Building on Our Core Values - AMN Healthcare · PDF fileMaintaining Customer Satisfaction ... Recycling & Waste Water Use Promoting Sustainability within our Supply Chain ... such

AMN 2013 Corporate Social Responsibility Report

Building on Our Core Values


2

Table of Contents

For more information about our CSR program or to submit feedback, please contact us at: [email protected]

Message from our CEO

Industry Trends

About AMN Healthcare

Our Business Model

The Link Between CSR and AMN’s Strategy

Corporate Social Responsibility at AMN Determining Priority Areas Engaging with Stakeholders Our Memberships

Our People

Our Workforce Our Culture of Engagement Attracting & Retaining the Best Talent in our Industry

Our Clients

Exceeding Client Expectations Using Innovative Technology to Meet Customer Needs Maintaining Customer Satisfaction Marketing & Communication

Community Engagement

Environment

Energy-Saving Initiatives Measuring GHG Emissions Recycling & Waste Water Use Promoting Sustainability within our Supply Chain

Financial Highlights & Governance

Code of Business Conduct & Ethics Our Governance Structure Appendix A: GRI Content Index

Appendix B: Impact Areas

Appendix C: 2013 Awards and Recognitions

3

4

5

8

14

22

25

28

33

36

43

46

This is our inaugural Corporate Social Responsibility (CSR) Report covering activities during the 2013 calendar year. For the purpose of this report, we have established separate reporting boundaries per issue area. All financial information reflects all brands, while workforce information reflects activities at all branch offices and environmental impacts are meant to showcase the model for resource efficiency being shaped at our headquarters in San Diego, CA. We move beyond our core operational control to describe efforts to engage the community and strengthen relationships with our customers. We anticipate broadening and aligning the scope and boundary of our reporting efforts in years to come. Our reporting process fulfills G4 “Core In- Accordance” requirements.

ABOUT THIS REPORT


3

Message from Susan Salka

Welcome to AMN Healthcare’s inaugural Corporate Social Responsibility Report! As a company steeped in our Core Values of passion, trust, respect, customer focus, continuous improvement and innovation, we always have held our operations to high standards. Our commitment to the community is matched by our commitment to the personal and professional growth of our team members, clinicians and physicians, and by our commitment to helping our clients operate as efficiently as possible while providing the best patient care. We are incredibly proud of the advancements we have made in all these areas since our inception in 1985.

As the leader in healthcare workforce solutions, and the nation’s largest healthcare staffing company, we are always seeking ways to further improve, and this report is a testament to that dedication. We understand the importance of looking at our business holistically, and seeking opportunities to enhance our business and our impact on society. It was said best in a message I recently received from a team member, who wrote, “It’s the transparency and community here at AMN that really opens up the potential for growth and opportunity, both personally and professionally.” This report is one more dimension of transparency for our company.

This report is intended to demonstrate AMN’s current measurements in key areas that fall within our control, as determined by sustainability experts and international sustainability reporting guidelines. These include:

• Economic Health and Governance

• Our People

• Services

• Community Engagement

• Environment

By establishing these “baseline” measures, we can then work to refine programs and set goals to continuously improve across these areas.

As the first healthcare staffing company to publish a report of this kind, our hope is to help lead our industry in this direction. We have both tremendous opportunities and responsibilities ahead of us: to our team members, our clients, our clinicians, physicians and all stakeholders in our business— as well as the environment in which we operate. We take all of these very seriously, and we take them equally to heart. We appreciate your continued support and interest in the mission of AMN.

Warm regards,

Susan R. SalkaPresident and Chief Executive Officer


4

In a rapidly growing and changing industry, there are several global shifts that provide risks and opportunities for AMN. By considering risk through the lens of corporate social responsibility, we will be better positioned to respond to issues as they arise, and more able to maintain our competitive advantage.

Industry Trends

Key Opportunities Impact on Our Business

Growing Adoption of Outsourced Workforce Solutions

Increased demand for our services

Retiring Clinicians and Physicians

Increased demand for clinicians and physicians

Aging Population Overall (65+ growing fast)

Increased demand for medical services

Influx of Patients due to Affordable Care Act (ACA)

Increased demand for medical professionals and services

Key Risks How we are Prepared

Technology Systems We maintain technology systems that are flexible, scalable, secure and reliable enough to support our strategy and business objectives into the future.

Operational Execution We execute sales and daily business activities with efficiency and excellence. We expect improvements and technologically based projects to be executed as intended, with beneficial return on investment and minimal business disruption.

Competitive Position We maintain and strengthen our competitive market positioning in light of existing competitors, new competitive entrants and changes in buyer behavior. Through that, we can prepare ourselves for disruptive technologies, new business models, client in-house recruitment advances, procurement strategies and other unforeseeable market forces.

Supply of Clinicians and Physicians We aim to secure an adequate supply of quality clinicians and

physicians to align with AMN’s strategy and growth objectives.

Talent Recruitment and Retention

We seek to acquire, develop, engage and return sufficient quantity and quality of leaders and team members with the skills and capabilities needed to successfully develop and execute our strategy of delivering service excellence to meet market demands.

Rate of Innovation We strive to quickly develop and adopt strategies, including technology that differentiates us. We want to serve an ever-changing marketplace of customer needs, ensuring value creation for our shareholders and other partners.

Regulatory Changes We pro-actively plan for and address significant changes in customer behaviors, needs and patient care delivery models as well as clinician supply brought about by regulatory actions.


5

Since its inception, AMN has grown to be the nation’s innovator in healthcare workforce solutions and staffing services through strategic acquisitions and organic growth.

AMN Healthcare’s workforce solutions - including managed services programs, vendor management systems, and recruitment process outsourcing - enable providers to successfully reduce complexity, increase efficiency and improve patient outcomes within the rapidly evolving healthcare environment. The Company provides unparalleled access to the largest network of quality clinicians and physicians through its innovative recruitment strategies and breadth of career opportunities. Clients include acute-care hospitals, government facilities, community health centers and clinics, physician practice groups and many other healthcare settings. Our innovative workforce solutions are designed to fit each of our clients’ unique needs. Our offerings cover 70 different specialist and sub-specialist disciplines, such as internal medicine, family practice and surgery. These also range from traditional temporary staffing assignments to outsourced staff management to permanent placement of clinicians and physicians.

About AMN Healthcare

1985 2013


6

AMN Brands

Healthcare Job Portals

Pharmacy Choice

®

® RxSchoolAMN Healthcare Education Services


7

OUR BUSINESS MODEL

We provide value to our clients through a seamless integration of our three capital resources: social, knowledge and financial.

Corporate Social Responsibility is embedded in our business model. We aspire to be the most respected and trusted healthcare workforce provider in our industry. All five pillars of our success are affected by our social responsibility efforts.

Figure 1: AMN’s 5 Pillars

Recruitment

Screening/ Licensing/ Training

Placement

Customer Satisfaction

Reputation

Social Capital Knowledge Capital Financial Capital

Our stock of social capital creates value for the people we connect and enables AMN to function and thrive. Our large social network includes corporate team members, clinicians, physicians and healthcare facilities.

