427) (7,758) (5,839) 9,537
Minority interest in earnings of
subsidiary(5)................. -- -- (9) (657) (1,325) -- -- --
Income tax (expense) benefit.... (167) (195) (9) (1,571) 872 2,560 1,927 (4,959)
------- ------- ------ ------- -------- -------- -------- --------
Income (loss) before
extraordinary item............ 4,500 4,063 (52) 1,632 (4,880) (5,198) (3,912) 4,578
Extraordinary loss on early
extinguishment of debt, net of
income tax benefit............ -- -- -- -- (730) -- -- --
------- ------- ------ ------- -------- -------- -------- --------
Net income (loss)............... $ 4,500 $ 4,063 $ (52) $ 1,632 $ (5,610) $ (5,198) $ (3,912) $ 4,578
======= ======= ====== ======= ======== ======== ======== ========
Net income (loss) per common
share:
Basic......................... N/A N/A N/A $ 0.09 $ (0.26) $ (0.23) $ (0.18) $ 0.16
======= ======= ====== ======= ======== ======== ======== ========
Diluted....................... N/A N/A N/A $ 0.09 $ (0.26) $ (0.23) $ (0.18) $ 0.15
======= ======= ====== ======= ======== ======== ======== ========
Weighted average common shares
outstanding:
Basic......................... N/A N/A N/A 17,751 21,715 22,497 21,491 28,835
======= ======= ====== ======= ======== ======== ======== ========
Diluted....................... N/A N/A N/A 17,751 21,715 22,497 21,491 31,431
======= ======= ====== ======= ======== ======== ======== ========
18
PREDECESSOR(1)
--------------------------
PERIOD FROM PERIOD FROM NINE MONTHS
JANUARY 1, DECEMBER 4, ENDED
YEAR ENDED THROUGH THROUGH YEARS ENDED DECEMBER 31, SEPTEMBER 30,
DECEMBER 31, DECEMBER 3, DECEMBER 31, ----------------------------- -------------------
1996 1997 1997(2) 1998 1999 2000 2000 2001
------------ ----------- ------------ ------- -------- -------- -------- --------
(UNAUDITED)
(DOLLARS AND SHARES IN THOUSANDS, EXCEPT PER SHARE DATA)
OTHER FINANCIAL AND OPERATING
DATA:
Revenue growth.................. N/A N/A N/A N/A 67% 58% N/A 135%
======= ======= ====== ======= ======== ======== ======== ========
Average temporary healthcare
professionals on assignment... 884 1,155 1,194 1,444 2,289 3,166 2,870 5,654
======= ======= ====== ======= ======== ======== ======== ========
Growth in average temporary
healthcare professionals on
assignment.................... N/A N/A N/A N/A 59% 38% N/A 97%
======= ======= ====== ======= ======== ======== ======== ========
Capital expenditures............ $ 115 $ 172 $ 112 $ 690 $ 1,656 $ 2,358 $ 1,865 $ 2,880
======= ======= ====== ======= ======== ======== ======== ========
Adjusted EBITDA(6).............. $ 4,699 $ 4,500 $ 246 $ 7,670 $ 14,053 $ 29,430 $ 19,214 $ 40,025
======= ======= ====== ======= ======== ======== ======== ========
Adjusted EBITDA growth.......... N/A N/A N/A N/A 83% 109% N/A 108%
======= ======= ====== ======= ======== ======== ======== ========
AS OF
AS OF DECEMBER 31, SEPTEMBER 30,
------------------------------------------------ ------------------
1996(1) 1997 1998 1999 2000 2000 2001
------- ------- ------- ------- -------- ------- --------
(UNAUDITED)
(DOLLARS IN THOUSANDS)
CONSOLIDATED BALANCE SHEET DATA:
Cash and cash equivalents........................... $ 918 $ 1,124 $ 888 $ 503 $ 546 $ 200 $ 3,953
Working capital..................................... 8,044 9,054 13,159 21,655 44,149 26,271 52,653
Total assets........................................ 9,919 42,229 65,337 79,878 209,410 115,547 256,214
Total long-term debt, including current portion..... -- 25,151 37,596 74,006 122,889 77,161 135,842
Total stockholders' equity (deficit)................ 8,281 12,348 19,477 (2,111) 67,070 21,878 84,266
---------------
(1) We were incorporated on November 10, 1997. We had no operations until we
acquired AMN Healthcare, Inc. on December 4, 1997. Therefore, the statement
of operations and balance sheet data for the year ended December 31, 1996
and the statement of operations data for the period January 1, 1997 through
December 3, 1997 reflect the activity of AMN Healthcare, Inc. only. See Note
3 of Notes to Consolidated Financial Statements of AMN Healthcare Services,
Inc.
(2) Reflects our statement of operations data from December 4, 1997 to December
31, 1997. We were incorporated on November 10, 1997, but had no operations
until we acquired AMN Healthcare, Inc. on December 4, 1997. See Note 3 of
Notes to Consolidated Financial Statements of AMN Healthcare Services, Inc.
(3) Non-cash stock-based compensation represents compensation expense related to
our performance-based stock option plans to reflect the difference between
the fair market value and the exercise price of stock options previously
issued to our officers. See Note 8 of Notes to Consolidated Financial
Statements for AMN Healthcare Services, Inc. Following the quarter in which
this offering occurs, we do not expect to incur additional non-cash
stock-based compensation charges in excess of $250,000 per quarter.
(4) Transaction costs represent non-capitalized costs incurred in connection
with our 1999 recapitalization and our acquisition of Preferred Healthcare
Staffing.
(5) On October 18, 1999, the minority stockholder of one of our subsidiaries
exchanged his shares of the subsidiary for our shares. As a result, no
minority interest is reflected after that date.
(6) Adjusted EBITDA represents income (loss) from operations plus depreciation,
amortization, transaction costs and non-cash stock-based compensation
expense. Adjusted EBITDA is presented because we believe that it is a widely
accepted financial indicator used by certain investors and securities
analysts to analyze and compare companies on the basis of operating
performance. Adjusted EBITDA is not intended to represent cash flows for the
period, nor has it been presented as an alternative to operating income as
an indicator of operating performance and should not be considered in
isolation or as a substitute for measures of performance prepared in
accordance with generally accepted accounting principles. Adjusted EBITDA,
as we define it, is not necessarily comparable to other similarly titled
captions of other companies due to potential inconsistencies in the method
of calculation. See our historical and unaudited pro forma financial
statements and the related notes appearing elsewhere in this prospectus.
19
MANAGEMENT'S DISCUSSION AND ANALYSIS
OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
Some of the statements in this "Management's Discussion and Analysis of
Financial Condition and Results of Operations" are forward-looking statements.
See "Forward-Looking Statements."
OVERVIEW
We are a leading temporary healthcare staffing company and the largest
nationwide provider of travel nurse staffing services, one of the fastest
growing segments of the temporary healthcare staffing industry. We recruit
nurses and allied health professionals, our "temporary healthcare
professionals," and place them on temporary assignments, typically for 13 weeks
away from their permanent homes, at hospitals and healthcare facilities
throughout the United States.
We derive substantially all of our revenue from fees paid directly by
hospitals and healthcare facilities rather than from payments by government or
other third parties. We enter into two types of contracts with our hospital and
healthcare facility clients: flat rate contracts and payroll contracts. Under a
flat rate contract, the temporary healthcare professional becomes an employee of
the hospital or healthcare facility and is placed on their payroll. We bill the
hospital or healthcare facility a "flat" weekly rate to compensate us for
providing recruitment, housing and travel services. Alternatively, under a
payroll contract, the temporary healthcare professional is our employee. We then
bill our hospital or healthcare facility client at an hourly rate to compensate
us for the temporary healthcare professional's wages and benefits, as well as
for recruitment, housing and travel services. Our clients generally prefer
payroll contracts because this arrangement eliminates significant employee and
payroll administrative burdens for them. Although the temporary healthcare
professional wage and benefits billed under a payroll contract primarily
represent a pass-through cost component for us, we are able to generate greater
profits by providing these value-added services. While payroll contracts
generate more gross profit than flat rate contracts, the gross margin generated
is lower due to the pass-through of the temporary healthcare professional's
compensation costs. Over the past five years, we, and the industry as a whole,
have migrated towards a greater utilization of payroll contracts. During 2001,
approximately 92% of our contracts with our hospital and healthcare facility
clients have been payroll contracts.
Over the course of the last three years, we have completed four strategic
acquisitions. We acquired Medical Express, Inc. in November 1998, which
strengthened our presence in the Pacific Northwest and Mountain states. During
2000, we completed the acquisitions of Nurses RX, Inc. in June, and Preferred
Healthcare Staffing, Inc. in November, which strengthened our presence in the
Eastern and Southern regions of the United States. We completed our fourth
acquisition in May 2001, acquiring O'Grady-Peyton International (USA), Inc., the
leading recruiter of registered nurses from English-speaking foreign countries
for placement in the United States. Each of these acquisitions has been
accounted for by the purchase method of accounting. Therefore, the operating
results of the acquired entities are included in our results of operations
commencing on the date of acquisition of each entity. As a result, our results
of operations following each acquisition may not be comparable with our prior
results.
Upon consummation of this offering, options to purchase 5,181,642 shares of
our common stock that we granted to members of our management will be vested.
These options have an average exercise price $10.45 below an assumed initial
public offering price of $15.00 per share. As a result, we expect to take a
non-cash charge against earnings of $18.7 million in the quarter in which this
offering is consummated. In addition, upon consummation of this offering, we
will take a charge against earnings of approximately $5.2 million, net of income
tax benefits, related to the write-off of unamortized discount on the senior
subordinated notes and unamortized deferred financing costs resulting from the
early extinguishment of our existing indebtedness, the termination of our
existing interest rate swap agreements, and a prepayment premium resulting from
the early extinguishment of the senior subordinated notes.
20
RESULTS OF OPERATIONS
The following table sets forth, for the periods indicated, certain
statement of operations data as a percentage of our revenue. Our results of
operations are reported as a single business segment.
NINE MONTHS
ENDED
YEARS ENDED DECEMBER 31, SEPTEMBER 30,
-------------------------- --------------
1998 1999 2000 2000 2001
------ ------ ------ ----- -----
(UNAUDITED)
CONSOLIDATED STATEMENT OF OPERATIONS:
Revenue............................................ 100.0% 100.0% 100.0% 100.0% 100.0%
Cost of revenue.................................... 76.7 76.3 73.9 74.3 74.9
----- ----- ----- ----- -----
Gross profit....................................... 23.3 23.7 26.1 25.7 25.1
Selling, general and administrative (excluding
non-cash stock-based compensation)............... 14.6 14.1 13.3 13.0 13.9
Non-cash stock-based compensation.................. -- -- 9.7 10.5 3.6
Amortization and depreciation expense.............. 1.5 1.4 1.4 1.4 1.6
Transaction costs.................................. -- 8.5 0.7 -- --
----- ----- ----- ----- -----
Income (loss) from operations...................... 7.2 (0.3) 1.0 0.8 6.0
Interest expense, net.............................. 2.8 2.7 4.4 (4.6) (3.3)
----- ----- ----- ----- -----
Income (loss) before minority interest, income
taxes and extraordinary item..................... 4.4 (3.0) (3.4) (3.8) 2.7
Minority interest in earnings of subsidiary........ (0.7) (0.9) -- -- --
Income tax (expense) benefit....................... (1.8) 0.6 1.1 1.3 (1.4)
Extraordinary loss on early extinguishment of debt,
net of income tax benefit........................ -- (0.5) -- -- --
----- ----- ----- ----- -----
Net income (loss).................................. 1.9% (3.8)% (2.3)% (2.5)% 1.3%
===== ===== ===== ===== =====
Comparison of Results for the Nine Months Ended September 30, 2000 to the Nine
Months Ended September 30, 2001
REVENUE. Revenue increased 135%, from $151.7 million for the first nine
months of 2000 to $357.1 million for the first nine months of 2001. Of the
$205.4 million increase, approximately $106.1 million was attributable to
expansion of our existing brands through growth in the number of temporary
healthcare professionals and enhancements in contract terms with our hospital
and healthcare facility clients, representing an organic growth rate for our
recurring operations of 70%. The total number of temporary healthcare
professionals on assignment in our existing brands grew 40% and contributed
approximately $61.0 million of the increase. Enhancements in contract terms
included increases in hourly rates charged to hospital and healthcare facility
clients that accounted for approximately $22.9 million of this increase, and a
shift in the mix of payroll versus flat rate temporary healthcare professional
contracts that accounted for approximately $22.2 million of this increase. The
remainder of the increase, $99.3 million, was attributable to the acquisitions
of NursesRx in June 2000, Preferred Healthcare Staffing in November 2000 and
O'Grady-Peyton International in May 2001.
COST OF REVENUE. Cost of revenue increased 137%, from $112.7 million for
the first nine months of 2000 to $267.3 million for the first nine months of
2001. Of the $154.6 million increase, approximately $79.8 million was
attributable to the organic growth of our existing brands, and approximately
$74.8 million was attributable to the acquisitions of NursesRx, Preferred
Healthcare Staffing and O'Grady-Peyton International.
GROSS PROFIT. Gross profit increased 130%, from $39.0 million for the
first nine months of 2000 to $89.8 million for the first nine months of 2001,
representing gross margins of 25.7% and 25.1%, respectively. The decrease in the
gross margin was primarily attributable to the shift in the mix of temporary
healthcare
21
professionals from flat rate contracts to payroll contracts, which generate
higher gross profits but lower gross margins due to the pass-through nature of
the temporary healthcare professionals' compensation costs.
SELLING, GENERAL AND ADMINISTRATIVE EXPENSES. Selling, general and
administrative expenses increased 152%, from $19.8 million for the first nine
months of 2000 to $49.8 million for the first nine months of 2001. Of the $30.0
million increase, approximately $14.2 million was attributable to the
acquisitions of NursesRx, Preferred Healthcare Staffing and O'Grady-Peyton
International. The remaining increase of $15.8 million was primarily
attributable to increases in nurse professional development, information systems
development, marketing, recruiting, and administrative and office expenses in
support of the recent and anticipated growth in temporary healthcare
professionals under contract.
NON-CASH STOCK-BASED COMPENSATION. We recorded non-cash compensation
charges of $15.9 million for the first nine months of 2000 and $13.1 million for
the first nine months of 2001 in connection with our stock option plans to
reflect the difference between the fair market value and the exercise price of
previously issued stock options. Following the consummation of this offering, we
do not expect to incur additional non-cash stock-based compensation charges in
excess of $1.0 million per year.
AMORTIZATION AND DEPRECIATION EXPENSE. Amortization expense increased from
$1.5 million for the first nine months of 2000 to $4.1 million for the first
nine months of 2001. This increase was attributable to the additional goodwill
associated with the acquisitions of NursesRx, Preferred Healthcare Staffing and
O'Grady-Peyton International. Depreciation expense increased from $0.6 million
for the first nine months of 2000 to $1.5 million for the first nine months of
2001. This increase was primarily attributable to the acquisitions of NursesRx,
Preferred Healthcare Staffing and O'Grady-Peyton International and the purchase
of furniture and equipment to support our recent and anticipated growth.
INTEREST EXPENSE, NET. Interest expense, net increased from $7.0 million
for the first nine months of 2000 to $11.8 million for the first nine months of
2001. Of the $4.8 million increase, approximately $3.2 million was attributable
to additional borrowings incurred in conjunction with the acquisitions of
NursesRx, Preferred Healthcare Staffing and O'Grady-Peyton International. The
remaining increase was primarily due to the new accounting treatment for
derivative instruments under SFAS No. 133. Beginning January 1, 2001, SFAS No.
133, as amended, requires us to recognize the unrealized gains and losses on our
hedging instruments attributable to changes in interest rates.
INCOME TAX (EXPENSE) BENEFIT. The provision for income tax for the first
nine months of 2000 was a benefit of $1.9 million as compared to income tax
expense of $5.0 million for the first nine months of 2001, reflecting effective
income tax rates of a 33.0% benefit and 52.0% expense for these periods,
respectively. The differences between these effective tax rates and our expected
effective tax rate of 41.0% are primarily attributable to the effect of various
permanent tax difference items, the impact of which is magnified by the
reduction in pre-tax income created by the non-cash stock-based compensation
charge.
Comparison of Results for the Year Ended December 31, 1999 to the Year Ended
December 31, 2000
REVENUE. Revenue increased 58%, from $146.5 million in 1999 to $230.8
million for 2000. Of the $84.3 million increase, approximately $63.0 million was
attributable to expansion of our existing brands through growth in the number of
temporary healthcare professionals and enhancements in contract terms with our
hospital and healthcare facility clients, representing an organic growth rate
for our recurring operation of 43%. The total number of temporary healthcare
professionals on assignment in our existing brands grew 27% and contributed
approximately $39.1 million of the increase. Enhancements in contract terms
included increases in hourly rates charged to our hospital and healthcare
facility clients that accounted for approximately $17.2 million of this
increase, and a shift in the mix of payroll versus flat rate temporary
healthcare professional contracts that accounted for approximately $6.7 million
of this increase. The remainder of the increase in revenue, $21.3 million, was
attributable to the acquisitions of NursesRx in June 2000 and Preferred
Healthcare Staffing in November 2000.
COST OF REVENUE. Cost of revenue increased 53%, from $111.8 million for
1999 to $170.6 million for 2000. Of the $58.8 million increase, approximately
$43.2 million was primarily attributable to the organic
22
growth of our existing brands and approximately $15.6 million was attributable
to the acquisitions of NursesRx and Preferred Healthcare Staffing.
GROSS PROFIT. Gross profit increased 73%, from $34.7 million for 1999 to
$60.2 million for 2000, representing gross margins of 23.7% and 26.1%,
respectively. The increase in gross margin was primarily attributable to
increases in hourly rates charged to our hospital and healthcare facility
clients and to the acquisition of NursesRx, which historically had higher gross
margins than us.
SELLING, GENERAL AND ADMINISTRATIVE EXPENSES. Selling, general and
administrative expenses increased 49%, from $20.7 million for 1999 to $30.7
million for 2000. Of the $10.0 million increase in selling, general and
administrative expenses, approximately $3.6 million was attributable to the
acquisitions of NursesRx and Preferred Healthcare Staffing. The remaining
increase, $6.4 million, was primarily attributable to increases in marketing,
recruiting, office and administrative expenses and development and
implementation of information systems to support the growth in temporary
healthcare professionals under contract.
NON-CASH STOCK-BASED COMPENSATION. We recorded non-cash compensation
charges of $22.4 million in 2000 in connection with our stock option plans to
reflect the difference between the fair market value and the exercise price of
previously issued stock options. No charge was recorded in 1999.
AMORTIZATION AND DEPRECIATION EXPENSE. Amortization expense increased from
$1.7 million for 1999 to $2.4 million for 2000. This increase was attributable
to the additional goodwill associated with the acquisitions of NursesRx and
Preferred Healthcare Staffing. Depreciation expense increased from $0.3 million
for 1999 to $0.9 million for 2000. This increase was attributable to the
acquisitions of NursesRx and Preferred Healthcare Staffing, the purchase of
furniture and equipment and the depreciation of internally developed computer
software.
TRANSACTION COSTS. Transaction costs of $1.5 million for 2000 relate to
the non-capitalized costs incurred in connection with the acquisition of
Preferred Healthcare Staffing. Transaction costs of $12.4 million for 1999
relate to costs incurred in connection with our recapitalization in November
1999.
INTEREST EXPENSE, NET. Interest expense, net increased from $4.0 million
for 1999 to $10.0 million for 2000. The $6.0 million increase was primarily
attributable to additional borrowings incurred in connection with our
recapitalization in November 1999 and with the acquisitions of NursesRx and
Preferred Healthcare Staffing in 2000.
MINORITY INTEREST IN EARNINGS OF SUBSIDIARY. An officer of ours owned a
minority interest in AMN Healthcare, Inc., our primary operating subsidiary,
until October 1999. Just prior to our November 1999 recapitalization, this
stockholder exchanged his shares of our subsidiary for shares of our common
stock, eliminating this minority ownership interest. The $1.3 million in
minority interest in earnings of our subsidiary for 1999 represents this
minority interest in the earnings of AMN Healthcare, Inc. for the period January
1, 1999 through October 18, 1999.
INCOME TAX (EXPENSE) BENEFIT. The income tax benefit for 1999 was $1.3
million, including the tax benefit of the extraordinary loss on early
extinguishment of debt, as compared to a benefit of $2.6 million for 2000,
reflecting effective income tax benefit rates of 18.8% and 33.0% for these
periods, respectively. The differences between these effective tax rates and our
expected effective rate of 41.0% is primarily attributable to the effect of the
minority interest in 1999 and the effect of various permanent tax difference
items, the impact of which is magnified by the reduction in pre-tax income
resulting from the non-cash stock-based compensation charge in 2000.
EXTRAORDINARY LOSS ON EARLY EXTINGUISHMENT OF DEBT, NET OF INCOME TAX
BENEFIT. The $0.7 million extraordinary loss on early extinguishment of debt
for 1999 was attributable to the write-off of deferred financing costs
associated with our November 1999 recapitalization.
Comparison of Results for the Year Ended December 31, 1998 to the Year Ended
December 31, 1999
REVENUE. Revenue increased 67%, from $87.7 million for 1998 to $146.5
million for 1999. Of the $58.8 million increase, approximately $21.0 million was
attributable to expansion of our existing brands
23
through growth in number of temporary healthcare professionals and enhancements
in contract terms with our hospital and healthcare facility clients,
representing an organic growth rate for recurring operations of 25%. The total
number of temporary healthcare professionals on assignment in our existing
brands grew by 16% and contributed approximately $13.3 million of the increase.
Enhancements in contract terms included increases in hourly rates charged to our
hospital and healthcare facility clients that accounted for approximately $5.6
million of this increase, and a shift in the mix of payroll versus flat rate
temporary healthcare professional contracts that accounted for approximately
$2.1 million of this increase. The remainder of the increase in revenue, $37.8
million, was attributable to the acquisition of Medical Express in November
1998.
COST OF REVENUE. Cost of revenue increased 66%, from $67.2 million for
1998 to $111.8 million for 1999. Of the $44.6 million increase, approximately
$15.4 million was attributable to the organic growth of our existing brands and
approximately $29.2 million was attributable to the acquisition of Medical
Express.
GROSS PROFIT. Gross profit increased 70%, from $20.5 million for 1998 to
$34.7 million for 1999, representing gross margins of 23.3% and 23.7%,
respectively. The increase in gross margin was primarily attributable to
increases in hourly rates charged to our hospital and healthcare facility
clients.
SELLING, GENERAL AND ADMINISTRATIVE EXPENSES. Selling, general and
administrative expenses increased 61%, from $12.8 million for 1998 to $20.7
million for 1999. Of the $7.9 million increase in selling, general and
administrative expenses, approximately $6.9 million was attributable to the
acquisition of Medical Express. The remaining increase was primarily
attributable to increases in administrative and recruiting expenses in support
of the growth in temporary healthcare professionals under contract.
AMORTIZATION AND DEPRECIATION EXPENSE. Amortization expense increased from
$1.2 million for 1998 to $1.7 million for 1999. This increase was primarily
attributable to the additional goodwill associated with the acquisition of
Medical Express. Depreciation expense increased from $0.2 million for 1998 to
$0.3 million for 1999. This increase was primarily attributable to the
acquisition of Medical Express.
TRANSACTION COSTS. Transaction costs of $12.4 million in 1999 relate to
non-capitalized costs incurred in connection with our November 1999
recapitalization.
INTEREST EXPENSE, NET. Interest expense, net increased from $2.5 million
for 1998 to $4.0 million for 1999. The increase was primarily attributable to
additional borrowings incurred in connection with the acquisition of Medical
Express.
MINORITY INTEREST IN EARNINGS OF SUBSIDIARY. Minority interest in income
of subsidiary increased from $0.7 million for 1998 to $1.3 million for 1999. The
increase was attributable to the increase in net income before minority interest
for the year.
INCOME TAX (EXPENSE) BENEFIT. The provision for income tax expense for
1998 was $1.6 million, as compared to a $1.3 million benefit, including the tax
benefit of the extraordinary loss on early extinguishment of debt, for 1999,
reflecting effective income tax rates of a 49.0% expense and an 18.8% benefit
for these periods, respectively. The differences between these effective tax
rates and our expected effective rate of 41.0% is primarily attributable to the
effect of the minority interest which was eliminated with the recapitalization
in November 1999.
EXTRAORDINARY LOSS ON EARLY EXTINGUISHMENT OF DEBT, NET OF INCOME TAX
BENEFIT. The $0.7 million extraordinary loss on early extinguishment of debt
for 1999 was attributable to the write-off of deferred financing costs
associated with our recapitalization in November 1999.
LIQUIDITY AND CAPITAL RESOURCES
Historically, our primary liquidity requirements have been for debt service
under our existing credit facility, acquisitions and working capital
requirements. We have funded these requirements through internally generated
cash flow and funds borrowed under our existing credit facility. At September
30, 2001, total debt under our existing credit facility was approximately $113.0
million, consisting of $43.8 million in senior term loans, $30.6 million in
tranche A acquisition loans, $7.5 million in tranche B acquisition loans, $18.0
million
24
in tranche C acquisition loans and $13.1 million outstanding under our revolving
credit facility. In October 2001, under the existing terms of our credit
agreement, we elected to increase the amount available under our revolving
credit facility from $20.0 million to $35.0 million. In addition, we had senior
subordinated notes outstanding at September 30, 2001 with an aggregate
outstanding principal balance of $24.9 million.
We intend to use the net proceeds from this offering to repay outstanding
indebtedness under our existing credit facility and the senior subordinated
notes. We will use the remaining net proceeds, if any, for working capital and
general corporate purposes. Upon the consummation of this offering, we intend to
amend and restate our existing credit agreement in order to eliminate all of our
term loans and to provide for a secured revolving credit facility of up to $50.0
million in borrowing capacity. The revolving credit facility will have a
maturity date that is three years after the consummation of this offering and
will contain a letter of credit sub-facility and a swing-line loan sub-facility.
The revolver will not have an excess "cash sweep" provision. Borrowings under
this revolving credit facility will bear interest at floating rates based upon
either a LIBOR or prime interest rate option selected by us, plus a spread, to
be determined based on the outstanding amount of the revolving credit facility.
Our amended and restated credit agreement will contain a minimum fixed charge
coverage ratio, a maximum leverage ratio and other customary covenants. Amounts
available under our revolving credit facility may be used for working capital
and general corporate purposes, subject to various limitations.
We have relatively low capital investment requirements. Capital
expenditures were $0.7 million, $1.7 million and $2.4 million in 1998, 1999 and
2000, respectively. In 2000, our primary capital expenditures were $1.5 million
for purchased and internally developed software and $0.9 million for computers,
furniture and equipment and other expenditures. We estimate that for fiscal
2001, approximately $4.5 million of capital expenditures will be required,
primarily for office furniture and computer equipment and software stemming from
the growth in our operations. For the nine months ended September 30, 2001, our
capital expenditures were $2.9 million.
Our business acquisition expenditures were $16.0 million in 1998, $91.8
million in 2000 and $13.0 million through September 30, 2001. We had no business
acquisition expenditures during 1999. In 1998, we acquired Medical Express.
During 2000, we completed the acquisitions of NursesRx and Preferred Healthcare
Staffing and in May 2001 we acquired O'Grady-Peyton International. These
acquisitions were financed through a combination of bank debt and equity
investments. In connection with our acquisition of NursesRx, we are obligated to
make a $3.0 million payment to the former shareholders, $1.0 million of which
was paid on June 30, 2001 and the remainder of which is to be paid in two equal
installments of $1.0 million on June 28, 2002 and June 30, 2003. In connection
with our acquisition of O'Grady-Peyton International, we are obligated to pay to
the former shareholders of O'Grady-Peyton International an aggregate amount of
up to approximately $5.3 million if O'Grady-Peyton International meets certain
revenue and earnings targets for the twelve months ended December 31, 2001.
There is also additional contingent consideration of up to $2.4 million subject
to collection of an outstanding receivable from a customer. We expect to be able
to finance any future acquisition either with cash provided from operations,
borrowings under our revolving credit facility, bank loans, debt or equity
offerings, or some combination of the foregoing.
Our principal working capital need is for accounts receivable, which has
increased with the growth in our business. Our principal sources of cash to fund
our working capital needs are cash generated from operating activities and
borrowings under our revolving credit facility. Net cash used in operations for
2000 was $1.6 million, resulting primarily from the growth in working capital
offset by cash earnings generated by us.
We believe that cash generated from operations, the remaining net proceeds
of this offering and borrowings under the new revolving credit facility will be
sufficient to fund our operations for at least the next 12 months.
POTENTIAL FLUCTUATIONS IN QUARTERLY RESULTS AND SEASONALITY
Due to the regional and seasonal fluctuations in the hospital patient
census of our hospital and healthcare facility clients and due to the seasonal
preferences for destinations by our temporary healthcare professionals,
25
the number of temporary healthcare professionals on assignment, revenue and
earnings are subject to moderate seasonal fluctuations. Many of our hospital and
healthcare facility clients are located in areas that experience seasonal
fluctuations in population, such as Florida and Arizona, during the winter and
summer months. These facilities adjust their staffing levels to accommodate the
change in this seasonal demand and many of these facilities utilize temporary
healthcare professionals to satisfy these seasonal staffing needs.
Historically the number of temporary healthcare professionals on assignment
has increased during January through March followed by declines or minimal
growth during April through August. During September through November, our
temporary healthcare professional count has historically increased, followed by
a decline in December. Seasonality of revenue and earnings is expected to
continue. As a result of all of these factors, results of any one quarter are
not necessarily indicative of the results to be expected for any other quarter
or for any year.
INFLATION
Although inflation has abated during the last several years, the rate of
inflation in healthcare related services continues to exceed the rate
experienced by the economy as a whole. Our contracts typically provide for an
annual increase in the fees paid to us by our clients based on increases in
various inflation indices allowing us to pass on inflation costs to our clients.
Historically, these increases have generally offset the increases in costs
incurred by us.
QUANTITATIVE AND QUALITATIVE DISCLOSURE ABOUT MARKET RISK
Market risk is the risk of loss arising from adverse changes in market
rates and prices, such as interest rates, foreign currency exchange rates and
commodity prices. Our primary exposure to market risk is interest rate risk
associated with our debt instruments. In instances where we have variable
(floating) rate debt, we attempt to minimize our interest rate risk by entering
into interest rate swap or cap instruments. Our corporate policy is to only
enter into derivative instruments only if the purpose of such instruments is to
hedge a known underlying risk.
A 1% change in interest rates on variable rate debt would have resulted in
interest expense fluctuating approximately $22,000 for 1998, $46,000 for 1999,
$73,000 for 2000 and $75,000 for the nine months ended September 30, 2001,
respectively.
RECENT ACCOUNTING PRONOUNCEMENTS
In June 1998, the Financial Accounting Standards Board issued SFAS No. 133,
Accounting for Derivative Instruments and Hedging Activities. This statement, as
amended, establishes accounting and reporting standards requiring that all
derivative instruments (including certain derivative instruments embedded in
other contracts) be recorded in the balance sheet as either an asset or a
liability measured at its fair value. This statement requires that changes in
the derivative's fair value be recognized currently in earnings unless specific
hedge accounting criteria are met. The accounting provisions for qualifying
hedges allow a derivative's gains and losses to offset related results of the
hedged item in the income statement and require that the company must formally
document, designate and assess the effectiveness of transactions that qualify
for hedge accounting. We implemented this pronouncement in January 2001.
In July 2001, the FASB issued SFAS No. 141, Business Combinations, and SFAS
No. 142, Goodwill and Other Intangible Assets. SFAS No. 141 requires that the
purchase method of accounting be used for all business combinations initiated
after June 30, 2001 as well as all purchase method business combinations
completed after June 30, 2001. SFAS No. 141 also specifies the criteria that
intangible assets acquired in a purchase method business combination must meet
to be recognized and reported apart from goodwill, noting that any purchase
price allocable to an assembled workforce may not be accounted for separately.
SFAS No. 142 will require that goodwill and intangible assets with indefinite
useful lives no longer be amortized, but instead tested for impairment at least
annually in accordance with the provisions of SFAS No. 142. SFAS No. 142 will
also require that intangible assets with definite useful lives be amortized over
their respective estimated useful lives to their estimated residual values, and
reviewed for impairment in
26
accordance with SFAS No. 121, Accounting for the Impairment of Long-Lived Assets
and for Long-Lived Assets to Be Disposed Of.
We are required to adopt the provisions of SFAS No. 141 immediately and
SFAS No. 142 effective January 1, 2002. Furthermore, any goodwill and any
intangible asset determined to have an indefinite useful life that is acquired
in a purchase business combination completed after June 30, 2001 will not be
amortized, but instead tested for impairment at least annually in accordance
with the provisions of SFAS No. 142. Goodwill and intangible assets acquired in
business combinations completed before July 1, 2001 will continue to be
amortized prior to the adoption of SFAS No. 142.
SFAS No. 141 will require, upon adoption of SFAS No. 142, that we evaluate
existing intangible assets and goodwill that were acquired in prior purchase
business combinations, and make any necessary reclassifications in order to
conform with the new criteria in SFAS No. 141 for recognition apart from
goodwill. Upon adoption of SFAS No. 142, we will be required to reassess the
useful lives and residual values of all intangible assets acquired in purchase
business combinations, and make any necessary amortization period adjustments by
the end of the first interim period after adoption. In addition, to the extent
an intangible asset is identified as having an indefinite useful life, we will
be required to test the intangible asset for impairment in accordance with the
provisions of SFAS No. 142 within the first interim period. Any impairment loss
will be measured as of the date of adoption and recognized as the cumulative
effect of a change in accounting principle in the first interim period.
As of the date of adoption, January 1, 2002, we expect to have unamortized
goodwill in the amount of $124.5 million and unamortized identifiable intangible
assets in the amount of $871,000, all of which will be subject to the transition
provisions of SFAS Nos. 141 and 142. Amortization expense related to goodwill
was $2.3 million and $3.9 million for the year ended December 31, 2000 and the
nine months ended September 30, 2001, respectively. Because of the extensive
effort needed to comply with adopting SFAS Nos. 141 and 142, it is not yet
practicable to reasonably estimate the impact of adopting these accounting
pronouncements on our financial statements, including whether any transitional
impairment losses will be required to be recognized as the cumulative effect of
a change in accounting principle.
27
BUSINESS
OUR COMPANY
We are a leading temporary healthcare staffing company and the largest
nationwide provider of travel nurse staffing services, one of the fastest
growing segments of the temporary healthcare staffing industry. We recruit
nurses and allied health professionals, our "temporary healthcare
professionals," and place them on temporary assignments, typically for 13 weeks
away from their permanent homes, at hospitals and healthcare facilities
throughout the United States. Approximately 90% of our temporary healthcare
professionals are nurses, while the remainder are technicians, therapists and
technologists. We are actively working with a pre-screened pool of over 25,000
prospective temporary healthcare professionals, of whom over 6,400 were on
assignment during September 2001. Additionally, in September 2001, we had over
17,000 open orders from our network of over 2,500 hospital and healthcare
facility clients.
In recent years our business has grown significantly, outpacing the growth
of the temporary healthcare staffing market. From 1996 to 2000, our revenue and
Adjusted EBITDA increased at compound annual growth rates of 48% and 58%,
respectively. Approximately one-third of this growth was generated through
strategic acquisitions, while the remaining two-thirds was generated through the
organic growth of our operations. On a combined basis, assuming all of our
acquisitions had occurred on January 1, 1996, the compound annual growth rate of
our revenues from 1996 to 2000 would have been 30%, as compared to the 13%
compound annual growth rate experienced by the temporary healthcare staffing
market during the same period. Additionally, since 1999, the pace of our organic
growth has accelerated. On the same combined basis as discussed above, for the
twelve months ended September 30, 2001, we would have generated revenues of
$467.3 million and Adjusted EBITDA of $54.5 million, representing organic
compound annual growth rates of 50% and 76%, respectively, since 1999.
We market our services to two distinct customer bases: (1) temporary
healthcare professionals and (2) hospital and healthcare facility clients. We
use a multi-brand recruiting strategy to enhance our ability to successfully
attract temporary healthcare professionals in the United States and
internationally. Our five separate brand names, American Mobile Healthcare,
Medical Express, NursesRx, Preferred Healthcare Staffing and O'Grady-Peyton
International, have distinct geographic market strengths and brand images. Our
large number of hospital and healthcare facility clients allows us to offer
traveling positions in all 50 states, and in a variety of work environments. In
addition, we provide our temporary healthcare professionals with valuable
benefits, including free or subsidized housing, travel reimbursement,
professional development opportunities, a 401(k) plan and health insurance. We
believe that we attract temporary healthcare professionals due to our
long-standing reputation for providing a high level of service, our numerous job
opportunities, our benefit packages, our innovative marketing programs and our
most effective recruiting tool, word-of-mouth referrals from our thousands of
current and former temporary healthcare professionals.
We have established a growing and diverse hospital and healthcare facility
client base, ranging from national healthcare providers to premier teaching and
regional hospitals. Over 95% of our temporary healthcare professional
assignments are at acute-care hospitals. We currently hold contracts with
approximately 42% of all acute-care hospitals in the United States. Our clients
include hospitals and healthcare systems such as Georgetown University Hospital,
HCA, Kaiser Permanente, NYU Medical Center, Stanford Health Care, UCLA Medical
Center and The University of Chicago Hospitals. We also provide services to
sub-acute healthcare facilities, dialysis centers, clinics and schools. Hospital
and healthcare facilities utilize our services to help cost-effectively manage
staff shortages, new unit openings, seasonal variations, budgeted vacant
positions, long-term leaves of absence and other flexible staffing needs.
INDUSTRY OVERVIEW
In 2000, total healthcare expenditures in the United States were estimated
at $1.3 trillion, representing approximately 13% of the U.S. gross domestic
product, and had grown approximately 8% over 1999 according to the Centers for
Medicare & Medicaid Services. Over the next decade, an aging U.S. population
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and advances in medical technology are expected to drive increases in hospital
patient populations and the consumption of healthcare services. As a result,
total healthcare expenditures are projected to increase by approximately $1.3
trillion during the next decade.
Within the healthcare staffing sector, temporary staffing has emerged as an
increasingly utilized method to efficiently deliver healthcare services. In the
mid-1990s, several factors prompted the increased usage of temporary staffing at
hospitals. A principal factor was cost containment. Managed care, Medicare,
Medicaid and competitive pressures created renewed emphasis on cost containment.
Among other responses, this led acute-care hospitals to redesign their staffing
models to reduce their levels of fixed staffing and to include a variable
staffing component.
The temporary healthcare staffing industry accounted for $7.2 billion in
revenues in 2000 and this amount is projected to increase by 21%, to $8.7
billion, in 2001 according to estimates by The Staffing Industry Report.
