On this page of StockholderLetter.com we present the 4/4/2023 shareholder letter from AMN HEALTHCARE SERVICES INC — ticker symbol AMN. Reading current and past AMN letters to shareholders can bring important insights into the investment thesis.

A Letter from Our President and CEO Dear Fellow Shareholders, In many ways, the AMN Healthcare story in 2022 was about delivering in times of significant need. During the year, we made 250,000 placements of greatly needed healthcare professionals in temporary and permanent roles when, at times, difficulty in recruiting reached extreme levels. AMN also provided language interpretation services with more than 3,000 interpreters serving patients in more than 14 million interactions, breaking down language and communication barriers to support access to healthcare and improve patient outcomes. The year began amid the worst healthcare labor shortage on record. As we entered year three of the COVID-19 pandemic, vacant jobs in healthcare outpaced the number of people who were hired per month by nearly 3x. Organizations across the care continuum experienced difficulties with worker hiring and retention on a scale they had never seen. AMN continued our focus on serving our clients talent needs. AMN team members and healthcare professionals extended their efforts to support the healthcare sector in its time of extraordinary labor demand. We reached all-time highs in both the size and organic growth rate of our business at the same time supporting our clients with managed staffing programs (MSP), including AMN staffing-led MSPs, vendor-neutral MSP and VMS. The worst labor crunch of the pandemic began to subside as the number of people hospitalized for COVID-19 tapered. However, the impact to the healthcare labor force remains and is expected to endure for years to come given underlying fundamentals that were exacerbated during the pandemic. Clinicians left the acute care setting for other, lower-stress environments, and retirements accelerated. A new generation of talent found they liked more job flexibility. Wage inflation increased not just in healthcare but across the U.S. economy, affecting our business in several ways. Our gross profit margins on staffing revenues fell as we paid the higher wages necessary to attract healthcare professionals. We believe serving our clients and communities in crisis was more important than maximizing our profitability during this time, and putting healthcare professionals, team members, and clients first was the right choice for the long-term success of AMN. As we worked through 2022, we saw a healthier balance between supply and demand. We flexed from an unprecedented demand environment to helping clients optimize their workforce to manage the cost of delivering high-quality outcomes. Our leadership role in providing healthcare talent solutions will demand more of us in the coming years as talent needs continue to outstrip available labor, wage inflation persists, and care delivery becomes increasingly complex. AMN Healthcare also completed its own leadership transition. Susan Salka superbly guided AMN for 17 years as CEO, retiring with an excellent track record of industry leadership and with AMN positioned to continue its success. I agreed to succeed Susan for several, equally important reasons. AMN needed a leader who had successfully managed peopleintensive businesses through scale barriers to become larger and more innovative organizations with attractive growth. Digital speed to market, data-empowered decision-making, and high-tech efficiencies will be key drivers of AMN s ability to scale and diversify. We will maintain and build on our leadership in serving the largest healthcare employers, rounding out our solution set into One AMN that strengthens our brand equity and market recognition of the tremendous breadth of what we can do. A value-creating acquisition strategy, powered by our strong balance sheet and cash flows, will accelerate our journey toward the comprehensive talent solutions that healthcare will demand. As a newcomer, it is easy for me to call out the obvious strengths of AMN. Our Company has followed the lead of our clients healthcare professionals and organizations to deliver market-leading solutions at the crucial intersection of health and talent. Reflecting the values of our clients, AMN has a mission-driven culture that thrives on serving healthcare professionals and organizations, our communities, and investors. Our leadership team is highly talented, diverse, experienced, and energized about the positive impact we can drive in healthcare. The growth opportunity at AMN is exciting because healthcare is changing, human capital is changing, and we have a sense of urgency about finding new ways for healthcare to operate efficiently and drive strong outcomes. Clients are responding positively as we reshape our business to help them, and they are more open to doing things differently than they were before the pandemic.