Our skills, know-how, technology and experience. AMN recognizes the importance of nurturing talent in the healthcare industry, encouraging innovation and supporting employees, clinicians, physicians and our healthcare facilities to work collaboratively toward a more sustainable and resilient business model.

By protecting and enhancing Social and Knowledge Capital, AMN can improve its ability to manage Financial Capital in ways that will generate more profitable business and growth. By looking at its business through the lens of sustainability, AMN can better manage risk and costs while generating indirect economic benefits in the communities where it operates.


8

CORPORATE SOCIAL RESPONSIBILITY AT AMN

At AMN, Corporate Social Responsibility represents our commitment to economic and social development that will have a positive impact on the health and well-being of our team members, local and global communities, and stakeholders at large while advancing the quality of our company through engagement in the world around us.

The Link Between CSR and AMN’s Strategy

Our Corporate Social Responsibility Vision

The overriding goals and objective of CSR encapsulate our higher mission.

AMN Team Members volunteering at Ronald McDonald House Charities - San Diego, CA

Core Values: What is it about: What are we doing about it:

Our values of respect, trust, passion, customer focus, innovation and continuous improvement all call for and are enhanced by a focus on the non-financial aspects of our business.

Our vision is to create and deliver innovative workforce solutions and services that help our clients reduce complexity, drive efficiency and improve the patient experience.

We continually refine our vision and people strategy for the future of our business and the markets we serve. Reporting is an essential tool for tracking and communicating progress against our commitments. It will help us advance our vision and demonstrate our efforts to innovate in the industry.


9

AMN influences change by being a leader and innovator in the industry. With a strong foundation of governance and ethical behavior, we excel at providing opportunities for practitioners to deliver the highest quality care, actively participate in industry groups and limit our environmental footprint along the way. Figure 2 shows the challenges faced and the commitments we’ve made in the areas of our governance, impact on team members, and environmental responsibility.

For the purpose of determining what is relevant to include in our inaugural report, we decided to limit our scope to key risks and opportunities under our operational control. Influence is related to high ethical standards set for those with whom we contract, whether our clients, clinicians and physicians or our vendors.

Key risks to our business that provide and preserve opportunity to create value serve as a foundation for drawing the link to our CSR agenda.

Figure 3 provides a list we have determined to be most relevant for AMN. It describes the importance of each, how we measure performance and what we want to achieve. We have begun the process to identify ways in which we can improve in years to come.

DETERMINING PRIORITY AREAS (GRI “MATERIALITY”)

Governance People The Environment

THE CHALLENGE We recognize the potential risk in our industry, where short-term financial performance can get in the way of ethical governance.

With an aging population, it is increasingly difficult and important to fill vacancies for clinicians and physicians.

Environmental resources are stretched and we realize that we too play a role in minimizing our impact, regardless of how seemingly small our corporate footprint might be.

OUR COMMITMENT We take the high road in our business dealings and expect the same from our partners. A strong foundation in governance is critical at AMN. We give time and attention to conveying ethical business practices to protect and serve all who are touched by our day-to-day operations.

Our product is our people and service. With people at our core, our attention and effort are aimed at supporting clinicians and physicians so that they deliver the best quality care across the country.

We are committed to implementing energy efficient and environmentally sensitive practices in our buildings and technological infrastructure. Today, technology allows the rapid response of our greatest asset-people. Limiting our footprint through the use of new energy-efficient technologies not only serves the environment, but also allows us to lead in the marketplace.

Figure 2: Challenges and Commitments


10

Figure 3: Corporate Social Responsibility at AMN

Metric Impact Area What this means to us

ECONOMIC AND GOVERNANCE

Financial Integrity Maintaining the financial health of our company allows us to continue to serve our customers

Governance, Ethics & Accountability

Operating our company in an ethical manner with integrity

Economic DevelopmentHaving a positive impact on the communities in which we operate and live

Trust & CredibilityTaking pride in knowing our clients trust us and we have credibility in the marketplace

SOCIAL –LABOR PRACTICES

Talent Recruitment Hiring the best and brightest available candidates

Talent Retention Helping our team members achieve professional and personal goals

SOCIAL –OUR PEOPLE

Training & Development Developing our workforce through training and a preference to promote from within

Diversity Recognizing that diversity is a strength of our team and fostering a welcoming environment

PRODUCT RESPONSIBILITY- OUR SERVICES

Satisfaction Providing top-notch service to our clients is essential to our company’s success

Business Loyalty Retaining current customers because they value and appreciate our services

SOCIAL –COMMUNITY ENGAGEMENT

Satisfaction Sustaining philanthropic partnerships with healthcare and human services organizations

Business Loyalty Supporting the efforts and engage our team members through our employee volunteer programs

ENVIRONMENT

Materials Minimizing waste and appropriately managing disposal in the office

Resource Conservation Doing our part to minimize our resource use footprint

Emissions Minimizing electricity use and associated indirect emissions

Travel Assessing the impact of employee travel on our total environmental impact


11

ENGAGING WITH STAKEHOLDERS

Engaging and building productive working partnerships with our stakeholders is a core part of our commitment to being a responsible and responsive company.

Our first stakeholder mapping exercise identified those who directly influence our daily activities or challenge our ability to effectively drive long-term strategy and growth. The graphic below displays our most important stakeholders and how we have engaged with them: team members, clinicians and physicians, clients, shareholders, local communities, local and federal governments, media and human rights watch groups.

As an organization with people at our core, their well-being and interests significantly impacts on our choice of issues to pursue.

We want to build productive relationships with our main stakeholder groups, both inside and outside AMN. We want to understand their expectations, engage in an open and constructive dialogue and develop our activities in response to what we hear. While no formal stakeholder engagement process for the Corporate Social Responsibility program currently exists, AMN has launched efforts internally to assess perspectives on what key sustainability issues we should evaluate further. We aim to distribute our full CSR report to all stakeholders via our website and our intranet.

Figure 4: Stakeholder Map

12+13+12+13+12+13+12+13+ALocal and Federal

Governments

Shareholders

Local Communities

Media

Clinicians, Nurses and Physicians

Clients

Team Members

Human Rights Watch Groups


12

OUR MEMBERSHIPS

We work collectively with others in our industry to address shared challenges and risks. AMN upholds this commitment as a participating member in the following industry groups:

National Association of Travel Healthcare Organizations (NATHO)

AMN is a founding member of NATHO. This group influences standards for traveling clinicians. These standards relate to the working conditions provided to these clinicians by the facilities at which they are placed as well as the performance and behavioral expectations of the clinicians.

National Association of Locum Tenens Organizations (NALTO)

NALTO provides a foundation of industry standards and ethical guidelines for companies specializing in physician locum tenens recruitment services. NALTO is committed to continuous educational programming focused on industry standards, ethical treatment of physicians and clients, and changes in the Locum Tenens marketplace which affect the members. Further, NALTO commits to a leadership role in developing a positive image of the industry, an increasing market share for the members, and a peer-review process based on fairness, honesty, and excellence.