Approximately 70% of the temporary healthcare staffing industry is comprised of
nurse staffing and approximately 30% is comprised of allied health, physicians
and other healthcare professionals. Temporary healthcare staffing has
experienced strong historical growth since 1996, growing at a compound annual
growth rate of 13%, but this growth has accelerated to approximately 15% over
the past two years. Within the temporary healthcare staffing industry, we
believe that travel nurse staffing is one of the fastest growing segments.
Demand and Supply Drivers
Since the mid-1990s, changes in the healthcare industry prompted a
permanent shift in staffing models that led to an increased usage of temporary
staffing at hospitals and other healthcare facilities. The supply of
professionals choosing travel healthcare as a short-term or long-term career
option has also grown alongside increased demand for temporary healthcare
professionals. We believe that this expanded demand and supply pattern will
continue, particularly in the travel nurse staffing sector, because of the
following drivers:
Demand Drivers
- DEMOGRAPHICS AND ADVANCES IN MEDICINE AND TECHNOLOGY. As the U.S.
population ages and as advances in medicine result in longer life
expectancy, it is likely that chronic illnesses and hospital populations
will continue to increase. We believe that these factors will increase
the demand for both temporary and permanent nurses, as well as for allied
health professionals. In addition, advances in healthcare technology have
increased the demand for specialty nurses who are qualified to operate
advanced medical equipment or perform complex medical procedures.
- SHIFT TO FLEXIBLE STAFFING MODELS. Nurse wages comprise the largest
percentage of hospitals' labor expenses. Cost containment initiatives and
a renewed focus on cost-effective healthcare service delivery continue to
lead many hospitals and other healthcare facilities to adopt flexible
staffing models that include reduced permanent staffing levels and
increased utilization of flexible staffing sources, such as traveling
nurses.
- NURSING SHORTAGE. Most regions of the United States are experiencing a
shortage of nurses. The American Hospital Association estimates that up
to 126,000 position vacancies currently exist for registered nurses,
representing approximately 10% of the hospital-based nursing workforce.
The Journal of the American Medical Association has reported that the
registered nurse workforce is expected to be 20% below projected
requirements by 2020. Faced with increasing demand for and a shrinking
supply of nurses, hospitals are utilizing more temporary nurses to meet
staffing requirements. Factors contributing to the current and projected
declining supply of nurses include:
-- DECREASING NUMBER OF ENTRANTS TO NURSING SCHOOL AND NEW NURSING
GRADUATES. According to the American Association of Colleges of
Nursing, enrollment in all basic nursing education programs
(baccalaureate, associate or diploma) has fallen each year since
1995 by approximately 5%.
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-- NURSES LEAVING PATIENT CARE ENVIRONMENTS FOR LESS STRESSFUL AND
DEMANDING CAREERS. Career opportunities for nurses have expanded
beyond the traditional bedside role. Pharmaceutical companies,
insurance companies, HMOs and hospital service and supply
companies increasingly offer nurses attractive positions which
involve less demanding work schedules and physical requirements.
-- AGING NURSE POPULATION. The average age of a registered nurse is
estimated to be 45.2 years old, an increase of 8.4% since 1988. By
2010, 40% of the nurse population is expected to be older than 50,
as compared to 29% of nurses that were older than 50 as of March
2000. As a growing number of nurses retire, the nursing shortage
is likely to worsen.
- SEASONALITY. Hospitals in areas that experience significant seasonal
fluctuations in population, such as Florida or Arizona during the winter
months, must be able to efficiently adjust their staffing levels to
accommodate the change in demand. Many of these hospitals utilize
temporary healthcare professionals to satisfy these seasonal staffing
needs.
- FAMILY AND MEDICAL LEAVE ACT. The adoption of the Family and Medical
Leave Act in 1993, which mandates 12-week job-protected maternity and
dependent care leave, continues to create temporary nursing vacancies at
healthcare facilities. Approximately 94% of the registered nurses working
at healthcare facilities in the United States are women.
- STATE LEGISLATION REQUIRING HEALTHCARE FACILITIES TO UTILIZE MORE
NURSES. In response to concerns by consumer groups over the quality of
care provided in healthcare facilities and concerns by nursing
organizations about the increased workloads and pressures placed upon
nurses, several states have passed or introduced legislation that is
expected to increase the demand for nurses.
-- MINIMUM NURSE-TO-PATIENT RATIOS. California passed legislation in
1999 (effective January 2002) that requires the establishment of
minimum nurse-to-patient ratios throughout all hospitals. Other
states have already adopted, and several are now considering,
similar legislation.
-- ELIMINATION OF MANDATORY OVERTIME. Many healthcare facilities
require their permanent staff to work overtime to cover staffing
shortages. Maine and Oregon recently passed legislation that
limits mandatory overtime for nurses, and similar legislation has
already been introduced in several other states.
Supply Drivers
- TRADITIONAL REASONS FOR A HEALTHCARE PROFESSIONAL TO WORK ON A TRAVEL
ASSIGNMENT. Traveling allows healthcare professionals to explore new
areas of the United States, work at prestigious hospitals, learn new
skills, build their resumes and avoid unwanted workplace politics that
may accompany a permanent position. Other benefits to temporary
healthcare professionals include free or subsidized housing, professional
development opportunities, competitive wages, health insurance and
completion bonuses for some assignments. All of these opportunities have
been constant supply drivers, bringing a growing number of new healthcare
professionals into traveling.
- WORD-OF-MOUTH REFERRALS. New applicants are most often referred to
travel staffing companies by current or former temporary healthcare
professionals. Growth in the number of healthcare professionals that have
traveled, as well as the increased number of hospital and healthcare
facilities that utilize temporary healthcare professionals, creates more
opportunities for referrals.
- MORE NURSES CHOOSING TRAVELING DUE TO THE NURSING SHORTAGE. In times of
nursing shortages, nurses with permanent jobs feel more secure about
their employment prospects. They have a higher degree of confidence that
they can leave their permanent position to join the temporary healthcare
professional workforce and have the ability to return to a permanent
position in the future. Additionally, during a nursing shortage,
permanent staff nurses are often required to assume greater
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responsibility and patient loads, work mandatory overtime and deal with
increased pressures within the hospital. Many experienced nurses
consequently choose to leave their permanent employer, and look for a
more flexible and rewarding position.
- NEW LEGISLATION ALLOWING NURSES TO BECOME MORE MOBILE. The Mutual
Recognition Compact Legislation, promoted by the National Council of
State Boards of Nursing, allows nurses to work more freely within states
participating in the Compact Legislation without obtaining new state
licenses. The recognition legislation began in 1999 and had been passed
in 14 states as of June 2001.
GROWTH STRATEGY
Our goal is to expand our leadership position within the temporary
healthcare staffing sector in the United States. The key components of our
business strategy include:
- EXPANDING OUR NETWORK OF QUALIFIED TEMPORARY HEALTHCARE
PROFESSIONALS. Through our recruiting efforts both in the United States
and internationally, we continue to expand our network of qualified
temporary healthcare professionals. Currently, our recruiters are
actively working with over 25,000 prospective temporary healthcare
professionals, of whom over 6,400 were on assignment with our clients
during September 2001. We have exhibited substantial growth in our
temporary healthcare professional base over the past five years primarily
through referrals from our current and former temporary healthcare
professionals, as well as through advertising and direct mailings. While
we expect these methods to continue to gain momentum, we are implementing
creative ways to attract additional qualified healthcare professionals.
Two recent examples include our acquisition of O'Grady-Peyton
International, the leading recruiter of registered nurses from
English-speaking foreign countries for placement in the United States,
and Internet recruitment tools such as our NurseZone.com website, which
is a leading nurse community site on the Internet.
- STRENGTHENING AND EXPANDING OUR RELATIONSHIPS WITH HOSPITALS AND
HEALTHCARE FACILITIES. We seek to continue to strengthen and expand our
relationships with our hospital and healthcare facility clients, and to
develop new relationships. Because we possess one of the largest national
networks of temporary nurse and allied health professionals, we are well
positioned to offer our hospital and healthcare facility clients
effective solutions to meet their staffing needs. We currently hold
contracts with approximately 42% of all acute-care hospitals in the
United States and we believe there is an opportunity to further grow our
existing relationships and develop new relationships with hospitals and
healthcare facilities.
- LEVERAGING OUR BUSINESS MODEL AND LARGE HOSPITAL AND HEALTHCARE FACILITY
CLIENT BASE TO INCREASE PRODUCTIVITY. We seek to increase our
productivity through our proven multi-brand recruiting strategy, large
network of temporary healthcare professionals, established hospital and
healthcare facility client relationships, proprietary information
systems, innovative marketing and recruitment programs, training programs
and centralized administrative support systems. Our multi-brand
recruiting strategy allows a recruiter in any of our brands to take
advantage of all of our nationwide placement opportunities. In addition,
our information systems and support personnel permit our recruiters to
spend more time focused on temporary healthcare professionals' needs and
placing them on appropriate assignments in hospitals or healthcare
facilities. Implementation of our business model at our acquired brands
has resulted in significant increases in our productivity. For example,
at Medical Express, which we acquired in November 1998, we achieved
increases of 25% in the number of placements per trained recruiter from
the first quarter of 1999 to the first quarter of 2001.
- EXPANDING SERVICE OFFERINGS THROUGH NEW STAFFING SOLUTIONS. In order to
further enhance the growth in our business and improve our competitive
position in the healthcare staffing sector, we continue to explore new
service offerings. We have most recently introduced temporary and
permanent programs for U.S. and Canadian newly-graduated nurses,
specialty training opportunities, on-site vendor management for hospitals
and healthcare facilities, permanent placement of nurses and placement of
temporary healthcare professionals in Canadian hospital and healthcare
facilities.
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- CAPITALIZING ON STRATEGIC ACQUISITION OPPORTUNITIES. In order to enhance
our competitive position, we will continue to selectively explore
strategic acquisitions. In the past after we have made acquisitions, we
have sought to leverage our hospital relationships and orders across our
brands, integrate back-office functions and maintain brand
differentiation for temporary healthcare professional recruitment
purposes. We also implement our proven business model in order to achieve
greater productivity, operating efficiencies and financial results.
BUSINESS OVERVIEW
Services Provided
Hospitals and healthcare facilities generally obtain supplemental staffing
from local temporary (per diem) agencies and national travel healthcare staffing
companies. Per diem staffing, which has historically comprised the majority of
the temporary healthcare staffing industry, involves the placement of
locally-based healthcare professionals on very short-term assignments, such as
daily shift work, on an as needed (per diem) basis. Hospitals and healthcare
facilities often give minimal advance notice of their per diem assignments, and
require a quick turnaround from their staffing agencies, generally less than 24
hours. Travel staffing, on the other hand, provides healthcare facilities with
staffing solutions to address anticipated staffing requirements, typically for
13 weeks. In contrast to per diem agencies, travel staffing companies select
from a national (and in some cases international) skilled labor pool and provide
pre-screened candidates to their hospital and healthcare facility clients,
usually at a lower cost. We focus on the travel segment of the temporary
healthcare staffing industry, and provide both nurse and allied health temporary
healthcare professionals to our hospital and healthcare facility clients.
NURSES. We provide medical nurses, surgical nurses, specialty nurses,
licensed practical or vocational nurses, and advanced practice nurses in a wide
range of specialties for travel assignments throughout the United States. We
place our qualified nurse professionals with premier, nationally recognized
hospitals and hospital networks. The majority of our assignments are in
acute-care hospitals, including teaching institutions, trauma centers and
community hospitals. Nurses comprise approximately 90% of the total temporary
healthcare professionals currently working for us.
ALLIED HEALTH PROFESSIONALS. We also provide allied health professionals
to hospitals and other healthcare facilities such as skilled nursing facilities,
rehabilitation clinics and schools. Allied health professionals include such
disciplines as surgical technologists, respiratory therapists, medical and
radiology technologists, dialysis technicians, speech pathologists and
rehabilitation assistants. Allied health professionals comprise approximately
10% of the total temporary healthcare professionals currently working for us.
Multi-Brand Recruiting Strategy
In order to enhance our opportunities to expand our network of traveling
professionals, we choose to recruit temporary healthcare professionals in the
United States and internationally separately under each of our five established
and recognized brand names: American Mobile Healthcare, Medical Express,
NursesRx, Preferred Healthcare Staffing and O'Grady-Peyton International. While
all of our brands have the capability to place temporary healthcare
professionals on assignments that we have throughout the United States using the
same placement opportunities, or "orders," our brands have distinct geographic
market strengths and brand images.
It is common for temporary healthcare professionals to register with more
than one brand in order to utilize more than one recruiter. Our multi-brand
recruiting strategy provides us with a competitive advantage, as potential
temporary healthcare professionals are able to work with more than one of our
brand recruiters. Accordingly, we believe that our probability of successfully
placing the temporary healthcare professional on assignment is significantly
enhanced.
To our hospital and healthcare facility clients, however, we market and
administer our services under the single corporate brand of AMN Healthcare.
Hospitals and healthcare facility clients in turn have the
32
advantage of managing one contract with us, but receiving the benefit of five
nationally known brands that recruit temporary healthcare professionals for
their open positions.
The following chart depicts our single staffing provider and multi-brand
recruiting model:
MULTI-BRAND RECRUITING SINGLE STAFFING PROVIDER
[AMN Healthcare Structure Flow Chart]
National Presence and Diversified Hospital and Healthcare Facility Client Base
We offer our temporary healthcare professionals nationwide placement
opportunities and provide temporary staffing solutions to our hospital and
healthcare facility clients that are located throughout the United States. We
typically have open temporary healthcare professional requests, or orders, in
all 50 states. The largest percentage of these open orders are typically
concentrated in the most heavily populated states, including approximately 17%
in Florida, 16% in California, 8% in Texas and 7% in Arizona. In September 2001,
we had over 17,000 open orders nationwide.
The number of our hospital and healthcare facility clients that we serve
has grown from approximately 600 in 1993 to over 2,500 active hospital and
healthcare facility clients today. Over 95% of our temporary healthcare
professional assignments are at acute-care hospitals. In addition to acute-care
hospitals, we also provide services to sub-acute healthcare facilities, dialysis
centers, clinics and schools. We currently hold contracts with approximately 42%
of all acute-care hospitals in the United States. Our clients include hospitals
and healthcare systems such as Georgetown University Hospital, HCA, Kaiser
Permanente, NYU Medical Center, Scripps Health Systems, Stanford Health Care,
Swedish Health Services, Texas Children's Hospital, UCLA Medical Center and The
University of Chicago Hospitals. As of September 30, 2001, no single client,
including affiliated groups, comprised more than 10% of our temporary healthcare
professionals on assignment and no single client facility comprised more than 2%
of our temporary healthcare professionals on assignment.
33
OUR BUSINESS MODEL
We have developed and continually refined our business model to achieve
greater levels of productivity and efficiency. Our model is designed to optimize
the communication with, and service to, both our temporary healthcare
professionals and our hospital and healthcare facility clients.
The following graph illustrates the elements of our business model:
[ELEMENTS OF OUR BUSINESS MODEL FLOW CHART]
Marketing and Recruitment of New Temporary Healthcare Professionals
We believe that nursing and allied health professionals are attracted to us
because of our large and diverse offering of work assignments, the opportunity
to travel to numerous attractive locations throughout the United States and our
service and relationship-oriented approach.
We believe that our multi-brand recruiting strategy makes us more effective
at reaching a larger number of temporary healthcare professionals. Because it is
common for these healthcare professionals to register with more than one brand
in the industry, we believe that by offering five distinct brands we increase
our ability to recruit temporary healthcare professionals. Each brand has its
own distinct marketing identity to prospective temporary healthcare
professionals, and we utilize different strategies in presenting each of the
brands as unique. We tailor the marketing of each of our brands through a
combination of websites, journal advertising, conferences and conventions,
direct mail, printed marketing material and, most importantly, through personal
word-of-mouth referrals from current and former temporary healthcare
professionals. Referrals from our current and former temporary healthcare
professionals represent approximately 49% of the temporary healthcare
professionals applying with us. We also operate NurseZone.com, a leading nurse
community website. This website caters to the professional and personal lives of
nurses, and offers nursing news and updates, links to other Internet sites,
discounted products and services, continuing education courses and career
opportunities sponsored by our five recruitment brands, including an online
temporary healthcare professional application process.
We have established an extensive network of traveling professionals to meet
the growth in our hospital and healthcare facility clients' demand for temporary
healthcare professionals. Currently, our recruiters are actively working with a
pre-screened pool of over 25,000 temporary healthcare professional candidates in
an effort to place them with one of our hospital or healthcare facility clients.
Year-to-date through September
34
2001, the new temporary healthcare professional applications received across our
domestic brands increased by an average of over 50% as compared to the similar
period in 2000.
Screening/Quality Management
Through our quality management department, we screen each candidate prior
to their placement and we continue to evaluate each temporary healthcare
professional after they are placed to ensure adequate performance as well as to
determine feasibility for future placements. Our internal processes are designed
to ensure that each temporary healthcare professional has the appropriate
experience, credentials and skills for the assignments that they accept. Our
experience has shown us that well-matched placements result in satisfied
temporary healthcare professionals and healthcare facility clients. Our
screening and quality management process includes three principal stages:
INITIAL SCREENING. Each new temporary healthcare professional
candidate who submits an application with us must meet certain criteria,
including appropriate prior work experience and proper educational and
licensing credentials. We independently verify each applicant's work
history and references to reasonably ensure that our hospital and
healthcare facility clients may depend on our temporary healthcare
professionals for clinical competency and personal reliability. Our
proprietary clinical skills checklists, developed for each healthcare
specialty area, are used by our hospital and healthcare facility clients'
hiring managers as a basis for evaluating candidates and conducting
interviews, and for facilitating the selection of a temporary healthcare
professional who can meet the hospital or healthcare facility client's
specific needs.
ASSIGNMENT SPECIFIC SCREENING. Once an assignment is accepted by a
temporary healthcare professional, our quality management department tracks
the necessary documentation and license verification required for the
temporary healthcare professional to meet the requirements set forth by us,
the hospital or healthcare facility, and, when required, the applicable
state board of health or nursing. These requirements may include obtaining
copies of specific health records, drug screening, criminal background
checks and certain certifications or continuing education courses.
ONGOING EVALUATION. We continually evaluate our temporary healthcare
professionals' performance through a verbal and written evaluation process.
We receive these evaluations directly from our hospital and healthcare
facility clients, and use the feedback to determine appropriate future
assignments for each temporary healthcare professional.
Sales and Marketing to Hospitals and Healthcare Facilities
Our team of regional client service directors markets our services to
prospective hospital and healthcare facility clients, and supervises ongoing
contract management of existing clients in their territory. We market ourselves
to hospitals and healthcare facilities under one corporate brand name, AMN
Healthcare, a single staffing provider with five recruitment sources of
temporary healthcare professionals: American Mobile Healthcare, Medical Express,
NursesRx, Preferred Healthcare Staffing and O'Grady-Peyton International.
The number of our hospital and healthcare facility clients that we serve
has grown from approximately 600 in 1993 to over 2,500 active clients today.
Over 95% of our temporary healthcare professional assignments are at acute-care
hospitals. In addition to acute-care hospitals, we also provide services to sub-
acute healthcare facilities, dialysis centers, clinics and schools. Our hospital
and healthcare facility clients include 15 of the top 16 hospitals in the United
States as ranked by US News and World Report in its July 2001 Best Hospitals
Honor Roll.
Account Management
Once hospital and healthcare facility contracts are obtained by our
regional client service directors, our hospital account managers are responsible
for soliciting and receiving orders from these clients and working with our
recruiters to fill those orders with qualified temporary healthcare
professionals. An "order" is a request from a client hospital or healthcare
facility for a temporary healthcare professional to fill an
35
assignment. Hospital account managers regularly call and solicit orders from our
clients, who also submit orders via the Internet and by fax. Depending upon
their size and specific needs, one hospital or healthcare facility client may
have up to 50 open orders at one time.
Our average number of orders for upcoming assignments has increased
significantly during the past three years. The combination of an increasing
number of open orders and a greater number of nurses choosing to travel benefits
us by providing us with numerous assignments to offer and an increasing supply
of new temporary healthcare professional applicants to place. In September 2001,
we had over 17,000 open customer orders nationwide. Our growth in open orders
can be attributed to factors including:
- continuing increased demand for traveling nurses;
- our extensive network of temporary healthcare professionals;
- our brand recognition and reputation as a quality provider of
temporary healthcare staffing services; and
- our increased number of hospital and healthcare facility client
relationships.
Because hospitals often list their orders with multiple service providers,
open orders may also be listed with our competitors. An order will generally be
filled by the company that provides a suitable candidate first, highlighting the
need for a large network of temporary healthcare professionals and integrated
operating and information systems to quickly and effectively match hospital and
healthcare facility client needs with appropriate temporary healthcare
professionals.
Placement
Orders are entered into our information network and are made available to
the recruiters at all of our recruitment brands. Our recruiters provide our
hospital account managers with the personnel profiles of the temporary
healthcare professionals who have expressed an interest in a particular
assignment. The hospital account manager approves the profiles to be sent to the
hospital or healthcare facility client, follows up to arrange a telephone
interview between the temporary healthcare professional and the hospital, and
confirms offers and placements with the hospital or healthcare facility.
Our recruiters seek to develop and maintain strong and long-lasting
relationships with our temporary healthcare professionals. Each recruiter
manages a group of approved temporary healthcare professionals and works to
understand the unique needs and desires of each healthcare professional. The
recruiter will present open order assignments to a temporary healthcare
professional, request that the personnel profile be submitted for placement
consideration, arrange a telephone interview with assistance from the hospital
account managers, make any special requests for housing and generally facilitate
each placement.
In the case of our international temporary healthcare professionals, the
recruiters at our O'Grady-Peyton International brand, including those located in
the United Kingdom, Australia, New Zealand and South Africa, assist candidates
in preparing for the national nursing examination and subsequently obtaining a
U.S. nursing license. These recruiters also assist our international temporary
healthcare professionals to obtain petitions to become lawful permanent
residents or to obtain work visas prior to their arrival in the United States.
Throughout the typical 13-week assignment, the recruiter will work with the
temporary healthcare professional to review their progress and to determine
whether the person would like to extend the length of the current assignment, or
move to a new hospital or healthcare facility at the end of the assignment term.
Our international temporary healthcare professionals are typically placed on
longer-term, 18-month assignments as a result of our substantial investment in
bringing them to work in the United States. Near completion of the 18-month
assignment, our recruiters will work with these temporary healthcare
professionals to explore their options for new assignments, including our more
traditional 13-week arrangements.
36
We share orders among our various brands to increase placement
opportunities for our temporary healthcare professionals. Our growth in
placement volume has been driven by enabling our recruiters at all of our brands
to offer more open assignment orders to their temporary healthcare
professionals. For example, we have been successful with this order sharing
strategy at Medical Express over the past two years, where 52% of Medical
Express placements of temporary healthcare professionals during the fourth
quarter 2000 were with clients who had not been hospital or healthcare facility
clients of Medical Express prior to its acquisition.
Housing
We offer substantially all of our temporary healthcare professionals free
or subsidized housing while on assignment. Our housing department is primarily
consolidated and managed at our San Diego corporate headquarters. Our housing
department facilitates the leasing of all apartments and furniture, manages
utilities, and arranges all housing and roommate assignments for the thousands
of temporary healthcare professionals that we place each year. We generally
offer our temporary healthcare professionals a free two-bedroom apartment to
share with another temporary healthcare professional. If a temporary healthcare
professional desires to have a private, one-bedroom apartment, they typically
pay a housing fee to us to cover the incremental costs. If a temporary
healthcare professional chooses not to accept housing provided by us, they
receive a monthly housing stipend in lieu of an apartment. Generally, our
international temporary healthcare professionals are provided with increased
travel reimbursements and assistance with immigration costs in lieu of free or
subsidized housing. We currently lease over 3,800 apartments nationwide with a
monthly housing expense of over $4 million.
Housing expenses are typically included in the hourly or weekly fees that
we charge to our hospital and healthcare facility clients. Based on the
contracted billing rate and gross profit for each hospital or healthcare
facility client, we estimate a budget for our housing coordinators to utilize
when locating apartments for each assignment. We carefully monitor performance
of actual housing costs incurred to the housing costs budgeted for each
placement. If housing costs rise in a particular city or region, our housing
department tracks these trends and communicates with our regional client service
directors to obtain increased billing rates to cover these costs. In the past,
we generally have been successful in obtaining rate increases from our hospital
and healthcare facility clients to cover the increased housing costs.
Temporary Healthcare Professional Payroll
During 2001, approximately 92% of our working temporary healthcare
professionals have been on our payroll, while approximately 8% have been paid
directly by the hospital or healthcare facility client. Providing payroll
services is a value-added and convenient service that hospitals and healthcare
facilities increasingly expect from their supplemental staffing sources. To
provide convenience and flexibility to our hospital and healthcare facility
clients, we accommodate several different payroll cycles, and allow the client
to choose the cycle that most closely matches that of their permanent staff.
This enables our hospital and healthcare facility clients to integrate
management of temporary healthcare professional scheduling and overtime with
their permanent staff.
Consistent accuracy and timeliness of making payroll payments is essential
to the retention of our temporary healthcare professionals. Our internal payroll
service group currently receives and processes timesheets for over 6,000
temporary healthcare professionals. Payroll is typically processed within 72
hours after the completion of each pay period, heightening the importance of
having adequately trained and skilled payroll personnel and appropriate
operating and information systems. We process our payroll utilizing a leading
national payroll processing service that can accommodate our large quantity of
transactions and the many federal, state and local withholding and employer
taxing requirements across the United States.
Our payroll service group offers our temporary healthcare professionals
several service benefits, including multi-account direct deposit, automatic
401(k) deductions, dependent care and flexible spending account deductions and
housing co-pays when the temporary healthcare professional chooses to upgrade to
a private one-bedroom apartment, rather than a free shared two-bedroom
apartment.
37
Temporary Healthcare Professional Benefits
In our effort to attract and retain highly qualified traveling
professionals, we offer a variety of benefits to our temporary healthcare
professionals. These benefits include:
- COMPLETION BONUSES. Many of our assignments offer special completion
bonuses, which we pay in a lump sum once the temporary healthcare
professional has completed his or her 13-week assignment. When offered,
completion bonuses usually range from $500 to $3,000 for a 13-week
assignment and are typically billed as a separate cost to the hospital
client, with a small markup to cover employer taxes and overhead.
- TRAVEL REIMBURSEMENT. Temporary healthcare professionals receive travel
reimbursement for each assignment. Reimbursements are calculated on a
"per mile" basis with a cap on the total, and are often billed as a
separate cost to the hospital or healthcare facility client.
- REFERRAL BONUSES. Through our referral bonus program, a temporary
healthcare professional receives a bonus if he or she successfully refers
a new temporary healthcare professional.
- 401(k) PLAN AND DEPENDENT CARE REIMBURSEMENT. We offer immediate
enrollment in our 401(k) plan, including matching employer contributions
after 1,000 hours of continued service. In addition, we provide pre-tax
deductions for employee dependent care expenses.
- GROUP MEDICAL, DENTAL AND LIFE INSURANCE. We pay 100% of premium
expenses for medical, dental and life insurance.
- PROFESSIONAL DEVELOPMENT CENTER. We are a fully accredited provider of
continuing education by the American Nurses Credentialing Center. Through
our professional development center, our temporary healthcare
professionals receive free continuing education courses. In addition,
they can obtain the information needed to apply for licensure in the
state where they will travel.
- 24-HOUR MANAGEMENT AND CLINICAL SUPPORT. It is our goal to always be
available to our temporary healthcare professionals. Professionals with
emergencies can be connected 24 hours per day with a clinical liaison,
recruitment manager or housing manager to help resolve their problem.
Hospital Billing
To accommodate the needs of our hospital clients, we offer two types of
billing: payroll contracts and flat rate contracts. During 2001 we have billed
approximately 92% of working temporary healthcare professionals based on payroll
contracts and approximately 8% based on flat rate contracts.
PAYROLL CONTRACTS. Under a payroll contract, the temporary healthcare
professional is our employee for payroll and benefits purposes. Under this
arrangement, we bill our hospital and healthcare facility clients at an hourly
rate which effectively includes reimbursement for recruitment fees, wages and
benefits for the temporary healthcare professional, employer taxes, and housing
expenses. Overtime and holiday hours worked are typically billed at a premium
rate. We in turn pay the temporary healthcare professional's wages, housing
costs and benefits. Providing payroll services is a value-added and convenient
service that hospitals and healthcare facilities increasingly expect from their
supplemental staffing sources. Providing these payroll services, which is cash
flow intensive, also gives us a competitive edge over smaller staffing firms.
FLAT RATE CONTRACTS. With flat rate billing, the temporary healthcare
professional is placed on the hospital or healthcare facility client's payroll.
We bill the hospital a "flat" weekly rate that includes reimbursement for
recruitment fees, temporary healthcare professional benefits and typically
housing expenses. Generally, if the temporary healthcare professional works
overtime, there is not an opportunity for us to receive increased fees under a
flat rate contract.
INFORMATION SYSTEMS
Our primary management information and communications systems are
centralized and controlled in our corporate headquarters and are utilized in
each of our staffing offices. Our financial systems are primarily centralized at
our corporate headquarters and our operational reporting is standardized at all
of our offices. To
38
facilitate payroll for our corporate employees and our temporary healthcare
professionals, we utilize a system provided by a national payroll processing
service.
During the past few years, we have developed a proprietary information
system called American Mobile Information Exchange, or "AMIE." AMIE is a
Windows-based, interactive system that is an important tool in maximizing our
productivity and accommodating our multi-brand recruiting strategy. The system
was custom-designed for our business model, including integrated processes for
temporary healthcare professional and healthcare facility contract management,
matching of temporary healthcare professionals to available assignments,
temporary healthcare professional file submissions for placements, quality
management tracking, controlling compensation packages and managing healthcare
facility contract and billing terms. AMIE provides our staff with fast, detailed
information regarding individual temporary healthcare professionals and hospital
and healthcare facility clients. AMIE also provides a platform for interacting
and transacting with temporary healthcare professionals and hospital and
healthcare facility clients via the Internet.
RISK MANAGEMENT
We have developed an integrated risk management program that focuses on
loss analysis, education and assessment in an effort to reduce our operational
costs and risk exposure. We continually analyze our losses on professional
liability claims and workers compensation claims to identify trends. This allows
us to focus our resources on those areas that may have the greatest impact on
us. We have also developed educational materials for distribution to our
temporary healthcare professionals that are targeted to address specific work-
injury risks. In addition, we have compiled a universal safety manual that every
temporary healthcare professional receives each year.
In addition to our proactive measures, we engage in a peer review process
of any incidents involving our temporary healthcare professionals. Upon
notification of a temporary healthcare professional's involvement in an incident
that may result in liability for us, a team of registered nurses located at our
San Diego headquarters reviews the temporary healthcare professional's actions.
Our peer review committee makes a prompt determination regarding whether the
temporary healthcare professional will continue the assignment and whether we
will place the temporary healthcare professional on future assignments.
COMPETITION
The healthcare staffing industry is highly competitive. We compete with
both national firms and local and regional firms. We compete with these firms to
attract nurses and other healthcare professionals as temporary healthcare
professionals and to attract hospital and healthcare facility clients. We
compete for temporary healthcare professionals on the basis of the quantity,
diversity and quality of assignments available, compensation packages, and the
benefits that we provide to a temporary healthcare professional while they are
on an assignment. We compete for hospital and healthcare facility clients on the
basis of the quality of our temporary healthcare professionals, the timely
availability of our professionals with requisite skills, the quality, scope and
price of our services, and the geographic reach of our services.
We believe that larger, nationally established firms enjoy distinct
competitive advantages over smaller, local and regional competitors in the
travel healthcare staffing industry. Continuing nursing shortages and factors
driving the demand for nurses over the past several years have made it
increasingly difficult for hospitals to meet their staffing needs. More
established firms have a critical mass of available nursing candidates,
substantial word-of-mouth referral networks and established brand names,
enabling them to attract a consistent flow of new applicants. Larger firms can
also more easily provide payroll services billing, which is cash flow intensive,
to healthcare providers. As a result, sizable and established firms such as ours
have had a significant advantage over smaller participants.
Some of our competitors in the temporary healthcare staffing sector include
Cross Country, InteliStaf, Medical Staffing Network and RehabCare Group.
39
GOVERNMENT REGULATION
The healthcare industry is subject to extensive and complex federal and
state laws and regulations related to professional licensure, conduct of
operations, payment for services and payment for referrals. Our business,
however, is not directly impacted by or subject to the extensive and complex
laws and regulations that generally govern the healthcare industry. The laws and
regulations which are applicable to our hospital and healthcare facility clients
could indirectly impact our business to a certain extent, but because we provide
services on a contract basis and are paid directly by our hospital and
healthcare facility clients, we do not have any direct Medicare or managed care
reimbursement risk.
Some states require state licensure for businesses that employ and/or
assign healthcare personnel to provide healthcare services on-site at hospitals
and other healthcare facilities. We are currently licensed in all ten states
that require such licenses.
Most of the temporary healthcare professionals that we employ are required
to be individually licensed or certified under applicable state laws. We take
reasonable steps to ensure that our employees possess all necessary licenses and
certifications in all material respects.
We recruit some temporary healthcare professionals from Canada for
placement in the United States. Canadian healthcare professionals can come to
the United States on TN Visas under the North American Free Trade Agreement. TN
Visas are renewable, one-year temporary work visas, which generally allow
immediate entrance into the United States provided the healthcare professional
presents at the border proof of waiting employment in the United States and
evidence of the necessary healthcare practice licenses.
With respect to our recruitment of international temporary healthcare
professionals through our O'Grady-Peyton International brand, we must comply
with certain United States immigration law requirements, including the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996. We primarily bring
temporary healthcare professionals to the United States as immigrants, or lawful
permanent residents (commonly referred to as "green card" holders). We screen
foreign temporary healthcare professionals and assist them in preparing for the
national nursing examination and subsequently obtaining a U.S. nursing license.
We file petitions with the Immigration and Naturalization Service for a
temporary healthcare professional to become a permanent resident of the United
States or obtain necessary work visas. Generally, such petitions are accompanied
by proof that the temporary healthcare professional has either passed the
Commission on Graduates of Foreign Nursing Schools Examination or holds a full
and unrestricted state license to practice professional nursing as well as a
contract between us and the temporary healthcare professional demonstrating that
there is a bona fide job offer.
LEGAL PROCEEDINGS
We are subject to various claims and legal actions in the ordinary course
of our business. Some of these matters include professional liability,
employee-related matters and inquiries and investigations by governmental
agencies regarding our employment practices. We are not aware of any pending or
threatened litigation that we believe is reasonably likely to have a material
adverse effect on us.
Our hospital and healthcare facility clients may also become subject to
claims, governmental inquiries and investigations and legal actions to which we
may become a party relating to services provided by our professionals. From time
to time, and depending upon the particular facts and circumstances, we may be
subject to indemnification obligations under our contracts with our hospital and
healthcare facility clients relating to these matters. At this time, we are not
aware of any such pending or threatened litigation that we believe is reasonably
likely to have a material adverse effect on us.
40
EMPLOYEES
As of September 30, 2001, we had 747 full-time corporate employees. We
believe that our employee relations are good. The following chart shows our
number of full-time corporate employees by department:
Recruitment................................................. 203
Regional Directors and Hospital Account Managers............ 42
Housing and Quality Management.............................. 184
Customer Accounting and Payroll............................. 180
MIS, Support Services, HR, Marketing and Facilities Staff... 118
Corporate and Subsidiary Management......................... 20
---
Total Corporate Employees:.................................. 747
===
During September 2001, we had over 6,400 temporary healthcare professionals
working on assignment.
PROPERTIES
We believe that our properties are adequate for our current needs. In
addition, we believe that adequate space can be obtained to meet our foreseeable
business needs. We are currently negotiating to buy or lease for approximately
ten years a new, 125,000 square foot headquarters building in San Diego,
California. We currently lease office space in ten locations, as identified in
the chart below:
LOCATION SQUARE FEET
-------- -----------
San Diego, California (corporate headquarters).............. 95,677
Ft. Lauderdale, Florida..................................... 34,631
Louisville, Colorado........................................ 19,427
Huntersville, North Carolina................................ 15,600
Savannah, Georgia........................................... 5,656
Birmingham (United Kingdom)................................. 988
Cape Town (South Africa).................................... 1,399
Canning Vale (Australia).................................... 958
Phoenix, Arizona............................................ 767
Sacramento, California...................................... 674
-------
Total:...................................................... 175,777
=======
41
MANAGEMENT
The following tables show certain information concerning our current
directors, director nominees, executive officers and other senior officers.
NAME AGE POSITION(S)
---- --- -----------
DIRECTORS, DIRECTOR NOMINEES AND EXECUTIVE
OFFICERS
Robert Haas............................... 54 Chairman of the Board and Director
Director, President and Chief Executive
Steven Francis............................ 47 Officer
William Miller III........................ 52 Director
Douglas Wheat............................. 50 Director
Michael Gallagher......................... 55 Director Nominee
Andrew Stern.............................. 52 Director Nominee
Susan Nowakowski.......................... 37 Chief Operating Officer and Secretary
Donald Myll............................... 43 Chief Financial Officer and Treasurer
OTHER SENIOR OFFICERS
Marcia Faller............................. 42 Senior Vice President
Denise Jackson............................ 36 General Counsel and Vice President
Beth Machado.............................. 39 Senior Vice President, Recruitment
Diane Stumph.............................. 51 Senior Vice President, Finance
Stephen Wehn.............................. 40 Senior Vice President, Client Services
Information with respect to the business experience and affiliations of our
directors, director nominees, executive officers and other senior officers is
set forth below.
Robert Haas has been our Chairman and a director since November 1999. Mr.
Haas has been actively involved in private business investments since 1978,
specializing in leveraged buyouts. He has served as Chairman of the Board and
Chief Executive Officer of Haas Wheat & Partners, L.P., a private investment
firm specializing in leveraged acquisitions, since 1992. Mr. Haas serves as
Chairman and a director of Playtex Products, Inc., Nebraska Book Company, Inc.
and NBC Acquisition Corp. He also serves as a director of Walls Holding Company,
Inc.
Steven Francis co-founded our predecessor company, AMN Healthcare, Inc., in
1985. He has been an executive officer and director since 1985 and our President
and Chief Executive Officer since June 1990. Prior to 1985, Mr. Francis served
in several management positions in the hospitality industry. In addition, he
served in the Nevada State Assembly from 1983 to 1987 and was elected as the
Majority Leader from 1985 to 1987. Mr. Francis serves on the Board of Directors
of the San Diego Chapter of the American Red Cross and served as Chairman in
1997. In addition, he serves as a board member of Father Joe's Villages, one of
the largest private homeless shelter organizations in the United States.