The labor force has become much more mobile. Workers are asking for a greater variety of roles, with more frequent feedback and recognition. They are much less attached to a given employer than they were in the past. A growing part of the labor force demands alternative work arrangements. These qualities leave me convinced that, although we are coming off a record year, AMN is primed for significant opportunity over the long term. The Year in Review AMN shares fell in value by 16% in 2022, in line with returns of broad market indices. AMN s stock performance was modestly better than industry benchmarks, such as the S&P Healthcare Services Select Index. Measured for longer-term returns, AMN remained well ahead of all these benchmarks. AMN reached an all-time high for revenue in 2022 at $5.2 billion, which grew 32% over the 2021 level. Other fundamentals reached new highs: $444 million net income, 36% better than in 2021. $9.90 diluted earnings per share, up 45% year over year. Among other 2022 highlights: Nurse and Allied Solutions soared to just under $4 billion in annual revenue, growing 33% year over year. Technology and Workforce Solutions contributed approximately $300 million of segment operating income, or a record-high 31% of our total segment operating income coming from solutions beyond staffing and retained search. Locum tenens physician staffing had one of its strongest organic growth years with revenue of $428 million up 21% compared with 2021. Our VMS and MSP solutions managed more than $12 billion of the healthcare sector s spending on contingent labor, about 5x what we managed five years ago. Interim leadership staffing reached a record high with $185 million in annual revenue. Our permanent placement businesses for physicians, nurses, and executive leaders totaled $93 million in revenue, the highest in company history. We strengthened our ability to go to market as One AMN, building brand equity and making it easier for clients and healthcare professionals to work with us. We acquired Connetics to extend our staffing solutions into direct hire of international nurses. The National Association of Corporate Directors named AMN the winner of the 2022 Diversity, Equity and Inclusion Award among US midcap public companies. As the pandemic began to subside, as expected, labor demand lessened, which resulted in lower volumes, pay rates and as a result, lower revenue in the back half of 2022 compared to the first half. At the beginning of 2023, though, vacant healthcare jobs remained 70% higher than pre-pandemic levels. Even without severe pressure from the pandemic, the healthcare labor market is still out of balance, a condition we expect to be dealing with for the foreseeable future. Looking Ahead The mission of AMN Healthcare remains the same to empower the future of healthcare with increased responsiveness, flexibility, and digital enablement of the healthcare labor force, leading to better care and greater career satisfaction. As we focus on our future growth, key priorities have risen to the forefront. Employers and professionals want new solutions. Our leadership team is committed to ensure that AMN is not just a provider of total talent solutions. We want to be the preferred partner for our clients, offering new answers to complex workforce challenges. AMN more than doubled its capital expenditures since 2019, the bulk of the increase directed at technology development and ITdriven improvements in the way we work and serve the healthcare sector. The pandemic was disruptive, and we recognize the need to get realigned with clients and work on long-term needs again to find new ways to solve the structural workforce supply challenges in healthcare. A rising concern about work/life balance is moving workers. Our periodic surveys show that healthcare professionals are placing more value on flexible scheduling and are less interested in working overtime. Clinical professionals are showing they will change jobs and style of work to pursue these goals. These trends are visible across the US economy, including inside AMN. Last year, almost one-third of our corporate team members were promoted or moved into new jobs inside AMN. Providing attractive, longterm career paths is an essential part of the AMN culture and an important way for AMN to remain a preferred employer amidst a changing American workforce.
We must serve and build. AMN grew annual revenue by more than 130% in three years, and we still expect our ongoing revenues to be higher than the pre-pandemic level. Over this span, we increased the size of our corporate team by 30%. We still have work to do making sure that our team, as well as our supporting technology platforms and processes, is equipped to support our current scale of business in all our 20 current solutions. At the same time, we are collaborating with clients to bring them more of the solutions they need to provide great care amid lasting changes in the workforce. The way we do business is our business. AMN is built around our commitment to, and performance on, sustainable business practices, leadership on social diversity, equality, equity, and inclusion, and corporate governance practices that embody these values. I am passionate about leading a Company that embraces being measured on environmental, social, and governance standards, because these strong values run through the AMN team every day. AMN will continue to attract those who want great opportunity in a rich, diverse culture that serves a critically important mission. We believe that our diverse workforce and inclusive environment drives better outcomes, which has made us the leader in total talent solutions for healthcare. We are proud that we have created an inclusive and diverse company, where 69% of our corporate team members are women and 45% are from historically underrepresented groups. We also understand that through supplier diversity, we have an opportunity to benefit the overall socioeconomic health of the communities we serve. To those ends, we increased our diverse and small supplier spend to more than $960 million for 2022, continued funding our pledge of 100 minority-owned business certifications, and expanded our Vendor Development Program. As demonstrated by several recent accolades we received, including the Diversity, Equity and Inclusion Award from the National Association of Corporate Directors, and being named to the Bloomberg Gender-Equality Index for our commitment to gender equality and equity for a sixth year in a row, AMN is a preferred employer for healthcare professionals and corporate team members. Finally, thank you to all our shareholders for enabling and supporting the past, present, and future AMN. CARY GRACE President and Chief Executive Officer
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AMN 4/4/2023 Shareholder/Stockholder Letter Transcript:


A Letter from Our President and CEO
Dear Fellow Shareholders,
In many ways, the AMN Healthcare story in 2022 was about delivering in times of significant need. During the year, we made
250,000 placements of greatly needed healthcare professionals in temporary and permanent roles when, at times, difficulty in
recruiting reached extreme levels. AMN also provided language interpretation services with more than 3,000 interpreters serving
patients in more than 14 million interactions, breaking down language and communication barriers to support access to healthcare
and improve patient outcomes.