Figure 5: Modes of Engagement with Stakeholders

Stakeholders Modes of Engagement on CSR

Board of Directors • A formal review and presentation

Team Members • Employee Engagement Survey • Company intranet• Discussion by CEO and other leaders at key Company

Clinicians and Physicians• Satisfaction ratings• Relevant information from this report sent via direct e-mails

• CSR Report highlight in Newsletters

Clients • Procurement requirements of our clients• Standards/practices related to CSR integrated in contracting• CSR Report highlight in Newsletter and websites

Peers • Benchmarking against our peers• Leadership roles in industry associations across the country

Regulations, Policy Makers • Participate in initiatives such as CA 2020 Waste Reduction and AB32-hospitals

events and meetings

and websites


13

American Staffing Association (ASA)

ASA is the voice of the U.S. staffing, recruiting, and workforce solutions industry. ASA advances the interests of staffing and recruiting firms of all sizes and across all sectors through legal and legislative advocacy, public relations, education, and the promotion of high standards of legal, ethical, and professional practices. ASA members provide the full range of employment and work force services and solutions, including temporary and contract staffing, recruiting and permanent placement, outplacement and outsourcing, training, and human resource consulting.

Staffing Industry Analysts (SIA)

AMN acts as an advisor to SIA, the global advisor on contingent work. SIA is known for its independent and objective industry insights, proprietary research, data, support tools, publications, and executive conferences. SIA provides practical, actionable, forward-thinking advice to help their members develop their business.

Association of Corporate Counsel (ACC)

The ACC is a global bar association that promotes the common professional and business interests of in-house counsel who work for corporations, associations and other private-sector organizations through information, education, networking opportunities and advocacy initiatives. ACC helps members deliver services to their corporate clients efficiently; promote the value of in-house services; influence the practice of law as it affects the in-house bar; and deliver a mix of relevant, timely services including information, education, networking and advocacy.


14

OUR WORKFORCE

Our people comprise our most important stakeholder and our biggest asset. In order to hire and retain a diverse and talented group of healthcare professionals, we are committed to providing an excellent work environment that helps team members thrive through development. Day in and day out, we build close-knit relationships while providing opportunities for everyone to grow and to become his or her best. We nurture our team members and strive to promote from within.

At the end of 2013, our workforce totaled 1,793. This figure consisted of those working out of our campuses in San Diego, California and Irving, Texas, including remote employees. While we try to retain those we hire, some level of turnover is to be expected as team members pursue other interests and relocate. In 2013, the 544 team members who left us account for a turnover rate of 33 percent. On the other hand, we filled 597 positions in 2013, 29 percent from internal transfers with the remaining 69 percent hired externally, leading to a total growth of 6.8% in our workforce for the year. (See Figure 6)

Our People

Figure 6: Total Workforce and Changes in 2013

200

-200

-400

-600

400

600

800

1,000

1,200

1,400

1,600

1,800

173

+597

1,7931,671

STARTING HEADCOUNT

TERMINATIONS INTERNAL TRANSFERS

HIRES ENDING HEADCOUNT

-544


15

Metric Count Percentage

TOTAL 1,793 100%

Female 1,194 67%

Male 599 33%


TOTAL 1793 100%

Asian 8 0.4%

Native American or Alaska Native 77 4.3%

Black or African American 122 6.8%

Hispanic or Latino 125 7.0%

Native Hawaiian/ Pacific Islander 15 0.8%

White (Not Hispanic or Latino) 1079 60.2%

Two or More races 35 2.0%

Decline to State 40 2.2%

Unknown 292 16.3%


OFFICERS 13

Female 6 46%

Male 7 54%

VICE PRESIDENTS 71

Female 26 37%

Male 45 63%

UPPER MANAGEMENT - DIRECTORS & OTHER LEADERS AND MANAGERS 260

Female 145 56%

Male 115 44%

LOWER MANAGEMENT - SUPERVISORS AND TEAM LEADS 75

Female 65 87%

Male 10 13%

INDIVIDUAL CONTRIBUTORS 1374

Female 952 69%

Male 422 31%

FIGURE 7: Total AMN Employees by Gender

FIGURE 9: AMN Team Members by Ethnicity

White

Two or More Races

Decline to StateNative Hawaiian/ Pacific Islander

Unknown

Hispanic or Latino

Black or African American

Native American or Alaska NativeAsian

FIGURE 8: AMN Team Members by Employment Type and Gender

Includes both full - and part time employees in San Diego, CA and Irving, TX

Includes both full- and part time employees in San Diego, CA and Irving, TX

Includes both full- and part time employees in San Diego, CA and Irving, TX

AMN Team Members by Ethnicity

FIGURE 8:

We are committed to diversity in the workplace and we thrive on building an inclusive culture. This commitment, especially to gender diversity shows in that 44 percent of our executive committee and 67 percent of our total workforce is female. In terms of ethnic diversity, 25 percent of our workforce identify with a minority group. Figures 7, 8 and 9 show our workforce broken down by gender and ethnicity.


16

OUR CULTURE OF ENGAGEMENT

Figure 10: Common Trainings by Departments

We are proud of a culture that encourages our team members to reach their potential by empowering them, investing in training and development and rewarding performance. This commitment is reaffirmed in AMN’s Core Purpose: Helping Achieve Professional and Personal Goals Every Day.

Empowering our Team Members

We support a positive internal culture and a healthy work-life balance for our team members. We judge our success in this area based on the annual Employee Engagement Survey. This survey has been in place since 2003, and gives team members a voice, encouraging their feedback on workplace programs, culture and organizational vitality. The 10th annual survey conducted in 2013 garnered an 82-percent response rate across AMN, and registered a 79-percent approval rating overall. Our senior management uses this information to continually assist team members in meeting their potential by focusing on removing the barriers that get in the way of their effectiveness.

AMN believes that our team members are empowered when they understand the Company’s strategy and how they contribute to overall success. To this end, our senior executives strive to inspire confidence and trust by building relationships throughout the Company.

To harness the great and innovative ideas of all our team members, AMN offers the Innovation Station, a portal on our intranet through which any team members can submit an idea to our AMN Innovation Committee. The AMN Innovation Committee screens, evaluates and prioritizes the ideas before submitting recommendations to the oversight committee for further evaluation. Finally, the committee follows up with the team members to share the status, outcome and rationale of the decision made about his or her idea.

Training & Education

AMN offers extensive training and development opportunities to help our team members broaden their knowledge and increase skills that help them excel in their jobs. There is currently no system to track hours of training completed by team members; however implementation of a company wide Learning Management System is being considered soon. Common trainings given by department can be found in Figure 10.

In support of team members who wish to continue their professional development and education to secure increased responsibility and build their career with AMN, the Company has established the Professional Development and Educational Assistance Program. This program offers reimbursement for approved expenses incurred through training organizations and accredited institutions of learning. All regular full-time team members, after completing six months of continuous employment with AMN, are eligible to apply for reimbursement. The Company will reimburse eligible team members up to a maximum of $2,000 per year. Reimbursements may include seminars, tuition, registration/course fees, books and lab fees.