William Miller III has been a director since November 1999. Mr. Miller is
currently Chairman, Chief Executive Officer and a director of Health Management
Systems, Inc., a healthcare information technology company. From 1983 to 1999,
Mr. Miller served as President and Chief Operating Officer of Emcare Holdings,
an emergency medical services company. Prior to joining Emcare, Mr. Miller held
financial and management positions in the healthcare industry, including
positions as chief executive officer and chief financial officer of various
hospitals, and administrator/director of operations of a multi-specialty
physician group practice. Mr. Miller also serves as a director of Lincare
Holdings, Inc.
Douglas Wheat has been a director since November 1999. Mr. Wheat has served
as President of Haas Wheat & Partners, L.P., a private investment firm
specializing in leveraged acquisitions, since 1992. He serves as a director of
Playtex Products, Inc., Smarte Carte Corporation, Walls Holding Company, Inc.,
Nebraska Book Company, Inc. and NBC Acquisition Corp.
42
Michael Gallagher will become a director upon the consummation of this
offering. Mr. Gallagher has served as Chief Executive Officer of Playtex
Products, Inc. since 1995. He also serves as a director of Playtex Products,
Inc., Allergan, Inc. and the Grocery Manufacturers Association.
Andrew Stern will become a director upon consummation of this offering. Mr.
Stern has served as Chairman of the Board and Chief Executive Officer of Sunwest
Communications, Inc., a public relations firm, since 1983. Mr. Stern also serves
as a director of Dallas National Bank and as an advisory director of NeoSpire,
Inc.
Susan Nowakowski joined us in 1990 and has been our Chief Operating Officer
since December 2000 and our Secretary since October 2001. Ms. Nowakowski served
as our Senior Vice President of Business Development from September 1998 to
December 2000. Following our acquisition of Medical Express, she was
additionally appointed President of Medical Express in April 1999. She also
served as our Chief Financial Officer and Vice President of Business Development
from 1990 to 1993 and 1993 to 1998, respectively. Prior to joining us, Ms.
Nowakowski worked as a financial analyst at a subsidiary of Eli Lilly & Co. and
as the finance manager of BioVest Partners, a venture capital firm. Ms.
Nowakowski also serves as a director of Playtex Products, Inc.
Donald Myll has been our Chief Financial Officer and Treasurer since May
2001. From September 1999 through October 2000, he served as Executive Vice
President and Chief Financial Officer of Daou Systems, Inc., a publicly-traded
technology services company in the healthcare industry. From September 1998 to
September 1999, Mr. Myll served as President, Chief Executive Officer and a
director of Hearing Science, Inc., a multi-state provider of hearing care
services. From March 1997 to September 1998, Mr. Myll was a consultant to
TheraTx, Inc., a publicly-traded national healthcare provider of rehabilitation,
post acute and long-term care services, as well as other venture capital and
entrepreneurial organizations in the healthcare industry. From June 1990 to
March 1997, Mr. Myll served as Executive Vice President and Chief Financial
Officer of TheraTx, Inc.
Marcia Faller, RN, joined us in 1989 and has been our Senior Vice President
since July 1997, with responsibility for quality management and professional
education, housing, information technologies and other office support. Ms.
Faller served as one of our Vice Presidents from July 1989 until July 1997, with
various responsibilities in recruiting and operations. Prior to joining us, Ms.
Faller worked for Sharp Memorial Hospital, where she was responsible for nurse
recruitment operations. Previously, she was a staff nurse and manager in
intensive and coronary care.
Denise Jackson has been our General Counsel and Vice President of
Administration since October 2000, with responsibility for legal, risk
management, facilities and human resource functions. From 1995 to September
2000, Ms. Jackson served as Vice President and Senior Counsel of The Mills
Corporation, a publicly traded real estate investment trust.
Beth Machado joined us in 1988 and has been our Senior Vice President of
Recruitment since May 1999, with responsibility for temporary healthcare
professional recruitment, placement and retention, as well as order growth and
management with our hospital and healthcare facility clients. Ms. Machado served
as our Vice President of Recruitment from March 1996 until May 1999. Prior to
joining us, Ms. Machado was a national commodities broker at Multivest, Inc.
Diane Stumph, CPA, joined us in 1991 and has been our Senior Vice President
of Finance since July 1997, with responsibility for accounting, payroll and
finance operations and cash and tax management. Ms. Stumph served as Vice
President of Finance from January 1995 until July 1997 and as our Chief
Financial Officer from January 1995 until May 2001. In addition, Ms. Stumph
served as our Controller from August 1991 until January 1995. Prior to joining
us, Ms. Stumph worked for Exxon Company, USA for 11 years in a variety of audit,
finance and accounting management roles.
Stephen Wehn joined us in 1993 and has been our Senior Vice President of
Client Services since December 2000, with responsibility for hospital and
healthcare facility client marketing, contracting and service. Mr. Wehn served
as our Vice President of Client Services from July 1997 until December 2000 and
as our National Director of Client Services from October 1993 until July 1997.
Prior to joining us, Mr. Wehn
43
worked for Manpower, Inc., serving first as a manager for a healthcare staffing
division and then as a district manager for two of Manpower's largest
multi-office franchises.
TERM OF EXECUTIVE OFFICERS AND DIRECTORS
Upon consummation of this offering, we expect that two independent persons
will be elected directors by our board of directors. Each director serves for a
term of one year. Directors hold office until the annual meeting of stockholders
and until their successors have been duly elected and qualified. Executive
officers are appointed by the board and serve at the discretion of the board.
COMMITTEES OF OUR BOARD OF DIRECTORS
Our board has established, effective upon consummation of this offering, an
audit committee, the members of which will be Messrs. Miller, Gallagher and
Stern, a compensation committee, the members of which will be Messrs. Miller and
Gallagher, an executive committee, the members of which will be Messrs. Haas,
Wheat and Francis, and a stock plan committee, the members of which will be
Messrs. Miller and Gallagher. Each of the decisions of our compensation and
stock plan committees will also be subject to approval by our board. The audit
committee will oversee actions taken by our independent auditors and review our
internal controls and procedures. The compensation committee will review and
approve the compensation of our officers and management personnel and administer
our employee benefit plans. The executive committee will exercise the authority
of our board in the interval between meetings of the board. The stock plan
committee will administer our stock-based and certain other incentive
compensation plans.
COMPENSATION COMMITTEE INTERLOCKS AND INSIDER PARTICIPATION
One of our director nominees, Michael Gallagher, serves as the Chief
Executive Officer of Playtex Products, Inc. and will serve as a member of our
compensation committee. Our chief operating officer, Susan Nowakowski, also
serves as a director of Playtex Products, Inc.
DIRECTORS' COMPENSATION
Directors who are not executive officers will receive an annual fee of
$10,000, $2,500 for each board meeting they attend and $1,000 for each committee
meeting they attend which is not held on the same day as a board meeting.
Directors will be reimbursed for out-of-pocket expenses incurred in connection
with attending meetings of the board and its committees.
COMPENSATION OF EXECUTIVE OFFICERS
The following table sets forth the salary and certain other compensation
paid by us for our Chief Executive Officer and our other executive officer whose
total salary and bonus exceeded $100,000 for services rendered to us during
2000:
ANNUAL COMPENSATION LONG-TERM COMPENSATION AWARDS
-------------------------------------------- -----------------------------------
NAME AND PRINCIPAL ALL OTHER RESTRICTED NUMBER OF SECURITIES
POSITION YEAR SALARY BONUS COMPENSATION(1) STOCK AWARDS UNDERLYING OPTIONS
------------------ ---- -------- -------- --------------- ------------ --------------------
Steven Francis,
President and Chief
Executive
Officer............ 2000 $304,875 $200,000 $1,950 -- 746,493
Susan Nowakowski,
Chief Operating
Officer............ 2000 181,496 67,412 1,950 -- 321,451
---------------
(1) Amounts consist of employer matching contributions to our 401(k) plan.
44
OPTIONS GRANTS DURING 2000
The following table sets forth information concerning stock options that we
granted to our named executive officers in 2000. We have never issued stock
appreciation rights.
POTENTIAL REALIZABLE
INDIVIDUAL GRANTS VALUE AT ASSUMED ANNUAL
---------------------------------------------------------------- RATES
NUMBER OF PERCENTAGE OF OF STOCK PRICE
SECURITIES TOTAL OPTIONS APPRECIATION FOR
UNDERLYING GRANTED TO OPTION TERM(2)
OPTIONS EMPLOYEES EXERCISE PRICE -----------------------
NAME GRANTED IN 2000 (PER SHARE) (1) EXPIRATION DATE 5% 10%
---- ---------- ------------- --------------- ----------------- ---------- ----------
Steven Francis....... 746,493 48.3% $6.68 December 31, 2009 $2,766,675 $6,823,944
Susan Nowakowski..... 202,006 13.1% $3.80 December 31, 2009 430,182 1,062,924
119,445 7.7% $6.68 December 31, 2009 442,691 1,091,877
---------------
(1) The exercise price for each option was equal to the fair market value of our
common stock as determined by our board on the date of grant. In determining
the fair market value of our common stock on the date of grant, our board
considered many factors including:
- the fact that option grants involved illiquid securities in a
non-reporting company;
- the fact that the securities underlying the option grants represented
a minority interest in our common stock;
- our performance and operating results at the time of grant; and
- our stage of development and business strategy.
(2) These amounts present hypothetical gains that could be achieved for the
respective options if exercised at the end of the option term. These gains
are based on assumed rates of stock price appreciation of 5.0% and 10.0%
compounded annually from the date the respective options were granted to
their expiration dates. These assumptions are not intended to forecast
future appreciation of our stock price. The potential realizable value
computation does not take into account federal or state income tax
consequences of option exercises or sales of appreciated stock. If we used
an assumed initial public offering price of $15.00 per share as the base to
compute the potential option values assuming annual rates of stock price
appreciation of 5.0% and 10.0%, the hypothetical gain that could be achieved
would be $12,428,267 and $21,542,849, respectively, to Steven Francis, and
$5,946,740 and $9,900,348, respectively, to Susan Nowakowski.
AGGREGATED OPTION EXERCISES IN 2000 AND YEAR-END OPTION VALUES
The following table sets forth information concerning options that our
named executive officers exercised during 2000 and the number of shares subject
to both exercisable and unexercisable stock options as of December 31, 2000. The
table also reports values for "in-the-money" options that represent the positive
spread between the exercise prices of outstanding options and an assumed initial
offering price of $15.00 per share.
NUMBER OF SECURITIES VALUE OF UNEXERCISED
NUMBER OF UNDERLYING UNEXERCISED IN-THE-MONEY OPTIONS AT
SHARES OPTIONS AT DECEMBER 31, 2000 DECEMBER 31, 2000
ACQUIRED VALUE ---------------------------- ----------------------------
NAME ON EXERCISE REALIZED EXERCISABLE UNEXERCISABLE EXERCISABLE UNEXERCISABLE
---- ----------- -------- ----------- ------------- ----------- -------------
Steven Francis....... -- -- -- 2,766,449 $-- $28,829,093
Susan Nowakowski..... -- -- -- 660,801 $-- 7,055,339
MANAGEMENT COMPENSATION INCENTIVE PLANS
Our Senior Management Bonus Plan will provide incentives and rewards to
some of our senior members of management for achievement of annual financial
goals. The bonus plan will be administered by our compensation committee. The
board may resolve to administer the plan, thereby assuming all the functions of
45
the compensation committee under the plan. Under the bonus plan, subject to
board approval, the compensation committee shall designate for each "performance
period" (which is the period during which performance is measured to determine
the level of attainment of an award) which participants will be eligible for an
award, the performance criteria for the performance period and the maximum
award. This information will be communicated to each participant prior to or
during the performance period. The performance criteria for 2001 has been
established in a Senior Management Bonus Plan for 2001 and the bonuses under our
bonus plan are earned based upon a pre-established level of EBITDA (as defined
in the bonus plan for 2001) achieved during the year, and are calculated for
each participating member of senior management based upon a specific percentage
of the individual's salary at targeted levels of EBITDA achievement. The board
has the power to amend the plan at any time and may amend any outstanding award
granted under the plan, subject to grantee consent in appropriate instances.
Adopting and maintaining this bonus plan does not stop the board from making
compensation or award arrangements outside of the plan.
STOCK OPTION PLANS
1999 Stock Option Plans
In November, 1999, we adopted our 1999 Performance Stock Option Plan and
our 1999 Super-Performance Stock Option Plan. Both of our 1999 stock option
plans allow us to:
- attract, motivate and retain executive personnel of outstanding ability;
- focus the attention of executive management on achievement of sustained
long-term results;
- foster management's attention on overall corporate performance and
thereby promote cooperation and teamwork among management of the
operating units; and
- provide executives with a direct economic interest in the attainment of
demanding long-term business objectives.
ADMINISTRATION. Upon consummation of this offering, our stock plan
committee will administer our 1999 stock option plans. The board may resolve to
administer the plan, thereby assuming all of the functions of the stock plan
committee under the plan. Subject to board approval, the stock plan committee
will have the authority to construe, interpret and implement our 1999 stock
option plans and any agreements evidencing any options granted under our 1999
stock option plans, and to prescribe, amend and rescind rules and regulations
relating to our 1999 stock option plans.
STOCK OPTIONS. The stock plan committee is authorized to grant options to
purchase shares of common stock that are either "qualified," which include those
options that satisfy the requirements of Section 422 of the Internal Revenue
Code for incentive stock options, or "nonqualified," which include those options
that are not intended to satisfy the requirements of Section 422 of the Internal
Revenue Code. These options will be subject to the terms and conditions
established by the stock plan committee (after consultation with our Chief
Executive Officer). Under the terms of our 1999 stock option plans, the exercise
price of the initial grant of options was the "initial founder's price" (as
defined in the 1999 stock option plans). The exercise price of all subsequent
grants of options is not less than the fair market value of our common stock at
the time of grant.
ELIGIBILITY. Any members of our senior management (including directors,
officers or employees) selected by the stock plan committee are eligible for
grants of options under our 1999 stock option plans.
SHARES SUBJECT TO OUR 1999 STOCK OPTION PLANS. The number of shares of our
common stock authorized for issuance under our 1999 Performance Stock Option
Plan is 3,688,617, and under our 1999 Super-Performance Stock Option Plan is
1,844,306. If the shares subject to an option under our 1999 stock option plans
expire, terminate, or are canceled for any reason without cash consideration
paid, the shares will again be available for future award. If there is any
recapitalization, or any acquisition, divestiture or any other corporate
transaction of any kind involving us that the committee in its discretion deems
of a kind appropriate to require an amendment or adjustment to our 1999 stock
option plans or to the options issued under these plans, the stock plan
committee will make appropriate adjustments to the type and number of
46
shares covered by options then outstanding, the exercise price of outstanding
options and the shares that remain available for award under our 1999 stock
option plans.
TERM AND VESTING. The options already granted generally will terminate on
December 31, 2009, unless terminated earlier because of a participant's
termination of employment, and will vest and become exercisable at such times
and subject to such conditions as the stock plan committee determines.
All options outstanding under the 1999 stock option plans at the completion
of this offering will become fully vested. The options, once vested, will be
exercisable at a rate of 25% per year, with the first 25% to become exercisable
on various dates following the expiration of the underwriters' lock-up period.
Under the terms of our 1999 stock option plans and unless a particular
stock option agreement provides otherwise, if a participant's employment is
terminated prior to the expiration of the options granted under our 1999 stock
option plans for any reason other than death or disability, then any vested and
non-exercisable portion of an option shall become exercisable at a rate of 25%
per year for the four years following the period that ends no earlier than three
years following this offering, provided, however, that if a participant
terminates employment due to death or disability, vested and exercisable options
shall remain exercisable for one year following termination of employment, or
the original expiration date of the option, if earlier.
The stock plan committee may permit a participant to deliver shares of
common stock to exercise an option, provided that the common stock has been
owned by the participant for at least six months. Otherwise, an option may be
exercised by delivery of a certified or official bank check or, with the stock
plan committee's consent, by personal check.
NONTRANSFERABILITY OF OPTIONS. Options awarded under our 1999 stock option
plans will generally not be assignable or transferable other than by will or by
the laws of descent and distribution. The stock plan committee may provide in a
particular stock option agreement that an option may be transferred for estate
planning purposes to a family trust or family partnership for the benefit of
immediate members of the participant's family.
STATUS OF PARTICIPANTS. A participant will have no rights as a stockholder
with respect to any shares covered by any option until the exercise of that
option.
TAX WITHHOLDING. Whenever shares of common stock are to be delivered
pursuant to an option, the stock plan committee may require as a condition of
delivery that the participant pay in cash or in stock an amount sufficient to
satisfy all related federal, state and other withholding tax requirements.
TERM AND AMENDMENT. Our 1999 stock option plans have ten year terms. Our
board may at any time amend, suspend or discontinue our 1999 stock option plans.
The expiration of the term of our 1999 stock option plans, or any amendment,
suspension or discontinuation will not adversely impair the rights under any
outstanding option held by a participant without the consent of that
participant, nor will any amendment for which shareholder approval would be
required be effective without receiving the necessary shareholder approval.
CHANGE OF CONTROL. Under the terms of our 1999 stock option plans, if
there is a change of control (as defined in our 1999 stock option plans), or in
the event that our board shall propose that we enter into a transaction that
would result in a change of control, the stock plan committee may in its
discretion, by written notice to a participant provide that the participant's
options will be terminated unless exercised within a specified period. The stock
plan committee also may in its discretion, by written notice to a participant,
provide that the participant's options shall be fully exercisable as to all or
some of the shares of common stock covered by that participant's options or that
some or all of the restrictions on any of that participant's options may lapse
in the event of a change of control.
2001 Stock Option Plan
In connection with this offering, we have adopted our 2001 stock option
plan for grants to be made to participants in anticipation of, and following,
this offering. The purpose of our 2001 stock option plan is to provide a means
through which we may attract able persons to enter and remain in the employ of
our
47
company and to provide a means whereby employees, directors and consultants can
acquire and maintain common stock ownership, thereby strengthening their
commitment to the welfare of our company and promoting an identity of interest
between stockholders and these employees.
ADMINISTRATION. The stock plan committee will administer our 2001 stock
option plan. The board may resolve to administer the plan, thereby assuming all
of the functions of the stock plan committee under the plan. Subject to board
approval, the stock plan committee will have the authority to interpret,
administer, reconcile any inconsistency and correct any default in our 2001
stock option plan and any agreements evidencing any options granted under our
2001 stock option plan, and to establish, amend, suspend or waive rules and
regulations relating to our 2001 stock option plan.
STOCK OPTIONS. The stock plan committee will be authorized to grant
options to purchase shares of common stock that are "nonqualified," which are
options that are not intended to satisfy the requirements of Section 422 of the
Internal Revenue Code. These options will be subject to such terms and
conditions as the stock plan committee shall determine. Under the terms of our
2001 stock option plan, the exercise price of the options will not be less than
the fair market value of our common stock at the time of grant.
ELIGIBILITY. Any of our employees, directors or consultants designated by
the stock plan committee will be eligible for grants of options under our 2001
stock option plan.
SHARES SUBJECT TO OUR 2001 STOCK OPTION PLAN. The number of shares of our
common stock authorized for issuance under our 2001 stock option plan is
2,178,013 shares. No participant may be granted options to purchase more than
544,503 shares of common stock in any one year. If the shares subject to an
option under our 2001 stock option plan expire, terminate, are surrendered or
forfeited for any reason, the shares will again be available for new grants
under our 2001 stock option plan. If there is any change in the outstanding
stock or in the capital structure of our company by reason of stock or
extraordinary cash dividends, stock splits, reverse stock splits,
recapitalizations, reorganizations, mergers, consolidations, combinations,
exchanges, or other relevant changes in capitalization, or if there is any
change in applicable laws or any change in circumstances that results in or
would result in any substantial dilution or enlargement of the rights granted
to, or available for, participants, the stock plan committee in its sole
discretion will make appropriate adjustments to the number of shares covered by
options then outstanding under our 2001 stock option plan, the exercise price of
outstanding options and the maximum number of shares and the per-person maximum
number of shares available for grant under our 2001 stock option plan.
TERM AND VESTING. The options granted will generally terminate on the
tenth anniversary of their grant, unless terminated earlier because of a
participant's termination of employment, and will vest and become exercisable in
increments of 25% on each of the first four anniversaries of the date of grant.
An option generally will be exercised by delivery of cash in an amount
equal to the exercise price of that option. The stock plan committee may permit
a participant to deliver shares of common stock to exercise an option, provided
the common stock delivered has been owned by the participant for at least six
months or was previously acquired by the participant on the open market. The
stock plan committee may also allow the option price to be paid in other
property or by brokered exercise.
Under the terms of our 2001 stock option plan and unless a particular stock
option agreement provides otherwise, if a participant's employment is terminated
prior to the expiration of the option granted under our 2001 stock option plan,
unvested portions of the option expire immediately and vested portions of the
option generally remain exercisable for three months.
The stock plan committee may permit the voluntary surrender of all or any
portion of any nonqualified stock option granted under our 2001 stock option
plan to be conditioned upon the granting to the participant of a new option for
the same or different number of shares as the option surrendered, or require
voluntary surrender before a grant of a new option to the participant. The new
option will be exercisable at a price and during a period in accordance with any
other terms or conditions specified by the stock plan committee at the time the
new option is granted, all determined in accordance with the provisions of the
2001 stock option plan without regard to the terms and conditions of the
nonqualified stock option surrendered.
48
NONTRANSFERABILITY OF OPTIONS. Options awarded under our 2001 stock option
plan are generally not assignable or transferable other than by will or by the
laws of descent and distribution. The stock plan committee may provide in a
particular stock option agreement that an option may be transferred for estate
planning purposes to a family trust or family partnership for the benefit of
immediate members of the participant's family.
TAX WITHHOLDING. A participant may be required to pay to us and we shall
have the right and are authorized to withhold from any shares of stock or other
property deliverable under any option or from any compensation or other amounts
owing to a participant the amount (in cash, stock or other property) of any
required tax withholding and payroll taxes in respect of an option, its
exercise, or any payment or transfer under an option or under our 2001 stock
option plan, and to take such other action as may be necessary in our opinion to
satisfy all obligations for the payment of these taxes.
If so provided in a stock option agreement, a participant may satisfy, in
whole or in part, withholding liability (but no more than the minimum required
withholding liability) by delivery of shares of stock owned by the participant
(which are not subject to any pledge or other security interest and which have
been owned by the participant for at least six months or purchased on the open
market) with a fair market value equal to the withholding liability or by having
us withhold from the number of shares of stock otherwise issuable pursuant to
the exercise of the option a number of shares with a fair market value equal to
the withholding liability.
TERM AND AMENDMENT. Our 2001 stock option plan has a term of ten years.
Our board may at any time amend, alter, suspend, discontinue or terminate our
2001 stock option plan. No amendment, suspension, discontinuation or termination
will impair the rights of any participant or any holder or beneficiary of any
option without the consent of the participant, holder, or beneficiary, nor will
any amendment for which shareholder approval would be required be effective
without receiving the necessary shareholder approval.
CHANGE OF CONTROL. Under the terms of our 2001 stock option plan, and
unless a particular stock option agreement provides otherwise, if there is a
change of control (as defined in our 2001 stock option plan), a participant's
options will become fully exercisable as to all the shares of common stock
covered by that participant's options. Alternatively, in the event of a change
of control, the stock plan committee may in its discretion, by written notice to
the participant, provide that the participant's options will be terminated
unless exercised within 10 days, in exchange for a payment in cash or stock of
the value of that participant's options based upon the per-share value to be
received by other shareholders pursuant to the transaction.
Recent Stock Options Awarded
In July 2001, we granted options to some members of our management for
546,314 shares of common stock at an exercise price equal to $9.09 per share,
including options to purchase 458,804 shares granted to Donald Myll, effective
as of the date of this offering. The first 25% of these options are expected to
vest on the first anniversary of the date of their grant.
EMPLOYMENT AND SEVERANCE AGREEMENTS
We are parties to an employment agreement with Steven Francis which
provides that Mr. Francis will serve as our President and Chief Executive
Officer and as a member of our board until December 31, 2003 (and thereafter
automatically for additional one-year periods unless either party gives prior
written notice of its intent to terminate the agreement) or until we terminate
his employment or he resigns, if earlier. The agreement provides that Mr.
Francis will receive a base salary of $300,000 per year (increased annually at
the discretion of our board), an annual bonus opportunity subject to meeting
certain performance based criteria, participation in our stock option plans,
eligibility in our employee benefit plans and other benefits provided in the
same manner and to the same extent as to our other senior management.
Mr. Francis's employment agreement provides that he will receive severance
benefits if we voluntarily terminate his employment for any reason other than
"cause" (as defined in the agreement), in the event of his disability or death
or if he terminates his employment for "good reason" (as defined in the
agreement).
49
In the event of such termination, Mr. Francis or his estate, as applicable, will
be entitled to any earned but unpaid base salary, an immediate lump sum
severance payment of two years of base salary, plus his bonus for the year of
termination. In addition, Mr. Francis has the right to resign for any reason or
no reason within 90 days following a "change of control" (as defined in the
agreement) and have such resignation be treated as "good reason."
Under some circumstances, amounts payable under Mr. Francis's employment
agreement are subject to a full "gross-up" payment to make Mr. Francis whole in
the event that he is deemed to have received "excess parachute payments" under
Section 280G and 4999 of the Internal Revenue Code.
Mr. Francis's employment agreement also contains a confidentiality
agreement and a covenant not to compete or solicit during its term and for a
period of two years thereafter.
We also entered into executive severance agreements with two of our
executive officers, Susan Nowakowski and Donald Myll, in November 1999 and May
2001, respectively. These executives' severance agreements provide that they
will receive severance benefits if their at-will employment is terminated by us
without cause (as defined in the agreements). Such benefits include cash
payments over a 12-month period equal to their annual salary plus reimbursement
for the COBRA costs for their health insurance for that 12-month period (or
until the executive becomes eligible for comparable coverage under another
employer's health plans, if earlier). Each executive severance agreement
contains a requirement that the executive execute our standard covenant not to
compete or solicit and general release of all claims form as a condition to
receiving the severance payments.
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RELATED PARTY TRANSACTIONS
TRANSACTIONS WITH THE HWP STOCKHOLDERS
AMN Acquisition Corp. was formerly our controlling stockholder and was
owned by the HWP stockholders. Robert Haas and Douglas Wheat, two of our
directors, are affiliates of the HWP stockholders and have indirect equity
interests in the HWP stockholders.
In June 2000, we issued shares to AMN Acquisition Corp. as consideration
for an aggregate capital contribution of $10.1 million in connection with our
acquisition of NursesRx. In addition, in November 2000, we issued shares to AMN
Acquisition Corp. as consideration for an aggregate capital contribution of
$35.6 million in connection with our acquisition of Preferred Healthcare
Staffing.
In connection with our acquisition of Preferred Healthcare Staffing, we
paid $1.5 million to AMN Acquisition Corp. in exchange for advisory services. In
addition, in November 1999, we paid $3.7 million to AMN Acquisition Corp. to
reimburse it for expenses incurred in our 1999 recapitalization.
During 2000 and 2001, we paid an affiliate of the HWP stockholders a fee
for management advisory services provided to us in the amounts of $150,000 and
$112,500, respectively. At the completion of this offering, we will pay a fee to
an affiliate of the HWP stockholders of up to $1.84 million and the agreement
governing these fees will terminate. We will make this payment concurrently with
the closing of this offering.
TRANSACTIONS WITH BANCAMERICA CAPITAL INVESTORS
BancAmerica Capital Investors SBIC I, L.P., currently beneficially owns
9.1% of our common stock and will beneficially own approximately 6.9% of our
common stock following this offering. BancAmerica Capital Investors also holds
our senior subordinated notes, and affiliates of BancAmerica Capital Investors
are acting as an underwriter of this offering and as a lender under our existing
credit facility. For more information, see "Underwriting."
In June 2000, we issued shares to BancAmerica Capital Investors as
consideration for an aggregate capital contribution of $1.3 million in
connection with our acquisition of NursesRx. In addition, in November 2000, we
issued shares to BancAmerica Capital Investors as consideration for an aggregate
capital contribution of $4.4 million in connection with our acquisition of
Preferred Healthcare Staffing.
TRANSACTIONS WITH OLYMPUS PARTNERS
In connection with our 1999 recapitalization, we paid $1.5 million in
advisory fees to our then majority stockholder, Olympus Partners.
TRANSACTIONS WITH DIRECTORS
In connection with our 1999 recapitalization, we paid $100,000 in advisory
fees to one of our minority stockholders and directors, William Miller. Prior to
the consummation of this offering, we paid Mr. Miller an annual fee of $25,000
to serve as a director (in addition to the fees described under "Management --
Directors' Compensation").
Steven Francis, our President and Chief Executive Officer, a director and
stockholder, owned a minority interest in AMN Healthcare, Inc., our primary
operating subsidiary, until October 1999. Prior to our November 1999
recapitalization, Steven Francis exchanged his shares of our subsidiary for
shares of our common stock, eliminating this minority ownership interest.
In June 2000, we issued shares to an affiliate of Steven Francis as
consideration for an aggregate capital contribution of $0.6 million in
connection with our acquisition of NursesRx.
We have secured services in the past from certain advertising agencies in
which Steven Francis currently holds a 30% interest. We incurred expenses of
$701,676, $30,723, $39,713 and $28,180 in 1998, 1999, 2000
51
and the nine month period ended September 30, 2001, respectively, related to the
services provided by these advertising agencies.
REGISTRATION RIGHTS
In consideration for approving amendments to our certificate of
incorporation and by-laws necessary to proceed with this offering and amending
their existing registration rights so that we may have a uniform set of
registration rights, we have agreed to enter into a registration rights
agreement with the HWP stockholders, BancAmerica Capital Investors, Steven
Francis and the Francis Family Trust upon consummation of this offering. Subject
to several exceptions, including our right to defer a demand registration under
certain circumstances, the HWP stockholders may require that we register for
public resale under the Securities Act all shares of common stock they request
be registered at any time after 180 days following this offering, and
BancAmerica Capital Investors may require that we register for public resale
under the Securities Act all shares of common stock they request be registered
at any time after one year following this offering. The HWP stockholders may
demand five registrations and BancAmerica Capital Investors may demand one
registration, in each case so long as the securities being registered in each
registration statement are reasonably expected to produce aggregate proceeds of
$5 million or more. If we become eligible to register the sale of our securities
on Form S-3 under the Securities Act, the HWP stockholders have the right to
require us to register the sale of the common stock held by them on Form S-3,
subject to offering size and other restrictions. BancAmerica Capital Investors,
Steven Francis and the Francis Family Trust are entitled to piggyback
registration rights with respect to any registration request made by the HWP
stockholders, and the HWP Stockholders, Steven Francis and the Francis Family
Trust are entitled to piggyback registration rights with respect to the
registration request made by BancAmerica Capital Investors. If the registration
requested by the HWP stockholders or BancAmerica Capital Investors is in the
form of a firm underwritten offering, and if the managing underwriter of the
offering determines that the number of securities to be offered would jeopardize
the success of the offering, the number of shares included in the offering shall
be determined as follows: (i) first, shares offered by the HWP stockholders,
BancAmerica Capital Investors, Steven Francis and the Francis Family Trust (pro
rata, based on their respective ownership of our common equity), (ii) second,
shares offered by stockholders other than the HWP stockholders, BancAmerica
Capital Investors, Steven Francis and the Francis Family Trust (pro rata, based
on their respective ownership of our common equity) and (iii) third, shares
offered by the Company.
In addition, the HWP stockholders, BancAmerica Capital Investors, Steven
Francis and the Francis Family Trust will be granted piggyback rights on any
registration for our account or the account of another stockholder. If the
managing underwriter in an underwritten offering determines that the number of
securities offered in a piggyback registration would jeopardize the success of
the offering, the number of shares included in the offering shall be determined
as follows: (i) first, shares offered by the Company for its own account and
(ii) second, shares offered by the stockholders (pro rata, based on their
respective ownership of our common equity).
In connection with these registrations, we are generally required to enter
into standard indemnification or underwriting agreements and to bear all fees,
costs and expenses (except for selling stockholder legal fees and underwriting
discounts and selling commissions).
52
PRINCIPAL STOCKHOLDERS
The following table summarizes certain information regarding the beneficial
ownership of our outstanding common stock for:
- each person or group who beneficially owns more than 5% of the common
stock;
- our chief executive officer;
- each of our other executive officers;
- each of our directors and director nominees; and
- all of our directors, director nominees and executive officers as a
group.
Beneficial ownership of shares is determined under the rules of the
Securities and Exchange Commission and generally includes any shares over which
a person exercises sole or shared voting or investment power. Except as
indicated by footnote, each person identified in the table possesses sole voting
and investment power with respect to all shares of common stock held by them.
Shares of common stock subject to options currently exercisable or exercisable
within 60 days are deemed outstanding for computing the percentage of the person
holding these options, but are not deemed outstanding for computing the
percentage of any other person. Applicable percentage ownership in the following
table is based on 30,714,643 shares of common stock outstanding before this
offering and 40,714,643 shares of common stock outstanding after the completion
of this offering. Unless otherwise indicated, the address of each of the named
individuals is c/o AMN Healthcare Services, Inc., 12235 El Camino Real, Suite
200, San Diego, CA 92130.
PERCENTAGE OF
SHARES THAT OUTSTANDING SHARES
CAN ----------------------
OUTSTANDING SHARES BE ACQUIRED BEFORE THE AFTER THE
NAME OF COMMON STOCK WITHIN 60 DAYS OFFERING OFFERING
---- ------------------ --------------- ---------- ---------
Robert Haas (1)............................... 26,427,048 -- 86.0% 64.9%
HWH Capital Partners, L.P. ................... 12,286,696 -- 40.0% 30.2%
HWH Nightingale Partners, L.P. ............... 9,418,313 -- 30.7% 23.1%
HWP Nightingale Partners II, L.P. ............ 3,395,621 -- 11.1% 8.3%
HWP Capital Partners II, L.P. ................ 1,326,418 -- 4.3% 3.3%
BancAmerica Capital Investors SBIC I, L.P.
(2)......................................... 2,810,276 -- 9.1% 6.9%
Steven Francis (3)............................ 1,214,422 -- 4.0% 3.0%
William Miller III (4)........................ 262,897 -- * *
Douglas Wheat................................. -- -- -- --
Michael Gallagher (5)......................... -- -- -- --
Andrew Stern (6).............................. -- -- -- --
Susan Nowakowski.............................. -- -- -- --
Donald Myll................................... -- -- -- --
All directors, director nominees and executive
officers as a group (7)..................... 27,904,367 -- 90.9% 68.5%
---------------
* Less than 1%
(1) Represents shares held by the following entities:
- 12,286,696 shares held by HWH Capital Partners, L.P.
- 9,418,313 shares held by HWH Nightingale Partners, L.P.
- 3,395,621 shares held by HWP Nightingale Partners II, L.P.
- 1,326,418 shares held by HWP Capital Partners II, L.P.
The ultimate general partner of each of these limited partnerships is either
a limited liability company or a corporation, in each case controlled by Mr.
Haas. By virtue of his control over each such limited
53
liability company and corporation, Mr. Haas has sole voting and dispositive
power over these 26,427,048 shares. The address of each of the limited
partnerships listed above is c/o Haas Wheat & Partners, L.P., 300 Crescent
Court, Suite 1700, Dallas, Texas 75201.
(2) The address of BancAmerica Capital Investors is NC1-007-25-01, 100 North
Tyron Street, 25th Floor, Charlotte, North Carolina 28255.
(3) Includes 1,214,422 shares owned by the Francis Family Trust dated May 24,
1996. Mr. Francis and his wife Gayle Francis are each Trustees of such
trust. As a result, he has investment power over these shares and is
therefore deemed to have beneficial ownership of these shares.
(4) Mr. Miller's address is c/o Health Management Systems, Inc., 401 Park Avenue
South, New York, New York 10016.
(5) Mr. Gallagher's address is c/o Playtex Products, Inc., 300 Nyala Farms Road,
Westport, Connecticut 06880.
(6) Mr. Stern's address is c/o Sunwest Communications, Inc., 5956 Sherry Lane,
Dallas, Texas 75225.
(7) The percentage of outstanding shares owned includes 26,427,048 shares owned
by the HWP stockholders, 1,214,422 shares owned by the Francis Family Trust
dated May 24, 1996 and 262,897 shares owned by William Miller.
54
DESCRIPTION OF CAPITAL STOCK
Our authorized capital stock currently consists of 200,000,000 shares of
common stock and 10,000,000 shares of preferred stock. After consummation of
this offering, we expect to have 40,714,643 shares of common stock and no shares
of preferred stock outstanding.
COMMON STOCK
The holders of our common stock are entitled to one vote per share on all
matters submitted to a vote of stockholders, including the election of
directors. The common stock does not have cumulative voting rights, which means
that the holders of a majority of the outstanding common stock voting for the
election of directors can elect all directors then being elected. The holders of
our common stock are entitled to receive dividends when, as, and if declared by
our board out of legally available funds. Upon our liquidation or dissolution,
the holders of common stock will be entitled to share ratably in our assets
legally available for the distribution to stockholders after payment of
liabilities and subject to the prior rights of any holders of preferred stock
then outstanding. All of the outstanding shares of common stock are, and the
shares of common stock to be sold in this offering when issued and paid for will
be, fully paid and nonassessable. The rights, preferences and privileges of
holders of common stock are subject to the rights of the holders of shares of
any series of preferred stock which may be issued in the future.
PREFERRED STOCK
Our preferred stock may be issued from time to time in one or more series.
Our board is authorized to fix the dividend rights, dividend rates, any
conversion rights or right of exchange, any voting rights, rights and terms of
redemption, the redemption price or prices, the payments in the event of
liquidation, and any other rights, preferences, privileges, and restrictions of
any series of preferred stock and the number of shares constituting such series
and their designation. We have no present plans to issue any shares of preferred
stock.
Depending upon the rights of such preferred stock, the issuance of
preferred stock could have an adverse effect on holders of our common stock by
delaying or preventing a change in control, adversely affecting the voting power
of the holders of common stock, including the loss of voting control to others,
making removal of the present management more difficult, or resulting in
restrictions upon the payment of dividends and other distributions to the
holders of common stock. These provisions could limit the price that investors
might be willing to pay in the future for shares of our common stock.
CERTAIN CERTIFICATE OF INCORPORATION, BY-LAW AND STATUTORY PROVISIONS
The provisions of our certificate of incorporation and by-laws and of the
Delaware General Corporation Law summarized below may have an anti-takeover
effect and may delay, defer or prevent a tender offer or takeover attempt that
you might consider in your best interest, including an attempt that might result
in your receipt of a premium over the market price for your shares.
Directors' Liability; Indemnification of Directors and Officers
Our certificate of incorporation provides that a director will not be
personally liable to us or our stockholders for monetary damages for breach of
fiduciary duty as a director, except:
- for any breach of the duty of loyalty;
- for acts or omissions not in good faith or which involve intentional
misconduct or knowing violations of law;
- for liability under Section 174 of the Delaware General Corporation Law
(relating to unlawful dividends, stock repurchases, or stock
redemptions); or
- for any transaction from which the director derived any improper personal
benefit.