The year began amid the worst healthcare labor shortage on record. As we entered year three of the COVID-19 pandemic, vacant
jobs in healthcare outpaced the number of people who were hired per month by nearly 3x. Organizations across the care continuum
experienced difficulties with worker hiring and retention on a scale they had never seen.
AMN continued our focus on serving our clients    talent needs. AMN team members and healthcare professionals extended their
efforts to support the healthcare sector in its time of extraordinary labor demand. We reached all-time highs in both the size and
organic growth rate of our business at the same time supporting our clients with managed staffing programs (MSP), including AMN
staffing-led MSPs, vendor-neutral MSP and VMS. The worst labor crunch of the pandemic began to subside as the number of people
hospitalized for COVID-19 tapered. However, the impact to the healthcare labor force remains and is expected to endure for years
to come given underlying fundamentals that were exacerbated during the pandemic. Clinicians left the acute care setting for other,
lower-stress environments, and retirements accelerated. A new generation of talent found they liked more job flexibility.
Wage inflation increased not just in healthcare but across the U.S. economy, affecting our business in several ways. Our gross profit
margins on staffing revenues fell as we paid the higher wages necessary to attract healthcare professionals. We believe serving our
clients and communities in crisis was more important than maximizing our profitability during this time, and putting healthcare
professionals, team members, and clients first was the right choice for the long-term success of AMN.
As we worked through 2022, we saw a healthier balance between supply and demand. We flexed from an unprecedented demand
environment to helping clients optimize their workforce to manage the cost of delivering high-quality outcomes. Our leadership role
in providing healthcare talent solutions will demand more of us in the coming years as talent needs continue to outstrip available
labor, wage inflation persists, and care delivery becomes increasingly complex.
AMN Healthcare also completed its own leadership transition. Susan Salka superbly guided AMN for 17 years as CEO, retiring with
an excellent track record of industry leadership and with AMN positioned to continue its success.
I agreed to succeed Susan for several, equally important reasons. AMN needed a leader who had successfully managed peopleintensive businesses through scale barriers to become larger and more innovative organizations with attractive growth. Digital speed
to market, data-empowered decision-making, and high-tech efficiencies will be key drivers of AMN   s ability to scale and diversify.
We will maintain and build on our leadership in serving the largest healthcare employers, rounding out our solution set into    One
AMN    that strengthens our brand equity and market recognition of the tremendous breadth of what we can do. A value-creating
acquisition strategy, powered by our strong balance sheet and cash flows, will accelerate our journey toward the comprehensive
talent solutions that healthcare will demand.
As a newcomer, it is easy for me to call out the obvious strengths of AMN. Our Company has followed the lead of our clients     healthcare
professionals and organizations     to deliver market-leading solutions at the crucial intersection of health and talent. Reflecting the
values of our clients, AMN has a mission-driven culture that thrives on serving healthcare professionals and organizations, our
communities, and investors. Our leadership team is highly talented, diverse, experienced, and energized about the positive impact
we can drive in healthcare.
The growth opportunity at AMN is exciting because healthcare is changing, human capital is changing, and we have a sense of
urgency about finding new ways for healthcare to operate efficiently and drive strong outcomes. Clients are responding positively
as we reshape our business to help them, and they are more open to doing things differently than they were before the pandemic.

The labor force has become much more mobile. Workers are asking for a greater variety of roles, with more frequent feedback and
recognition. They are much less attached to a given employer than they were in the past. A growing part of the labor force demands
alternative work arrangements.
These qualities leave me convinced that, although we are coming off a record year, AMN is primed for significant opportunity over
the long term.
The Year in Review
AMN shares fell in value by 16% in 2022, in line with returns of broad market indices. AMN   s stock performance was modestly better
than industry benchmarks, such as the S&P Healthcare Services Select Index. Measured for longer-term returns, AMN remained well
ahead of all these benchmarks.
AMN reached an all-time high for revenue in 2022 at $5.2 billion, which grew 32% over the 2021 level. Other fundamentals reached
new highs:
    $444 million net income, 36% better than in 2021.
    $9.90 diluted earnings per share, up 45% year over year.