Aspect TypeInformation Technology

Virtual classroom, voluntary training provided for new technology including:

• Microsoft Office Suite• Collaboration technologies

Human Resources

• Harassment prevention• On the job training• Comprehensive training by department and function• Extensive leadership development• Competency mentoring program

Legal • Context of compliance and ethics • HIPAA bi-annual training• Privacy/code of conduct • Antitrust training

• Key Talent development program• Emerging Leader development program• Team Member competency development• Team building• Development through assessments


17

Leadership Development

As part of AMN’s commitment to building talented leaders who excel in their specialties, newly promoted leaders are invited to the Emerging Leader Essentials, a LEAD @ AMN program. The purpose of this six-part program (see Figure 11) is to orient AMN’s new leaders with information they will need to become a successful leader at AMN. In addition to covering AMN’s leadership competencies and expectations for a Leader of Others at AMN, the program includes a variety of LEAD @ AMN topics and resources that will prove to be very valuable in leading team members and managing teams.

In addition, AMN offers a Competency Mentor Program called IGNITE! This six-month program carefully selects and matches internal Mentors and Mentees based on competency expertise and potential for growth. The objectives of the program are to:

• Set a development plan with specific actions that continue momentum and self-development;

• Focus on one competency that will help prepare Mentee for continued career growth;

• Stretch participants beyond their comfort zone by trying and implementing new skills and techniques;

• Achieve a noticeable improvement in leadership effectiveness; and

• Create a culture that uses mentorship as a way to develop individuals.

Reviewing & Rewarding Performance

AMN actively supports and encourages career growth and development for team members at all levels so they may navigate their future and grow with the company. In addition, we are committed to recognizing our team members for their accomplishments.

You Make the Difference

At AMN we realize that recognition is important to motivation, so we strive to recognize team members for their achievements. The “You Make the Difference” program salutes team members across AMN as they achieve results or demonstrate behaviors that support our company’s unique culture. Team members can officially recognize colleagues through this system by awarding them with a token. These tokens can then be redeemed for gifts and other rewards.

AMN’S CULTURE

SELF PEOPLE PROCESSES

INDIVIDUALSLEADLEADLEADLEAD LEAD LEAD

TEAMS THE AMN BUSINESS

AMN’S CULTURE

SELF PEOPLE PROCESSES

INDIVIDUALSLEAD LEADLEADLEADLEADLEADTEAMS THE AMN

BUSINESS

LIFE INSURANCE

STOCK OPTION AND

EQUITY PLANS

DISCOUNT PROGRAMS

VISIONMEDICAL LIFE

INSURANCE

CRITICAL ILLNESS

INSURANCE

VOLUNTARY ACCIDENT &SHORT-TERM DISABILITY

401(K) PLAN STOCK OPTION &

EQUITY PLANS

DISCOUNT PROGRAMS

PRESCIPTIONS DENTAL VISION

Figure 11: LEAD@ AMN Process


18

Performance Success Plans

AMN’s annual review process is called the Performance Success Plan (PSP). The process is intended to foster conversation between leaders and team members about performance and the goals they have set for the year. Although these plans are updated annually, leaders are encouraged to have PSP conversations with team members throughout the year to ensure they are on the right track.

Individual Development Plans

AMN’s Individual Development Plans (IDPs) are designed to support and document our Succession & Career Management process. Unlike the PSP process, which evaluates the previous year’s performance, IDPs offer a great opportunity to focus on the future. This process provides a forum for team members and their leaders to honestly discuss the team member’s career aspirations and, most importantly, identify a realistic path to get there. When team members have previous experience that lends itself to future opportunities, for example, the IDPs and discussions about them are a perfect forum for sharing this with their leader. This process creates a shared responsibility for success. To best use the time in a team member’s IDP session, team members are encouraged to complete an assessment about their career aspirations. They bring the completed form to their IDP session and share their insights with their leader.

VIP Awards

Values In Practice Award is the only enterprise-wide recognition program that is peer-nominated and peer-selected. Its aim is to recognize AMN team members who consistently demonstrate one of AMN’s Core Values.


19

ATTRACTING & RETAINING THE BEST TALENT IN OUR INDUSTRY

Diversity

Maintaining a diverse workforce is important to allow us to offer the best clinicians and physicians possible. We set an example for this at the top and this model carries through every level of our workforce. We have an equal employment opportunity policy that we maintain for all team members from sourcing to employment and take affirmative actions in connection with our status as a government contractor.

Women in Leadership Roles

AMN has for eight consecutive years, won the University of California-Davis award that recognizes achievements for high percentages of women in executive leadership roles. In early 2012, AMN Healthcare President and CEO Susan Salka was named “Woman of the Year” at San Diego Magazine’s annual “Women Who Move the City” event in honor of her commitment to business excellence and effecting positive change in the community. Susan Salka is a mentor and role model for other female executives in the company and in the community.

Compensation Packages & Benefits

We offer comprehensive benefits packages for eligible team members and their families (see Figure 12).

Figure 12: Benefits Package

MEDICAL

Medical

Rx

H.S.A

Healthcare FSA

Department Care FSA

DENTAL & VISION

Dental

Vision

DISABILITY

STD

LTD

LIFE

Employee Term Life

Spouse Term Life

Child Term Life

AD&D

OTHER

Wellness Program

Biometric Screenings

Health Assessments

Coaching

Telemedicine

EAP

Financial Incentives


20

Since its implementation in late 2010, Connect to Your Health has improved team member engagement by offering incentives for positive behaviors that ultimately affect physical and mental well-being. A Wellness Champion Committee of approximately 50 team member offers guidance, support and motivation in their departments and divisions for Connect to Your Health. Additionally, senior leaders across the organization, including our CEO, CFO and General Counsel, promote healthy living through their behavior, actions and committee involvement. Their “lead by example” attitude has helped shift AMN to a more aware and health-conscious company culture across all our offices.

In addition, AMN maintains an ergonomics program that pro-actively works to prevent potential health problems related to team members’ workstations. It includes giving team members self-evaluation tools and educational resources about healthy ergonomics practices, conducting workstation assessments to ensure optimum use of equipment and securing consultations with a certified ergonomist, when necessary.

For team members with urgent or sensitive health and wellness issues, AMN’s Employee Assistance Program offers customized, free and confidential support in areas regarding family, finances, substance abuse, violence, stress management, bereavement, and other services.

One way we measure the effectiveness of our health and well-being programs is through a reduction in workers’ compensation claims. AMN tracks team members injuries based on claims per $1 million in payroll cost. Since 2010, this rate has dropped each year (see Figure 13).

Figure 13: Worker’s Compensation Claims per $1 Million in Payroll

Health & Well-being

As healthcare focused, the health and well-being of our team members is of utmost importance to AMN. We operate a 24/7 hotline to help manage any concerns that our team members may have.