55
This provision does not limit or eliminate our rights or those of any
shareholder to seek non-monetary relief such as an injunction or rescission in
the event of a breach of a director's duty of care. The provisions will not
alter the liability of directors under federal securities laws. In addition, our
certificate of incorporation and by-laws provide that we indemnify each director
and the officers, employees, and agents determined by our board to the fullest
extent provided by the laws of the State of Delaware.
Special Meetings of Stockholders
Our certificate of incorporation provides that special meetings of
stockholders may be called only by the chairman or by a majority of the members
of our board. Stockholders are not permitted to call a special meeting of
stockholders, to require that the chairman call such a special meeting, or to
require that our board request the calling of a special meeting of stockholders.
Advance Notice Requirements For Stockholder Proposals and Director Nominations
Our by-laws establish advance notice procedures for:
- stockholders to nominate candidates for election as a director; and
- stockholders to propose topics at stockholders' meetings.
Stockholders must notify our corporate secretary in writing prior to the
meeting at which the matters are to be acted upon or the directors are to be
elected. The notice must contain the information specified in our by-laws. To be
timely, the notice must be received at our corporate headquarters not less than
60 days nor more than 130 days prior to the first anniversary of the date on
which we mailed our proxy materials for the preceding year's annual meeting of
stockholders. If the annual meeting is advanced by more than 30 days, or delayed
by more than 30 days, from the anniversary of the preceding year's annual
meeting, notice by the stockholder to be timely must be received not earlier
than the 130th day prior to the annual meeting and not later than the later of
the 90th day prior to the annual meeting or the 10th day following the day on
which we notify stockholders of the date of the annual meeting, either by mail
or other public disclosure. In the case of a special meeting of stockholders
called to elect directors, the stockholder notice must be received not earlier
than 130 days prior to the special meeting and not later than the later of the
90th day prior to the special meeting or 10th day following the day on which we
notify stockholders of the date of the special meeting, either by mail or other
public disclosure. These provisions may preclude some stockholders from bringing
matters before the stockholders at an annual or special meeting or from
nominating candidates for director at an annual or special meeting.
Anti-Takeover Provisions of Delaware Law
In general, Section 203 of the Delaware General Corporation Law prevents an
interested stockholder (defined generally as a person owning 15% or more of the
corporation's outstanding voting stock) of a Delaware corporation from engaging
in a business combination (as defined) for three years following the date that
person became an interested stockholder unless various conditions are satisfied.
Under our certificate of incorporation, we will opt out of the provisions of
Section 203.
TRANSFER AGENT AND REGISTRAR
The transfer agent and registrar for the common stock is American Stock
Transfer & Trust Company. Its telephone number is (212) 936-5100.
56
CERTAIN U.S. FEDERAL TAX
CONSIDERATIONS FOR NON-U.S. HOLDERS
The following discussion sets forth the opinion of Paul, Weiss, Rifkind,
Wharton & Garrison with respect to the expected material United States federal
income and estate tax consequences of the acquisition, ownership, and
disposition of our common stock purchased pursuant to this offering by a holder
that, for U.S. federal income tax purposes, is not a U.S. person as we define
that term below. A beneficial owner of our common stock who is not a U.S. person
is referred to below as a "non-U.S. holder." We assume in this discussion that
you will hold our common stock issued in this offering as a capital asset within
the meaning of the Internal Revenue Code of 1986, as currently amended. This
discussion does not address all aspects of taxation that may be relevant to
particular non-U.S. holders in light of their personal investment or tax
circumstances or to persons that are subject to special tax rules. In
particular, this description of U.S. tax consequences does not address the tax
treatment of special classes of non-U.S. holders, such as banks, insurance
companies, tax-exempt entities, financial institutions, broker-dealers, persons
holding our common stock as part of a hedging or conversion transaction or as
part of a "straddle," or U.S. expatriates. Our discussion is based on current
provisions of the Internal Revenue Code, U.S. Treasury regulations, judicial
opinions, published positions of the U.S. Internal Revenue Service and other
applicable authorities, all as in effect on the date of this prospectus and all
of which are subject to differing interpretations or change, possibly with
retroactive effect. We have not sought, and will not seek, any ruling from the
IRS with respect to the tax consequences discussed in this prospectus, and there
can be no assurance that the IRS will not take a position contrary to the tax
consequences discussed below or that any position taken by the IRS would not be
sustained. Furthermore, this discussion does not give a detailed discussion of
any state, local or foreign tax considerations. We urge you to consult your tax
advisor about the U.S. federal tax consequences of acquiring, holding, and
disposing of our common stock, as well as any tax consequences that may arise
under the laws of any foreign, state, local, or other taxing jurisdiction or
under any applicable tax treaty.
For purposes of this discussion, a U.S. person means any one of the
following:
- a citizen or resident of the U.S.;
- a corporation (including any entity treated as a corporation for U.S. tax
purposes) or partnership (including any entity treated as a partnership
for U.S. tax purposes) created or organized in the U.S. or under the laws
of the U.S. or of any political subdivision of the U.S.;
- an estate the income of which is subject to U.S. federal income taxation
regardless of its source; or
- a trust, the administration of which is subject to the primary
supervision of a U.S. court and one or more U.S. persons have the
authority to control all substantial decisions of the trust, or the trust
has a valid election in effect under applicable U.S. Treasury regulations
to be treated as a U.S. person.
DIVIDENDS
We do not anticipate paying cash dividends on our common stock in the
foreseeable future. See "Dividend Policy." If dividends are paid on shares of
our common stock, however, such dividends will generally be subject to
withholding of U.S. federal income tax at the rate of 30% or such lower rate as
may be specified by an applicable income tax treaty and we have received proper
certification of the application of such income tax treaty. Non-U.S. holders
should consult their tax advisors regarding their entitlement to benefits under
an applicable income tax treaty and the manner of claiming the benefits of such
treaty. A non-U.S. holder that is eligible for a reduced rate of U.S. federal
withholding tax under an income tax treaty may obtain a refund or credit of any
excess amounts withheld by filing an appropriate claim for a refund with the
IRS.
Dividends that are effectively connected with a non-U.S. holder's conduct
of a trade or business in the U.S. or, if provided in an applicable income tax
treaty, dividends that are attributable to a permanent establishment in the
United States, are not subject to the U.S. withholding tax, but are instead
taxed in the manner applicable to U.S. persons. In that case, we will not have
to withhold U.S. federal withholding tax if the non-U.S. holder complies with
applicable certification and disclosure requirements. In addition, dividends
57
received by a foreign corporation that are effectively connected with the
conduct of a trade or business in the U.S. may be subject to a branch profits
tax at a 30% rate, or a lower rate specified in an applicable income tax treaty.
GAIN ON DISPOSITION
A non-U.S. holder will generally not be subject to U.S. federal income tax,
including by way of withholding, on gain recognized on a sale or other
disposition of our common stock unless any one of the following is true:
- the gain is effectively connected with the non-U.S. holder's conduct of a
trade or business in the U.S. and, if an applicable tax treaty requires,
attributable to a U.S. permanent establishment maintained by such
non-U.S. holder;
- the non-U.S. holder is an individual who is present in the U.S. for 183
or more days in the taxable year of the sale, exchange or other
disposition and certain other requirements are met; or
- our common stock constitutes a United States real property interest by
reason of our status as a "United States real property holding
corporation" (a "USRPHC") for U.S. federal income tax purposes at any
time during the shorter of (i) the period during which you hold our
common stock or (ii) the 5-year period ending on the date you dispose of
our common stock and, assuming that our common stock is regularly traded
on an established securities market for tax purposes, the non-U.S. holder
held, directly or indirectly, at any time within the five-year period
preceding such disposition more than 5% of such regularly traded common
stock.
We believe that we are not currently and do not anticipate becoming a
USRPHC. However, since the determination of USRPHC status in the future will be
based upon the composition of our assets from time to time and there are
uncertainties in the application of certain relevant rules, there can be no
assurance that we will not become a USRPHC in the future.
Individual non-U.S. holders who are subject to U.S. tax because the holder
was present in the U.S. for 183 days or more during the year of disposition are
taxed on their gains (including gains from sale of our common stock and net of
applicable U.S. losses from sale or exchanges of other capital assets incurred
during the year) at a flat rate of 30%. Other non-U.S. holders who may be
subject to U.S. federal income tax on the disposition of our common stock will
be taxed on such disposition in the same manner in which citizens or residents
of the U.S. would be taxed. In addition, if any such gain is taxable because we
are or were a USRPHC, the buyer of our common stock will be required to withhold
a tax equal to 10% of the amount realized on the sale.
U.S. FEDERAL ESTATE TAXES
Our common stock owned or treated as owned by an individual who at the time
of death is a non-U.S. holder will be included in his or her estate for U.S.
federal estate tax purposes, unless an applicable estate tax treaty provides
otherwise.
INFORMATION REPORTING AND BACKUP WITHHOLDING
A non-U.S. holder may have to comply with specific certification procedures
to establish that the holder is not a U.S. person as described above in order to
avoid backup withholding tax requirements with respect to our payments of
dividends on our common stock. Under U.S. Treasury regulations, we must report
annually to the IRS and to each non-U.S. holder the amount of dividends paid to
that non-U.S. holder and the tax withheld with respect to those dividends. These
information reporting requirements apply even if withholding was not required
because the dividends were effectively connected dividends or withholding was
reduced or eliminated by an applicable tax treaty. Pursuant to an applicable tax
treaty, that information may also be made available to the tax authorities in
the country in which the non-U.S. holder resides.
The payment of the proceeds of the disposition of common stock by a
non-U.S. holder to or through the U.S. office of a broker generally will be
reported to the IRS and reduced by backup withholding unless the non-U.S. holder
either certifies its status as a non-U.S. holder under penalties of perjury or
otherwise establishes an exemption and the broker has no actual knowledge to the
contrary. The payment of the
58
proceeds on the disposition of common stock by a non-U.S. holder to or through a
non-U.S. office of a broker generally will not be reduced by backup withholding
or reported to the IRS. If, however, the broker is a U.S. person or has certain
enumerated connections with the U.S., the proceeds from such disposition
generally will be reported to the IRS (but not reduced by backup withholding)
unless certain conditions are met.
Backup withholding is not an additional tax. Any amounts that we withhold
under the backup withholding rules will be refunded or credited against the
non-U.S. holder's U.S. federal income tax liability if certain required
information is furnished to the IRS. Non-U.S. holders should consult their own
tax advisors regarding application of backup withholding in their particular
circumstance and the availability of and procedure for obtaining an exemption
from backup withholding under current U.S. Treasury regulations.
The foregoing discussion is included for general information only. Each
prospective purchaser is urged to consult his tax advisor with respect to the
United States federal income tax and federal estate tax consequences of the
ownership and disposition of common stock, including the application and effect
of the laws of any state, local, foreign or other taxing jurisdiction.
59
SHARES ELIGIBLE FOR FUTURE SALE
Prior to this offering, there has been no public market for our common
stock, and we cannot predict the effect, if any, that market sales of shares or
the availability of any shares for sale will have on the market price of the
common stock prevailing from time to time. Sales of substantial amounts of
common stock, or the perception that such sales could occur, could adversely
affect the market price of our common stock and our ability to raise capital
through a sale of our securities.
Upon completion of this offering, we will have 40,714,643 shares of common
stock outstanding (or 42,214,643 shares if the underwriters' over-allotment
option is exercised in full) of which 30,714,643 will be "restricted shares."
These shares will be eligible for sale in the public market after 180 days from
the date of this prospectus (subject, in some cases, to volume limitations).
The 10,000,000 shares (or up to 11,500,000 shares if the underwriters'
over-allotment option is exercised in full) of common stock sold in this
offering will be freely tradable without further restriction or further
registration under the Securities Act, except for shares purchased by an
affiliate (as this term is defined in the Securities Act) of ours, which will be
subject to the limitations of Rule 144 under the Securities Act. Subject to
certain contractual limitations, holders of restricted shares generally will be
entitled to sell these shares in the public securities market without
registration either pursuant to Rule 144 or any other applicable exemption under
the Securities Act.
In general, under Rule 144 under the Securities Act, a person (or persons
whose shares are aggregated) who has beneficially owned restricted securities
within the meaning of Rule 144 for at least one year, and including the holding
period of any prior owner except an affiliate, would be entitled to sell within
any three-month period a number of shares that does not exceed the greater of
one percent of the then outstanding shares of our common stock or the average
weekly trading volume of our common stock on the New York Stock Exchange during
the four calendar weeks preceding such sale. Sales under Rule 144 are also
subject to certain manner of sale provisions, notice requirements and the
availability of current public information about our company. Any person (or
persons whose shares are aggregated) who is not deemed to have been our
affiliate at any time during the three months preceding a sale, and who has
beneficially owned shares for at least two years (including any period of
ownership of preceding non-affiliated holders), would be entitled to sell such
shares under Rule 144(k) without regard to the volume limitations, manner of
sale provisions, public information requirements or notice requirements. An
"affiliate" is a person that directly, or indirectly through one or more
intermediaries, controls, or is controlled by, or under common control with, an
issuer.
After the date of this prospectus, we intend to file one or more
registration statements on Form S-8 under the Securities Act to register shares
of common stock subject to outstanding stock options or reserved for issuance
under our equity compensation plans. Upon completion of this offering, options
to purchase approximately 5,727,955 shares will be outstanding under our equity
compensation plans.
Our directors, executive officers, all of our existing stockholders and all
option holders have entered into lock-up agreements pursuant to which they have
agreed that they will not sell directly or indirectly, any shares of common
stock without the prior written consent of Banc of America Securities LLC for a
period of 180 days from the date of this prospectus.
We have granted registration rights to certain of our stockholders who hold
approximately 33,218,195 shares in the aggregate (including shares issuable upon
the exercise of outstanding options). Beginning 180 days after the date of this
offering, some of these stockholders can require us to file registration
statements that permit them to re-sell their shares. For more information, see
"Related Party Transactions -- Registration Rights Agreements."
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UNDERWRITING
We are offering the shares of common stock described in this prospectus
through a number of underwriters. Banc of America Securities LLC, UBS Warburg
LLC and J.P. Morgan Securities Inc. are the representatives of the underwriters.
We have entered into a firm commitment underwriting agreement with the
representatives. Subject to the terms and conditions of the underwriting
agreement, we have agreed to sell to the underwriters, and each underwriter has
agreed to purchase the number of shares of common stock listed next to its name
in the following table:
UNDERWRITER NUMBER OF SHARES
----------- ----------------
Banc of America Securities LLC..............................
UBS Warburg LLC.............................................
J.P. Morgan Securities Inc. ................................
-----------
Total.................................................. 10,000,000
===========
The underwriters initially will offer shares to the public at the price
specified on the cover page of this prospectus. The underwriters may allow to
some dealers a concession of not more than $ per share. The underwriters
also may allow, and any dealers may reallow, a concession of not more than
$ per share to some other dealers. If all the shares are not sold at the
initial public offering price, the underwriters may change the offering price
and the other selling terms. The common stock is offered subject to a number of
conditions, including:
- receipt and acceptance of our common stock by the underwriters; and
- the right to reject orders in whole or in part.
The underwriters have an option to buy up to 1,500,000 additional shares of
common stock from us to cover sales of shares by the underwriters which exceed
the number of shares specified in the table above. The underwriters have 30 days
to exercise this option. If the underwriters exercise this option, they will
each purchase additional shares approximately in proportion to the amounts
specified in the table above. We will pay the expenses associated with the
exercise of the over-allotment option.
The following table shows the per share and total underwriting discounts
and commissions to be paid to the underwriters assuming both no exercise and
full exercise of the underwriters' option to purchase
additional shares.
PAID BY AMN HEALTHCARE SERVICES, INC.
-------------------------------------
NO EXERCISE FULL EXERCISE
--------------- ----------------
Per share................................................... $ $
Total....................................................... $ $
We and our directors, executive officers, all of our existing stockholders
and all option holders have entered into lock-up agreements with the
underwriters. Under those agreements, we and those persons may not dispose of or
hedge any of our common stock or securities convertible into or exchangeable for
shares of our common stock unless permitted to do so by Banc of America
Securities LLC. These restrictions will be in effect for a period of 180 days
after the date of this prospectus. At any time and without notice, Banc of
America Securities LLC may, in its sole discretion, release all or some of the
securities from these lock-up agreements.
We will indemnify the underwriters against liabilities, including
liabilities under the Securities Act. If we are unable to provide this
indemnification, we will contribute to payments the underwriters may be required
to make in respect of those liabilities.
61
In connection with this offering, the underwriters may engage in
stabilizing transactions, which involves making bids for, purchasing and selling
shares of common stock in the open market for the purpose of preventing or
retarding a decline in the market price of the common stock while this offering
is in progress.
These stabilizing transactions may including making short sales of the
common stock, which involves the sale by the underwriters of a greater number of
shares of common stock than they are required to purchase in this offering, and
purchasing shares of common stock on the open market to cover positions created
by short sales. Short sales may be "covered" shorts, which are short positions
in an amount not greater than the underwriters' over-allotment option referred
to above, or may be "naked" shorts, which are short positions in excess of that
amount.
The underwriters may close out any covered short position either by
exercising their over-allotment option, in whole or in part, or by purchasing
shares in the open market. In making this determination, the underwriters will
consider, among other things, the price of shares available for purchase in the
open market compared to the price at which the underwriters may purchase shares
through the over-allotment option.
A naked short position is more likely to be created if the underwriters are
concerned that there may be downward pressure on the price of the common stock
in the open market that could adversely affect investors who purchased in this
offering. To the extent that the underwriters create a naked short position,
they will purchase shares in the open market to cover the position.
The underwriters may also engage in other activities that stabilize,
maintain or otherwise affect the price of the common stock, including the
imposition of penalty bids. This means that if the representatives of the
underwriters purchase common stock in the open market in stabilizing
transactions or to cover short sales, the representatives can require the
underwriters that sold those shares as part of this offering to repay the
underwriting discount received by them.
As a result of these activities, the price of the common stock may be
higher than the price that otherwise might exist in the open market. If the
underwriters commence these activities, they may discontinue them at any time.
The underwriters may carry out these transactions on the New York Stock
Exchange, in the over-the-counter-market or otherwise.
The underwriters do not expect sales to discretionary accounts to exceed
five percent of the total number of shares of common stock offered by this
prospectus.
Prior to this offering, there has been no public market for our common
stock. The initial public offering price has been negotiated between us and the
representatives. Among the factors considered in these negotiations were:
- the history of, and prospects for, our company and the industry in
which we compete;
- the past and present financial performance of our company;
- an assessment of our management;
- the present state of our development;
- the prospects for our future earnings;
- the prevailing market conditions of the applicable United States
securities market at the time of this offering;
- market valuations of publicly traded companies that we and the
representatives believe to be comparable to our company; and
- other factors deemed relevant.
The underwriters, at our request, have reserved for sale to certain of our
employees and affiliates at the initial public offering price up to five percent
of the shares being offered by this prospectus. The sale of shares to our
employees and affiliates will be made by UBS Warburg LLC. We do not know if our
employees or affiliates will choose to purchase all or any portion of these
reserved shares, but any purchases they do
62
make will reduce the number of shares available to the general public. If all of
these reserved shares are not purchased, the underwriters will offer the
remainder to the general public on the same terms as the other shares offered by
this prospectus.
Banc of America Securities LLC is an affiliate of Bank of America, N.A.,
which is the agent and a lender under our existing credit facility, and
BancAmerica Capital Investors SBIC I, L.P., one of our stockholders and the
holder of our senior subordinated notes. A portion of the net proceeds from this
offering will be used to repay our existing credit facility and our senior
subordinated notes. Following this offering, BancAmerica Capital Investors will
own approximately 6.9% of our common stock. BancAmerica Capital Investors is
also party to a registration rights agreement with us. See "Related Party
Transactions."
UBS AG, Stamford Branch, an affiliate of UBS Warburg LLC, is a lender under
our existing credit facility. A portion of the net proceeds from this offering
will be used to repay our existing credit facility. In addition, an affiliate of
Banc of America Securities LLC and an affiliate of J.P. Morgan Securities Inc.
hold limited partnership interests in certain HWP stockholders.
Banc of America Securities LLC and UBS Warburg LLC are both members of the
National Association of Securities Dealers, Inc. (NASD). Because we expect that
more than 10% of the net proceeds of this offering will be paid to affiliates of
Banc of America Securities LLC and UBS Warburg LLC under the existing credit
facility and the senior subordinated notes, and because an affiliate of Banc of
America Securities LLC is the holder of our senior subordinated notes, this
offering is being conducted in accordance with the applicable requirements of
Conduct Rule 2720 of the NASD regarding the underwriting of securities of a
company with which a member has a conflict of interest within the meaning of
that rule. Conduct Rule 2720(c)(3) requires that the public offering price of an
equity security must be no higher than the price recommended by a qualified
independent underwriter which has participated in the preparation of the
registration statement and performed its usual standard of due diligence in
connection with that preparation. J.P. Morgan Securities Inc. has agreed to act
as qualified independent underwriter with respect to this offering. The public
offering price of our common stock will be no higher than that recommended by
J.P. Morgan Securities Inc. J.P. Morgan Securities Inc. will not receive any
compensation for acting in this capacity in connection with this offering;
however, we have agreed to indemnify J.P. Morgan Securities Inc. in its capacity
as qualified independent underwriter against certain liabilities under the
Securities Act of 1933. Additionally, in accordance with Conduct Rule 2720(l),
no member of the NASD participating in the offering will execute a transaction
in the common stock in a discretionary account without the prior specific
written approval of the member's customer.
LEGAL MATTERS
Paul, Weiss, Rifkind, Wharton & Garrison, New York, New York will pass on
the validity of the common stock offered by this prospectus for us. Latham &
Watkins, New York, New York, will pass upon certain legal matters in connection
with this offering for the underwriters. Paul, Weiss, Rifkind, Wharton &
Garrison has represented the HWP stockholders from time to time and Latham &
Watkins has represented us and our senior management from time to time.
EXPERTS
The consolidated financial statements and schedule of AMN Healthcare
Services, Inc. and subsidiaries as of December 31, 1999 and 2000 and for each of
the years in the two-year period ended December 31, 2000, have been included
herein and in the registration statement in reliance upon the report of KPMG
LLP, independent certified public accountants, appearing elsewhere herein, and
upon the authority of said firm as experts in accounting and auditing.
The consolidated statements of operations, stockholders equity and cash
flows included in the prospectus and the related financial statement schedule
included elsewhere in the registration statement of AMN Healthcare Services,
Inc. and subsidiary (formerly AMN Holdings, Inc.) for the year ended December
31, 1998 have been audited by Deloitte & Touche LLP, independent auditors, as
stated in their reports appearing herein
63
and elsewhere in the registration statement, and are included in reliance upon
the reports of such firm given upon their authority as experts in accounting and
auditing.
The financial statements of Nurses RX, Inc. as of December 31, 1998 and
1999 and for each of the years in the two-year period ended December 31, 1999,
have been included herein and in the registration statement in reliance upon the
report of DDK & Company LLP, independent certified public accountants, appearing
elsewhere herein, and upon the authority of said firm as experts in accounting
and auditing.
The financial statements of Preferred Healthcare Staffing, Inc. as of
December 31, 1999 and November 30, 2000 and for the years ended December 31,
1998 and 1999 and the eleven months ended November 30, 2000, have been included
herein and in the registration statement in reliance upon the report of KPMG
LLP, independent certified public accountants, appearing elsewhere herein, and
upon the authority of said firm as experts in accounting and auditing.
The financial statements of O'Grady-Peyton International (USA), Inc. as of
December 31, 1999 and 2000 and for each of the years in the two-year period
ended December 31, 2000, have been included herein and in the registration
statement in reliance upon the report of KPMG LLP, independent certified public
accountants, appearing elsewhere herein, and upon the authority of said firm as
experts in accounting and auditing.
CHANGE OF ACCOUNTANTS
In February 2000, in connection with our recapitalization, our board of
directors elected to change our independent auditors from Deloitte & Touche LLP
to KMPG LLP. In connection with Deloitte & Touche LLP's audit of the financial
statements for the year ended December 31, 1998, there were no disagreements
with Deloitte & Touche LLP on any matters of accounting principles or practices,
financial statement disclosures or auditing scope or procedures, nor any
reportable events. Deloitte & Touche LLP's report on our financial statements
for the year ended December 31, 1998 contained no adverse opinions or
disclaimers of opinion and was not modified or qualified as to uncertainty,
audit scope or accounting principles. We have provided Deloitte & Touche LLP
with a copy of the disclosure contained in this section of the prospectus. Prior
to retaining KPMG LLP, we did not consult with KPMG LLP regarding the
application of accounting principles to a specified transaction or the type of
audit opinion that might be rendered on our financial statements.
WHERE YOU CAN FIND MORE INFORMATION
We have filed a registration statement on Form S-1 with the Securities and
Exchange Commission for the common stock we are offering by this prospectus.
This prospectus does not include all of the information contained in the
registration statement. You should refer to the registration statement and its
exhibits for additional information. Whenever we make reference in this
prospectus to any of our contracts, agreements or other documents, the
references are not necessarily complete and you should refer to the exhibits
attached to the registration statement for copies of the actual contract,
agreement or other document. When we complete this offering, we will also be
required to file annual, quarterly and special reports, proxy statements and
other information with the Securities and Exchange Commission.
You can read our Securities and Exchange Commission filings, including the
registration statement, over the Internet at the Securities and Exchange
Commission's website at http://www.sec.gov. You may also read and copy any
document we file with the Securities and Exchange Commission at its public
reference facilities at 450 Fifth Street, N.W., Washington, D.C. 20549. You may
also obtain copies of these documents at prescribed rates by calling the Public
Reference Section of the Securities and Exchange Commission at 1-800-SEC-0330
for further information on the operation of the public reference facilities.
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INDEX TO CONSOLIDATED FINANCIAL STATEMENTS
PAGE
----
AMN HEALTHCARE SERVICES, INC.
Independent Auditors' Report for the year ended December 31,
1998...................................................... F-2
Independent Auditors' Report for the years ended December
31, 1999 and 2000......................................... F-3
Consolidated Balance Sheets as of December 31, 1999, 2000
and September 30, 2001 (unaudited)........................ F-4
Consolidated Statements of Operations for the years ended
December 31, 1998, 1999 and 2000 and for the nine months
ended September 30, 2000 (unaudited) and 2001
(unaudited)............................................... F-5
Consolidated Statements of Stockholders' Equity for the
years ended December 31, 1998, 1999 and 2000 and for the
nine months ended September 30, 2001 (unaudited).......... F-6
Consolidated Statements of Cash Flows for the years ended
December 31, 1998, 1999 and 2000 and for the nine months
ended September 30, 2000 (unaudited) and 2001
(unaudited)............................................... F-7
Notes to Consolidated Financial Statements.................. F-8 to F-23
NURSES RX, INC.
Independent Auditors' Report................................ F-24
Balance Sheets as of December 31, 1998 and 1999............. F-25
Statements of Income and Retained Earnings for the years
ended December 31, 1998 and 1999.......................... F-26
Statements of Cash Flows for the years ended December 31,
1998 and 1999............................................. F-27
Notes to Financial Statements............................... F-28 to F-30
PREFERRED HEALTHCARE STAFFING, INC.
Independent Auditors' Report................................ F-31
Balance Sheets as of December 31, 1999 and November 30,
2000...................................................... F-32
Statements of Operations for the years ended December 31,
1998 and 1999 and for the eleven months ended November 30,
2000...................................................... F-33
Statements of Shareholder's Equity for the years ended
December 31, 1998 and 1999 and for the eleven months ended
November 30, 2000......................................... F-34
Statements of Cash Flows for the years ended December 31,
1998 and 1999 and for the eleven months ended November 30,
2000...................................................... F-35
Notes to Financial Statements............................... F-36 to F-42
O'GRADY-PEYTON INTERNATIONAL (USA), INC.
Independent Auditors' Report................................ F-43
Consolidated Balance Sheets as of December 31, 1999, 2000
and March 31, 2001 (unaudited)............................ F-44
Consolidated Statements of Income for the years ended
December 31, 1999 and 2000 and for the three months ended
March 31, 2000 (unaudited) and 2001 (unaudited)........... F-45
Consolidated Statements of Shareholders' Equity for the
years ended December 31, 1999 and 2000 and for the three
months ended March 31, 2001 (unaudited)................... F-46
Consolidated Statements of Cash Flows for the years ended
December 31, 1999 and 2000 and for the three months ended
March 31, 2000 (unaudited) and 2001 (unaudited)........... F-47
Notes to Consolidated Financial Statements.................. F-48 to F-51
F-1
INDEPENDENT AUDITORS' REPORT
To the Board of Directors and Stockholders
AMN Healthcare Services, Inc.:
We have audited the accompanying consolidated statements of operations,
stockholders' equity and cash flows of AMN Healthcare Services, Inc. and
subsidiary, formerly AMN Holdings, Inc. (the Company) for the year ended
December 31, 1998. These financial statements are the responsibility of the
Company's management. Our responsibility is to express an opinion on these
financial statements based on our audit.
We conducted our audit in accordance with auditing standards generally
accepted in the United States of America. Those standards require that we plan
and perform the audit to obtain reasonable assurance about whether the financial
statements are free of material misstatement. An audit includes examining, on a
test basis, evidence supporting the amounts and disclosures in the financial
statements. An audit also includes assessing the accounting principles used and
significant estimates made by management, as well as evaluating the overall
financial statement presentation. We believe that our audit provides a
reasonable basis for our opinion.
In our opinion, the 1998 consolidated financial statements referred to
above present fairly, in all material respects, the results of operations and
cash flows of AMN Healthcare Services, Inc. and subsidiary for the year ended
December 31, 1998 in conformity with accounting principles generally accepted in
the United States of America.
DELOITTE & TOUCHE LLP
San Diego, California
September 23, 1999
F-2
INDEPENDENT AUDITORS' REPORT
The Board of Directors and Stockholders
AMN Healthcare Services, Inc.:
We have audited the accompanying consolidated balance sheets of AMN
Healthcare Services, Inc. and subsidiaries, formerly AMN Holdings, Inc., (the
Company), as of December 31, 1999 and 2000, and the related consolidated
statements of operations, stockholders' equity, and cash flows for each of the
years in the two-year period ended December 31, 2000. These consolidated
financial statements are the responsibility of the Company's management. Our
responsibility is to express an opinion on these consolidated financial
statements based on our audits.
We conducted our audits in accordance with auditing standards generally
accepted in the United States of America. Those standards require that we plan
and perform the audit to obtain reasonable assurance about whether the financial
statements are free of material misstatement. An audit includes examining, on a
test basis, evidence supporting the amounts and disclosures in the financial
statements. An audit also includes assessing the accounting principles used and
significant estimates made by management, as well as evaluating the overall
financial statement presentation. We believe that our audits provide a
reasonable basis for our opinion.
In our opinion, the consolidated financial statements referred to above
present fairly, in all material respects, the financial position of AMN
Healthcare Services, Inc. and subsidiaries as of December 31, 1999 and 2000, and
the results of their operations and their cash flows for each of the years in
the two-year period ended December 31, 2000, in conformity with accounting
principles generally accepted in the United States of America.
KPMG LLP
San Diego, California
March 29, 2001, except as to Note 12,
which is as of October 18, 2001
F-3
AMN HEALTHCARE SERVICES, INC.
CONSOLIDATED BALANCE SHEETS
(IN THOUSANDS, EXCEPT PAR VALUE)
DECEMBER 31, DECEMBER 31, SEPTEMBER 30,
1999 2000 2001
------------ ------------ -------------
(UNAUDITED)
ASSETS
Current assets:
Cash and cash equivalents.......................... $ 503 $ 546 $ 3,953
Accounts receivable, net........................... 26,178 63,401 88,297
Income taxes receivable............................ 3,036 -- --
Other current assets............................... 2,379 4,812 8,071
-------- -------- --------
Total current assets....................... 32,096 68,759 100,321
Fixed assets, net.................................... 2,242 5,006 6,687
Deferred income taxes................................ 838 10,565 17,133
Deposits............................................. 36 102 141
Goodwill, net........................................ 39,365 118,423 125,864
Other intangibles, net............................... 5,301 6,555 6,068
-------- -------- --------
Total assets............................... $ 79,878 $209,410 $256,214
======== ======== ========
LIABILITIES AND STOCKHOLDERS' EQUITY
Current liabilities:
Book overdraft..................................... $ 1,005 $ 556 $ 1,597
Accounts payable and accrued expenses.............. 961 2,431 4,360
Accrued compensation and benefits.................. 4,299 11,017 20,466
Income taxes payable............................... -- 1,745 6,271
Due to former shareholder.......................... 1,676 342 --
Current portion of notes payable................... 2,500 7,500 13,125
Other current liabilities.......................... -- 1,019 1,849
-------- -------- --------
Total current liabilities.................. 10,441 24,610 47,668
Notes payable, less current portion.................. 71,506 115,389 122,717
Other long-term liabilities.......................... 42 2,341 1,563
-------- -------- --------
Total liabilities.......................... 81,989 142,340 171,948
-------- -------- --------
Stockholders' equity:
Common stock, $.01 par value; 200,000 shares
authorized; 20,375, 28,835, and 28,835 shares
issued and outstanding at December 31, 1999 and
2000, and September 30, 2001, respectively...... 204 288 288
Additional paid-in capital......................... 62,440 136,735 149,831
Accumulated deficit................................ (64,755) (69,953) (65,375)
Accumulated other comprehensive loss............... -- -- (478)
-------- -------- --------
Total stockholders' equity (deficit)....... (2,111) 67,070 84,266
-------- -------- --------
Commitments and contingencies
Total liabilities and stockholders'
equity................................... $ 79,878 $209,410 $256,214
======== ======== ========
See accompanying notes to consolidated financial statements.
F-4
AMN HEALTHCARE SERVICES, INC.
CONSOLIDATED STATEMENTS OF OPERATIONS
(IN THOUSANDS, EXCEPT PER SHARE AMOUNTS)
NINE MONTHS ENDED
YEARS ENDED DECEMBER 31, SEPTEMBER 30,
----------------------------- -------------------------
1998 1999 2000 2000 2001
------- -------- -------- ----------- -----------
(UNAUDITED) (UNAUDITED)
Revenue..................................... $87,718 $146,514 $230,766 $151,713 $357,108
Cost of revenue............................. 67,244 111,784 170,608 112,729 267,333
------- -------- -------- -------- --------
Gross profit........................... 20,474 34,730 60,158 38,984 89,775
------- -------- -------- -------- --------
Expenses:
Selling, general and administrative,
excluding non-cash stock-based
compensation........................... 12,804 20,677 30,728 19,770 49,750
Non-cash stock-based compensation......... -- -- 22,379 15,901 13,096
Amortization.............................. 1,163 1,721 2,387 1,504 4,128
Depreciation.............................. 171 325 916 605 1,484
Transaction costs......................... -- 12,404 1,500 -- --
------- -------- -------- -------- --------
Total expenses......................... 14,138 35,127 57,910 37,780 68,458
------- -------- -------- -------- --------
Income (loss) from operations.......... 6,336 (397) 2,248 1,204 21,317
Interest expense, net....................... 2,476 4,030 10,006 7,043 11,780
------- -------- -------- -------- --------
Income (loss) before minority interest,
income taxes, and extraordinary
item................................. 3,860 (4,427) (7,758) (5,839) 9,537
Minority interest in earnings of
subsidiary................................ (657) (1,325) -- -- --
Income tax (expense) benefit................ (1,571) 872 2,560 1,927 (4,959)
------- -------- -------- -------- --------
Income (loss) before extraordinary
item................................. 1,632 (4,880) (5,198) (3,912) 4,578
Extraordinary loss on early extinguishment
of debt, net of income tax benefit of
$427...................................... -- (730) -- -- --
------- -------- -------- -------- --------
Net income (loss)...................... $ 1,632 $ (5,610) $ (5,198) $ (3,912) $ 4,578
======= ======== ======== ======== ========
Basic net income (loss) per common share:
Income (loss) before extraordinary item... $ 0.09 $ (0.23) $ (0.23) $ (0.18) $ 0.16
Extraordinary loss........................ -- (0.03) -- -- --
------- -------- -------- -------- --------
Basic net income (loss) per common
share................................ $ 0.09 $ (0.26) $ (0.23) $ (0.18) $ 0.16
======= ======== ======== ======== ========
Diluted net income (loss) per common share:
Income (loss) before extraordinary item... $ 0.09 $ (0.23) $ (0.23) $ (0.18) $ 0.15
Extraordinary loss........................ -- (0.03) -- -- --
------- -------- -------- -------- --------
Diluted net income (loss) per common
share................................ $ 0.09 $ (0.26) $ (0.23) $ (0.18) $ 0.15
======= ======== ======== ======== ========
Weighted average common shares outstanding:
Basic..................................... 17,751 21,715 22,497 21,491 28,835
======= ======== ======== ======== ========
Diluted................................... 17,751 21,715 22,497 21,491 31,431
======= ======== ======== ======== ========
See accompanying notes to consolidated financial statements.
F-5
AMN HEALTHCARE SERVICES, INC.
CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY
YEARS ENDED DECEMBER 31, 1998, 1999 AND 2000 AND FOR
THE NINE MONTHS ENDED SEPTEMBER 30, 2001 (UNAUDITED)
(IN THOUSANDS)
RETAINED ACCUMULATED
COMMON STOCK ADDITIONAL EARNINGS OTHER
----------------- PAID-IN (ACCUMULATED COMPREHENSIVE
SHARES AMOUNT CAPITAL DEFICIT) INCOME (LOSS) TOTAL
------- ------ ---------- ------------ ------------- --------
Balance, December 31, 1997........ 17,243 $ 172 $ 12,228 $ (53) $ -- $ 12,347
Issuance of stock for cash........ 1,577 16 2,034 -- -- 2,050
Issuance of common stock.......... 2,631 26 3,422 -- -- 3,448
Net income........................ -- -- -- 1,632 -- 1,632
------- ----- -------- -------- ----- --------
Balance, December 31, 1998........ 21,451 214 17,684 1,579 -- 19,477
Repurchase of common stock........ (21,187) (212) (19,143) (62,915) -- (82,270)
Issuance of common stock in
exchange for minority
interest........................ 4,464 45 1,537 2,191 -- 3,773
Issuance of common stock.......... 15,647 157 59,362 -- -- 59,519
Issuance of warrants.............. -- -- 3,000 -- -- 3,000
Net loss.......................... -- -- -- (5,610) -- (5,610)
------- ----- -------- -------- ----- --------
Balance, December 31, 1999........ 20,375 204 62,440 (64,755) -- (2,111)
Issuance of common stock.......... 8,460 84 51,916 -- -- 52,000
Stock-based compensation.......... -- -- 22,379 -- -- 22,379
Net loss.......................... -- -- -- (5,198) -- (5,198)
------- ----- -------- -------- ----- --------
Balance, December 31, 2000........ 28,835 288 136,735 (69,953) -- 67,070
Stock-based compensation
(unaudited)..................... -- -- 13,096 -- -- 13,096
Net income (unaudited)............ -- -- -- 4,578 -- 4,578
Comprehensive income (loss):
SFAS No. 133 (derivatives)
transition adjustment
(unaudited)..................... -- -- -- -- (589) (589)
Amortization of SFAS No. 133
transition adjustment
(unaudited)..................... -- -- -- -- 111 111
--------
Total comprehensive loss
(unaudited)..................... -- -- -- -- -- (478)
------- ----- -------- -------- ----- --------
Balance, September 30, 2001
(unaudited)..................... 28,835 $ 288 $149,831 $(65,375) $(478) $ 84,266
======= ===== ======== ======== ===== ========
See accompanying notes to consolidated financial statements.
