AMN Healthcare Services (AMN) Q4 2025 earnings summary

Executive summary

• Q4 2025 revenue reached $748 million, up 2% year-over-year and 18% sequentially, driven by strong nurse and allied staffing and significant labor disruption events, exceeding the high end of guidance.

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

• Labor disruption revenue in Q4 was $124 million, nearly double the prior year, and is expected to be $600 million in Q1 2026.

• The company demonstrated operational resilience, leveraging technology and dedicated teams to manage large-scale strike events while supporting core business.

• Travel nurse volume increased 5–6% sequentially, with allied business also showing sequential growth.

Financial highlights

• Q4 gross margin was 26.1%, down 370 bps year-over-year, impacted by labor disruption revenue.

• Q4 Adjusted EBITDA was $54–$54.5 million (7.3% margin), down 27% year-over-year.

• Q4 net loss was $7.7–$8 million, a significant improvement from a $188 million loss in the prior year.

• Q4 Adjusted EPS was $0.22, down from $0.75 in the prior year.

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

Outlook and guidance

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

• Q1 gross margin expected at 23.5%–24%, with labor disruption reducing margin by ~300 bps.

• Q1 Adjusted EBITDA margin projected at 9.7%–10.2%.

• Nurse and Allied Solutions revenue expected to be up 137–139% year-over-year; Physician and Leadership Solutions and Technology and Workforce Solutions segments expected to decline.

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