AMN operates a wellness program called Connect to Your Health. This innovative wellness strategy aligns program initiatives with company fiscal goals. The wellness program engages team members through motivation and inspiration, and provides them with the resources and tools needed to fulfill individual wellness goals.

0.2

0.1

0.3

0.4

0.5

0.6

0.30 0.29

0.48

2010 2011 2012 2013

0.42


21

Human Rights & Fair Labor

We are committed to fair labor and respect human rights. We use contracts to ensure that we strictly adhere to all federal and state employment laws. AMN takes the following positions to support human rights and equality in our workplace:

AMN is an equal opportunity employer and opposes discrimination of any kind.

We hire and promote based on skills and abilities. AMN has never incurred an Equal Employment Opportunity Commission lawsuit.

AMN ensures that health and safety issues are addressed.

There are certain protective contract clauses to ensure health and safety is safeguarded for our contractors. In our corporate office, there are relatively few hazards or risks that would affect health and safety.

AMN provides leave to team members in need.

This includes victims of domestic violence and stalking.


22

Our clients are hospitals, healthcare systems, and healthcare companies in all 50 states. The majority of our healthcare professionals are placed at acute-care hospitals; however we also provide services to sub-acute healthcare facilities, physician groups, rehabilitation centers, dialysis clinics, pharmacies, home health service providers and ambulatory surgery centers. We also maintain a strategic alliance with Novation, the leading healthcare group purchasing organization.

A nationwide presence is important to AMN as we partner with our hospital and other healthcare facility clients across America. Figure 14 shows just a small sample of the facilities where our work is making a difference.

Swedish Medical Center

Kaiser Permanente

Standford University Medical Center

UCLA Medical Center

Sharp Healthcare Systems

University of Utah Hospital

University of Missouri Hospitals and Clinics

Parkland Memorial Hospital

Scott & White Healthcare Tulane University

Hospital

Emory University Hospital

HCA Florida Group

Vanderbilt University Medical Center

Duke University Medical Center

MedStar Health

Johns Hopkins University Hospital

New York Presbyterian Hospital

Yale New Haven Hospital

Massachusetts General

The University of Chicago Hospitals

Northwestern Memorial Hospital

Allina HospitalsNebraska Health Systems

University of Colorado Hospital

Our Clients

Figure 14: AMN Offices and Client Locations


23

EXCEEDING CLIENT EXPECTATIONS

USING INNOVATIVE TECHNOLOGY TO MEET CUSTOMER NEEDS

As an innovator in healthcare workforce solutions, AMN is committed to delivering the highest level of service and convenience to our valued clients. We attract these clients based on the depth and quality of our clinicians and physicians, the scalability and breadth of our service offerings, our experience with delivering desired results to our clients and our strong client reference base. We thoroughly screen all of our clinicians and physicians prior to placement and maintain compliance with The Joint Commission accreditation. We mitigate risk and monitor compliance through our innovative investments in proprietary technologies that automate the credentialing process and trigger escalations and pro-actively resolve issues. . We design our internal processes to ensure that our healthcare professionals have the appropriate experience, credentials and skills for the assignments they accept.

Another way AMN differentiates itself in the marketplace is through our innovative technology solutions for clients. These proprietary technologies help our clients manage all aspects of their complicated staffing needs. In 2014, AMN is investing in a large overhaul of our technology systems to be able to continue delivering excellent and innovative service to our clients.

In all of our client relationships, safeguarding patient and client information is essential. AMN is moving all data to a cloud-based system that is authenticated and protects information for clients and contractors. This system is also compliant with the federal Health Insurance Portability and Accountability Act (HIPAA). To ensure this, our Legal Department works closely with Information Technology and our vendors to make sure their security practices are on par with AMN’s standards. This minimizes the risk that they experience a patient data breach. If a breach does occur, it is investigated by our management and the most appropriate course of action is determined by all involved. All breaches are tracked and reported per HIPAA. I

–Justin Border, Vice President, Advantage Rehab

”Our strategic partnership with AMN has enabled us to grow and ensured that we are able to provide appropriate levels of care. It is clear that the strength of the people AMN has provided has contributed directly to the success of our company.”

–Piper Frithsen, Director Patient Care Services, Tucson Medical Center

”The three benefits of our managed service from a nursing standpoint are consistency of quality, partnership with the same point of contact, and then the time savings.”


24

MAINTAINING CUSTOMER SATISFACTION

MARKETING & COMMUNICATION

Measuring Customer Loyalty

Many of our clients maintain long-term contracts with us by extending or establishing new contracts at the end of their initial term. We measure customer loyalty by tracking this repeat business.

Measuring Customer Satisfaction

In order to better understand how our services are received, AMN conducted a competitive brand survey in 2013 that measured the satisfaction of both our clinicians and our clients. This helps us understand how our clients perceive us in relation to our competitors, which of our services are most valued and where we can improve our service to clients.

AMN has never had any incidents of non-compliance regarding our marketing communication. This is in large part due to the internal policies that govern the way in which we review and distribute press releases and other documents. Our Information Disclosure policy ensures that our communications are complete and accurate.

AMN has a policy that regulates commercial email. The majority of our commercial email is handled by third parties. We generate lists through our databases and monitor compliance. From there, we manage complaints and determine what adjustments to make. Periodic training is conducted with our Marketing Department on how to run contests or sweepstakes, and ideas are then run by the Legal Department to make sure that they are in compliance with the law. AMN respects the decision of people who wish to be taken off a call or email list.

–Director of Talent Acquisition, Large U.S. Retail Pharmacy Chain

“On a scale of 5, AMN kept coming in at 5. It was a high bar, but they kept hitting it. That’s really important in our fast-paced business. At the end of the day, we had people who knew what they were doing every step of the way. If AMN can do this, they can do anything…and they did it!”


25

Helping Achieve Professional and Personal Goals Every Day extends into our communities. AMN is a committed and proactive corporate community partner in San Diego and the other communities where our team members live and work. We support several non-profit organizations through focused efforts in health and human services, women’s and children’s initiatives, education, and economic development/civic initiatives that are making a difference. We do this through charitable giving, in-kind donations, relief efforts, scholarship programs and team-member volunteering.

Highlights of AMN’s community engagement programs in 2013 include:

Volunteerism

We are particularly proud of our team member volunteer program because it reflects the strong philanthropic efforts/spirit of our team members. The program reinforces our mission of “Helping Achieve Professional and Personal Goals Every Day” by encouraging team members to take an active role in their community. In 2013, our team members collectively put in more than 6,000 volunteer hours.

Community Engagement

AMN TEAM MEMBERS TRAVEL TO GUATEMALA TO PROVIDE CARE:

In 2013, an AMN-sponsored team of physicians, nurses and others traveled to San Cristobal in the highlands of Guatemala to treat medical disorders and tackle some of the issues were causing chronic health problems there. During the weeklong trip, the group conducted nearly 100 surgeries, 550 clinical visits and over 100 dental treatments, all at no cost to the patients. This experience was so powerful for the volunteers on the AMN team that another group has returned to the area in 2014, including CEO Susan Salka. See the YouTube video, “Crossroads of Poverty and Disease – AMN Healthcare,” for more information on this trip.