F-6
AMN HEALTHCARE SERVICES, INC.
CONSOLIDATED STATEMENTS OF CASH FLOWS
(IN THOUSANDS)
NINE MONTHS ENDED
YEARS ENDED DECEMBER 31, SEPTEMBER 30,
------------------------------ -------------------------
1998 1999 2000 2000 2001
-------- -------- -------- ----------- -----------
(UNAUDITED) (UNAUDITED)
Cash flows from operating activities:
Net income (loss)......................................... $ 1,632 $ (5,610) $ (5,198) $ (3,912) $ 4,578
Adjustments to reconcile net income (loss) to net cash
provided by (used in) operating activities:
Depreciation and amortization........................... 1,334 2,046 3,303 2,109 5,612
Minority interest in earnings of subsidiary............. 657 1,325 -- -- --
Debt extinguishment before income tax benefit........... -- 1,157 -- -- --
Provision for bad debts................................. 30 260 435 169 2,100
Noncash interest expense................................ 163 633 4,188 3,066 4,068
Deferred income taxes................................... 350 (1,196) (9,727) (6,003) (6,376)
Stock-based compensation................................ -- -- 22,379 15,901 13,096
Loss on disposal of fixed assets........................ 31 1 17 (1) (1)
Changes in assets and liabilities, net of effects from
acquisitions:
Accounts receivable................................... (2,420) (7,847) (23,572) (11,829) (21,499)
Income taxes receivable and other current assets...... (411) (2,976) 1,921 1,326 (2,985)
Deposits.............................................. 107 (36) (63) -- (39)
Accounts payable and accrued expenses................. (301) (232) 68 74 1,984
Accrued compensation and benefits..................... (161) 1,195 3,772 2,540 8,234
Income taxes payable.................................. -- -- 1,745 965 3,568
Due to former shareholder............................. -- 1,676 (1,334) -- (1,940)
Other liabilities..................................... -- 42 480 36 32
-------- -------- -------- -------- --------
Net cash provided by (used in) operating
activities........................................ 1,011 (9,562) (1,586) 4,441 10,432
-------- -------- -------- -------- --------
Cash flows from investing activities:
Purchase of fixed assets.................................. (690) (1,656) (2,358) (1,865) (2,880)
Proceeds from disposal of fixed assets.................... 3 -- 8 -- --
Acquisitions, including acquisition costs................. (15,995) -- (91,793) (16,440) (12,976)
-------- -------- -------- -------- --------
Net cash used in investing activities............... (16,682) (1,656) (94,143) (18,305) (15,856)
-------- -------- -------- -------- --------
Cash flows from financing activities:
Capital lease repayments.................................. -- -- (18) (11) (59)
Proceeds from issuance of notes payable................... 71,426 76,675 48,180 2,167 18,000
Payment of financing costs................................ (423) (5,338) (1,405) -- (629)
Payments on notes payable................................. (58,980) (37,596) (2,500) (1,440) (9,522)
Repurchase of common stock................................ -- (82,270) -- -- --
Proceeds from issuance of common stock.................... 2,050 59,519 52,000 12,000 --
Proceeds from issuance of stock by AMN.................... 200 -- -- -- --
Change in book overdraft, net of effects of
acquisitions............................................ 1,162 (157) (485) 845 1,041
-------- -------- -------- -------- --------
Net cash provided by (used in) financing
activities........................................ 15,435 10,833 95,772 13,561 8,831
-------- -------- -------- -------- --------
Net increase (decrease) in cash and cash equivalents........ (236) (385) 43 (303) 3,407
Cash and cash equivalents at beginning of period............ 1,124 888 503 503 546
-------- -------- -------- -------- --------
Cash and cash equivalents at end of period.................. $ 888 $ 503 $ 546 $ 200 $ 3,953
======== ======== ======== ======== ========
Supplemental disclosures of cash flow information:
Cash paid for interest (net of $0, $36, $58, $4
(unaudited) and $46 (unaudited) capitalized in 1998,
1999 and 2000, and during the nine months ended
September 30, 2000 and 2001, respectively).............. $ 2,298 $ 3,269 $ 5,853 $ 3,946 $ 7,168
======== ======== ======== ======== ========
Cash paid for income taxes................................ $ 2,357 $ 2,723 $ 4,640 $ 2,096 $ 6,816
======== ======== ======== ======== ========
Supplemental disclosures of noncash investing and financing
activities:
Common stock issued in exchange for minority interest..... $ -- $ 3,773 $ -- $ -- $ --
======== ======== ======== ======== ========
Accrued interest on notes payable converted to notes
payable................................................. $ -- $ 273 $ 2,544 $ 2,238 $ 2,476
======== ======== ======== ======== ========
Fixed assets obtained through capital leases.............. $ -- $ -- $ 109 $ 62 $ 54
======== ======== ======== ======== ========
Fair value of assets acquired in acquisitions, net of cash
received................................................ $ 5,732 $ -- $ 16,644 $ 4,239 $ 6,205
Goodwill.................................................. 15,332 -- 81,315 15,484 11,325
Noncompete covenants...................................... -- -- 1,036 836 200
Liabilities assumed....................................... (1,622) -- (4,693) (1,610) (4,754)
Present value of deferred purchase payments............... -- -- (2,509) (2,509) --
Common stock issued in connection with acquisition........ (3,447) -- -- -- --
-------- -------- -------- -------- --------
Net cash paid for acquisitions...................... $ 15,995 $ -- $ 91,793 $ 16,440 $ 12,976
======== ======== ======== ======== ========
See accompanying notes to consolidated financial statements.
F-7
AMN HEALTHCARE SERVICES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
DECEMBER 31, 1998, 1999, AND 2000
(1) SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
(a) General
On April 19, 2001, AMN Holdings, Inc. changed its name to AMN Healthcare
Services, Inc. (Services). Services was incorporated in Delaware on November 10,
1997. On December 4, 1997, Services acquired 80% of the outstanding common stock
of AMN Healthcare, Inc. (AMN). On November 18, 1998, AMN purchased 100% of
Medical Express, Inc. (MedEx). Pursuant to a share exchange completed on October
18, 1999, AMN became a wholly owned subsidiary of Services. On June 28, 2000,
AMN purchased 100% of Nurses RX, Inc. (NRx). On November 28, 2000, AMN purchased
100% of Preferred Healthcare Staffing, Inc. (PHS). On May 1, 2001, AMN purchased
100% of O'Grady-Peyton International (USA), Inc. (OGP). Services, AMN, MedEx,
NRx, PHS and OGP collectively are referred to herein as the Company. The Company
recruits nurses and allied health professionals and places them on temporary
assignments at hospitals and other healthcare facilities throughout the United
States.
(b) Principles of Consolidation
The accompanying consolidated financial statements include the accounts of
Services, AMN, MedEx, NRx, PHS and OGP. All significant intercompany balances
and transactions have been eliminated in consolidation.
(c) Interim Financial Information (unaudited)
The interim financial statements of the Company as of September 30, 2001
and for the nine months ended September 30, 2000 and June 30, 2001, included
herein, have been prepared by the Company, without audit, pursuant to the rules
and regulations of the Securities and Exchange Commission (SEC). The unaudited
interim financial statements include all adjustments, consisting of normal
recurring adjustments, considered necessary for a fair presentation of the
results for the interim periods presented. Certain information and footnote
disclosures normally included in the financial statements prepared in accordance
with generally accepted accounting principles have been condensed or omitted
pursuant to such rules and regulations relating to interim financial statements.
In the opinion of management, the accompanying unaudited statements reflect all
adjustments necessary to present fairly the results of its operations and its
cash flows for the nine months ended September 30, 2000 and September 30, 2001.
(d) Minority Interest
On October 18, 1999, the minority stockholder of AMN exchanged its shares
of AMN for shares of Services resulting in the elimination of the minority
interest in AMN and the consolidation of all of the AMN shareholder interests in
the Services shareholder group. Services' only asset was its investment in AMN,
and no other assets or consideration was exchanged in this transaction. The
relative ownership interests in Services and AMN before and after this event
remained the same. Following this exchange, AMN became a wholly owned
subsidiary. The exchange of shares was accounted for at historical cost and
purchase accounting was not applied. The assets, liabilities and earnings of AMN
and its subsidiary, MedEx, are consolidated in the accompanying financial
statements, and the ownership interests of the minority stockholder of AMN is
reported as minority interest through October 18, 1999.
(e) Cash and Cash Equivalents
The Company considers all highly liquid investments with an original
maturity of three months or less to be cash equivalents. Cash and cash
equivalents include currency on hand and deposits with financial institutions.
At December 31, 1999 and 2000, and at September 30, 2001, the Company had
$174,000, $434,000, and $2,789,000 (unaudited) respectively, in deposits with
major financial institutions that exceeded the federally insured limit of
$100,000.
F-8
AMN HEALTHCARE SERVICES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
(f) Fixed Assets
Furniture, equipment, leasehold improvements and software are stated at
cost. Equipment acquired under capital leases are stated at the present value of
the future minimum lease payments. Additions and improvements are capitalized,
maintenance and repairs are expensed when incurred. Depreciation on furniture
and equipment is calculated using the straight-line method based on the
estimated useful lives of the related assets (generally five years). Leasehold
improvements and equipment obtained under capital leases are amortized over the
shorter of the term of the lease or the useful life. Amortization of equipment
obtained under capital leases is included in depreciation in the accompanying
consolidated financial statements. Software is amortized over the estimated
useful life (generally three years).
(g) Goodwill
The excess of purchase price over the fair value of the net assets of
entities acquired is recorded as goodwill and amortized on a straight-line basis
over the estimated period of future benefit of 25 years. The Company assesses
the recoverability of this intangible asset by determining whether the
amortization of the goodwill balance over its remaining life can be recovered
through future operating cash flows of the acquired operation. The amount of
goodwill impairment, if any, is measured based on the projected discounted
future operating cash flows using a discount rate reflecting the Company's
average cost of funds. The assessment of the recoverability of goodwill will be
impacted if estimated future operating cash flows are not achieved.
(h) Debt Issuance Costs
Debt issuance costs related to the notes payable are deferred and amortized
to interest expense using the effective interest method over the respective term
of the notes.
(i) Concentration of Credit Risk
Most of the Company's business activity is with hospitals located
throughout the United States. Credit is extended based on the evaluation of each
entity's financial condition and collateral is generally not required. Credit
losses have been within management's expectations.
(j) Revenue Recognition
Revenue is recognized in the period in which services are provided.
Provisions for discounts to customers and other adjustments are provided for in
the period the related revenue is recorded.
(k) Advertising Expenses
The Company's policy is to expense advertising costs as incurred.
(l) Income Taxes
The Company records income taxes using the asset and liability method of
accounting for income taxes. Under the asset and liability method, deferred tax
assets and liabilities are recognized for the future tax consequences
attributable to differences between the financial statement carrying amounts of
existing assets and liabilities and their respective tax basis. Deferred tax
assets and liabilities are measured using enacted tax rates expected to apply to
taxable income in the years in which those temporary differences are expected to
be recovered or settled. The effect on deferred tax assets and liabilities of a
change in tax rates is recognized in operations in the period that includes the
enactment date.
F-9
AMN HEALTHCARE SERVICES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
(m) Impairment of Long-Lived Assets
Long-lived assets and certain identifiable intangibles are reviewed for
impairment whenever events or changes in circumstances indicate that the
carrying amount of an asset may not be recoverable. Recoverability of assets to
be held and used is measured by a comparison of the carrying amount of an asset
to future net cash flows, undiscounted and without interest, expected to be
generated by the asset. If such assets are considered to be impaired, the
impairment to be recognized is measured by the amount by which the carrying
amount of the assets exceeds the fair value of the assets. Assets to be disposed
of are reported at the lower of the carrying amount or fair value less costs to
sell.
(n) Common Stock Split
On November 19, 1999, the Company effected a 200-for-1 stock split of its
common stock. All references in the consolidated financial statements to number
of shares outstanding, price per share and per share amounts related to Services
have been retroactively restated to reflect the stock split for all periods
presented (See also Note 12).
(o) Stock-Based Compensation
The Company applies the intrinsic value-based method of accounting
prescribed by Accounting Principles Board (APB) Opinion No. 25, Accounting for
Stock Issued to Employees, and related interpretations including Financial
Accounting Standards Board (FASB) Interpretation No. 44, Accounting for Certain
Transactions involving Stock Compensation an interpretation of APB Opinion No.
25 issued in March 2000, to account for its stock option plans. Under this
method, compensation expense is recorded on the date of grant only if the
current market price of the underlying stock exceeded the exercise price. SFAS
No. 123, Accounting for Stock-Based Compensation, established accounting and
disclosure requirements using a fair value-based method of accounting for
stock-based employee compensation plans. As allowed by SFAS No. 123, the Company
has elected to continue to apply the intrinsic value-based method of accounting
described above, and has adopted the disclosure requirements of SFAS No. 123.
(p) Net Income (Loss) per Common Share
Basic net income (loss) per common share is calculated by dividing net
income (loss) by the weighted average number of common shares outstanding during
the reporting period. Diluted net income (loss) per common share reflects the
effects of potentially dilutive securities. Net income (loss) and weighted
average shares used to compute net income (loss) per share are presented below
(in thousands, except per share amounts):
NINE MONTHS
YEARS ENDED DECEMBER 31, ENDED SEPTEMBER 30,
-------------------------- -------------------------
1998 1999 2000 2000 2001
------ ------- ------- ----------- -----------
(UNAUDITED) (UNAUDITED)
Net income (loss)....................... $1,632 $(5,610) $(5,198) $(3,912) $4,578
====== ======= ======= ======= ======
Weighted average shares, basic.......... 17,751 21,715 22,497 21,491 28,835
Dilutive effect of stock options........ -- -- -- -- 716
Dilutive effect of warrants............. -- -- -- -- 1,880
------ ------- ------- ------- ------
Weighted average shares, dilutive....... 17,751 21,715 22,497 21,491 31,431
====== ======= ======= ======= ======
Basic net income (loss) per share....... $ 0.09 $ (0.26) $ (0.23) $ (0.18) $ 0.16
====== ======= ======= ======= ======
Diluted net income (loss) per share..... $ 0.09 $ (0.26) $ (0.23) $ (0.18) $ 0.15
====== ======= ======= ======= ======
F-10
AMN HEALTHCARE SERVICES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
Options to purchase 3,838,000 shares of common stock at December 31, 2000,
and warrants to purchase 2,518,000 shares of common stock at December 31, 1999
and 2000 and September 30, 2000 were not included in the calculation of diluted
net (loss) per common share because the effect of these instruments was
anti-dilutive.
(q) Other Comprehensive Income
SFAS No. 130, Reporting Comprehensive Income, establishes rules for the
reporting of comprehensive income and its components. The Company's net income
(loss) is the same as comprehensive income (loss) for the years ended December
31, 1998, 1999, and 2000 and for the nine month period ended September 30, 2000.
Comprehensive (loss) for the nine months ended September 30, 2001 includes a
$478,000 (unaudited) unrealized loss on derivative instruments.
(r) New Accounting Pronouncements
In June 1998, the FASB issued SFAS No. 133, Accounting for Derivative
Instruments and Hedging Activities. This statement, as amended, establishes
accounting and reporting standards requiring that all derivative instruments
(including certain derivative instruments embedded in other contracts) be
recorded in the balance sheet as either an asset or a liability measured at its
fair value. This statement requires that changes in the derivative's fair value
be recognized currently in earnings unless specific hedge accounting criteria
are met. The accounting provisions for qualifying hedges allow a derivative's
gains and losses to offset related results of the hedged item in the income
statement and require that the Company must formally document, designate and
assess the effectiveness of transactions that qualify for hedge accounting.
The impact of SFAS No. 133, which was adopted by the Company on January 1,
2001, resulted in a transition adjustment to other comprehensive loss as of
January 1, 2001 in the amount of $589,000 (unaudited), and charge to net income
for the nine month period ended September 30, 2001 in the amount of $348,000
(unaudited).
In July 2001, the FASB issued SFAS No. 141, Business Combinations, and SFAS
No. 142, Goodwill and Other Intangible Assets. SFAS No. 141 requires that the
purchase method of accounting be used for all business combinations initiated
after June 30, 2001 as well as all purchase method business combinations
completed after June 30, 2001. SFAS No. 141 also specifies the criteria that
intangible assets acquired in a purchase method business combination must meet
to be recognized and reported apart from goodwill, noting that any purchase
price allocable to an assembled workforce may not be accounted for separately.
SFAS No. 142 will require that goodwill and intangible assets with indefinite
useful lives no longer be amortized, but instead tested for impairment at least
annually in accordance with the provisions of SFAS No. 142. SFAS No. 142 will
also require that intangible assets with definite useful lives be amortized over
their respective estimated useful lives to their estimated residual values, and
reviewed for impairment in accordance with SFAS No. 121, Accounting for the
Impairment of Long-Lived Assets and for Long-Lived Assets to Be Disposed Of.
We are required to adopt the provisions of SFAS No. 141 immediately and
SFAS No. 142 effective January 1, 2002. Furthermore, any goodwill and any
intangible asset determined to have an indefinite useful life that are acquired
in a purchase business combination completed after June 30, 2001 will not be
amortized, but instead tested for impairment at least annually in accordance
with the provisions of SFAS No. 142. Goodwill and intangible assets acquired in
business combinations completed before July 1, 2001 will continue to be
amortized prior to the adoption of SFAS No. 142.
SFAS No. 141 will require, upon adoption of SFAS No. 142, that we evaluate
existing intangible assets and goodwill that were acquired in prior purchase
business combinations, and make any necessary reclassifications in order to
conform with the new criteria in SFAS No. 141 for recognition apart from
F-11
AMN HEALTHCARE SERVICES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
goodwill. Upon adoption of SFAS No. 142, we will be required to reassess the
useful lives and residual values of all intangible assets acquired in purchase
business combinations, and make any necessary amortization period adjustments by
the end of the first interim period after adoption. In addition, to the extent
an intangible asset is identified as having an indefinite useful life, we will
be required to test the intangible asset for impairment in accordance with the
provisions of SFAS No. 142 within the first interim period. Any impairment loss
will be measured as of the date of adoption and recognized as the cumulative
effect of a change in accounting principle in the first interim period.
As of the date of adoption, January 1, 2002, we expect to have unamortized
goodwill in the amount of $124,502,000 and unamortized identifiable intangible
assets in the amount of $871,000, all of which will be subject to the transition
provisions of SFAS Nos. 141 and 142. Amortization expense related to goodwill
was $2,257,000 and $3,897,000 for the year ended December 31, 2000 and the nine
months ended September 30, 2001, respectively. Because of the extensive effort
needed to comply with adopting SFAS Nos. 141 and 142, it is not yet practicable
to reasonably estimate the impact of adopting these accounting pronouncements on
our financial statements, including whether any transitional impairment losses
will be required to be recognized as the cumulative effect of a change in
accounting principle.
(s) Segment Information
SFAS No. 131, Disclosures about Segments of an Enterprise and Related
Information, establishes annual and interim reporting standards for an
enterprise's operating segments and related disclosures about its products,
services, geographic areas and major customers. An operating segment is defined
as a component of an enterprise that engages in business activities from which
it may earn revenues and incur expenses, and about which separate financial
information is regularly evaluated by the chief operating decision maker in
deciding how to allocate resources. This statement allows aggregation of similar
operating segments into a single operating segment if the businesses are
considered similar under the criteria of this statement. For all periods
presented, the Company believes it operated in a single segment, temporary
healthcare staffing.
(t) Use of Estimates
The preparation of financial statements in conformity with accounting
principles generally accepted in the United States of America requires
management to make a number of estimates and assumptions relating to the
reporting of assets and liabilities and the disclosure of contingent assets and
liabilities at the date of the financial statements and the reported amounts of
revenue and expenses during the reporting period. Actual results could differ
from those estimates.
(u) Reclassifications
Certain amounts in the 1998 and 1999 consolidated financial statements have
been reclassified to conform to the 2000 presentation.
(2) LEVERAGED RECAPITALIZATION
On November 19, 1999, Services consummated a leveraged recapitalization
(the 1999 Recapitalization) pursuant to which the Company's outstanding debt and
capital stock were restructured. As part of the 1999 Recapitalization, the
Company obtained $70.0 million in new and senior debt financing and $20.0
million in new debt financing through the issuance of senior subordinated notes.
The Company also sold 15,647,000 shares to AMN Acquisition Corp. (Acquisition),
a newly-formed entity created by the new majority stockholder to effect the 1999
Recapitalization, for cash consideration of $59.5 million. Acquisition acquired
an additional 3,413,000 shares directly from existing shareholders for cash
consideration of $13.0 million. After the reorganization, Acquisition held
19,060,000 shares of Services, representing a 93.5% ownership interest. Existing
stockholders retained shares representing the remaining 6.5% ownership interest
in Services.
F-12
AMN HEALTHCARE SERVICES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
Proceeds from the equity and debt financing were used to retire existing debt,
repurchase stock of existing stockholders and pay fees and expenses incurred in
connection with the recapitalization. These transactions were recognized as
capital and debt transactions with no change to recorded amounts for existing
assets and liabilities. On March 29, 2001, AMN Acquisition Corp. was merged into
AMN Healthcare Services, Inc.
In conjunction with the 1999 Recapitalization, the Company incurred the
following charges which are included in the 1999 results of operations: (i) an
extraordinary loss of $730,000 (net of tax benefit of $427,000) from the
retirement of debt outstanding prior to the 1999 Recapitalization; and (ii)
transaction costs of $12,404,000 comprised of bonus payments and option buyouts
of $6,503,000, a warrant buyout of $1,077,000 and professional service fees of
$4,824,000 (including the payment of $2,587,000 to the majority stockholder of
Services). In addition, the Company incurred $5,050,000 in financing costs,
which have been recorded as deferred financing costs and will be amortized over
the term of the related debt.
(3) ACQUISITIONS
(a) AMN
On December 4, 1997, Services acquired 80% of the outstanding common stock
of AMN for total consideration of $33,513,000. The transaction has been
accounted for in the accompanying consolidated financial statements using the
purchase method of accounting, and the assets and liabilities of AMN were
recorded at fair value as of the acquisition date. In connection with this
transaction, the Company recorded goodwill of $26,985,000, which is being
amortized over 25 years. Also in connection with this transaction, the Company
borrowed $25,151,000 from a bank (see Note 6) and incurred deferred financing
costs totaling $1,084,000, which were being amortized over the life of the loans
until the 1999 Recapitalization when they were written off.
On November 18, 1998, in connection with the acquisition of MedEx, Services
acquired an additional 2.77% of AMN for $2,050,000.
(b) MedEx
On November 18, 1998, Services acquired 100% of the issued and outstanding
stock of MedEx in exchange for 2,638,000 shares of Services common stock valued
at $3,448,000 and cash of $16,362,000, for a total purchase price of
$19,809,000. The transaction was accounted for using the purchase method of
accounting, and the assets and liabilities of MedEx were recorded at fair value
as of the acquisition date. Results of MedEx operations from the acquisition
date through December 31, 1998 are included in the accompanying financial
statements for the year ended December 31, 1998. In connection with this
transaction, the Company recorded goodwill of $15,332,000, which is being
amortized over 25 years.
(c) NRx
On June 28, 2000, AMN acquired 100% of the issued and outstanding stock of
NRx. The acquisition was recorded using the purchase method of accounting. Thus,
the results of operations from the acquired assets are included in the Company's
consolidated financial statements from the acquisition date. The purchase price
to the former shareholders of NRx included a payment of $16,181,000 in cash and
$3,000,000 to be paid in three equal installments of $1,000,000 each on June 29,
2001, June 28, 2002, and June 30, 2003 provided that the terms of the agreement
are met. Since the deferred payment in the amount of $3,000,000 is not interest
bearing, AMN recorded the present value of the future payments on the date of
the acquisition utilizing an interest rate of 9.5%. As of December 31, 2000, the
present value of the amount due on June 29, 2001 is $954,000 and is included in
other current liabilities. As of December 31, 2000, the present value of the
amounts due on June 28, 2002 and June 30, 2003 is $1,676,000 and is included in
other long-term liabilities.
F-13
AMN HEALTHCARE SERVICES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
AMN acquired NRx's assets of $4,239,000, assumed its liabilities of
$1,610,000, and recorded goodwill in the amount of $15,484,000, which is being
amortized over 25 years under the straight line method. AMN allocated $836,000
of the purchase price to the noncompete covenant, which is being amortized over
the four-year life of the covenant. As of December 31, 2000, the amortized cost
of the covenant is $730,000.
(d) PHS
On November 28, 2000, AMN acquired 100% of the issued and outstanding stock
of PHS. The acquisition was recorded using the purchase method of accounting.
Thus, the results of operations from the acquired assets are included in the
Company's consolidated financial statements from the acquisition date. The
purchase price to the former stockholders of PHS included a payment of
$75,041,000 in cash (net of cash received), $4,000,000 of which was delivered to
an escrow agent on the acquisition date in accordance with the purchase
agreement. The funds held in escrow are to be released to the former shareholder
in the amount of $2,000,000 on May 31, 2001 and $2,000,000 on December 31, 2001,
provided that terms of the agreement are met.
AMN acquired PHS's assets of $12,405,000 (net of cash received), assumed
its liabilities of $3,083,000, and recorded goodwill in the amount of
$65,831,000, which is being amortized over 25 years using the straight-line
method. AMN allocated $200,000 to the noncompete covenant, which is being
amortized over the four-year life of the covenant. The amortized cost of this
covenant is $195,000 as of December 31, 2000.
(e) OGP
On May 1, 2001, AMN acquired 100% of the issued and outstanding stock of
OGP, a healthcare staffing company specializing in the recruitment of nurses
domestically and from English-speaking foreign countries. The acquisition was
recorded using the purchase method of accounting. The purchase price paid to the
former stockholders of OGP included a payment of $11,973,000 in cash (net of
$1,574,000 cash received), and $800,000 which was delivered to an escrow agent
on the acquisition date in accordance with the purchase agreement. The funds
held in escrow are to be released to the former shareholders on November 1,
2002, provided that terms of the agreement are met. The OGP acquisition was
financed by an $18,000,000 term loan which bears interest at a rate of either
the higher of (i) the federal funds rate plus 0.5% or (ii) the prime rate, plus
2% or LIBOR plus 3.75%, depending on the composition of the loan. Interest is
payable in arrears on a quarterly basis, and the principal is due in full on
March 31, 2005.
Included in the asset purchase agreement is an earn-out provision whereby
AMN agrees to pay the OGP selling stockholders additional consideration
contingent on certain annual revenue results of OGP. Earn-out payments, if
earned, are capped at $5,340,000 and are to be paid in April 2002. There is also
additional contingent consideration of up to $2,369,000 depending upon
collection of an outstanding receivable from a customer.
AMN acquired OGP's assets of $7,766,000, assumed its liabilities of
$4,754,000, and recorded goodwill in the amount of $11,325,000, which is being
amortized over 25 years using the straight-line method. AMN allocated $200,000
of the purchase price to the noncompete agreement, which is being amortized over
the four-year life of the agreement.
(f) Pro Forma Consolidated Results of Operations
The following summary presents pro forma consolidated results of operations
for the years ended December 31, 1998, 1999, and 2000 as if the MedEx
acquisition described above had occurred on January 1, 1998, and the NRx and PHS
acquisitions described above had occurred on January 1, 1999. The following
unaudited pro forma financial information gives effect to certain adjustments,
including the amortization of intangible assets and interest expense on
acquisition debt and depreciation on fixed assets. The pro forma financial
information is not necessarily indicative of the operating results that would
have occurred had the
F-14
AMN HEALTHCARE SERVICES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
acquisitions been consummated as of the dates indicated, nor are they
necessarily indicative of future operating results (in thousands, except per
share amounts).
PRO FORMA
---------
YEARS ENDED DECEMBER 31,
---------------------------------
1998 1999 2000
-------- --------- --------
Revenue............................................ $121,062 $215,323 $301,807
Income from operations............................. $ 9,791 $ 1,036 $ 5,492
Income (loss) before extraordinary loss............ $ 3,077 $ (6,134) $ (5,120)
Net income (loss).................................. $ 3,077 $ (6,865) $ (5,120)
======== ======== ========
Earnings per share -- basic and diluted............ $ 0.17 $ (0.32) $ (0.23)
======== ======== ========
Weighted average shares -- basic and diluted....... 17,751 21,715 22,497
======== ======== ========
(4) BALANCE SHEET DETAILS
The consolidated balance sheets detail is as follows as of December 31,
1999 and 2000 (in thousands):
DECEMBER 31,
-------------------
1999 2000
------- --------
Accounts receivable, net:
Accounts receivable....................................... $26,434 $ 64,331
Allowance for doubtful accounts........................... (256) (930)
------- --------
Accounts receivable, net............................... $26,178 $ 63,401
======= ========
Fixed assets, net:
Furniture and equipment................................... $ 2,126 $ 3,538
Software.................................................. 863 2,798
Leasehold improvements.................................... 174 432
------- --------
3,163 6,768
Accumulated depreciation and amortization................. (921) (1,762)
------- --------
Fixed assets, net...................................... $ 2,242 $ 5,006
======= ========
Goodwill, net:
Goodwill.................................................. $42,307 $123,622
Accumulated amortization.................................. (2,942) (5,199)
------- --------
Goodwill, net.......................................... $39,365 $118,423
======= ========
Other intangibles, net:
Debt issuance costs....................................... $ 5,338 $ 6,742
Non-compete covenants..................................... 100 1,136
------- --------
5,438 7,878
Accumulated amortization.................................. (137) (1,323)
------- --------
Other intangibles, net................................. $ 5,301 $ 6,555
======= ========
Included in fixed assets is equipment acquired through capital leases in the
amount of $190,000 as of December 31, 2000. Accumulated amortization on these
capital leases is $48,000 as of December 31, 2000. There were no capitalized
leases as of December 31, 1999.
F-15
AMN HEALTHCARE SERVICES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
(5) INCOME TAXES
The provision (benefit) for income taxes for the years ended December 31,
1998, 1999, and 2000 consists of the following (in thousands):
DECEMBER 31,
----------------------------
1998 1999 2000
------ ------- -------
Current income taxes:
Federal............................................... $ 970 $ (103) $ 5,954
State................................................. 251 -- 1,213
------ ------- -------
Total.............................................. 1,221 (103) 7,167
------ ------- -------
Deferred income taxes:
Federal............................................... 254 (925) (8,550)
State................................................. 96 (271) (1,177)
------ ------- -------
Total.............................................. 350 (1,196) (9,727)
------ ------- -------
Provision (benefit) for income taxes, including tax
benefit of $427 on extraordinary loss in 1999.... $1,571 $(1,299) $(2,560)
====== ======= =======
The Company's income tax expense (benefit) differs from the amount that
would have resulted from applying the federal statutory rate of 35% to pretax
income (loss) because of the effect of the following items during the years
ended December 31, 1998, 1999, and 2000 (in thousands):
DECEMBER 31,
----------------------------
1998 1999 2000
------ ------- -------
Tax expense (benefit) at federal statutory rate......... $1,121 $(2,418) $(2,715)
State taxes, net of federal benefit..................... 228 (210) 24
Nondeductible transaction costs......................... -- 730 --
Minority interest....................................... 192 464 --
Interest................................................ -- -- 171
Other, net.............................................. 30 135 (40)
------ ------- -------
Income tax expense (benefit)....................... $1,571 $(1,299) $(2,560)
====== ======= =======
F-16
AMN HEALTHCARE SERVICES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
The tax effects of temporary differences that give rise to significant
portions of deferred tax assets and deferred tax liabilities are presented below
as of December 31, 1999, and 2000 (in thousands):
DECEMBER 31,
-----------------
1999 2000
------ -------
Deferred tax assets:
Stock compensation........................................ $ -- $ 8,453
Debt issuance costs....................................... 1,084 1,454
Interest and warrants..................................... -- 1,026
Accrued bonuses........................................... 270 461
State taxes............................................... -- 425
Allowance for doubtful accounts........................... 105 314
Other..................................................... 314 506
------ -------
Total deferred tax assets.............................. 1,773 12,639
------ -------
Deferred tax liabilities:
Intangibles............................................... (711) (1,232)
Capitalized software...................................... -- (633)
Other..................................................... (224) (209)
------ -------
Total deferred tax liabilities......................... (935) (2,074)
------ -------
Net deferred tax assets..................................... $ 838 $10,565
====== =======
Management believes it is more likely than not that the results of the
future operations will generate sufficient taxable income to realize the
deferred tax assets and, accordingly, has not provided a valuation allowance.
(6) NOTES PAYABLE
DECEMBER 31,
-------------------
1999 2000
------- --------
(IN THOUSANDS)
12% Senior subordinated notes issued with attached warrants
(see Note 8(b)) due November 19, 2005. Interest payable in
cash or through issuance of additional notes.............. $20,000 $ 20,000
12% Senior subordinated notes issued for conversion of
accrued interest to notes payable due November 19, 2005... 273 2,818
$20,000,000 Revolver due November 19, 2004 with variable
interest rates based on LIBOR, federal funds or the prime
lending rate ranging from 8.5% to 11.25% (weighted average
of 9.8% at December 31, 2000). An unused fee of .5% per
annum is due quarterly on the unused Revolver
commitment................................................ 6,675 15,045
$50,000,000 Term Loan due in 18 consecutive quarterly
installments beginning with a principal payment of
$1,250,000 on September 30, 2000. The quarterly principal
payment escalates to $2,500,000 on March 31, 2002 and to
$3,750,000 and $4,375,000 on March 31 in the succeeding
years, maturing on November 19, 2004. Interest is paid
quarterly and varies based on LIBOR plus 2.5% to 3.25%
(9.5% at December 31, 2000)............................... 50,000 47,500
F-17
AMN HEALTHCARE SERVICES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
DECEMBER 31,
-------------------
1999 2000
------- --------
(IN THOUSANDS)
$32,500,000 Tranche A Acquisition Loan due March 31, 2005,
with interest at LIBOR plus 3% (9.44% at December 31,
2000). Principal is due in 17 consecutive quarterly
installments beginning with a payment of $625,000 on March
31, 2001. The quarterly payment escalates to $1,250,000 on
March 31, 2002 until December 31, 2004, with a full
payment of $15,000,000 at the maturity date. Interest is
paid quarterly............................................ -- 32,500
$7,500,000 Tranche B Acquisition Loan due March 31, 2005,
with interest at LIBOR plus 2.5% (8.94% at December 31,
2000). Principal is due at maturity and interest is paid
quarterly................................................. -- 7,500
------- --------
Total notes payable.................................... 76,948 125,363
Unamortized discount on senior subordinated notes (See Note
8(b))..................................................... (2,942) (2,474)
------- --------
74,006 122,889
Less current portion of notes payable....................... (2,500) (7,500)
------- --------
Long-term portion of notes payable..................... $71,506 $115,389
======= ========
Annual maturities of long-term debt are as follows (in thousands):
2001.............................................. $ 7,500
2002.............................................. 15,000
2003.............................................. 20,000
2004.............................................. 37,545
2005.............................................. 45,318
--------
$125,363
========
The Company's debt is secured by all assets of the Company and the common
stock of its subsidiaries. The credit agreement and senior subordinated notes
contain various financial ratio covenants, as well as restrictions on assumption
of additional indebtedness, declaration of dividends, dispositions of assets,
consolidation into another entity, capital expenditures in excess of specified
amounts and allowable investments. The Company was in compliance with all
covenants and ratios at December 31, 2000.
In conjunction with the 1999 Recapitalization, $37,412,000 of notes payable
were repaid with proceeds from the new borrowings. In connection with the early
pay-off of these notes, debt issuance costs of $1,157,000 were written off and
are reflected net of tax in the accompanying consolidated statements of
operations as an extraordinary loss on early extinguishment of debt.
During 2000, the Company entered into interest rate swap agreements as a
means to hedge its interest rate exposure on debt instruments. In addition, the
Company's credit agreement requires that the Company maintain protection against
fluctuations in interest rates providing coverage in an aggregate notional
amount equal to $25,000,000. As a result of adopting SFAS No. 133 on January 1,
2001, net settlement amounts to be received or paid under the swap agreements
are reflected as adjustments to interest expense. The Company recorded a
transition adjustment to other comprehensive income in the amount of $589,000
(unaudited), which will be amortized into interest expense over the remaining
life of the debt agreements being hedged. Additionally, included in interest
expense for the nine month period ended September 30, 2001 is $348,000
(unaudited) related to additional unrealized losses related to these swap
agreements that were incurred during the period.
F-18
AMN HEALTHCARE SERVICES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
At December 31, 2000, the Company had three interest rate swaps outstanding
with major financial institutions that effectively convert variable-rate debt to
fixed rate. Two swaps have notional amounts of $25,000,000 each, whereby the
Company pays fixed rates of 6.585% and 6.57%, respectively, and receives a
floating three-month LIBOR. One swap has a notional amount of $40,000,000, which
decreases by $325,000 at the end of each three-month period beginning December
29, 2000; under this agreement, the Company pays a fixed rate of 6.5% and
receives a floating three-month LIBOR. All agreements expire in December 2001
and no initial investments were made to enter into these agreements.
Effective December 6, 1999, the Company entered into a three-year interest
rate cap agreement. The agreement applies to $25,000,000, which was 50% of the
term loan outstanding on that date. The agreement provides a 7% interest rate
cap on the three-month LIBOR rate. The cost of the agreement of $289,000 is
included in debt issuance costs, and is being amortized over the three-year term
of the agreement.
On January 26, 1998, the Company entered into an interest rate collar
agreement with a bank to reduce the impact of changes in interest rates on its
floating rate long-term debt. The agreement required the Company to make
payments to the bank for the difference between the selected interest rate,
based on a three-month LIBOR, and the floor rate as specified in the agreement.
In addition, the agreement entitled the Company to receive payments from the
bank for the difference between the selected interest rate, based on three-month
LIBOR, and the cap rate as specified in the agreement. On November 19, 1999, the
Company paid $25,000 to terminate this agreement.
(7) RETIREMENT PLAN
The Company maintains the AMN Healthcare Retirement Savings Plan (the AMN
Plan), a profit sharing plan that complies with the Internal Revenue Code
Section 401(k) provisions. The AMN Plan covers substantially all employees that
meet certain age and other eligibility requirements. An annual discretionary
matching contribution is determined by the Board of Directors each year and may
be up to a maximum 6% of eligible compensation paid to all participants during
the plan year. The amount of the employer contributions was $86,000, $213,000,
and $422,000 for the years ended December 31, 1998, 1999 and 2000, respectively.