Among other 2022 highlights:
    Nurse and Allied Solutions soared to just under $4 billion in annual revenue, growing 33% year over year.
    Technology and Workforce Solutions contributed approximately $300 million of segment operating income, or a record-high 31%
of our total segment operating income coming from solutions beyond staffing and retained search.
    Locum tenens physician staffing had one of its strongest organic growth years with revenue of $428 million up 21% compared
with 2021.
    Our VMS and MSP solutions managed more than $12 billion of the healthcare sector   s spending on contingent labor, about 5x
what we managed five years ago.
    Interim leadership staffing reached a record high with $185 million in annual revenue.
    Our permanent placement businesses     for physicians, nurses, and executive leaders     totaled $93 million in revenue, the highest
in company history.
    We strengthened our ability to go to market as One AMN, building brand equity and making it easier for clients and healthcare
professionals to work with us.
    We acquired Connetics to extend our staffing solutions into direct hire of international nurses.
    The National Association of Corporate Directors named AMN the winner of the 2022 Diversity, Equity and Inclusion Award among
US midcap public companies.
As the pandemic began to subside, as expected, labor demand lessened, which resulted in lower volumes, pay rates and as a result,
lower revenue in the back half of 2022 compared to the first half. At the beginning of 2023, though, vacant healthcare jobs remained
70% higher than pre-pandemic levels. Even without severe pressure from the pandemic, the healthcare labor market is still out of
balance, a condition we expect to be dealing with for the foreseeable future.
Looking Ahead
The mission of AMN Healthcare remains the same     to empower the future of healthcare with increased responsiveness, flexibility,
and digital enablement of the healthcare labor force, leading to better care and greater career satisfaction. As we focus on our future
growth, key priorities have risen to the forefront.
Employers and professionals want new solutions. Our leadership team is committed to ensure that AMN is not just a provider
of total talent solutions. We want to be the preferred partner for our clients, offering new answers to complex workforce challenges.
AMN more than doubled its capital expenditures since 2019, the bulk of the increase directed at technology development and ITdriven improvements in the way we work and serve the healthcare sector. The pandemic was disruptive, and we recognize the need
to get realigned with clients and work on long-term needs again to find new ways to solve the structural workforce supply challenges
in healthcare.
A rising concern about work/life balance is moving workers. Our periodic surveys show that healthcare professionals are
placing more value on flexible scheduling and are less interested in working overtime. Clinical professionals are showing they will
change jobs and style of work to pursue these goals. These trends are visible across the US economy, including inside AMN. Last year,
almost one-third of our corporate team members were promoted or moved into new jobs inside AMN. Providing attractive, longterm career paths is an essential part of the AMN culture and an important way for AMN to remain a preferred employer amidst a
changing American workforce.

We must serve and build. AMN grew annual revenue by more than 130% in three years, and we still expect our ongoing revenues
to be higher than the pre-pandemic level. Over this span, we increased the size of our corporate team by 30%. We still have work to
do making sure that our team, as well as our supporting technology platforms and processes, is equipped to support our current scale
of business in all our 20 current solutions. At the same time, we are collaborating with clients to bring them more of the solutions
they need to provide great care amid lasting changes in the workforce.
The way we do business is our business. AMN is built around our commitment to, and performance on, sustainable business
practices, leadership on social diversity, equality, equity, and inclusion, and corporate governance practices that embody these values.
I am passionate about leading a Company that embraces being measured on environmental, social, and governance standards,
because these strong values run through the AMN team every day. AMN will continue to attract those who want great opportunity
in a rich, diverse culture that serves a critically important mission.
We believe that our diverse workforce and inclusive environment drives better outcomes, which has made us the leader in total talent
solutions for healthcare. We are proud that we have created an inclusive and diverse company, where 69% of our corporate team
members are women and 45% are from historically underrepresented groups. We also understand that through supplier diversity,
we have an opportunity to benefit the overall socioeconomic health of the communities we serve. To those ends, we increased our
diverse and small supplier spend to more than $960 million for 2022, continued funding our pledge of 100 minority-owned business
certifications, and expanded our Vendor Development Program.
As demonstrated by several recent accolades we received, including the Diversity, Equity and Inclusion Award from the National
Association of Corporate Directors, and being named to the Bloomberg Gender-Equality Index for our commitment to gender
equality and equity for a sixth year in a row, AMN is a preferred employer for healthcare professionals and corporate team members.
Finally, thank you to all our shareholders for enabling and supporting the past, present, and future AMN.
CARY GRACE
President and Chief
Executive Officer

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