AMN Team Members volunteer with HELPS International project in Guatemala

http://link.brightcove.com/services/player/bcpid1956333305001?bckey=AQ~~,AAABxzD3Y9k~,w_VmDmf4kc-wuuJ3PVpKH7hNJtmY6P2q&bctid=2777473922001


26

Scholarship & Educational Support

AMN is committed to the future of the healthcare industry. To ensure that the best and the brightest fulfill their educational goals in nursing, medicine and the life sciences, we have established a program to provide financial support to organizations that give scholarship awards to students and faculty based on merit, need and dedication to America’s health. In 2013, AMN gave over $100,000 in scholarship funds. This amount included a large, one-time gift to San Diego State University School of Nursing.

Fundraising & Charitable Contributions

One of AMN’s charity involvement includes yearly sponsorship of the Susan G. Komen Race for the Cure to support the fight against breast cancer. As part of our commitment to our team members and AMN community involvement, we form teams and pay the registration fees for all participating corporate team members joining any of the 5K Race for the Cure events across the nation. In addition to our corporate sponsorship, team members raise and donate funds to their local Komen affiliates. AMN has received numerous awards and regular recognition from national and local charity groups for our support and charitable contributions.

Disaster Relief

In the wake of the 9/11 terrorist attacks on the Unites States, AMN team members raised more than $32,000 for American Red Cross relief efforts. Following the Indian Ocean earthquake and tsunami, and Hurricane Katrina along the U.S. Gulf Coast, AMN team members raised more than $50,000 for various relief efforts. More recently, AMN and our team members donated generously to disaster relief efforts in Haiti; Japan; Philippines, San Diego, CA; Joplin, MO and to recovery efforts for healthcare workers following Hurricane Sandy.

–Steve Wehn, Vice President, Community and Government Affairs

“AMN is a committed and proactive community partner. We are dedicated to using our resources to improve health wherever there is a great need and to make the world a better place.”


27

Non-Profits Supported by AMN

AMN’s Community Relations program includes long-term philanthropic partnerships with many nonprofit organizations. Many of these focus on health and healthcare activities such as seeking treatment improvements, providing support for those with medical needs and promoting public awareness of particular health risks and diseases. Here is a list of non-profits to which AMN contributed in 2013, by category:

Health Social Issues Including Disaster Recovery

Children’s Initiatives

Komen Race for the Cure

National Multiple Sclerosis Society

Alzheimer’s Association

Mental Health Systems

American Heart Association

Fresh Start Surgical Gifts

American Cancer Society

Challenged Athletes Foundation

Ronald McDonald House

San Diego Burn Institute

Make a Wish Foundation

Various food banks across the country

Father Joe’s Villages

San Diego Social Venture Partners

San Diego Hunger Coalition

Habitat for Humanity

Doctors without Borders

The Community Health Improvement Partners

Joplin, Missouri, Tornado Recovery (to support displaced healthcare workers)

HELPS International

Girls on the Run

Voices for Children

Angels Foster Family Network

YMCA

Girl Scouts of America

Boys and Girls Clubs of America

Boy Scouts of America

Miracle Babies

Education Professional and Economic Development/Civic Initiatives

Various nursing school scholarships

Junior Achievement

Community scholarships

Various nursing association scholarships

Leadership scholarships

San Diego Economic Development Council

Athena San Diego

San Diego Organization of Healthcare Leaders

San Diego Regional Chamber of Commerce

San Diego Coastal Chamber of Commerce

LEAD San Diego

CONNECT of San Diego

BIOCOM

American Staffing Association

NATHO - National Association of Travel Healthcare Organizations

NALTO – National Association of Locum Tenens Organization

HCC – Health Care Communicators

San Diego Police Foundation

Various nurses associations

CAPP– California Allied for Patient Protection

Various Hospital Associations


28

Environment

Being a responsible corporate citizen at AMN requires individual and organization-wide environmental responsibility. At the heart of AMN’s responsible environmental efforts is our Green Team. The Green Team consists of 10 volunteer team members who give a one-year commitment. The diverse team members work in departments throughout the company, but are tied together by their shared passion for sustainability. The Green Team allows our team members to get involved and help the company improve its environmental impact.

In addition to working on day-to-day environmental issues such as recycling, the Green Team organized and held AMN’s first Earth Day Expo in 2013, which included daily articles by team members on the Company’s intranet, an eWaste recycling drop-off and awareness-building about simple changes that team members can make to reduce their impact at work and at home.

With the guidance of the Green Team, the Company undertakes these green initiatives as we strive to create less waste and preserve resources as part of our overall strategy for greater sustainability. AMN is committed to devising and implementing programs and services that will reduce energy consumption, greenhouse gas emissions (GHGs), waste to landfills and water usage.

*Natural Gas therms data contained gaps that were interpolated based on daily usage in existing data **Emissions from electricity calculated with EPA regional emissions factor: CAMX WECC California ***Emissions from natural gas calculated with EPA Calculations and References: http://www.epa.gov/cleanenergy/energy-resources/refs.html

*Data is for San Diego Corporate Headquarters only

Gases that trap heat in the atmosphere are called Greenhouse Gases (GHG).

Figure 15: Environmental Performance Metrics

Aspect Type Amount UnitsEnergy Electricity 3,313,326 kWh

Natural Gas 46,130* therms

GHG Emissions Total 2,563,053 lbs CO2e (carbon dioxide equivalent)

From Electricity 2,023,846** lbs CO2e (carbon dioxide equivalent)

From Natural Gas 539,207 lbs CO2e (carbon dioxide equivalent)

Waste Recycling 177,996 lbs


29

–Jeanette Sanchez, SVP Information Technology

“Technology will make the cultural shift to more efficient practices easier.”

In partnership with Kilroy Realty, our management made several changes to more-efficient practices, including:

ENERGY STAR: The appliances in our office are all ENERGY STAR-rated for efficiency. This includes printers, refrigerators, dishwashers and even café equipment, though our onsite café is managed by a third-party vendor.

Lighting: We use two distinct strategies for reducing lighting energy use: controlled shutoffs and bulb efficiency. Our lighting control system runs on motion sensors and a main control system that cycles lights on when people are in the building and off otherwise, excluding nighttime emergency lighting and parking area lights for safety and security. AMN has explored the possibility of LED lighting retrofits for the decorative lighting in the building. Due to high upfront cost, AMN is reviewing the long-term payback of this switch, and will further consider its feasibility in 2014.

Servers and data centers: In 2014, we are consolidating all of our servers and moving data centers to Las Vegas. This will reduce our current set of 250 servers to just nine in the new facility. In addition to giving AMN more space to accommodate a growing workforce, the switch will constitute a 90-percent reduction in energy consumption.

Heating: An award-winning system provides heat in our building. This completely computer-controlled system has saved us energy and money since 2003.