Employees of PHS became eligible under the AMN Plan at the date of acquisition.
NRx maintained a separate profit sharing plan that complied with the
Internal Revenue Code Section 401(k) provisions. The plan covered substantially
all employees that had been employed for at least 12 months. No match was
provided under this plan. Effective January 1, 2001, NRx employees were eligible
to participate in the AMN Plan and the NRx plan was terminated.
(8) STOCKHOLDERS' EQUITY
(a) Stock Option Plans
In November 1999, Services established two performance stock option plans
(the 1999 Plans) to provide for the grant of options to upper management of AMN.
Options for a maximum of 4,040,000 shares of common stock were authorized at an
exercise price of $3.80 per option for grants within 120 days of the 1999
Recapitalization and not less than the fair market value in the case of
subsequent grants. Options under the plan vest 25% per year beginning in 2000 if
certain earnings performance criteria are met and grantee remains an employee.
If the Company does not meet the performance criteria for the particular year,
that portion of the option, which was eligible to become vested, will terminate.
Options that vest expire in nine to ten years from the grant date. In 1999, the
Company granted options for 3,636,000 shares of common stock at an exercise
price of $3.80 per share. At December 31, 1999, 404,000 shares of common stock
were reserved for future issuance related to the 1999 Plans.
During 2000, options for an additional 1,493,000 shares were reserved under
the 1999 Plans. In November 2000, additional options totaling 202,000 were
granted at an exercise price of $3.80. In
F-19
AMN HEALTHCARE SERVICES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
December 2000, 1,344,000 options were granted at an exercise price of $6.68 per
share. At December 31, 2000, 351,000 shares of common stock were reserved for
future issuance related to the 1999 Plans.
In accordance with the provisions of SFAS No. 123, the Company applies APB
Opinion No. 25, and related interpretations in accounting for its 1999 Plan.
Accordingly, because the 1999 plan is performance based, the Company applies
variable accounting and recorded compensation expense of $22,379,000 in 2000 and
$15,901,000 (unaudited) and $13,096,000 (unaudited) for the nine month periods
ended September 30, 2000 and 2001, respectively, in connection with the 1999
Plans in accordance with APB 25 and FIN 44. Pursuant to the provisions of the
1999 Plans, options become fully vested upon the occurrence of an initial public
offering.
A summary of stock option activity under the 1999 Plans is as follows:
WEIGHTED-
OPTIONS AVERAGE
OUTSTANDING EXERCISE PRICE
----------- --------------
Outstanding at December 31, 1998.................... -- --
Granted........................................... 3,636,000 $3.80
Exercised......................................... -- --
Canceled.......................................... -- --
---------
Outstanding at December 31, 1999.................... 3,636,000 3.80
Granted........................................... 1,546,000 6.30
Exercised......................................... -- --
Canceled.......................................... -- --
---------
Outstanding at December 31, 2000.................... 5,182,000 $4.55
=========
Exercisable as of December 31, 2000................. 959,000 $3.80
The following table summarizes options outstanding and exercisable as of
December 31, 2000:
OPTIONS OUTSTANDING OPTIONS EXERCISABLE
-------------------------------------- --------------------------------------
WEIGHTED- WEIGHTED-
AVERAGE WEIGHTED- AVERAGE WEIGHTED-
REMAINING AVERAGE REMAINING AVERAGE
EXERCISE NUMBER CONTRACTUAL EXERCISE NUMBER CONTRACTUAL EXERCISE
PRICE OUTSTANDING LIFE (YEARS) PRICE OUTSTANDING LIFE (YEARS) PRICE
-------- ----------- ------------ --------- ----------- ------------ ---------
$3.80 3,838,000 9 $3.80 959,000 9 $3.80
6.68 1,344,000 9 6.68 -- -- --
--------- -------
5,182,000 959,000
========= =======
In December 1997, AMN established a stock incentive plan to provide an
equity-based incentive plan to certain officers and key employees. Options for a
maximum of 10,400,000 shares of common stock were authorized. In 1997, AMN
granted ten-year options for 10,400,000 shares of common stock at an exercise
price of $0.06 per share. In March 1999, the Company amended the plan to include
certain officers and key employees of MedEx. Options for an additional 4,200,000
shares of common stock were authorized, and the Company granted ten-year options
for 4,000,000 shares of stock at an exercise price of $0.11 per share. Options
under the plan vested 25% each year over four years, provided that certain
performance criteria were met and grantee remained an employee. However, all
options would have become fully vested on December 31, 2004, provided that the
grantee was employed by the Company on that date. In conjunction with the 1999
Recapitalization, all options previously granted related to this plan were
repurchased by the Company for $3,953,000, which is included in transaction
costs in the accompanying 1999 consolidated statements of operations.
F-20
AMN HEALTHCARE SERVICES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
Under SFAS No. 123, the weighted average per share fair value of the
options granted during 1998, 1999 and 2000 was $5.61, $11.50 and $11.28,
respectively on the date of grant. Fair value under SFAS No. 123 is determined
using the Black-Scholes option-pricing model with the following assumptions:
1998 1999 2000
---- ---- ----
Expected life............................................... 3 5 5
Risk-free interest rate..................................... 6.00% 5.95% 5.30%
Volatility.................................................. 60% 60% 60%
Dividend yield.............................................. 0% 0% 0%
Had compensation expense been recognized for stock-based compensation plans
in accordance with SFAS No. 123, the Company would have recorded the following
net income (loss) and net income (loss) per share amounts (in thousands, except
per share amounts):
1998 1999 2000
------ ------- -------
Pro forma net income (loss)............................. $1,589 $(5,610) $(4,992)
Pro forma income per common share:
Basic................................................. $ 0.09 $ (0.26) $ (0.22)
Diluted............................................... $ 0.09 $ (0.26) $ (0.22)
(b) Common Stock Warrants
On November 19, 1999, in connection with the issuance of its $20,000,000
senior subordinated notes, Services issued warrants to purchase 2,518,000 shares
of its common stock at $3.80 per share. These warrants are exercisable upon
issuance and expire at the earlier of a qualified public stock offering, as
defined, or November 19, 2009. The fair value of the warrants in the amount of
$3,000,000 was based upon a third-party valuation and was recorded as a discount
to the related senior subordinated notes payable. This discount is being
amortized to interest expense over the term of the notes using the effective
interest method. Discount amortization was $58,000, $468,000 in 1999 and 2000,
respectively.
On December 5, 1997, AMN granted warrants to purchase 19,000 shares of
AMN's common stock, at $12.45 per share, to a bank in connection with certain
loans. The warrants were immediately exercisable and expire ten years from the
date of issuance. In conjunction with the 1999 Recapitalization, these warrants
were repurchased by the Company for $1,077,000, and is included in transaction
costs in the accompanying 1999 consolidated statements of operations.
(c) Stockholders' Agreement
The stockholders of Services have entered into a stockholders' agreement
conferring certain rights and restrictions, including among others: restrictions
on transfers of shares, "tag along" and "drag along" rights, rights to acquire
shares, and piggyback registration rights, as defined in the agreement. This
agreement will terminate at the time of an initial public offering by Services.
(9) FAIR VALUE OF FINANCIAL INSTRUMENTS
SFAS No. 107, Disclosures about Fair Value of Financial Instruments,
requires that fair values be disclosed for most of the Company's financial
instruments. Estimated fair values for the Company's financial instruments and a
description of the methodologies and assumptions used to determine such amounts
follow:
(a) Cash and Cash Equivalents
The carrying amount is assumed to be the fair value due to the liquidity of
these instruments.
F-21
AMN HEALTHCARE SERVICES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
(b) Accounts Receivable, Income Taxes Receivable, Other Current Assets,
Deposits, Book Overdraft, Accounts Payable and Accrued Expenses, Income
Taxes Payable, Accrued Compensation and Benefits, and Other Current
Liabilities
The carrying amounts of these financial instruments are considered to be
representative of their respective fair values because of the short-term nature
of these financial instruments.
(c) Notes Payable
The carrying amounts of notes payable are considered to be reasonable
estimates of their fair values, as these borrowings have variable rates that
reflect currently available terms and conditions for similar debt. The carrying
amounts of fixed rate obligations also approximate their fair value.
(d) Other Long-Term Liabilities
Other long-term liabilities consist primarily of the present value of
deferred payments related to the acquisition of NRx (Note 3(c)). The carrying
value is considered to be representative of the fair value due to the imputed
interest rate approximating the current market rate.
(e) Derivative Financial Instruments, Including Off-Balance Sheet Derivative
Financial Instruments
Included in debt issuance costs is the amortized cost of the interest rate
cap agreement discussed in Note 6 of $281,000 and $185,000 at December 31, 1999
and 2000, respectively. As of December 31, 2000, the fair value of this
agreement is estimated based on quoted market price. As of December 31, 1999,
the carrying amount of this agreement was considered to be a reasonable estimate
of its fair value, due to the recent timing of the agreement.
During 2000, the Company entered into interest rate swap agreements as a
means to hedge its interest rate exposure on debt instruments as discussed in
Note 6. These agreements did not require an initial investment by the Company.
The fair value of these agreements are estimated based on quoted market prices
for these or similar instruments. As of December 31, 2000, the fair value of
interest rate swap agreements were $589,000 less than the carrying amount.
(10) OTHER RELATED PARTY TRANSACTIONS
During 2000, the Company issued 8,460,000 shares of common stock to
existing stockholders for $52,000,000.
In connection with the acquisition of PHS, the Company paid $1,500,000 to
the Company's majority stockholder for advisory services which is reported as
transaction costs in the accompanying 2000 statement of operations. During 2000,
the Company paid $150,000 in management advisory fees to the majority
stockholder which is included in selling, general and administrative expenses.
In addition, in conjunction with the 1999 Recapitalization, the Company paid
advisory fees to the majority stockholder and to a minority shareholder of
$1,500,000 and $100,000, respectively, which is included in transaction costs in
fiscal 1999.
The Company was provided the advisory services of the majority stockholder
of the Company until the 1999 Recapitalization. The Company paid for
out-of-pocket expenses of $32,000 in 1999.
The Company received services from an advertising agency which was 20%
owned by the minority stockholders during 1998 and 30% owned by the minority
stockholders during 1999 and 2000. The Company incurred expenses of $702,000,
$31,000, and $40,000 in 1998, 1999 and 2000, respectively.
F-22
AMN HEALTHCARE SERVICES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
(11) COMMITMENTS AND CONTINGENCIES
(a) Legal
The Company is party to legal actions in the normal course of business. In
the opinion of management and legal counsel, the outcome of legal actions will
not have a material impact on the financial position or results of operations of
the Company.
(b) Leases
The Company leases certain office facilities and equipment under various
operating and capital leases that expire over the next five years. Future
minimum lease payments under noncancelable operating leases (with initial or
remaining lease terms in excess of one year) and future minimum capital lease
payments as of December 31, 2000 are as follows (in thousands):
CAPITAL OPERATING
LEASES LEASES
------- ---------
Years ending December 31:
2001.................................................... $ 71 $2,574
2002.................................................... 71 2,639
2003.................................................... 18 1,795
2004.................................................... 6 1,157
2005.................................................... 2 583
---- ------
Total minimum lease payments......................... 168 $8,748
======
Less amount representing interest (at rates ranging from
5.7% to 11.97%)...................................... (77)
----
Present value of minimum lease payments.............. 91
Less current installments of obligations under capital
leases............................................... (33)
----
Obligations under capital leases, excluding current
installments....................................... $ 58
====
Obligations under capital leases are included in other current and other
long-term liabilities, respectively, in the accompanying financial statements.
Rent expense was $529,000, $1,077,000, and $1,810,000 for the years ended
December 31, 1998, 1999 and 2000, respectively.
(12) SUBSEQUENT EVENTS
On October 18, 2001, the Company effected a 43.10849-for-1 stock split of
its common stock. All references in the consolidated financial statements to
number of shares outstanding, price per share and per share amounts related to
Services have been retroactively restated to reflect the stock split for all
periods presented.
F-23
INDEPENDENT AUDITORS' REPORT
The Board of Directors
Nurses RX, Inc.
We have audited the accompanying balance sheets of Nurses RX, Inc. as of
December 31, 1998 and 1999, and the related statements of income and retained
earnings, and cash flows for the years then ended. These financial statements
are the responsibility of the Company's management. Our responsibility is to
express an opinion on these financial statements based on our audits.
We conducted our audits in accordance with auditing standards generally
accepted in the United States of America. Those standards require that we plan
and perform the audit to obtain reasonable assurance about whether the financial
statements are free of material misstatement. An audit includes examining, on a
test basis, evidence supporting the amounts and disclosures in the financial
statements. An audit also includes assessing the accounting principles used and
significant estimates made by management, as well as evaluating the overall
financial statement presentation. We believe that our audits provide a
reasonable basis for our opinion.
In our opinion, the financial statements referred to above present fairly,
in all material respects, the financial position of Nurses RX, Inc. as of
December 31, 1998 and 1999, and the results of its operations and its cash flows
for the years then ended in conformity with accounting principles generally
accepted in the United States of America.
DDK & Company LLP
New York, New York
March 31, 2001
F-24
NURSES RX, INC.
BALANCE SHEETS
DECEMBER 31, 1998 AND 1999
1998 1999
---------- ----------
ASSETS
Current Assets:
Cash and cash equivalents................................. $ 121,473 $ 20,843
Accounts receivable, less allowance for doubtful accounts
of $141,138 in 1998 and $211,788 in 1999............... 2,583,929 2,921,756
Unbilled income........................................... 466,680 543,179
Prepaid expenses and other current assets................. 283,232 315,027
---------- ----------
Total current assets.............................. 3,455,314 3,800,805
Property and equipment, at cost, less accumulated
depreciation and amortization of $217,336 in 1998 and
$215,620 in 1999.......................................... 278,014 333,188
Other assets -- security deposit............................ 2,627 3,829
---------- ----------
Total assets...................................... $3,735,955 $4,137,822
========== ==========
LIABILITIES AND SHAREHOLDERS' EQUITY
Current Liabilities:
Bank debt................................................. $ 522,111 $ 586,530
Accounts payable and accrued expenses..................... 640,722 546,691
Due to officer............................................ 270,000 98,000
Income taxes payable...................................... 16,972 36,000
---------- ----------
Total current liabilities......................... 1,449,805 1,267,221
Other liabilities -- due to officer......................... 98,000 --
---------- ----------
Total liabilities................................. 1,547,805 1,267,221
---------- ----------
Commitment and Contingencies
Shareholders' equity:
Common stock, no par value; 100 shares authorized, issued
and outstanding........................................ 500 500
Retained earnings......................................... 2,187,650 2,870,101
---------- ----------
Total shareholders' equity........................ 2,188,150 2,870,601
---------- ----------
Total liabilities and shareholders'
equity.......................................... $3,735,955 $4,137,822
========== ==========
See accompanying notes to financial statements.
F-25
NURSES RX, INC.
STATEMENTS OF INCOME AND RETAINED EARNINGS
THREE MONTHS ENDED
YEARS ENDED DECEMBER 31, MARCH 31,
-------------------------- --------------------------
1998 1999 1999 2000
----------- ----------- ----------- -----------
(UNAUDITED) (UNAUDITED)
Revenue................................. $21,438,179 $22,451,359 $6,047,389 $7,490,182
Cost of revenue......................... 15,343,056 15,424,600 4,179,581 5,091,914
----------- ----------- ---------- ----------
Gross profit............................ 6,095,123 7,026,759 1,867,808 2,398,268
----------- ----------- ---------- ----------
Operating expenses:
Selling and marketing................. 2,017,191 2,284,234 498,301 578,096
General and administrative (including
interest of $81,339 in 1998 and
$26,340 in 1999 and $12,167 during
the three months ended March 31,
1999 and $9,464 during the three
months ended March 31, 2000)....... 2,832,872 3,128,291 556,866 635,104
----------- ----------- ---------- ----------
4,850,063 5,412,525 1,055,167 1,213,200
----------- ----------- ---------- ----------
Income before other income and income
taxes................................. 1,245,060 1,614,234 812,641 1,185,068
----------- ----------- ---------- ----------
Other income:
Interest income....................... 7,305 11,630 1,111 --
Management fee........................ 203,078 -- -- --
----------- ----------- ---------- ----------
210,383 11,630 1,111 --
----------- ----------- ---------- ----------
Income before income taxes.............. 1,455,443 1,625,864 813,752 1,185,068
Income taxes............................ 41,117 57,460 9,000 10,500
----------- ----------- ---------- ----------
Net income.............................. 1,414,326 1,568,404 804,752 1,174,568
Retained earnings -- beginning.......... 1,459,969 2,187,650 2,187,650 2,870,101
Distributions to shareholders........... (686,645) (885,953) (7,333) (215,519)
----------- ----------- ---------- ----------
Retained earnings -- ending............. $ 2,187,650 $ 2,870,101 $2,985,069 $3,829,150
=========== =========== ========== ==========
See accompanying notes to financial statements.
F-26
NURSES RX, INC.
STATEMENTS OF CASH FLOWS
THREE MONTHS ENDED
YEARS ENDED DECEMBER 31, MARCH 31,
-------------------------- --------------------------
1998 1999 1999 2000
----------- ----------- ----------- -----------
(UNAUDITED) (UNAUDITED)
Operating Activities:
Net income............................. $ 1,414,326 $ 1,568,404 $ 804,752 $1,174,568
Adjustments to reconcile net income to
net cash provided by operating
activities
Depreciation and amortization....... 70,129 85,007 19,013 27,646
Bad debts........................... 74,686 70,650 21,082 26,161
Changes in operating assets and
liabilities
Accounts receivable............... (416,344) (408,477) (534,493) (749,322)
Unbilled income................... (106,726) (76,499) (75,104) (311,750)
Prepaid expenses and other current
assets......................... (41,280) (32,997) 149,299 28,280
Accounts payable and accrued
expenses....................... 115,918 (94,031) 359,604 192,250
Income taxes payable.............. 9,775 19,028 (16,972) (14,286)
----------- ----------- --------- ----------
Net cash provided by operating
activities................... 1,120,484 1,131,085 727,181 373,547
----------- ----------- --------- ----------
Investing Activities -- purchase of
property and equipment................. (77,474) (140,181) (14,031) (50,955)
----------- ----------- --------- ----------
Net cash used in investing
activities................... (77,474) (140,181) (14,031) (50,955)
----------- ----------- --------- ----------
Financing Activities:
Principal payments on officer loans.... (1,247,857) (270,000) (100,000) (61,000)
Proceeds of bank debt, net............. 522,111 64,419 (490,728) (13,128)
Distributions to shareholders.......... (686,645) (885,953) (7,333) (215,519)
----------- ----------- --------- ----------
Net cash used in financing
activities................... (1,412,391) (1,091,534) (598,061) (289,647)
----------- ----------- --------- ----------
Net decrease in cash and cash
equivalents............................ (369,381) (100,630) 115,089 32,945
Cash and cash equivalents -- beginning... 490,854 121,473 121,473 20,843
----------- ----------- --------- ----------
Cash and cash equivalents -- ending...... $ 121,473 $ 20,843 $ 236,562 $ 53,788
=========== =========== ========= ==========
Supplemental Information:
Interest paid.......................... $ 81,349 $ 25,542 $ 9,727 $ 3,407
Income taxes paid...................... $ 31,342 $ 38,432 $ 34,544 $ 24,786
Noncash Transactions -- retirement of
property and equipment................. -- $ 86,723 -- --
See accompanying notes to financial statements.
F-27
NURSES RX, INC.
NOTES TO FINANCIAL STATEMENTS
YEARS ENDED DECEMBER 31, 1998 AND 1999
(1) SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
(a) Nature of Business
Nurses RX, Inc. ("Company"), a temporary healthcare staffing company, was
incorporated on August 7, 1990, under the laws of the State of North Carolina.
The Company primarily sells the services of registered nurses throughout North
America.
(b) Interim Financial Information (unaudited)
The interim financial statements of the Company for the three months ended
March 31, 1999 and March 31, 2000, included herein, have been prepared by the
Company, without audit, pursuant to the rules and regulations of the Securities
and Exchange Commission (SEC). The unaudited interim financial statements
include all adjustments, consisting of normal recurring adjustments, considered
necessary for a fair presentation of the results for the interim periods
presented. Certain information and footnote disclosures normally included in the
financial statements prepared in accordance with generally accepted accounting
principles have been condensed or omitted pursuant to such rules and regulations
relating to interim financial statements. In the opinion of management, the
accompanying unaudited statements reflect all adjustments necessary to present
fairly the results of its operations and its cash flows for the three months
ended March 31, 1999 and March 31, 2000.
(c) Revenue Recognition
Fees are primarily billed on a bi-weekly basis in direct proportion to
completed work. Income and direct costs are recognized through the balance sheet
date on unbilled work.
(d) Cash and Cash Equivalents
The Company considers all short-term investments with an original maturity
of three months or less to be cash equivalents.
(e) Property, Equipment and Depreciation
Property and equipment are stated at cost. Major expenditures for property
and those which substantially increase useful lives are capitalized.
Maintenance, repairs, and minor renewals are expensed as incurred. When assets
are retired or otherwise disposed of, their costs and related accumulated
depreciation are removed from the accounts and resulting gains or losses are
included in operations. Depreciation is provided by both straight-line and
accelerated methods over the estimated useful lives of the assets. Amortization
of leasehold improvements is calculated by the straight-line method over the
lesser of the term of the related lease or the useful lives of the improvements.
(f) Income Taxes
The Company has elected to have its income taxed under Section 1362
(Subchapter S) of the Internal Revenue Code of 1986 which provides that, in lieu
of corporate income taxes, the Company's income or loss is passed to the
shareholders and combined with their other personal income and deductions to
determine taxable income on their individual tax returns. Therefore, no
provision or liability for Federal income tax is reflected in the financial
statements. Provision has been made for certain state and local taxes. On June
28, 2000, the Company was acquired by AMN Healthcare, Inc. and the Subchapter S
election was terminated.
The Company recognizes deferred tax assets and liabilities for the expected
future tax consequences of temporary differences between the carrying amounts
and the tax bases of assets and liabilities and the effect of future tax
planning strategies to reduce any deferred tax liability.
F-28
NURSES RX, INC.
NOTES TO FINANCIAL STATEMENTS -- (CONTINUED)
The Company reports on a cash basis for income tax purposes, creating
timing differences between tax and financial reporting. The resultant effect is
currently considered immaterial and no deferred income taxes are provided.
(g) Use of Estimates
The preparation of financial statements in conformity with generally
accepted accounting principles requires management to make estimates and
assumptions that affect certain reported amounts and disclosures. Accordingly,
actual results could differ from those estimates.
(h) Advertising
Advertising costs are expensed as incurred. Advertising costs totaled
approximately $500,000 in 1998 and 1999.
2. PROPERTY AND EQUIPMENT
Property and equipment are summarized as follows:
ESTIMATED
USEFUL
LIVES 1998 1999
------------- -------- --------
Furniture and fixtures.......................... 7 years $163,703 $193,548
Machinery and equipment......................... 5 years 323,133 325,777
Leasehold improvements.......................... Life of lease 8,514 8,514
Computer software............................... 3 years -- 20,969
-------- --------
Total property and equipment.................... 495,350 548,808
Less -- accumulated depreciation and
amortization.................................. 217,336 215,620
-------- --------
Net property and equipment...................... $278,014 $333,188
======== ========
Depreciation and amortization expense for the years ended December 31, 1998
and 1999 was $70,129 and $85,007, respectively. Expense for the three months
ended March 31, 1999 and 2000 was approximately $19,000 and $28,000,
respectively.
3. DUE TO OFFICER
The debt to officer includes repayments of $1,247,857 during 1998 and
$270,000 during 1999. Loans bear interest at 9.50%. Related interest expense
charged to operations was $70,073 in 1998 and $20,737 in 1999. This officer sold
his minority interest to the remaining shareholders on January 1, 1998. This
loan was repaid in full during 2000.
4. BANK DEBT
During February 1998, the Company executed a revolving step down line of
credit with a bank providing for maximum borrowings (Commitment Amount) of
$1,500,000. The Commitment Amount is reduced annually by $200,000 through
January 31, 2003 and is subject to a borrowing base which cannot exceed 80% of
eligible accounts receivable and 50% of eligible net book value of furniture and
fixtures. The agreement contains certain covenants and restrictions and is
secured by all accounts receivable and equipment. Interest is charged at the
bank's prime rate and related interest expense charged to operations was
approximately $11,000 in 1998 and $4,500 in 1999. This loan was paid in full and
the line was closed during June 2000.
5. RELATED PARTY TRANSACTIONS
For the year ended December 31, 1998, the Company charged management fees
of $203,078 to an affiliated company for services and expenses incurred on
behalf of the affiliate. The affiliate and the Company
F-29
NURSES RX, INC.
NOTES TO FINANCIAL STATEMENTS -- (CONTINUED)
have common stockholders. At December 31, 1998 and 1999, included in other
current assets is $70,227 due from this affiliate.
6. COMMITMENT AND CONTINGENCIES
Lease
Effective December 1, 1999, the Company entered into a new lease for office
space, expiring in December 2005, which requires future minimum base rental
payments plus escalation rent and common area maintenance charges. Minimum base
rental payments as of December 31, 1999 are as follows:
YEARS ENDING DECEMBER 31, AMOUNT
------------------------- --------
2000.............................................. $153,300
2001.............................................. 155,850
2002.............................................. 161,100
2003.............................................. 161,100
2004.............................................. 175,500
2005.............................................. 179,400
--------
$986,250
========
Total rent expense charged to operations was approximately $94,000 in 1998
and $116,000 in 1999, $27,000 for the three months ended March 31, 1999 and
$41,000 for the three months ended March 31, 2000.
Cash and Cash Equivalents
At December 31, 1998, bank balances exceeded the $100,000 FDIC insured
limit by approximately $232,000.
Claims
The Company is involved in various claims incidental to its business. These
claims are substantially covered by insurance. While it is not feasible to
predict or determine the final outcome of these claims, management does not
believe they should result in a materially adverse effect on the Company's
financial position, results of operations or liquidity.
7. PROFIT-SHARING PLAN
The Company has a 401(k) profit-sharing plan covering substantially all of
its employees. Eligible employees may elect to have a maximum of 15% of their
wages withheld up to a statutory maximum as adjusted annually. The annual
contribution to the plan is at the discretion of the Board of Directors. There
were no Company contributions in 1998 and 1999.
8. CAFETERIA PLAN
The Company maintains a contributory Premium Payment Plan which qualifies
as a "Cafeteria Plan" under Section 125 of the Internal Revenue Code of 1986, as
amended. The plan provides for health insurance and other benefits for all
eligible employees.
9. SUBSEQUENT EVENT
On June 28, 2000, the shareholders sold all of their stock to AMN
Healthcare, Inc.
F-30
INDEPENDENT AUDITORS' REPORT
The Board of Directors
Preferred Healthcare Staffing, Inc.:
We have audited the accompanying balance sheets of Preferred Healthcare
Staffing, Inc. (a wholly owned subsidiary of Preferred Employers Holdings, Inc.)
as of December 31, 1999 and November 30, 2000, and the related statements of
operations, shareholder's equity and cash flows for the years ended December 31,
1998 and 1999 and the eleven months ended November 30, 2000. These financial
statements are the responsibility of the Company's management. Our
responsibility is to express an opinion on these financial statements based on
our audits.
We conducted our audits in accordance with auditing standards generally
accepted in the United States of America. Those standards require that we plan
and perform the audits to obtain reasonable assurance about whether the
financial statements are free of material misstatement. An audit includes
examining, on a test basis, evidence supporting the amounts and disclosures in
the financial statements. An audit also includes assessing the accounting
principles used and significant estimates made by management, as well as
evaluating the overall financial statement presentation. We believe that our
audits provide a reasonable basis for our opinion.
In our opinion, the financial statements referred to above present fairly,
in all material respects, the financial position of Preferred Healthcare
Staffing, Inc. as of December 31, 1999 and November 30, 2000, and the results of
its operations and its cash flows for the years ended December 31, 1998 and 1999
and the eleven months ended November 30, 2000 in conformity with accounting
principles generally accepted in the United States of America.
KPMG LLP
Miami, Florida
April 4, 2001
F-31
PREFERRED HEALTHCARE STAFFING, INC.
(A WHOLLY OWNED SUBSIDIARY OF
PREFERRED EMPLOYERS HOLDINGS, INC.)
BALANCE SHEETS
DECEMBER 31, 1999 AND NOVEMBER 30, 2000
1999 2000
----------- -----------
ASSETS
Current assets:
Cash...................................................... $ 240,957 $ 147,062
Accounts receivable, net.................................. 6,921,417 10,980,481
Prepaid and other current assets.......................... 974,392 1,016,658
Deferred tax asset........................................ 62,063 --
----------- -----------
Total current assets.............................. 8,198,829 12,144,201
Property and equipment, net................................. 635,044 886,229
Goodwill, net............................................... 4,707,657 4,489,361
----------- -----------
Total assets...................................... $13,541,530 $17,519,791
=========== ===========
LIABILITIES AND SHAREHOLDER'S EQUITY
Current liabilities:
Accounts payable and accrued expenses..................... $ 1,977,582 $ 3,196,460
Due to Parent............................................. 1,445,960 --
----------- -----------
Total current liabilities......................... 3,423,542 3,196,460
Deferred tax liability...................................... 65,950 46,122
----------- -----------
Total liabilities................................. 3,489,492 3,242,582
----------- -----------
Shareholder's equity:
Common stock, no par value, $1 per share assigned value,
15,000 shares authorized, 10,000 shares issued and
outstanding............................................ 10,000 10,000
Additional paid-in capital................................ 7,470,437 7,470,437
Retained earnings......................................... 2,571,601 6,796,772
----------- -----------
Total shareholder's equity........................ 10,052,038 14,277,209
Commitments and contingencies
----------- -----------
Total liabilities and shareholder's equity........ $13,541,530 $17,519,791
=========== ===========
See accompanying notes to financial statements.
F-32
PREFERRED HEALTHCARE STAFFING, INC.
(A WHOLLY OWNED SUBSIDIARY OF
PREFERRED EMPLOYERS HOLDINGS, INC.)
STATEMENTS OF OPERATIONS
YEARS ENDED DECEMBER 31, 1998 AND 1999 AND
FOR THE ELEVEN MONTHS ENDED NOVEMBER 30, 2000
1998 1999 2000
----------- ----------- -----------
Staffing revenue, net............................... $34,461,735 $46,358,045 $57,162,456
Cost of revenue..................................... 27,140,355 35,775,512 44,567,866
----------- ----------- -----------
Gross profit................................... 7,321,380 10,582,533 12,594,590
----------- ----------- -----------
Expenses:
Selling, general and administrative expenses...... 4,587,357 6,295,793 6,616,595
Depreciation and amortization..................... 277,209 391,301 417,006
----------- ----------- -----------
Total expenses................................. 4,864,566 6,687,094 7,033,601
----------- ----------- -----------
Income from operations......................... 2,456,814 3,895,439 5,560,989
----------- ----------- -----------
Non-operating income (expenses):
Interest income (expense), net.................... (494,191) (78,232) 43,654
Other (expenses) income........................... 299 (4,867) (19,864)
----------- ----------- -----------
Total non-operating income (expenses).......... (493,892) (83,099) 23,790
----------- ----------- -----------
Income before income tax expense............... 1,962,922 3,812,340 5,584,779
Income tax expense.................................. 561,155 1,465,509 807,325
----------- ----------- -----------
Net income..................................... $ 1,401,767 $ 2,346,831 $ 4,777,454
=========== =========== ===========
Pro forma information:
Historical income before income tax............... $ 1,962,922 $ -- $ 5,584,779
Pro forma income tax expense...................... 814,058 -- 2,042,743
Pro forma net income.............................. 1,148,864 -- 3,542,036
See accompanying notes to financial statements.
F-33
PREFERRED HEALTHCARE STAFFING, INC.
(A WHOLLY OWNED SUBSIDIARY OF PREFERRED EMPLOYERS HOLDINGS, INC.)
STATEMENTS OF SHAREHOLDER'S EQUITY
YEARS ENDED DECEMBER 31, 1998 AND 1999 AND
FOR THE ELEVEN MONTHS ENDED NOVEMBER 30, 2000
COMMON STOCK ADDITIONAL
----------------- PAID-IN RETAINED
SHARES AMOUNT CAPITAL EARNINGS TOTAL
------ ------- ---------- ----------- -----------
Balance as of December 31,
1997........................... 10,000 $10,000 $ -- $(1,176,997) $(1,166,997)
Net income..................... -- -- -- 1,401,767 1,401,767
Capital contribution........... -- -- 7,470,437 -- 7,470,437
------ ------- ---------- ----------- -----------
Balance as of December 31,
1998........................... 10,000 10,000 7,470,437 224,770 7,705,207
Net income..................... -- -- -- 2,346,831 2,346,831
------ ------- ---------- ----------- -----------
Balance as of December 31,
1999........................... 10,000 10,000 7,470,437 2,571,601 10,052,038
Net income..................... -- -- -- 4,777,454 4,777,454
Forgiveness of receivable from
parent company.............. -- -- -- (552,283) (552,283)
------ ------- ---------- ----------- -----------
Balance as of November 30,
2000........................... 10,000 $10,000 $7,470,437 $ 6,796,772 $14,277,209
====== ======= ========== =========== ===========
See accompanying notes to financial statements.
F-34
PREFERRED HEALTHCARE STAFFING, INC.
(A WHOLLY OWNED SUBSIDIARY OF PREFERRED EMPLOYERS HOLDINGS, INC.)
STATEMENTS OF CASH FLOWS
YEARS ENDED DECEMBER 31, 1998 AND 1999 AND
FOR THE ELEVEN MONTHS ENDED NOVEMBER 30, 2000
1998 1999 2000
----------- ----------- -----------
Cash flows from operating activities:
Net income......................................... $ 1,401,767 $ 2,346,831 $ 4,777,454
Adjustments to reconcile net income to net cash
provided by (used in) operating activities:
Depreciation.................................... 82,769 149,151 198,710
Amortization of goodwill........................ 194,440 242,150 218,296
Loss on retirement of property and equipment.... -- -- 20,179
Provision for doubtful accounts receivable...... 96,054 64,706 61,009
Deferred taxes.................................. 11,030 40,032 42,235
Changes in other assets and liabilities:
Accounts receivable........................... (4,500,264) (455,694) (4,120,073)
Prepaid and other current assets.............. (540,088) (363,630) (42,266)
Accounts payable and accrued expenses......... 255,627 460,049 1,218,878
----------- ----------- -----------
Net cash provided by (used in) operating
activities............................... (2,998,665) 2,483,595 2,374,422
----------- ----------- -----------
Cash flows from investing activities:
Purchase of property and equipment................. (317,583) (346,524) (470,074)
Purchase of HSSI Travel Nurse Operations, Inc...... (5,000,000) -- --
----------- ----------- -----------
Net cash used in investing activities...... (5,317,583) (346,524) (470,074)
----------- ----------- -----------
Cash flows from financing activities:
Proceeds from line of credit....................... 2,000,000 -- --
Repayment of lines of credit....................... (2,590,000) (1,850,000) --
Repayment of capital lease......................... (17,559) (500) --
Bank overdraft..................................... 420,969 (459,296) --
Capital contribution............................... 7,470,437 -- --
Net advances and receipts from parent company...... 1,050,026 395,933 (1,998,243)
----------- ----------- -----------
Net cash (used in) provided by financing
activities............................... 8,333,873 (1,913,863) (1,998,243)
----------- ----------- -----------
Net (decrease) increase in cash...................... 17,625 223,208 (93,895)
Cash, at beginning of period......................... 124 17,749 240,957
----------- ----------- -----------
Cash, at end of period............................... $ 17,749 $ 240,957 $ 147,062
=========== =========== ===========
Supplemental disclosure:
Cash paid for taxes................................ $ -- $ 85,545 $ 209,649
=========== =========== ===========
Cash paid for interest............................. $ 398,244 $ 78,706 $ --
=========== =========== ===========
Supplemental disclosure of noncash financing
activities -- forgiveness of receivable from parent
company............................................ $ -- $ -- $ 552,283
=========== =========== ===========
See accompanying notes to financial statements.
F-35
PREFERRED HEALTHCARE STAFFING, INC.
(A WHOLLY OWNED SUBSIDIARY OF
PREFERRED EMPLOYER'S HOLDINGS, INC.)
NOTES TO FINANCIAL STATEMENTS
DECEMBER 31, 1998, DECEMBER 31, 1999 AND NOVEMBER 30, 2000
(1) SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES AND PRACTICES
(a) Description of Business
Preferred Healthcare Staffing, Inc. (the "Company") was incorporated in
1997 under the laws of the state of Delaware as a wholly owned subsidiary of
Preferred Employers Holdings, Inc. ("PEHI"). The Company is in the business of
providing health care professionals to health care organizations throughout the
United States, its territories and possessions. The Company negotiates and
enters into contracts with health care organizations on behalf of its network of
health care professionals who render medical services to patients affiliated
with those facilities.
In March 1998, the Company purchased certain of the assets of HSSI Travel
Nurse Operations, Inc. ("Travel Nurse"), which was formerly a wholly owned
subsidiary of Hospital Staffing Services, Inc., for $5 million in cash. Based in
Fort Lauderdale, Florida since 1981, Travel Nurse has provided registered nurses
and other professional medical personnel, often referred to as "temporary
healthcare professionals," primarily to client hospitals in the United States
and the Caribbean on a contractual basis for periods generally averaging 13
weeks in duration. In August 1998, PEHI issued 517,085 shares of common stock in
exchange for all the outstanding common stock of National Explorers and
Travelers Healthcare, Inc. ("NET Healthcare"), an employee staffing company and
provider of temporary registered nurses and other professional medical personnel
primarily to client hospitals, and combined its operations with Travel Nurse.
This business combination was accounted for as a pooling-of-interests
combination and, accordingly, the Company's financial statements for applicable
periods prior to the combination include the accounts and results of operations
of NET Healthcare.
On November 28, 2000, AMN Healthcare, Inc. acquired 100 percent of the
issued and outstanding stock of the Company. The purchase price to the former
shareholder of the Company included a payment of $75,041,267 in cash (net of
cash received), $4,000,000 of which was delivered to an escrow agent on the
acquisition date in accordance with the purchase agreement. The funds held in
escrow are to be released to the former shareholder in the amount of $2,000,000
on May 31, 2001 and $2,000,000 on December 31, 2001, provided that terms of the
agreement are not violated.
(b) Basis of Presentation
These financial statements have been prepared to reflect the historical
results prior to the change in control, as discussed above, although the period
presented for this purpose was November 30, 2000. Certain transactions with AMN
Healthcare, Inc. subsequent to the purchase have been excluded.
