CROSS COUNTRY HEALTHCARE INC

What they do

The company recruits and places clinical and non-clinical professionals, including travel and per diem nurses, allied therapists, physicians, certified registered nurse anesthetists, nurse practitioners, and physician assistants, on temporary, permanent, and local short-term assignments. It also sells workforce solutions such as managed service programs (MSPs), vendor management systems (VMS), recruitment process outsourcing, education health services, and home-based PACE caregiver services. Customers include acute and non-acute hospitals, physician practices, rehabilitation facilities, schools, correctional facilities, government facilities, and managed care providers. It operates through two reportable segments, Nurse and Allied Staffing and Physician Staffing, and owns the Intellify SaaS vendor management platform.

Revenue drivers

• Nurse and Allied Staffing — Largest segment at approximately 82% of 2025 revenue and 84% of Q1 2026 revenue; places travel, per diem, and contract nurses and allied professionals and also provides executive and contingent search plus MSP, RPO, and consulting services.
• Physician Staffing — Approximately 18% of 2025 revenue and 16% of Q1 2026 revenue; supplies physicians across specialties plus certified registered nurse anesthetists, nurse practitioners, and physician assistants as independent contractors on temporary assignments.
• Cross Country Community Care (home-based PACE services) — Caregiver services to PACE programs; grew 28.0% for full-year 2025 and 15.8% year-over-year in Q1 2026, partly offsetting declines elsewhere.
• Workforce solutions and Intellify technology — MSP, VMS, RPO, project management, and consultative services, plus the Intellify SaaS vendor management platform, licensed in Q1 2026 to a top ten healthcare staffing provider.

Recent performance

Full-year 2025 revenue fell 21.6% to $1.1 billion and net loss attributable to common stockholders widened to $94.9 million from $14.6 million in 2024. Q4 2025 included a $77.9 million non-cash goodwill impairment on the Nurse and Allied and Physician Staffing segments, a $29.6 million deferred tax valuation allowance, and $6.0 million of executive transition severance for the former CEO's December 2025 separation. Q1 2026 revenue was $241.1 million, down 17.8% year-over-year but up 2% sequentially; gross margin was 19.7%, net loss was $4.3 million, and diluted EPS was a loss of $0.14. Adjusted EBITDA was $3.9 million (1.6% of revenue) and operating cash flow was $4.8 million. Nurse and Allied revenue was $201.4 million (FTEs 6,363; revenue per FTE per day $351) and Physician Staffing revenue was $39.6 million (17,688 days filled; $2,240 per day).

Strategy

Management is focused on disciplined execution while awaiting the pending transaction with Knox Lane, which it expects to close in the third quarter of 2026. The company continues to advance technology initiatives, including licensing its Intellify workforce intelligence platform to third parties. It added four new MSP/VMS agreements in Q1 2026 and expanded existing programs, while home-based Cross Country Community Care remains a growth area. Capital return continued through buybacks: 803,175 shares repurchased in Q4 2025 and over 650,000 shares (2.1% of shares outstanding) in Q1 2026. The December 2025 termination of the Aya Healthcare merger produced a $20.0 million termination fee paid to the company, and the company had no ABL borrowings drawn at year-end 2025.

Risks

• Segment volume declines — Revenue fell 21.6% in 2025 and 17.8% year-over-year in Q1 2026 on volume declines in both Nurse and Allied Staffing and Physician Staffing, with Nurse and Allied FTEs down to 6,363 from 7,411 a year earlier.
• Goodwill impairment and tax valuation allowance — A $77.9 million non-cash goodwill impairment in Q4 2025 and a $29.6 million deferred tax asset valuation allowance followed cumulative losses and a fourth-quarter decline in equity market capitalization.
• Pending Knox Lane merger execution — The May 6, 2026 merger agreement with KL Criss Cross Intermediate, LLC would make the company a wholly owned subsidiary and delist its shares from Nasdaq, creating closing and integration uncertainty; the earlier Aya Healthcare merger agreement was terminated effective December 4, 2025.
• Thin margins and cash flow pressure — Q1 2026 gross margin was 19.7% (down 30 bps year-over-year), Adjusted EBITDA margin was 1.6%, and full-year 2025 operating cash flow fell to $48.3 million from $120.1 million in 2024.

Outlook

Management said it ended Q1 2026 with positive momentum, citing sequential revenue growth, new MSP wins and expansions, and technology licensing, and is awaiting the close of the Knox Lane transaction in the third quarter. The company has not provided 2025 or 2026 guidance figures in the provided excerpts beyond noting Q1 2026 revenue exceeded its guidance range. It describes its focus as disciplined execution and advancing technology initiatives to support clients' evolving workforce needs. The prior-year numbers include a large loss quarter (Q4 2025 net loss of $82.9 million) that makes year-over-year comparisons noisy.