Cross Country Healthcare is one of the largest health care staffing firms in the US. Under several brands, the company places traveling nurses and other health care professionals through about 4,300 contracts with acute care hospitals, pharmaceutical companies, nursing homes, schools, and other related facilities across the nation. The firm coordinates travel and housing arrangements for its nurses, whose assignments usually last about three months at a time. Cross Country also provides health care education, training, and recruiting services for doctors and health care executives. Subsidiaries and brands include Assignment America, Allied Health Group, NovaPro, Med-Staff, TravCorps, and Cejka Search.
The company's nurse staffing services business segment is headquartered in Boca Raton, Florida. Its travel staffing business has operation centers in Florida, Georgia, Massachusetts, and Pennsylvania. Its Cross Country Education (CCE) subsidiary is headquartered in Brentwood, Tennessee while its Cejka Search subsidiary is headquartered in Creve Coeur, Missouri.
The company operates through three reportable segments: nurse and allied staffing (63% of net sales), physician staffing (28%), and other human capital management services (9%).
Sales and Marketing
Cross Country markets is services through direct mail marketing, online advertising, print media, and promotional material. It spends about $3 million each year on advertising.
Cross Country has experienced two straight years of revenue declines and net losses. Revenues dipped 1% from $442 million in 2012 to $438 million in 2013, while its net loss grew from $42 million to $52 million over the same time period. Cash flow from its operations also decreased due to timing of payments and receipts in 2013.
The overall decrease in revenue was due to lower sales from other human capital management services, reflecting less seminars and lower seminar attendance in education and training business and from retained search business. This was partially offset by an increase in revenue from its nurse and allied staffing business segment due to previous acquisitions.
The company's recent net losses have been the result of nearly $4 million in depreciation costs, $2 million in amortization costs, and around $1 million, collectively, in acquisition and restructuring costs during 2013. Cross Country also paid a legal settlement charge of $750,000 and impairment charges of $6.4 million during the year.
Cross Country is counting on its diverse portfolio of services and its strong relationships with hospitals all over the country to sustain itself until the conditions of the broader labor market improve.
To focus on its core markets and to streamline its operations, in 2013 Cross Country sold its former clinical trial services division to contract research firm ICON for some $52 million.
Mergers and Acquisitions
Cross Country plans to grow by focusing on making strategic acquisitions in high growth, high margin businesses and by seeking additional MSP contracts and EMR engagements with hospitals and health systems.
In 2014 the company acquired Medical Staffing Network, a comprehensive healthcare staffing company with 55 locations throughout the US that provides per diem, local, contract, travel, and permanent hire staffing services. Cross Country paid $48 million on the deal, which increased its branch network and market share and diversified its customer base and brings them new service lines.
In late 2013 Cross Country obtained On Assignment’s Allied Healthcare Staffing division for $29 million. That transaction added new expertise to its traditional staffing offerings, expanded its local branch network, and diversified its customer base into the local ambulatory care and retail market.