(c) Revenue Recognition
Revenue is recognized as staffing services are rendered. Provisions for
discounts to customers and other adjustments are provided for in the period the
related revenue is recorded.
(d) Property and Equipment
Property and equipment are stated at cost, less accumulated depreciation.
Depreciation on property and equipment is calculated on the straight-line basis
over the estimated useful lives of the related assets which ranges from five to
seven years. Leasehold improvements are amortized using the straight-line basis
over the lesser of the lease term or estimated useful life of the related
improvements. Software and software development costs are depreciated over the
estimated useful life which has been established as three years.
F-36
PREFERRED HEALTHCARE STAFFING, INC.
(A WHOLLY OWNED SUBSIDIARY OF
PREFERRED EMPLOYER'S HOLDINGS, INC.)
NOTES TO FINANCIAL STATEMENTS -- (CONTINUED)
(e) Goodwill
Goodwill was established as a result of the purchase during March 1998 of
certain of the assets of Travel Nurse which was formerly a wholly owned
subsidiary of Hospital Staffing Services, Inc. The goodwill is being amortized
on a straight-line basis over the expected future periods to be benefited,
estimated at approximately 20 years. Amortization of goodwill for the year ended
December 31, 1999 and the eleven-month period ended November 30, 2000 was
$242,150 and $218,296, respectively, resulting in accumulated amortization of
$436,590 and $654,885 as of December 31 1999 and November 30, 2000,
respectively.
The Company assesses the recoverability of goodwill by determining whether
the amortization of the goodwill balance over its remaining estimated life can
be recovered through undiscounted future operating cash flows of the acquired
operation. The assessment of the recoverability of goodwill will be impacted if
estimated future operating cash flows are not achieved.
(f) Impairment of Long-Lived Assets and for Long-Lived Assets to be Disposed
Of
Long-lived assets and certain identifiable intangibles are reviewed for
impairment whenever events or changes in circumstances indicate that the
carrying amount of an asset may not be recoverable. Recoverability of assets to
be held and used is measured by a comparison of the carrying amount of an asset
to future net cash flows, undiscounted and without interest, expected to be
generated by the asset. If such assets are considered to be impaired, the
impairment to be recognized is measured by the amount by which the carrying
amount of the assets exceed the fair value of the assets. Assets to be disposed
of are reported at the lower of the carrying amount or fair value less costs to
sell.
(g) Income Taxes
The Company filed a consolidated U.S. federal and state income tax return
with its parent, PEHI, for the years ended December 31, 1999 and 1998.
Accordingly, all income-tax-related balances are included as due to parent in
the accompanying financial statements.
On June 28, 2000, International Insurance Group, Inc. ("IIG"), an S
corporation, merged with Preferred Employers Holdings, Inc., the parent
corporation of the Company, and IIG was the surviving entity. On June 29, 2000,
IIG elected to treat the Company as a Qualified Subchapter S Subsidiary ("QSSS")
as provided under Internal Revenue Code section 1361(b)(3). A corporation which
is a QSSS for federal income tax purposes is not treated as a separate
corporation. All of the assets, liabilities, and items of income and expense of
the QSSS are treated as items of the S corporation, in this case items of IIG.
No provision has been made for income taxes subsequent to June 28, 2000 since
the Company is not directly subject to income taxes and the results of
operations for the period are includable in the tax returns of the shareholders
of IIG.
In August of 1998, the Company merged with NET Healthcare, an S
corporation, under a business combination accounted for under the
pooling-of-interests method. As a result of the business combination, Net
Healthcare's tax status cease to exist. No provision has been made for income
taxes prior to the date of the business combination since NET Healthcare was not
subject to income tax and the results of operations for the period were included
in the tax returns of the shareholders of NET Healthcare.
Income taxes are accounted for under the asset and liability method.
Deferred tax assets and liabilities for the periods prior to the conversion to a
QSSS are recognized for the future tax consequences attributable to differences
between the financial statement carrying amounts of existing assets and
liabilities and their respective tax bases and operating loss and tax credit
carryforwards. For the period subsequent to the conversion, the Company follows
the built-in gain system of recognizing income taxes. Deferred tax liabilities
are recognized on taxable temporary differences for the excess of the current
financial statement carrying
F-37
PREFERRED HEALTHCARE STAFFING, INC.
(A WHOLLY OWNED SUBSIDIARY OF
PREFERRED EMPLOYER'S HOLDINGS, INC.)
NOTES TO FINANCIAL STATEMENTS -- (CONTINUED)
amount over the tax basis at conversion. Deferred tax assets would be recognized
only for the tax benefits of deductible temporary differences and carryforwards
that are expected to be realized by offsetting taxable amounts under the
provisions of the tax law. Deferred tax assets and liabilities are measured
using enacted tax rates expected to apply to taxable income in the years in
which those temporary differences are expected to be recovered or settled. The
effect on deferred tax assets and liabilities of a change in tax rates is
recognized in income in the period that includes the enactment date.
Pro forma income taxes presented for 2000 and 1998 represents the total of
historical income tax that would have been reported had the respective entities
been taxable C corporations for each of the periods presented.
(h) Use of Estimates
Management of the Company has made a number of estimates and assumptions
relating to the reporting of assets and liabilities and the disclosure of
contingent assets and liabilities to prepare these financial statements in
conformity with accounting principles generally accepted in the United States of
America. Actual results could differ from those estimates.
The Company estimates an allowance for doubtful accounts based on the
credit worthiness of its customers as well as the general economic conditions in
their respective geographical regions. Consequently, a change in those factors
could affect the Company's estimate of its allowance for doubtful accounts.
(i) Concentration of Credit Risk
Most of the Company's business activity is with healthcare organizations
located throughout the United States and the Caribbean. Credit is extended based
on the evaluation of each entity's financial condition and collateral is
generally not required.
(j) Reclassifications
Certain amounts in the 1999 financial statements have been reclassified to
conform to the 2000 presentation.
(k) Pro Forma Net Income
Pro forma net income represents the results of operations for the eleven
months ended November 30, 2000 and the year ended December 31, 1998, adjusted to
reflect a provision for income tax on historical income before income taxes as
if the respective entities had been a taxable C corporation.
(2) ACCOUNTS RECEIVABLE
Accounts receivable consist of the following as of December 31, 1999 and
November 30, 2000.
1999 2000
---------- -----------
Accounts receivable billed......................... $5,086,231 $ 9,272,543
Unbilled accounts receivable....................... 2,000,116 1,997,430
---------- -----------
7,086,347 11,269,973
Less allowance for doubtful accounts............... (164,930) (289,492)
---------- -----------
Accounts receivable, net........................... $6,921,417 $10,980,481
========== ===========
F-38
PREFERRED HEALTHCARE STAFFING, INC.
(A WHOLLY OWNED SUBSIDIARY OF
PREFERRED EMPLOYER'S HOLDINGS, INC.)
NOTES TO FINANCIAL STATEMENTS -- (CONTINUED)
(3) PROPERTY AND EQUIPMENT
Property and equipment consists of the following as of December 31, 1999
and November 30, 2000:
1999 2000
--------- ----------
Leasehold improvements............................... $ 30,118 $ 77,460
Office and computer equipment........................ 340,383 479,332
Software and software development.................... 355,717 528,551
Furniture and fixtures............................... 151,490 197,271
--------- ----------
877,708 1,282,614
Less accumulated depreciation and amortization....... (242,664) (396,385)
--------- ----------
Property and equipment, net.......................... $ 635,044 $ 886,229
========= ==========
(4) ACCOUNTS PAYABLE AND ACCRUED EXPENSES
Accounts payable and accrued expenses consist of the following as of
December 31, 1999 and November 30, 2000:
1999 2000
---------- ----------
Accounts payable.................................... $1,023,680 $ 874,985
Accrued payroll and payroll taxes................... 822,080 2,029,561
Other accrued expenses.............................. 131,822 291,914
---------- ----------
Accounts payable and accrued expenses............... $1,977,582 $3,196,460
========== ==========
(5) LINE OF CREDIT
In May 1998, the Company entered into a $3,000,000 unsecured revolving line
of credit with a bank, unconditionally guaranteed by PEHI. The Company paid the
outstanding balance during 1999 and eliminated the facility. The rate of
interest on the line of credit floated with the prime lending rate. Interest
expense related to the line of credit for the eleven months ended November 30,
2000 and for the years ended December 31, 1999 and 1998 amounted to
approximately $0, $56,000 and $107,000, respectively.
F-39
PREFERRED HEALTHCARE STAFFING, INC.
(A WHOLLY OWNED SUBSIDIARY OF
PREFERRED EMPLOYER'S HOLDINGS, INC.)
NOTES TO FINANCIAL STATEMENTS -- (CONTINUED)
(6) INCOME TAXES
Income tax expense for the years ended December 31, 1998 and 1999 and for
the eleven months ended November 30, 2000 consists of the following:
1998
------------------------------------
CURRENT DEFERRED TOTAL
---------- -------- ----------
U.S. federal..................................... $ 469,967 $ 9,967 $ 479,934
State and local.................................. 80,158 1,063 81,221
---------- ------- ----------
Total....................................... $ 550,125 $11,030 $ 561,155
========== ======= ==========
1999
------------------------------------
CURRENT DEFERRED TOTAL
---------- -------- ----------
U.S. federal..................................... $1,216,882 $36,170 $1,253,052
State and local.................................. 208,595 3,862 212,457
---------- ------- ----------
Total....................................... $1,425,477 $40,032 $1,465,509
========== ======= ==========
2000
------------------------------------
CURRENT DEFERRED TOTAL
---------- -------- ----------
U.S. federal..................................... $ 690,292 $38,743 $ 729,035
State and local.................................. 74,798 3,492 78,290
---------- ------- ----------
Total....................................... $ 765,090 $42,235 $ 807,325
========== ======= ==========
Income tax expense and for the years ended December 31, 1998 and 1999 and
for the eleven months ended November 30, 2000 differed from the amounts computed
by applying the U.S. federal income tax rate of 34 percent to pretax income as a
result of the following:
1998 1999 2000
--------- ---------- -----------
Computed "expected" tax expense................ $ 667,393 $1,296,195 $ 1,898,825
Increase (reduction) in income taxes resulting
from:
State and local income taxes, net of federal
income tax benefit........................ 54,146 96,948 52,892
S corporation earnings of Net Healthcare
prior to merger........................... (252,903) -- --
Meals and entertainment...................... 92,697 27,829 1,029
Other, net................................... (178) 44,537 2,056
Change in tax status......................... -- -- 69,123
Income during QSSS status.................... -- -- (1,216,600)
--------- ---------- -----------
$ 561,155 $1,465,509 $ 807,325
========= ========== ===========
F-40
PREFERRED HEALTHCARE STAFFING, INC.
(A WHOLLY OWNED SUBSIDIARY OF
PREFERRED EMPLOYER'S HOLDINGS, INC.)
NOTES TO FINANCIAL STATEMENTS -- (CONTINUED)
As of December 31, 1999 and November 30, 2000, the Company has a net
deferred tax liability of $3,887 and $46,122, respectively. The tax effects of
temporary differences between financial statement carrying amounts and tax basis
of assets and liabilities that give rise to the deferred tax assets and
liabilities are as follows:
1999 2000
------- -------
Deferred tax assets:
Allowance for doubtful accounts........................... $31,518 $ --
Allowance for billing adjustments......................... 30,545 --
------- -------
Total deferred tax assets.............................. 62,063 --
Deferred tax liabilities -- depreciation and amortization... 65,950 46,122
------- -------
Net deferred tax liability............................. $ 3,887 $46,122
======= =======
In assessing the realizability of deferred tax assets, management considers
whether it is more likely than not that some portion or all of the deferred tax
assets will not be realized. The ultimate realization of deferred tax assets is
dependent upon the generation of future taxable income during the periods in
which those temporary differences become deductible. Management considers the
scheduled reversal of deferred tax liabilities, projected future taxable income
and tax planning strategies in making this assessment. Based upon the level of
historical taxable income and projections for future taxable income over the
periods which the deferred tax assets are deductible, management believes it is
more likely than not the Company will realize the benefits of these deductible
differences.
(7) LEASES
The Company has several noncancelable operating leases, primarily for
office space, a telephone system and a copy machine. Approximate future minimum
annual lease payments under the noncancelable operating leases (with initial or
remaining lease terms in excess of one year) as of November 30, 2000 are as
follows:
YEARS ENDING NOVEMBER 30, TOTAL
------------------------- ----------
2001............................................. $ 399,000
2002............................................. 409,000
2003............................................. 415,000
2004............................................. 345,000
2005............................................. 264,000
----------
$1,832,000
==========
Rent expenses for operating leases was $241,635, $415,325 and $397,629 for
the years ended December 31, 1998 and 1999 and for the eleven months ended
November 30, 2000, respectively.
(8) COMMITMENTS AND CONTINGENCIES
Self-Insurance
Beginning in 1999, the Company became self-insured for its group health
insurance up to predetermined specific and aggregate amounts with stop-loss
limits above such amount for which third-party insurance applies. The Company
has a recorded liability of approximately $198,000 and $70,000 as of December
31,
F-41
PREFERRED HEALTHCARE STAFFING, INC.
(A WHOLLY OWNED SUBSIDIARY OF
PREFERRED EMPLOYER'S HOLDINGS, INC.)
NOTES TO FINANCIAL STATEMENTS -- (CONTINUED)
1998 and 1999, respectively, for such amounts under this agreement. No amounts
were recorded as of November 30, 2000.
Legal Proceedings
The Company is involved in various claims and actions arising in the
ordinary course of business. In the opinion of management, the ultimate
disposition of these matters will not have a material adverse effect on the
Company's financial position, results of operations or liquidity.
(9) FAIR VALUE OF FINANCIAL INSTRUMENTS
The carrying value of the Company's financial instruments approximates fair
value due to the short-term maturity and/or liquidity of these instruments.
F-42
INDEPENDENT AUDITORS' REPORT
The Board of Directors and Shareholders
O'Grady-Peyton International (USA), Inc.:
We have audited the consolidated balance sheets of O'Grady-Peyton
International (USA), Inc. and subsidiary as of December 31, 1999 and 2000, and
the related consolidated statements of income, shareholders' equity, and cash
flows for each of the years in the two-year period ended December 31, 2000.
These financial statements are the responsibility of the Company's management.
Our responsibility is to express an opinion on these financial statements based
on our audits.
We conducted our audits in accordance with auditing standards generally
accepted in the United States of America. Those standards require that we plan
and perform the audit to obtain reasonable assurance about whether the financial
statements are free of material misstatement. An audit includes examining, on a
test basis, evidence supporting the amounts and disclosures in the financial
statements. An audit also includes assessing the accounting principles used and
significant estimates made by management, as well as evaluating the overall
financial statement presentation. We believe that our audits provide a
reasonable basis for our opinion.
In our opinion, the consolidated financial statements referred to above
present fairly, in all material respects, the financial position of
O'Grady-Peyton International (USA), Inc. and subsidiary as of December 31, 1999
and 2000, and the results of their operations and their cash flows for each of
the years in the two-year period ended December 31, 2000, in conformity with
accounting principles generally accepted in the United States of America.
KPMG LLP
Atlanta, Georgia
May 11, 2001
F-43
O'GRADY-PEYTON INTERNATIONAL (USA), INC. AND SUBSIDIARY
CONSOLIDATED BALANCE SHEETS
DECEMBER 31,
------------------------ MARCH 31,
1999 2000 2001
---------- ---------- -----------
(UNAUDITED)
ASSETS
Cash and cash equivalents.............................. $ 14,915 $ 754,703 $1,121,778
Trade accounts receivable including unbilled amounts of
$92,000, $563,000, and $1,273,000, and net of
allowance for doubtful accounts of $384,000,
$275,000, and $151,000 in 1999, 2000, and 2001
(unaudited), respectively............................ 3,333,597 4,958,960 5,855,614
Prepaid expenses and other assets...................... 207,171 92,352 208,249
Deferred taxes......................................... 126,317 152,543 152,543
---------- ---------- ----------
3,682,000 5,958,558 7,338,184
Equipment and furniture, net........................... 47,784 150,638 178,934
---------- ---------- ----------
Total assets................................. $3,729,784 $6,109,196 $7,517,118
========== ========== ==========
LIABILITIES AND SHAREHOLDERS' EQUITY
Current liabilities:
Borrowings under line of credit...................... $1,500,000 $1,510,654 $2,000,000
Current installments of long-term debt............... 99,996 -- --
Notes payable to related party....................... -- 300,000 300,000
Accounts payable..................................... 509,746 282,247 128,334
Accrued expenses..................................... 457,955 1,129,179 595,928
Accrued payroll and payroll taxes.................... 346,206 642,031 1,109,915
Income taxes payable................................. -- 611,498 1,057,478
---------- ---------- ----------
Total current liabilities.................... 2,913,903 4,475,609 5,191,655
Long-term debt......................................... 391,671 -- --
Notes payable to related party......................... 300,000 -- --
---------- ---------- ----------
Total liabilities............................ 3,605,574 4,475,609 5,191,655
---------- ---------- ----------
Shareholders' equity:
Common stock -- authorized 12,500 shares of no par
value; 5,000 shares issued and outstanding........ 4,125 4,125 4,125
Retained earnings.................................... 120,085 1,629,462 2,321,338
---------- ---------- ----------
Total shareholders' equity................... 124,210 1,633,587 2,325,463
Commitments
---------- ---------- ----------
Total liabilities and shareholders' equity... $3,729,784 $6,109,196 $7,517,118
========== ========== ==========
See accompanying notes to consolidated financial statements.
F-44
O'GRADY-PEYTON INTERNATIONAL (USA), INC. AND SUBSIDIARY
CONSOLIDATED STATEMENTS OF INCOME
YEARS ENDED THREE MONTHS ENDED
DECEMBER 31, MARCH 31,
-------------------------- ------------------------
1999 2000 2000 2001
----------- ----------- ---------- ----------
(UNAUDITED)
Revenue................................. $14,541,030 $24,548,075 $5,121,693 $7,774,735
Cost of revenue......................... 11,344,779 17,228,208 3,581,210 5,432,611
----------- ----------- ---------- ----------
Gross profit....................... 3,196,251 7,319,867 1,540,483 2,342,124
General and administrative expenses..... 3,852,565 4,709,212 1,328,695 1,199,594
----------- ----------- ---------- ----------
(Loss) income from operations...... (656,314) 2,610,655 211,788 1,142,530
Interest expense, net................... 91,264 162,006 82,470 25,449
----------- ----------- ---------- ----------
(Loss) income before income
taxes............................ (747,578) 2,448,649 129,318 1,117,081
Income tax (benefit) expense............ (280,724) 939,272 55,067 425,205
----------- ----------- ---------- ----------
Net (loss) income.................. $ (466,854) $ 1,509,377 $ 74,251 $ 691,876
=========== =========== ========== ==========
See accompanying notes to consolidated financial statements.
F-45
O'GRADY-PEYTON INTERNATIONAL (USA), INC. AND SUBSIDIARY
CONSOLIDATED STATEMENTS OF SHAREHOLDERS' EQUITY
YEARS ENDED DECEMBER 31, 1999 AND 2000 AND
THREE MONTHS ENDED MARCH 31, 2001 (UNAUDITED)
COMMON RETAINED
STOCK EARNINGS TOTAL
------ ---------- ----------
Balances, December 31, 1998.............................. $4,125 $ 586,939 $ 591,064
Net loss................................................. -- (466,854) (466,854)
------ ---------- ----------
Balances, December 31, 1999.............................. 4,125 120,085 124,210
Net income............................................... -- 1,509,377 1,509,377
------ ---------- ----------
Balances, December 31, 2000.............................. 4,125 1,629,462 1,633,587
Net income (unaudited)................................... -- 691,876 691,876
------ ---------- ----------
Balances, March 31, 2001................................. $4,125 $2,321,338 $2,325,463
====== ========== ==========
See accompanying notes to consolidated financial statements.
F-46
O'GRADY-PEYTON INTERNATIONAL, INC. (USA) AND SUBSIDIARY
CONSOLIDATED STATEMENTS OF CASH FLOWS
YEARS ENDED THREE MONTHS ENDED
DECEMBER 31, MARCH 31,
-------------------------- -----------------------
1999 2000 2000 2001
----------- ----------- --------- ----------
(UNAUDITED)
Cash flows from operating activities:
Net (loss) income...................... $ (466,854) $ 1,509,377 $ 74,251 $ 691,876
Adjustments to reconcile net (loss)
income to cash (used in) provided by
operating activities:
Depreciation........................ 129,394 36,545 6,522 18,016
Deferred tax benefit................ (280,724) (26,226) -- --
Changes in:
Accounts receivable............... (1,119,883) (1,625,363) 473,999 (896,654)
Prepaid expenses and other
assets......................... 185,297 114,819 (191,784) (115,897)
Accounts payable and accrued
expenses....................... 594,263 739,550 239,286 (219,280)
Income taxes payable.............. -- 611,498 105,444 445,980
----------- ----------- --------- ----------
Cash (used in) provided by
operating activities......... (958,507) 1,360,200 707,718 (75,959)
----------- ----------- --------- ----------
Cash flows used in investing activities--
acquisition of equipment and
furniture.............................. (44,844) (139,399) (9,506) (46,312)
----------- ----------- --------- ----------
Cash flows from financing activities:
Net borrowings under line of credit.... 1,100,000 10,654 -- 489,346
Proceeds from long-term debt........... 500,000 -- -- --
Payments on notes payable to related
parties............................. (603,955) -- -- --
Repayment of long-term debt............ (8,332) (491,667) (25,000)
----------- ----------- --------- ----------
Net cash provided by (used in)
financing activities......... 987,713 (481,013) (25,000) 489,346
----------- ----------- --------- ----------
Net (decrease) increase in cash
and cash equivalents......... (15,638) 739,788 673,212 367,075
Cash and cash equivalents at beginning of
year................................... 30,553 14,915 14,915 754,703
----------- ----------- --------- ----------
Cash and cash equivalents at end of
year................................... $ 14,915 $ 754,703 $ 688,127 $1,121,778
=========== =========== ========= ==========
Supplemental cash flows
information -- cash paid during the
year for:
Interest............................... $ 85,028 $ 219,000 $ 86,280 $ 32,043
=========== =========== ========= ==========
Income taxes........................... $ 24,011 $ 354,000 $ -- $ 3,580
=========== =========== ========= ==========
See accompanying notes to consolidated financial statements.
F-47
O'GRADY-PEYTON INTERNATIONAL (USA), INC. AND SUBSIDIARY
CONSOLIDATED FINANCIAL STATEMENTS
DECEMBER 31, 1999 AND 2000 AND MARCH 31, 2001 (UNAUDITED)
(1) DESCRIPTION OF BUSINESS AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
O'Grady-Peyton International (USA), Inc. (the "Company"), employs
registered nurses and contracts their services to hospitals and health care
facilities throughout the United States. The Company extends credit to its
customers on an unsecured basis. The Company recruits many of its nurses from
the United States, Ireland, United Kingdom, South Africa, Australia, New
Zealand, Philippines, and Canada.
The accompanying consolidated interim financial statements (including notes
to financial statements) of the Company as of March 31, 2001 and for the three
months ended March 31, 2000 and 2001, are unaudited. In the opinion of
management, the accompanying unaudited consolidated interim financial statements
reflect all adjustments, consisting only of normal recurring adjustments,
necessary to present fairly the financial position of the Company at March 31,
2001, and the results of its operations and its cash flows for the three months
ended March 31, 2000 and 2001.
The following is a summary of the more significant accounting policies and
practices of the Company.
(a) Consolidation
The accompanying financial statements include the accounts of the Company
and its wholly owned subsidiary. Significant intercompany accounts and
transactions have been eliminated in consolidation.
(b) Revenue Recognition
The Company recognizes revenue when services are performed.
(c) Cash Equivalents
The Company considers all highly liquid investments with a maturity of
three months or less at the date of acquisition to be cash equivalents.
(d) Equipment and Furniture
Equipment and furniture are recorded at cost less accumulated depreciation.
Depreciation is computed using the straight-line method over the following
estimated useful lives:
Equipment................................................ 3 - 5 years
Furniture................................................ 5 years
(e) Self-Insurance
The Company provides a self-insured medical reimbursement program covering
substantially all full-time employees whereby it assumes limited liabilities
with the excess liability assumed by the insurance company. Provision for claims
under the self-insured program is recorded based on the Company's experience.
(f) Income Taxes
Income taxes are accounted for under the asset and liability method.
Deferred tax assets and liabilities are recognized for the future tax
consequences attributable to differences between the financial statement
carrying amounts of existing assets and liabilities and their respective tax
bases and operating loss and tax credit carryforwards. Deferred tax assets and
liabilities are measured using enacted tax rates expected to apply to taxable
income in the years in which those temporary differences are expected to be
recovered or settled. The effect on deferred tax assets and liabilities of a
change in tax rates is recognized in income in the period that includes the
enactment date.
F-48
O'GRADY-PEYTON INTERNATIONAL (USA), INC. AND SUBSIDIARY
CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
(g) Estimates
Management of the Company has made a number of estimates and assumptions
relating to the reporting of assets and liabilities and the disclosure of
contingent assets and liabilities to prepare these financial statements in
conformity with accounting principles generally accepted in the United States of
America. Actual results could differ from those estimates.
(h) Fair Value of Financial Instruments
The fair value of financial instruments is determined by reference to
various market data and other valuation techniques, as appropriate. The Company
believes that the fair value of financial instruments, including cash and cash
equivalents, trade accounts receivable, and accounts payable and accrued
expenses, approximates their recorded values due primarily to the short-term
nature of their maturities. The carrying amounts of long-term debt is considered
to be reasonable estimates of their fair values, as the borrowings have variable
rates that reflect currently available terms and conditions for similar debt.
The carrying amounts of notes payable to related party are impractical to
determine due to their related party nature.
(2) PROPERTY AND EQUIPMENT
Property and equipment consists of the following:
DECEMBER 31,
--------------------
1999 2000
-------- --------
Equipment.............................................. $307,271 $422,489
Furniture.............................................. 65,271 93,582
-------- --------
372,542 516,071
Less accumulated depreciation.......................... 324,758 365,433
-------- --------
Property and equipment, net....................... $ 47,784 $150,638
======== ========
Depreciation expense charged to operations was approximately $129,000,
$37,000, $7,000 and $18,000 for the years ended December 31, 1999 and 2000 and
the three months ended March 31, 2000 and 2001 (unaudited), respectively.
(3) LINE OF CREDIT
The Company has a $2,000,000 line of credit facility with a commercial
bank. Interest on outstanding borrowings is payable monthly at rates ranging
from the prime rate less .25% to prime plus .5% (10% at December 31, 2000),
depending on the Company's debt-to-net worth ratio. Borrowings under the
facility are secured by substantially all assets of the Company. The line of
credit agreement contains provisions which place limitations on indebtedness and
the disposition of assets. At December 31, 2000, the Company was in compliance
with these covenants. The facility matures on June 30, 2001.
F-49
O'GRADY-PEYTON INTERNATIONAL (USA), INC. AND SUBSIDIARY
CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
(4) LONG-TERM DEBT
Long-term debt consists of the following:
DECEMBER 31,
----------------
1999 2000
-------- ----
Installment note payable in monthly principal payments of
$8,333 plus interest at the prime rate through November
2004; secured by substantially all assets of the
Company................................................. $491,667 $ --
Less current installments................................. 99,996 --
-------- ----
$391,671 $ --
======== ====
(5) RETIREMENT PLAN
The Company sponsors a salary deferral plan that covers all full-time
employees who have met certain age and service requirements. Contributions to
the plan are at the discretion of the Board of Directors. The Company made no
contributions to the plan in 1999 and 2000.
(6) INCOME TAX
Income tax (benefit) expense consists of:
CURRENT DEFERRED TOTAL
-------- --------- ---------
Year ended December 31, 1999:
U.S. Federal.................................... $ -- $(251,174) $(251,174)
State and local................................. -- (29,550) (29,550)
-------- --------- ---------
$ -- $(280,724) $(280,724)
======== ========= =========
Year ended December 31, 2000:
U.S. Federal.................................... $812,890 $ (23,465) $ 789,425
State and local................................. 152,608 (2,761) 149,847
-------- --------- ---------
$965,498 $ (26,226) $ 939,272
======== ========= =========
Income tax (benefit) expense differed from the amounts computed by applying
the U.S. Federal income tax rate of 34% to (loss) income before taxes as a
result of the following:
1999 2000
--------- --------
Computed "expected" tax expense (benefit)............. $(254,176) $832,540
Increase (reduction) in income taxes resulting from:
Meals and entertainment............................. 3,002 8,497
State and local income taxes, net of Federal income
tax benefit...................................... (19,503) 98,899
Other, net.......................................... (10,047) (664)
--------- --------
$(280,724) $939,272
========= ========
F-50
O'GRADY-PEYTON INTERNATIONAL (USA), INC. AND SUBSIDIARY
CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
The tax effects of temporary differences that give rise to significant
portions of the deferred tax assets and deferred tax liabilities at December 31,
1999 and 2000 are presented below:
1999 2000
-------- --------
Deferred tax assets:
Accounts receivable, principally due to allowance for
doubtful accounts................................. $ -- $104,500
Depreciation......................................... 9,514 --
Accrued expenses..................................... -- 42,650
Net operating loss carryforwards..................... 115,929 --
Other................................................ 874 5,393
-------- --------
Total gross deferred tax asset.................... $126,317 $152,543
======== ========
Management believes that it is more likely than not that the results of the
future operations will generate sufficient taxable income to realize the
deferred tax assets and, accordingly, has not provided a valuation allowance.
(7) COMMITMENTS
The Company leases office space under noncancelable leases. Minimum annual
rentals are as follows:
YEARS ENDING DECEMBER 31, AMOUNT
------------------------- --------
2001.............................................. $165,000
2002.............................................. 156,000
2003.............................................. 56,000
--------
$377,000
========
Total rent expense amounted to $179,339 and $139,254 in 1999 and 2000 and
$49,560 and $42,376 for the three months ended March 31, 2000 and 2001
(unaudited), respectively.
(8) RELATED PARTY TRANSACTIONS
The Company has a $300,000 note payable to a party related to the
shareholders of the Company. The note is unsecured, bears interest at 8%, and is
due June 2001. Interest paid on the note amounted to $24,000 in 1999 and 2000.
The Company pays recruiting expenses to various companies under common
management control. Recruiting costs include approximately $1,561,000 and
$1,500,000 paid to these related companies in 1999 and 2000, respectively. In
addition, the Company pays a management fee to a company under common management
control. The fee in 2000 was $800,000. Accrued expenses includes approximately
$692,000 owed to a related company.
(9) SUBSEQUENT EVENT
Effective May 1, 2001, the Company was acquired by AMN Healthcare Services,
Inc.
F-51
AMN HEALTHCARE SERVICES, INC.
INDEX TO PRO FORMA CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
PAGE
----
Unaudited Pro Forma Condensed Consolidated Financial
Statements................................................ P-2
Unaudited Pro Forma Condensed Consolidated Statement of
Operations for the year ended December 31, 2000........... P-3
Notes to Unaudited Pro Forma Condensed Consolidated
Statement of Operations for the year ended December 31,
2000...................................................... P-4
Unaudited Pro Forma Condensed Consolidated Statement of
Operations for the nine months ended September 30, 2001... P-5
Notes to Unaudited Pro Forma Consolidated Statement of
Operations for the nine months ended September 30, 2001... P-6
Unadjusted Pro Forma Condensed Consolidated Statement of
Operations for the nine months ended September 30, 2000... P-7
Notes to Unaudited Pro Forma Consolidated Statement of
Operations for the nine months ended September 30, 2000... P-8
P-1
UNAUDITED PRO FORMA CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
We acquired Nurses RX, Inc., Preferred Healthcare Staffing, Inc., and
O'Grady-Peyton International (USA), Inc. on June 28, 2000, November 28, 2000 and
May 1, 2001, respectively. NursesRx and Preferred Healthcare's results of
operations for the six months and one month ended December 31, 2000,
respectively, are included in our condensed consolidated statement of operations
for the year ended December 31, 2000. The unaudited pro forma condensed
consolidated statements of operations for the year ended December 31, 2000 and
the nine months ended September 30, 2000 give effect to the acquisitions of
NursesRx, Preferred Healthcare and O'Grady-Peyton, as well as this initial
public offering, including application of the proceeds thereof to repay
outstanding indebtedness under our credit facility and our senior subordinated
notes as required pursuant to the debt agreements, as if these events had
occurred on January 1, 2000. The unaudited pro forma condensed consolidated
statement of operations for the nine months ended September 30, 2001 gives
effect to the acquisition of O'Grady-Peyton and this initial public offering as
if these events had occurred on January 1, 2000.
This pro forma financial information does not purport to represent what our
actual results of operations or financial position would have been had the
acquisitions occurred on the dates indicated or for any future period or date.
The pro forma adjustments give effect to available information and assumptions
that we believe are reasonable. You should read our pro forma condensed
consolidated financial information in conjunction with our financial statements
and the related notes, as well as "Selected Consolidated Financial and Operating
Data," "Summary Consolidated Financial and Operating Data," "Capitalization" and
"Management's Discussion and Analysis of Financial Condition and Results of
Operations" appearing elsewhere in this prospectus.
P-2
AMN HEALTHCARE SERVICES, INC.
UNAUDITED PRO FORMA CONDENSED CONSOLIDATED
STATEMENT OF OPERATIONS
FOR THE YEAR ENDED DECEMBER 31, 2000
(IN THOUSANDS, EXCEPT SHARE AND PER SHARE DATA)
HISTORICAL(1)
----------------------------------------------
PREFERRED O'GRADY- PRO FORMA PRO
AMN NURSESRX HEALTHCARE PEYTON ADJUSTMENTS FORMA
-------- -------- ---------- -------- ----------- --------
Revenue..................... $230,766 $13,879 $57,162 $24,548 $ -- $326,355
Cost of revenue............. 170,608 9,580 44,568 17,228 -- 241,984
-------- ------- ------- ------- -------- --------
Gross profit.............. 60,158 4,299 12,594 7,320 -- 84,371
Expenses:
Selling, general, and
administrative
(excluding non-cash
stock-based
compensation).......... 30,728 3,580 6,637 4,672 (1,018)(2) 44,599
Non-cash stock-based
compensation........... 22,379 -- -- -- 31,771(3) 54,150
Amortization.............. 2,387 -- 218 -- 3,130(4) 5,735
Depreciation.............. 916 55 199 37 -- 1,207
Transaction costs......... 1,500 -- -- -- -- 1,500
-------- ------- ------- ------- -------- --------
Total expenses.............. 57,910 3,635 7,054 4,709 33,883 107,191
-------- ------- ------- ------- -------- --------
Income (loss) from
operations................ 2,248 664 5,540 2,611 (33,883) (22,820)
Interest income (expense),
net....................... (10,006) (18) 44 (162) 10,173(5) 31
-------- ------- ------- ------- -------- --------
Income (loss) before income
tax benefit (expense) and
extraordinary item........ (7,758) 646 5,584 2,449 (23,710) (22,789)
Income tax benefit
(expense)................. 2,560 (189) (807) (940) 6,896(6) 7,520
-------- ------- ------- ------- -------- --------
Income (loss) before
extraordinary item(7)..... $ (5,198) $ 457 $ 4,777 $ 1,509 $(16,814) $(15,269)
======== ======= ======= ======= ======== ========
Net loss per common share --
basic and diluted......... $ (0.38)
========
Weighted average common
shares -- basic and
diluted................... 40,715(8)
========
See accompanying notes to Unaudited Pro Forma Condensed Consolidated Statement
of Operations.
P-3
AMN HEALTHCARE SERVICES, INC.
NOTES TO UNAUDITED PRO FORMA CONDENSED CONSOLIDATED
STATEMENT OF OPERATIONS
FOR THE YEAR ENDED DECEMBER 31, 2000
(1) The historical results of operations of AMN includes the results of NursesRx
and Preferred Healthcare commencing June 28, 2000 and November 28, 2000,
respectively, their dates of acquisition by AMN. The historical results of
operations of NursesRx and Preferred Healthcare reflect their results from
January 1, 2000 through June 28, 2000 and November 28, 2000, respectively.
The historical results of operations of O'Grady-Peyton reflects its results
for the year ended December 31, 2000.
(2) The pro forma selling, general and administrative expense gives effect to
the elimination of certain payments to the former owners of Preferred
Healthcare and NursesRx. Specifically, these amounts were made up of
$878,000 related to the NursesRx acquisition and $140,000 related to the
Preferred Healthcare acquisition. Of the $878,000 attributable to NursesRx,
$610,000 relates to payments made to the former owners of NursesRx in excess
of their annual compensation. As these amounts are not included in their
current contractual employment agreements with the Company, these payments
would not have been made if the acquisition had occurred on January 1, 2000.
The remaining $268,000 was paid to senior management by the sellers as a
bonus for the successful sale of NursesRx to the Company. These payments
were paid by the seller in the month of the closing of the transaction.
The $140,000 related to the Preferred Healthcare acquisition was recorded as
a pro forma adjustment as it relates to nominal management services provided
by the former owners of Preferred Healthcare that will be provided by
existing company management at no additional cost. Therefore, this expense
was eliminated by the Company after the acquisition and will not have a
continuing impact on the Company going forward.
(3) The pro forma stock-based compensation adjustment gives effect to the
vesting of all outstanding stock options under the 1999 stock option plans
as if the consummation of this initial public offering had occurred on
January 1, 2000. Pursuant to the provisions of the 1999 stock option plans,
options become fully vested upon the occurrence of an initial public
offering.
(4) The pro forma amortization expense gives effect to additional goodwill
amortization of $305,000, $2,174,000, and $453,000 in connection with the
NursesRx, Preferred Healthcare and O'Grady-Peyton acquisitions,
respectively. It also gives effect to additional non-compete amortization of
$103,000, $45,000, and $50,000 for NursesRx, Preferred Healthcare, and
O'Grady-Peyton, respectively.
(5) The pro forma interest expense, net gives effect to the reduction of
interest expense in the amount of $10,173,000 related to the payment of all
outstanding debt with the proceeds of this initial public offering.
(6) The pro forma adjustment represents the additional tax expense, calculated
at our effective tax rate of approximately 33.0% related to the pro forma
adjustments described above and pre-tax income of NursesRx, Preferred
Healthcare and O'Grady-Peyton.
(7) Pro forma income (loss) does not include $5,471,000 in extraordinary loss,
net of income tax benefit of $2,694,000, resulting from the write-off of the
unamortized discount on the senior subordinated notes and unamortized
deferred financing costs as this is a nonrecurring charge which will be
included in our income (loss) following this initial public offering.
(8) Pro forma basic and diluted weighted average shares gives effect to the
shares issued in this initial public offering plus the shares of common
stock to be issued upon exercise of warrants at the time of this initial
public offering, but does not give effect to the shares that had been issued
under stock options outstanding under the 1999 stock option plans, as the
impact would be anti-dilutive.
P-4
AMN HEALTHCARE SERVICES, INC.