MEASURING GHG EMISSIONS

We have broken our emissions profile into two main components. The largest portion of our emissions comes from the energy we purchase. We use both electricity (kWh) and natural gas (therms) to power, heat and cool our building. The second, smaller component of our emissions comes from business travel and team members commuting. Though we track dollars spent on business-related travel, we do not currently have a mechanism for tracking specific emissions from business travel. We will explore ways in which we can better track this data on a more detailed level in the future.

ENERGY-SAVING INITIATIVES

AMN is currently focusing on reducing energy consumption at our San Diego headquarters. With the help of our landlord Kilroy Realty, we are able to monitor consumption and manage our impact. AMN is responsible for 85 percent of the building’s energy usage, based on the square footage we occupy in the complex. This includes usage on the floors we occupy, as well as our share of the centralized services of the building such as the parking lot, common areas and heating, ventilation and air-conditioning (HVAC) systems.


30

RECYCLING & WASTE

Responsible waste management is important to AMN. Reduction and recycling not only divert waste from landfills, they can cut costs, increase work effectiveness and minimize environmental health issues. This is an area of particular focus for our Green Team (See narrative at beginning of Section 8 for more information). To better understand the composition of our waste streams, the Green Team voluntarily conducted an initial waste audit; a full analysis is still being planned.

Led by our Green Team, here are some of the waste management initiatives we have in place:

Recycling: Recycling receptacles are available by team members’ desks as well as in all kitchens, break rooms and common areas throughout the building. AMN’s recycling generally is composed of 75 percent cardboard and 25 percent mixed paper, metals, glass and plastics. While our recycling is not weighed by the hauler at the time of pickup, using the U.S. Environmental Protection Agency’s Volume to Weight Conversion table, our vendor estimates that 2,282 pounds of recycling is collected at each pickup, with pickups occurring approximately three times each week. We are working with our upstream vendors to purchase more sustainable supplies and downstream with our waste-hauling vendor, Waste Management to help better manage waste and recycling. See Figure 16 for monthly recycling amounts in 2013.

Dishes and Cups: We transitioned from Styrofoam to paper products, which reduces costs and benefits the environment. We eliminated paper cups and bought reusable dishwasher-safe ceramics. Before this switch in 2010, we were buying 10 cases of paper cups each week.

Paper: Our printers are all configured for double-sided printing and we support and invest in infrastructure to allow more of our business processes to become paperless. This includes technology for paperless meetings, digital contracting, invoicing and other client transactions. In order to reduce our office footprint significantly, it is important to promote behavioral changes in paper use. One example of this is a study conducted by a Green Team member on inefficient AMN headquarters uses of paper. The team member published an article on the findings on the Company’s intranet, encouraging all team members to use less paper.

E-Waste: AMN disposes of e-waste when necessary through a vendor in San Diego. In 2013, 15 servers and 110 personal computers (including monitor and mouse) were responsibly disposed of through this service. In addition, AMN team members are encouraged to bring in their old batteries and other e-waste. In 2014, 1,400 computers will be replaced; the old equipment will be reused when either sold to team members, donated to schools or sent back to manufacturers for reuse.

Carpeting: We use carpet squares rather than wall-to-wall carpeting for easy replacement. This material choice not only reduces waste, but also limits downtime during re-carpeting.

ENVIRONMENTAL INITIATIVES AT AMN HEALTHCARE TER-RACE CAFÉWater conservation: To save water we thaw frozen items overnight in our walk-in refrigerator as much as space and time permits.

Energy conservation: To reduce energy use all equipment is turned on only as needed and each day at the end of the meal service we shut down the convection ovens.

Local products: To reduce the miles our food travels all produce is locally sourced and we do not use imported produce.

Organic and responsible sourcing: To ensure we are serving food that is healthy for the earth in addition to our team members, we feature organic items and all seafood is MSC certified. Additionally we reduce beef and dairy menu items due to the increased carbon emissions those products produce compared to poultry, seafood and pork.

Waste/spoilage: To keep waste low we prepare only what is needed. We tend to run out of food versus having it go to waste.

Recycling: To avoid sending all of our daily waste to the landfill we recycle all cardboard packaging and recyclable food containers

Café utensils, plates, cups, and napkins: To reduce the impact of our disposable items we use Eco-Friendly Earth Choice brand napkins containing 30% post-consumer recycled and unbleached paper. We do not use any Styrofoam.

Figure 16: Monthly Recycling in Pounds

JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC

14,833 14,833 14,833 14,833 14,833 14,833 14,833 14,833

15,974 15,974

13,692 13,692


31

* Natural Gas therms data contained gaps that were interpolated based on daily usage in existing data **Emissions from electricity calculated with EPA regional emissions factor: CAMX WECC California ***Emissions from natural gas calculated with EPA Calculations and References: http://www.epa.gov/cleanenergy/energy-resources/refs.html

WATER USE

PROMOTING SUSTAINABILITY WITHIN OUR SUPPLY CHAIN

Our water footprint has two dimensions: potable water used inside the building and water used outside for landscaping. Inside the building, our water consumption is from ordinary restroom and kitchen use. Our outside landscaping is handled by our property manager and it employs an advanced rain cut-off system for efficient watering. There are no sources of water contamination reintroduced to the municipal system or to groundwater either within the building or via landscaping. The cooling towers for our HVAC units do contain chemically treated water; however, it is a closed system and the water does not leave the building.

AMN would like to position itself as an environmental leader in the healthcare industry. AMN deals directly not only with clinicians, physicians and facilities, but it also maintains business-to-business relationships with numerous companies outside the healthcare field such as professional services firms, property managers, utilities and countless suppliers, large and small.

As such, AMN has a tremendous opportunity to influence environmentally responsible business practices across a wide range of sectors. It also can affect substantially the rate at which the healthcare staffing industry adopts sustainable operating principles. In addition, AMN works with its partners and supply chain to prevent environmental health risks to people through eco-responsible business practices.

AMN has a specific sustainability impact downstream when we provide staff that helps our clients transition to paperless record systems. These systems eliminate paper waste and improve operational efficiency, allowing our clients to continue delivering the highest standards of care to their patients.

Some of our largest and most important clients are federal government agencies, therefore we have aligned our efforts with the sustainability goals in the Strategic Sustainability Performance Plan released by the General Services Administration (GSA). The environmental goals of the plan and our status in each area are as follows.

(see next page)

Figure 17: Water Use

Aspect Type Amount Units

Water Indoor 5,771 ccf (hundred cubic feet)

Outdoor 4,480 ccf (hundred cubic feet)


32

GSA Goal Specific Target AMN Performance Future Considerations

Scope 1 & 2 GHG Reduction

By FY 2020, GSA will reduce Scope 1 and 2 Greenhouse Gas (GHG) emissions 28.7 percent below FY 2008 levels.

See GHG emissions section above

2013 is our baseline for Scope 2 emissions. By Year-End 2014, we aim to have SMART targets set.