UNAUDITED PRO FORMA CONDENSED CONSOLIDATED
STATEMENT OF OPERATIONS
FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2001
(IN THOUSANDS, EXCEPT SHARE AND PER SHARE DATA)
HISTORICAL(1)
----------------------
O'GRADY- PRO FORMA
AMN PEYTON ADJUSTMENTS PRO FORMA
---------- -------- ----------- ---------
Revenue........................................ $357,108 $10,582 $ -- $367,690
Cost of revenue................................ 267,333 7,373 -- 274,706
-------- ------- ------- --------
Gross profit................................. 89,775 3,209 -- 92,984
Expenses:
Selling, general, and administrative
(excluding non-cash stock-based
compensation)............................. 49,750 1,818 -- 51,568
Non-cash stock-based compensation............ 13,096 -- (13,096)(2) --
Amortization................................. 4,128 -- 168(3) 4,296
Depreciation................................. 1,484 25 -- 1,509
-------- ------- ------- --------
Total expenses................................. 68,458 1,843 (12,928) 57,373
-------- ------- ------- --------
Income from operations......................... 21,317 1,366 12,928 35,611
Interest income (expense), net................. (11,780) (43) 11,776(4) (47)
-------- ------- ------- --------
Income before income tax expense............... 9,537 1,323 24,704 35,564
Income tax expense............................. (4,959) (539) (12,995)(5) (18,493)
-------- ------- ------- --------
Net income..................................... $ 4,578 $ 784 $11,709 $ 17,071
======== ======= ======= ========
Net income per common share
Basic........................................ $ 0.42
========
Diluted...................................... $ 0.39
========
Weighted average common shares
Basic........................................ 40,715(6)
========
Diluted...................................... 44,325(7)
========
See accompanying notes to Unaudited Pro Forma Condensed Consolidated Statement
of Operations.
P-5
AMN HEALTHCARE SERVICES, INC.
NOTES TO UNAUDITED PRO FORMA CONDENSED CONSOLIDATED BALANCE SHEET AND
UNAUDITED PRO FORMA CONSOLIDATED STATEMENT OF OPERATIONS
AS OF AND FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2001
(1) The historical results of operations of AMN includes the results of
O'Grady-Peyton, commencing May 1, 2001, its date of acquisition by AMN. The
historical results of operations of O'Grady-Peyton reflect its results from
January 1, 2001 through May 1, 2001.
(2) The pro forma stock-based compensation adjustment gives effect to the
vesting of all outstanding stock options under the 1999 stock option plans
as if the consummation of this initial public offering had occurred on
January 1, 2000. Pursuant to the provisions of the 1999 stock option plans,
options become fully vested upon the occurrence of an initial public
offering. Therefore, there would be no charge during the nine months ended
September 30, 2001 related to these options.
(3) The pro forma amortization expense gives effect to additional goodwill
amortization of $151,000 and additional non compete amortization of $17,000
in connection with the O'Grady-Peyton acquisition.
(4) The pro forma interest expense, net gives effect to the reduction of
interest expense in the amount of $10,950,000 and the settlement of the
derivative instrument agreements in the amount of $826,000 in connection
with the payment of all outstanding debt with the proceeds of this initial
public offering.
(5) The pro forma tax adjustment represents the additional tax expense,
calculated at AMN's effective tax rate of approximately 52%, for the pro
forma adjustments described above and the pre-tax income of O'Grady-Peyton.
(6) Pro forma basic weighted average shares gives effect to the shares issued
in this initial public offering plus the shares of common stock to be
issued upon the exercise of warrants at the time of this initial public
offering.
(7) Pro forma diluted weighted average shares gives effect to the stock options
outstanding under the 1999 stock option plans.
P-6
AMN HEALTHCARE SERVICES, INC.
UNAUDITED PRO FORMA CONDENSED CONSOLIDATED
STATEMENT OF OPERATIONS
FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2000
(IN THOUSANDS, EXCEPT SHARE AND PER SHARE DATA)
HISTORICAL(1)
-------------------------------------------
PREFERRED O'GRADY- PRO FORMA PRO
AMN NURSESRX HEALTHCARE PEYTON ADJUSTMENTS FORMA
-------- -------- ---------- -------- ----------- --------
Revenue.......................... $151,713 $13,879 $44,507 $16,634 $ -- $226,733
Cost of revenue.................. 112,729 9,580 33,602 11,604 -- 167,515
-------- ------- ------- ------- -------- --------
Gross profit................... 38,984 4,299 10,905 5,030 -- 59,218
Expenses:
Selling, general, and
administrative (excluding
non-cash stock-based
compensation)............... 19,770 3,580 6,689 3,468 (1,018)(2) 32,489
Non-cash stock-based
compensation................ 15,901 -- -- -- 38,249(3) 54,150
Amortization................... 1,504 -- 179 -- 2,618(4) 4,301
Depreciation................... 605 55 159 27 -- 846
Transaction costs.............. -- -- -- -- -- --
-------- ------- ------- ------- -------- --------
Total expenses................... 37,780 3,635 7,027 3,495 39,849 91,786
-------- ------- ------- ------- -------- --------
Income (loss) from operations.... 1,204 664 3,878 1,535 (39,849) (32,568)
Interest income (expense), net... (7,043) (18) 32 (141) 7,165(5) (5)
-------- ------- ------- ------- -------- --------
Income (loss) before income tax
benefit (expense) and
extraordinary item............. (5,839) 646 3,910 1,394 (32,684) (32,573)
Income tax benefit (expense)..... 1,927 (189) (802) (407) 10,220(6) 10,749
-------- ------- ------- ------- -------- --------
Income (loss) before
extraordinary item(7).......... $ (3,912) $ 457 $ 3,108 $ 987 $(22,464) $(21,824)
======== ======= ======= ======= ======== ========
Net loss per common share --basic
and diluted.................... $ (0.54)(8)
========
Weighted average common shares --
basic and diluted.............. 40,715(8)
========
See accompanying notes to Unaudited Pro Forma Condensed Consolidated Statement
of Operations.
P-7
AMN HEALTHCARE SERVICES, INC.
NOTES TO UNAUDITED PRO FORMA CONDENSED CONSOLIDATED
STATEMENT OF OPERATIONS
FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2000
(1) The historical results of operations of AMN includes the results of NursesRx
commencing June 28, 2000, its date of acquisition by AMN. The historical
results of operations of NursesRx and Preferred Healthcare reflect their
results from January 1, 2000 through June 28, 2000 and September 30, 2000,
respectively. The historical results of operations of O'Grady-Peyton
reflects its results for the nine months ended September 30, 2000.
(2) The pro forma selling, general and administrative expense gives effect to
the elimination of certain payments to the former owners of Preferred
Healthcare and NursesRx. Specifically, these amounts were made up of
$878,000 related to the NursesRx acquisition and $140,000 related to the
Preferred Healthcare acquisition. Of the $878,000 attributable to NursesRx,
$610,000 relates to payments made to the former owners of NursesRx in excess
of their annual compensation. As these amounts are not included in their
current contractual employment agreements with the Company, these payments
would not have been made if the acquisition had occurred on January 1, 2000.
The remaining $268,000 was paid to senior management by the sellers as a
bonus for the successful sale of NursesRx to the Company. These payments
were paid by the seller in the month of the closing of the transaction.
The $140,000 related to the Preferred Healthcare acquisition was recorded as
a pro forma adjustment as it relates to nominal management services provided
by the former owners of Preferred Healthcare that will be provided by
existing company management at no additional cost. Therefore, this expense
was eliminated by the Company after the acquisition and will not have a
continuing impact on the Company going forward.
(3) The pro forma stock-based compensation adjustment gives effect to the
vesting of all outstanding stock options under the 1999 stock option plans
as if the consummation of this initial public offering had occurred on
January 1, 2000. Pursuant to the provisions of the 1999 stock option plans,
options become fully vested upon the occurrence of an initial public
offering.
(4) The pro forma amortization expense gives effect to additional goodwill
amortization of $305,000, $1,796,000, and $340,000 in connection with the
NursesRx, Preferred Healthcare and O'Grady-Peyton acquisitions,
respectively. It also gives effect to additional non-compete amortization of
$103,000, $37,000, and $37,000 for NursesRx, Preferred Healthcare, and
O'Grady-Peyton, respectively.
(5) The pro forma interest expense, net gives effect to the reduction of
interest expense in the amount of $7,165,000 related to the payment of all
outstanding debt with the proceeds of this initial public offering.
(6) The pro forma adjustment represents the additional tax expense, calculated
at our effective tax rate of approximately 33.0% related to the pro forma
adjustments described above and pre-tax income of NursesRx, Preferred
Healthcare and O'Grady-Peyton.
(7) Pro forma income (loss) does not include $5,471,000 in extraordinary loss,
net of income tax benefit of $2,694,000, resulting from the write-off of the
unamortized discount on the senior subordinated notes and unamortized
deferred financing costs as this is a nonrecurring charge which will be
included in our income (loss) following this initial public offering.
(8) Pro forma basic and diluted weighted average shares gives effect to the
shares issued in this initial public offering plus the shares of common
stock to be issued upon exercise of warrants at the time of this initial
public offering, but does not give effect to the shares that had been issued
under stock options outstanding under the 1999 stock option plans, as the
impact would be anti-dilutive.
P-8
[Art work: A collage of photos (four depicting travel scenes and two depicting
clinical scenes), five brand name logos, NurseZone.com logo and Registrant's
logo, a listing of Registrant's offices and a screen map of the world.]
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
10,000,000 SHARES
[AMN HEATHCARE SERVICES, INC. LOGO]
------------------------------
PROSPECTUS
, 2001
------------------------------
BANC OF AMERICA SECURITIES LLC
UBS WARBURG
------------------------------
JPMORGAN
Until , 2001, all dealers that buy, sell or trade the common
stock may be required to deliver a prospectus, regardless of whether they are
participating in this offering. This is in addition to the dealers' obligation
to deliver a prospectus when acting as underwriters and with respect to their
unsold allotments or subscriptions.
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
PART II
INFORMATION NOT REQUIRED IN PROSPECTUS
ITEM 13. OTHER EXPENSES OF ISSUANCE AND DISTRIBUTION.
The following sets forth the estimated expenses and costs (other than
underwriting discounts and commissions) expected to be incurred in connection
with the issuance and distribution of the common stock registered hereby:
SEC registration fee........................................ $ 46,000
NASD fee.................................................... 31,000
Printing and engraving expenses............................. 900,000
Accounting fees and expenses................................ 1,080,000
Legal fees and expenses..................................... 1,250,000
Blue Sky fees and expenses.................................. 40,000
NYSE listing application fee................................ 266,000
Transfer agent fees and expenses............................ 5,000
Miscellaneous............................................... 466,000
----------
TOTAL.................................................. $4,084,000
==========
ITEM 14. INDEMNIFICATION OF DIRECTORS AND OFFICERS.
Section 145 of the General Corporation Law of the State of Delaware provides as
follows:
A corporation may indemnify any person who was or is a party or is
threatened to be made a party to any threatened, pending or completed action,
suit or proceeding, whether civil, criminal, administrative or investigative
(other than an action by or in the right of the corporation) by reason of the
fact that the person is or was a director, officer, employee or agent of the
corporation, or is or was serving at the request of the corporation as a
director, officer, employee or agent or another corporation, partnership, joint
venture, trust or other enterprise, against expenses (including attorneys'
fees), judgments, fines and amounts paid in settlement actually and reasonably
incurred by the person in connection with such action, suit or proceeding if the
person acted in good faith and in a manner the person reasonably believed to be
in or not opposed to the best interest of the corporation, and, with respect to
any criminal action or proceeding, had no reasonable cause to believe the
person's conduct was unlawful. The termination of any action, suit or proceeding
by judgment, order, settlement, conviction or upon a plea of nolo contendere or
its equivalent, shall not, of itself, create a presumption that the person did
not act in good faith and in a manner which he reasonably believed to be in or
not opposed to the best interests of the corporation, and, with respect to any
criminal action or proceeding, had reasonable cause to believe that the person's
conduct was unlawful.
A corporation may indemnify any person who was or is a party or is
threatened to be made a party to any threatened, pending or completed action or
suit by or in the right of the corporation to procure a judgment in its favor by
reason of the fact that he is or was a director, officer, employee or agent of
the corporation, or is or was serving at the request of the corporation as a
director, officer, employee or agent of another corporation, partnership, joint
venture, trust or other enterprise against expenses (including attorneys' fees)
actually and reasonably incurred by the person in connection with the defense or
settlement of such action or suit if the person acted in good faith and in a
manner the person reasonably believed to be in or not opposed to the best
interests of the corporation and except that no indemnification will be made in
respect to any claim, issue or matter as to which such person shall have been
adjudged to be liable to the corporation unless and only to the extent that the
Court of Chancery or the court in which such action or suit was brought shall
determine upon application that, despite the adjudication of liability but in
view of all the circumstances of the case, such person is fairly and reasonably
entitled to indemnity for such expenses which the Court of Chancery or such
other court shall deem proper.
II-1
Our amended and restated certificate of incorporation provides that we will
indemnify any person, including persons who are not our directors and officers,
to the fullest extent permitted by Section 145 of the Delaware General
Corporation Law.
In addition, pursuant to our Bylaws, we will indemnify our directors and
officers against expenses (including judgments or amounts paid in settlement)
incurred in any action, civil or criminal, to which any such person is a party
by reason of any alleged act or failure to act in his capacity as such, except
as to a matter as to which such director or officer shall have been finally
adjudged to be liable for negligence or misconduct in the performance of his
duty to the corporation or not to have acted in good faith in the reasonable
belief that his action was in the best interest of the corporation.
The underwriting agreement provides that the underwriters are obligated,
under certain circumstances, to indemnify our directors, officers and
controlling persons against certain liabilities, including liabilities under the
Securities Act. Reference is made to the form of underwriting agreement filed as
Exhibit 1.1 hereto.
We maintain directors and officers liability insurance for the benefit of
our directors and certain of our officers.
Reference is made to Item 17 for our undertakings with respect to
indemnification for liabilities arising under the U.S. Securities Act of 1993.
ITEM 15. RECENT SALES OF UNREGISTERED SECURITIES.
The following is a summary of transactions by us involving sales of our
securities that were not registered under the Securities Act during the last
three years preceding the date of this registration statement:
(a) On November 18, 1998, we issued 1,800 shares of common stock upon a
stock split to our then existing stockholders.
(b) On November 18, 1998, we issued 182 shares of common stock at a price
of $11,265.21 per share to our then existing stockholders.
(c) On November 18, 1998, we issued 306 shares of common stock to the
stockholders of Medical Express, Inc. in connection with our
acquisition of Medical Express, Inc.
(d) On October 18, 1999, we issued 517.8 shares of common stock in
exchange for AMN Healthcare, Inc. shares.
(e) On November 19, 1999, we issued 1,814.9 shares of common stock at a
price of $32,794.87 per share upon our recapitalization to some of our
existing stockholders.
(f) On November 19, 1999, we issued 472,634.9 shares of common stock upon
the split of 2,363.17 outstanding shares, on the basis of 200 shares
for each outstanding share to our then existing stockholders.
(g) On November 19, 1999, we issued options to purchase an aggregate of
84,343.4 shares of stock to members of management, each at an exercise
price of $163.9743 per share.
(h) On June 26, 2000, we issued an aggregate of 73,182.2 shares at a price
of $163.9743 per share for capital contributions in connection with
our acquisition of Nurses RX, Inc. to some of our existing
stockholders.
(i) On November 20, 2000, we issued options to purchase 4,686 shares of
stock to a member of management at an exercise price of $163.9743 per
share.
(j) On November 28, 2000, we issued an aggregate of 123,077 shares at a
price of $325.00 per share for capital contributions in connection
with our acquisition of Preferred Healthcare Staffing, Inc. to some of
our existing stockholders.
(k) On December 13, 2000, we issued options to purchase an aggregate of
31,170.6 shares of stock to members of management, each at an exercise
price of $287.84 per share.
II-2
(l) On March 29, 2001, we issued 616,694.9 shares of common stock to the
HWP stockholders in connection with the merger of AMN Acquisition Corp.
with and into us and the 616,694.9 shares previously held by AMN
Acquisition Corp. were canceled.
(m) On July 24, 2001, we issued options to purchase an aggregate of 12,673
shares of stock to members of management, each at an exercise price of
$392.04 per share.
(n) On October 18, 2001, we issued 28,835,015 shares of common stock upon
the split of 668,894.1 outstanding shares, on the basis of 43.10849
shares for each outstanding share to our existing stockholders.
(o) Prior to the effectiveness of this offering, we issued 1,879,628
shares of common stock to BancAmerica Capital Investors SBIC I, L.P.
in connection with the exercise of a warrant.
The issuances listed above are exempt from registration under Section 4(2)
of the Securities Act as transactions by an issuer not involving a public
offering.
ITEM 16. EXHIBITS AND FINANCIAL STATEMENT SCHEDULES.
a. Exhibits
1.1 Form of Underwriting Agreement.**
2.1 Acquisition Agreement, dated as of October 1, 1999, among
the Registrant, AMN Healthcare, Inc., AMN Acquisition Corp.,
Olympus Growth Fund II, L.P., Olympus Growth Executive Fund,
L.P., Steven Francis, as Trustee of the Francis Family Trust
dated May 24, 1996, Gayle Francis, as Trustee of the Francis
Family Trust dated May 24, 1996, Todd Johnson and Deborah
Johnson.**
2.2 Stock Purchase Agreement, dated as of June 23, 2000, by and
between AMN Healthcare, Inc., Suzanne Confoy and George
Robert Kraus, Jr.**
2.3 Stock Purchase Agreement, dated as of October 12, 2000, by
and between AMN Healthcare, Inc. and Preferred Employers
Holdings, Inc.**
2.4 Stock Purchase Agreement, dated as of April 3, 2001, by and
between AMN Healthcare, Inc., Joseph O'Grady and Teresa
O'Grady-Peyton.**
3.1 Form of Amended and Restated Certificate of Incorporation of
AMN Healthcare Services, Inc.**
3.2 Form of By-laws of AMN Healthcare Services, Inc.**
4.1 Form of Specimen Stock Certificate.**
4.2 Form of Registration Rights Agreement among the Registrant,
HWH Capital Partners, L.P., HWH Nightingale Partners, L.P.,
HWP Nightingale Partners II, L.P., HWP Capital Partners II,
L.P., BancAmerica Capital Investors SBIC I, L.P., the
Francis Family Trust dated May 24, 1996 and Steven
Francis.**
5.1 Opinion of Paul, Weiss, Rifkind, Wharton & Garrison
regarding the legality of the shares.*
8.1 Opinion of Paul, Weiss, Rifkind, Wharton & Garrison as to
certain tax matters.*
10.1 Note and Warrant Purchase Agreement, dated as of November
19, 1999, between the Registrant and BancAmerica Capital
Investors SBIC I, L.P.**
10.2 First Amendment to Note and Warrant Purchase Agreement,
dated as of November 21, 2000, by and among the Registrant
and BancAmerica Capital Investors SBIC I, L.P.**
10.3 Subscription Agreement, dated as of November 28, 2000,
between the Registrant and BancAmerica Capital Investors
SBIC I, L.P.**
10.4 Warrant Agreement, dated as of November 19, 1999, among the
Registrant, BancAmerica Capital Investors SBIC I, L.P. and
each of the warrantholders who are or may become a party
thereto.**
10.5 AMN Holdings, Inc. 1999 Performance Stock Option Plan, as
amended.**
10.6 AMN Holdings, Inc. 1999 Super-Performance Stock Option Plan,
as amended.**
10.7 AMN Healthcare Services, Inc. 2001 Stock Option Plan.**
II-3
10.8 Employment and Non-Competition Agreement, dated as of
November 19, 1999, among AMN Holdings, Inc., AMN Acquisition
Corp. and Steven Francis.**
10.9 Executive Severance Agreement, dated as of November 19,
1999, between AMN Healthcare, Inc. and Susan Nowakowski.**
10.10 Executive Severance Agreement, dated as of May 21, 2001,
between AMN Healthcare, Inc. and Donald Myll.**
10.11 1999 Performance Stock Option Plan Stock Option Agreement,
dated as of November 19, 1999, between the Registrant and
Steven Francis.**
10.12 Amendment, dated as of December 13, 2000, to the 1999
Performance Stock Option Plan Stock Option Agreement, dated
as of November 19, 1999, between the Registrant and Steven
Francis.**
10.13 Amendment No. 2, dated as of July 24, 2001, to the 1999
Performance Stock Option Plan Stock Option Agreement, dated
as of November 19, 1999, as amended December 13, 2000,
between the Registrant and Steven Francis.**
10.14 1999 Super-Performance Stock Option Plan Stock Option
Agreement, dated as of November 19, 1999, between the
Registrant and Steven Francis.**
10.15 Amendment, dated as of December 13, 2000, to the
Super-Performance Stock Option Plan Stock Option Agreement,
dated as of December 13, 2000, between the Registrant and
Steven Francis.**
10.16 Amendment No. 2, dated as of July 24, 2001, to the 1999
Super-Performance Stock Option Plan Stock Option Agreement,
dated as of November 19, 1999, as amended December 13, 2000,
between the Registrant and Steven Francis.**
10.17 1999 Performance Stock Option Plan Stock Option Agreement,
dated as of November 19, 1999, between the Registrant and
Susan Nowakowski.**
10.18 Amendment, dated as of December 13, 2000, to the 1999
Performance Stock Option Plan Stock Option Agreement, dated
as of November 19, 1999, between the Registrant and Susan
Nowakowski.**
10.19 Amendment No. 2, dated as of July 24, 2001, to the 1999
Performance Stock Option Plan Stock Option Agreement, dated
as of November 19, 1999, as amended December 13, 2000,
between the Registrant and Susan Nowakowski.**
10.20 1999 Super-Performance Stock Option Plan Stock Option
Agreement, dated as of November 19, 1999, between the
Registrant and Susan Nowakowski.**
10.21 Amendment, dated as of December 13, 2000, to the
Super-Performance Stock Option Plan Stock Option Agreement,
dated as of November 19, 1999, between the Registrant and
Susan Nowakowski.**
10.22 Amendment No. 2, dated as of July 24, 2001, to the 1999
Super-Performance Stock Option Plan Stock Option Agreement,
dated as of November 19, 1999, as amended December 13, 2000,
between the Registrant and Susan Nowakowski.**
10.23 1999 Performance Stock Option Plan Stock Option Agreement,
dated as of November 20, 2000, between the Registrant and
Susan Nowakowski.**
10.24 Amendment, dated as of July 24, 2001, to the 1999
Performance Stock Option Plan Stock Option Agreement, dated
as of November 20, 2000, between the Registrant and Susan
Nowakowski.**
10.25 1999 Super-Performance Stock Option Plan Stock Option
Agreement, dated as of November 20, 2000, between the
Registrant and Susan Nowakowski.**
10.26 Amendment, dated as of July 24, 2001, to the 1999
Super-Performance Stock Option Plan Stock Option Agreement,
dated as of November 20, 2000, between the Registrant and
Susan Nowakowski.**
10.27 1999 Performance Stock Option Plan Stock Option Agreement,
dated as of December 13, 2000, between the Registrant and
Steven Francis.**
II-4
10.28 Amendment, dated as of July 24, 2001, to the 1999
Performance Stock Option Plan Stock Option Agreement, dated
as of December 13, 2000, between the Registrant and Steven
Francis.**
10.29 1999 Super-Performance Stock Option Plan Stock Option
Agreement, dated as of December 13, 2000, between the
Registrant and Steven Francis.**
10.30 Amendment, dated as of July 24, 2001, to the 1999
Super-Performance Stock Option Plan Stock Option Agreement,
dated as of December 13, 2000, between the Registrant and
Steven Francis.**
10.31 1999 Performance Stock Option Plan Stock Option Agreement,
dated as of December 13, 2000, between the Registrant and
Susan Nowakowski.**
10.32 Amendment, dated as of July 24, 2001, to the 1999
Performance Stock Option Plan Stock Option Agreement, dated
as of December 13, 2000, between the Registrant and Susan
Nowakowski.**
10.33 1999 Super-Performance Stock Option Plan Stock Option
Agreement, dated as of December 13, 2000, between the
Registrant and Susan Nowakowski.**
10.34 Amendment, dated as of July 24, 2001, to the 1999
Super-Performance Stock Option Plan Stock Option Agreement,
dated as of December 13, 2001, between the Registrant and
Susan Nowakowski.**
10.35 2001 Stock Option Plan Stock Option Agreement between the
Registrant and Donald Myll.**
10.36 Form of Amended and Restated Financial Advisory Agreement
between the Registrant and Haas Wheat & Partners, L.P.**
10.37 Form of Amended and Restated Credit Agreement.**
10.38 AMN Healthcare Services, Inc. 2001 Senior Management Bonus
Plan.**
16.1 Letter from Deloitte & Touche LLP regarding change in
certifying accountant.**
21.1 Subsidiaries of the Registrant.*
23.1 Consent of Paul, Weiss, Rifkind, Wharton & Garrison
(included in Exhibit 5.1).*
23.2 Independent Auditors' Report on Schedule and Consent of KPMG
LLP with respect to the Registrant.*
23.3 Consent of KPMG LLP with respect to Preferred Healthcare
Staffing, Inc.*
23.4 Consent of KPMG LLP with respect to O'Grady-Peyton
International (USA), Inc.*
23.5 Consent of Deloitte & Touche LLP with respect to the
Registrant.*
23.6 Independent Auditors' Report on Schedule of Deloitte &
Touche LLP with respect to the Registrant.*
23.7 Consent of DDK & Company LLP with respect to Nurses RX,
Inc.*
24.1 Power of Attorney.**
99.1 Consent of Michael Gallagher to be named as a director
nominee.**
99.2 Consent of Andrew Stern to be named as a director nominee.**
---------------
* Filed herewith.
** Previously filed.
b. Financial Statement Schedules
The following financial statement schedules are included herein:
Schedule II -- Valuation and qualifying accounts
All other schedules are omitted because they are either not required, not
applicable or the required information is included in the financial statements
or notes thereto.
ITEM 17. UNDERTAKINGS
Insofar as indemnification for liabilities arising under the Securities Act
of 1933 may be permitted to directors, officers and controlling persons of the
registrant pursuant to the foregoing provisions, or otherwise,
II-5
the registrant has been advised that in the opinion of the Securities and
Exchange Commission such indemnification is against public policy as expressed
in the Act and is, therefore, unenforceable. In the event that a claim for
indemnification against such liabilities (other than the payment by the
registrant of expenses incurred or paid by a director, officer or controlling
person of the registrant in the successful defense of any action, suit or
proceeding) is asserted by such director, officer or controlling person in
connection with the securities being registered, the registrant will, unless in
the opinion of its counsel the matter has been settled by controlling precedent,
submit to a court of appropriate jurisdiction the question whether such
indemnification by it is against public policy as expressed in the Act and will
be governed by the final adjudication of such issue.
The undersigned registrant hereby undertakes that:
(1) For purposes of determining any liability under the Securities Act of
1933, the information omitted from the form of prospectus filed as part
of this registration statement in reliance upon Rule 430A and contained
in a form of prospectus filed by the registrant pursuant to Rule
424(b)(1) or (4) or 497(h) under the Securities Act shall be deemed to
be part of this registration statement as of the time it was declared
effective.
(2) For the purpose of determining any liability under the Securities Act
of 1933, each post-effective amendment that contains a form of
prospectus shall be deemed to be a new registration statement relating
to the securities offered therein, and the offering of such securities
at that time shall be deemed to be the initial bona fide offering
thereof.
The undersigned registrant hereby undertakes to provide to the underwriters
at the closing specified in the underwriting agreements, certificates in such
denominations and registered in such names as required by the underwriters to
permit prompt delivery to each purchaser.
II-6
SIGNATURES
Pursuant to the requirements of the Securities Act of 1933, the registrant
has duly caused this amendment to the registration statement to be signed on its
behalf by the undersigned, thereunto duly authorized, in the City of San Diego,
State of California, on October 19, 2001.
AMN Healthcare Services, Inc.
By: /s/ STEVEN FRANCIS
------------------------------------
Name: Steven Francis
Title: President and Chief
Executive Officer
Pursuant to the requirements of the Securities Act of 1933, this amendment
to the registration statement has been signed below by the following persons in
the following capacities on the 19th day of October, 2001.
*
--------------------------------------
Name: Robert Haas
Title: Chairman of the Board and
Director
/s/ STEVEN FRANCIS
--------------------------------------
Name: Steven Francis
Title: President, Chief Executive
Officer and Director
*
--------------------------------------
Name: William Miller
Title: Director
*
--------------------------------------
Name: Douglas Wheat
Title: Director
*
--------------------------------------
Name: Donald Myll
Title: Chief Accounting Officer and
Chief Financial Officer
*By: /s/ STEVEN FRANCIS
-----------------------------------------------------
Steven Francis
Attorney-in-fact
II-7
INDEX TO FINANCIAL
STATEMENT SCHEDULES
PAGE
----
Schedule II -- Valuation and Qualifying Accounts............ S-2
S-1
SCHEDULE II
AMN HEALTHCARE SERVICES, INC.
VALUATION AND QUALIFYING ACCOUNTS
FOR THE YEARS ENDED DECEMBER 31, 1998, 1999 AND 2000
(IN THOUSANDS)
BALANCE AT PROVISION
BEGINNING OF DUE TO BALANCE AT
ALLOWANCE FOR DOUBTFUL ACCOUNTS PERIOD PROVISION ACQUISITIONS DEDUCTIONS(*) END OF PERIOD
------------------------------- ------------ --------- ------------ ------------- -------------
Year ended December 31, 1998.... $ 70 $ 30 $ 35 $ -- $135
Year ended December 31, 1999.... $135 $260 -- $(139) $256
Year ended December 31, 2000.... $256 $270 $441 $ (37) $930
---------------
(*) Accounts written off
See accompanying notes to consolidated financial statements
S-2
EXHIBIT INDEX
EXHIBIT
NUMBER EXHIBIT TITLE
------- -------------
1.1 Form of Underwriting Agreement.**
2.1 Acquisition Agreement, dated as of October 1, 1999, among
the Registrant, AMN Healthcare, Inc., AMN Acquisition Corp.,
Olympus Growth Fund II, L.P., Olympus Growth Executive Fund,
L.P., Steven Francis, as Trustee of the Francis Family Trust
dated May 24, 1996, Gayle Francis, as Trustee of the Francis
Family Trust dated May 24, 1996, Todd Johnson and Deborah
Johnson.**
2.2 Stock Purchase Agreement, dated as of June 23, 2000, by and
between AMN Healthcare, Inc., Suzanne Confoy and George
Robert Kraus, Jr.**
2.3 Stock Purchase Agreement, dated as of October 12, 2000, by
and between AMN Healthcare, Inc. and Preferred Employers
Holdings, Inc.**
2.4 Stock Purchase Agreement, dated as of April 3, 2001, by and
between AMN Healthcare, Inc., Joseph O'Grady and Teresa
O'Grady-Peyton.**
3.1 Form of Amended and Restated Certificate of Incorporation of
AMN Healthcare Services, Inc.**
3.2 Form of By-laws of AMN Healthcare Services, Inc.**
4.1 Form of Specimen Stock Certificate.**
4.2 Form of Registration Rights Agreement among the Registrant,
HWH Capital Partners, L.P., HWH Nightingale Partners, L.P.,
HWP Nightingale Partners II, L.P., HWP Capital Partners II,
L.P., BancAmerica Capital Investors SBIC I, L.P., the
Francis Family Trust dated May 24, 1996 and Steven
Francis.**
5.1 Opinion of Paul, Weiss, Rifkind, Wharton & Garrison
regarding the legality of the shares.*
8.1 Opinion of Paul, Weiss, Rifkind, Wharton & Garrison as to
certain tax matters.*
10.1 Note and Warrant Purchase Agreement, dated as of November
19, 1999, between the Registrant and BancAmerica Capital
Investors SBIC I, L.P.**
10.2 First Amendment to Note and Warrant Purchase Agreement,
dated as of November 21, 2000, by and among the Registrant
and BancAmerica Capital Investors SBIC I, L.P.**
10.3 Subscription Agreement, dated as of November 28, 2000,
between the Registrant and BancAmerica Capital Investors
SBIC I, L.P.**
10.4 Warrant Agreement, dated as of November 19, 1999, among the
Registrant, BancAmerica Capital Investors SBIC I, L.P. and
each of the warrantholders who are or may become a party
thereto.**
10.5 AMN Holdings, Inc. 1999 Performance Stock Option Plan, as
amended.**
10.6 AMN Holdings, Inc. 1999 Super-Performance Stock Option Plan,
as amended.**
10.7 AMN Healthcare Services, Inc. 2001 Stock Option Plan.**
10.8 Employment and Non-Competition Agreement, dated as of
November 19, 1999, among AMN Holdings, Inc., AMN Acquisition
Corp. and Steven Francis.**
10.9 Executive Severance Agreement, dated as of November 19,
1999, between AMN Healthcare, Inc. and Susan Nowakowski.**
10.10 Executive Severance Agreement, dated as of May 21, 2001,
between AMN Healthcare, Inc. and Donald Myll.**
10.11 1999 Performance Stock Option Plan Stock Option Agreement,
dated as of November 19, 1999, between the Registrant and
Steven Francis.**
10.12 Amendment, dated as of December 13, 2000, to the 1999
Performance Stock Option Plan Stock Option Agreement, dated
as of November 19, 1999, between the Registrant and Steven
Francis.**
EXHIBIT
NUMBER EXHIBIT TITLE
------- -------------
10.13 Amendment No. 2, dated as of July 24, 2001, to the 1999
Performance Stock Option Plan Stock Option Agreement, dated
as of November 19, 1999, as amended December 13, 2000,
between the Registrant and Steven Francis.**
10.14 1999 Super-Performance Stock Option Plan Stock Option
Agreement, dated as of November 19, 1999, between the
Registrant and Steven Francis.**
10.15 Amendment, dated as of December 13, 2000, to the
Super-Performance Stock Option Plan Stock Option Agreement,
dated as of December 13, 2000, between the Registrant and
Steven Francis.**
10.16 Amendment No. 2, dated as of July 24, 2001, to the 1999
Super-Performance Stock Option Plan Stock Option Agreement,
dated as of November 19, 1999, as amended December 13, 2000,
between the Registrant and Steven Francis.**
10.17 1999 Performance Stock Option Plan Stock Option Agreement,
dated as of November 19, 1999, between the Registrant and
Susan Nowakowski.**
10.18 Amendment, dated as of December 13, 2000, to the 1999
Performance Stock Option Plan Stock Option Agreement, dated
as of November 19, 1999, between the Registrant and Susan
Nowakowski.**
10.19 Amendment No. 2, dated as of July 24, 2001, to the 1999
Performance Stock Option Plan Stock Option Agreement, dated
as of November 19, 1999, as amended December 13, 2000,
between the Registrant and Susan Nowakowski.**
10.20 1999 Super-Performance Stock Option Plan Stock Option
Agreement, dated as of November 19, 1999, between the
Registrant and Susan Nowakowski.**
10.21 Amendment, dated as of December 13, 2000, to the
Super-Performance Stock Option Plan Stock Option Agreement,
dated as of November 19, 1999, between the Registrant and
Susan Nowakowski.**
10.22 Amendment No. 2, dated as of July 24, 2001, to the 1999
Super-Performance Stock Option Plan Stock Option Agreement,
dated as of November 19, 1999, as amended December 13, 2000,
between the Registrant and Susan Nowakowski.**
10.23 1999 Performance Stock Option Plan Stock Option Agreement,
dated as of November 20, 2000, between the Registrant and
Susan Nowakowski.**
10.24 Amendment, dated as of July 24, 2001, to the 1999
Performance Stock Option Plan Stock Option Agreement, dated
as of November 20, 2000, between the Registrant and Susan
Nowakowski.**
10.25 1999 Super-Performance Stock Option Plan Stock Option
Agreement, dated as of November 20, 2000, between the
Registrant and Susan Nowakowski.**
10.26 Amendment, dated as of July 24, 2001, to the 1999
Super-Performance Stock Option Plan Stock Option Agreement,
dated as of November 20, 2000, between the Registrant and
Susan Nowakowski.**
10.27 1999 Performance Stock Option Plan Stock Option Agreement,
dated as of December 13, 2000, between the Registrant and
Steven Francis.**
10.28 Amendment, dated as of July 24, 2001, to the 1999
Performance Stock Option Plan Stock Option Agreement, dated
as of December 13, 2000, between the Registrant and Steven
Francis.**
10.29 1999 Super-Performance Stock Option Plan Stock Option
Agreement, dated as of December 13, 2000, between the
Registrant and Steven Francis.**
10.30 Amendment, dated as of July 24, 2001, to the 1999
Super-Performance Stock Option Plan Stock Option Agreement,
dated as of December 13, 2000, between the Registrant and
Steven Francis.**
10.31 1999 Performance Stock Option Plan Stock Option Agreement,
dated as of December 13, 2000, between the Registrant and
Susan Nowakowski.**
10.32 Amendment, dated as of July 24, 2001, to the 1999 Performance Stock Option Plan Stock Option
Agreement, dated as of December 13, 2000, between the Registrant and Susan Nowakowski.**
10.33 1999 Super-Performance Stock Option Plan Stock Option Agreement, dated as of December 13,
2000, between the Registrant and Susan Nowakowski.**
10.34 Amendment, dated as of July 24, 2001, to the 1999 Super-Performance Stock Option Plan Stock
Option Agreement, dated as of December 13, 2001, between the Registrant and Susan
Nowakowski.**
10.35 2001 Stock Option Plan Stock Option Agreement between the Registrant and Donald Myll.**
10.36 Form of Amended and Restated Financial Advisory Agreement between the Registrant and Haas
Wheat & Partners, L.P.**
10.37 Form of Amended and Restated Credit Agreement.**
10.38 AMN Healthcare Services, Inc. 2001 Senior Management Bonus Plan.**
16.1 Letter from Deloitte & Touche LLP regarding change in certifying accountant.**
21.1 Subsidiaries of the Registrant.*
23.1 Consent of Paul, Weiss, Rifkind, Wharton & Garrison (included in Exhibit 5.1).*
23.2 Independent Auditors' Report on Schedule and Consent of KPMG LLP with respect to the
Registrant.*
23.3 Consent of KPMG LLP with respect to Preferred Healthcare Staffing, Inc.*
23.4 Consent of KPMG LLP with respect to O'Grady-Peyton International (USA), Inc.*
23.5 Consent of Deloitte & Touche LLP with respect to the Registrant.*
23.6 Independent Auditors' Report on Schedule of Deloitte & Touche LLP with respect to the
Registrant.*
23.7 Consent of DDK & Company LLP with respect to Nurses RX, Inc.*
24.1 Power of Attorney.**
99.1 Consent of Michael Gallagher to be named as a director nominee.**
99.2 Consent of Andrew Stern to be named as a director nominee.**
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* Filed herewith.
** Previously filed.