Scope 3 GHG Reduction

By FY 2020, GSA will reduce Scope 3 Greenhouse Gas (GHG) emissions by 14.6 percent below FY 2008 levels.

See GHG emissions section above

Trending data does not yet exist We will aim to set our Scope 3 baseline for 2014 then develop targets in 2015.

Sustainable Design, Green Buildings and Local Planning

By FY 2015, 18 percent of GSA-owned Federal buildings greater than 5,000 gross square feet (GSF) and leases greater than 5,000 GSF will incorporate the sustainable practices in the Guiding Principles for Federal Leadership in High Performance and Sustainable Buildings.

AMN and Kilroy Property Management have worked hard to manage efficiency, but have not yet attempted to attain certification.

AMN will engage Kilroy on the possibility of seeking LEED Certification for HQ in San Diego, which already meets criteria through natural lighting, efficient hardware and environment.

Water Use Efficiency and Management

By FY 2020, GSA will reduce potable water use intensity 26 percent below FY 2007 levels.

See Water Management section above

2013 is our baseline year for water consumption. By Year- End 2014, we aim to devise a SMART corporate-wide reduction strategy.

By FY 2020, GSA will reduce industrial, landscaping, and agricultural (ILA) water use by at least 20 percent below FY 2010 consumption.

See Water Management section above

2013 is our baseline year for water consumption. Because this impact is managed by our property management company, we aim to engage it in 2014 to determine the most effective course of action.

Pollution Prevention and Waste Reduction

By FY 2015, GSA will divert at least 50 percent of non-hazardous solid waste from landfills through reduction, recycling, re-use and composting methods.

See Waste Management section above

Conduct a complete waste stream audit and establish data tracking mechanism for KPIs such as production and diversion rates.

GSA laptops, desktops and monitors are 100-percent-compliant with ENERGY STAR specifications and power management settings, 100 percent of GSA electronic product acquisitions are EPEAT-registered, and 100 percent of GSA electronic assets are covered by sound disposition practices.

See E-waste section above Continue phasing out old hardware.

Agency Innovation and Government Support

GSA will continue to work with industry to develop a process for voluntary disclosure of supply-chain GHG emissions to the Federal government for use in agency GHG emissions inventories and the Federal procurement process.

We will consider how to further engage and influence our supply chain in 2014.


33

Financial Highlights & Governance

AMN understands that in order to sustain our ability to deliver for our clients, investors and other stakeholders that financial responsibility is essential. The Company is in a strong financial position as can be seen in the following financial highlights from 2013:

Delivered a total shareholder return of 27 percent through solid execution of our differentiated strategy

Achieved basic and diluted earnings per share of $0.72 and $0.69 respectively

Full-year consolidated revenue grew 6 percent, with year-over-year growth in all three business segments

Ended the year with a healthy balance sheet containing $159 million of debt and a leverage ratio of 2.0 times

Adjusted EBITDA grew 16 percent and the adjusted EBITDA margin improved 70 basis points to 8.4 percent

Gross profit increased 10 percent to $297 million, representing a consolidated gross margin of 29.4 percent

Cash flow from operations was $59 million for the full year

On Nov. 20, 2013, the Company acquired ShiftWise, the leading national provider of web-based healthcare workforce solutions, including its vendor management system


34

Through this financial success, AMN generates value with stakeholders by paying wages and purchasing from suppliers. Figure 18 shows the amount of economic value generated, distributed and retained in 2013, 2012 and 2011.

Figure 18: Economic Value Generated, Distributed and Retained

CODE OF BUSINESS CONDUCT & ETHICS

At AMN, we understand that the tone at the top pervades. We take pride in being a company that sets the tone as a good corporate citizen and are visionary leaders. At the core of AMN ethics program are the Company’s values: passion, trust, respect, customer service and continuous improvement. Ethics and integrity is the first success factor on which all team members’ annual review is based, including AMN’s Leadership Team.

AMN Healthcare’s Code of Business Conduct & Ethics is one of the cornerstones of the Company’s compliance program. All corporate team members are trained to ensure their familiarity with its principles. The Ethics & Compliance Committee is responsible for monitoring and oversight of this ethics and compliance education. AMN believes that while well-defined, high-level supervision of the compliance program is vital, the best way to achieve and maintain an ethical and compliant culture is to instill accountability at all levels. This is why we have identified Ethics Champions that represent each business unit.

Training on Ethics

AMN conducts several ethics training programs for team members. Upon hiring and annually, team members receive Company orientation and training on the Code of Conduct and Company’s values, as well as the premium AMN places on an ethical culture. Code of Conduct training is required biennially by the Legal Department, which provides tailored presentations and web-based training to departments and roles as needed to reinforce or emphasize regulatory measures and/or company policies. Ethics training specifically covers:

Antitrust Training: Antitrust training is administered, dealing with our competition policy and consumer rights. We do everything we can to ensure that team members do not use information that they do not own and which may be competitive in nature, particularly because our competitor network consists of approximately 500 companies that help us fill positions.

Privacy Training: Each department is required to address information privacy at a department level. This year, leaders from various departments were trained as Ethics Champions who then delivered training to their departments. This program was effective in raising awareness. Team members and contractors receive HIPAA training annually.

Impact Area 2013 2012 2011

DIRECT ECONOMIC VALUE GENERATED

Revenues $1,011,816 $953,951 $887,466

ECONOMIC VALUE DISTRIBUTED

Operating costs $946,314 $900,609 $849,819

Payments to providers of capital $9,665 $26,019 $23,727

Payments to government $22,904 $11,010 $8,904

ECONOMIC VALUE RETAINED

(Value generated – Value distributed) $32,933 $16,313 $5,016

*all figures above are in thousands

*Please see the Company’s 2013 Annual Report filed on Form 10-K for financial statements prepared in conformity with accounting principals generally accepted in the United States.


35

OUR GOVERNANCE STRUCTURE

Our internal corporate social responsibility governance starts with our Board of Directors and Executive Management. The executive with direct oversight of the CSR Committee is the Vice President of Government and Community Relations but implementation is guided by each department head, as impacts and associated responsibilities are different for each. See Figure 19 for an organizational diagram of this CSR Governance structure.

Figure 19: CSR Governance Structure

Board of Directors

Our Board of Directors comprises of eight people, two of whom are female and none of whom represents a minority group. The basic responsibility of the directors is to exercise their business judgment in the best interests of the Company and all stakeholders, including shareholders. Directors adhere to the Company’s Code of Business Conduct and Ethics at all times. In discharging that obligation, directors rely on the honesty and integrity of the Company’s officers, team members, outside advisers and independent auditors.

In order to execute its responsibilities, the Board has several committees, including: Audit, Compensation and Stock plan, Corporate Governance, and Executive. The charters for each of these committees can be found at: http://amnhealthcare.investorroom.com/committeecharters. In future years we intend to evaluate each committee’s specific roles related to sustainability.

The Compensation and Stock Plan Committee evaluates, on an annual basis, the status of company director compensation in relation to other companies of AMN’s size and within its industry. Effective Jan. 1, 2012, the Company established the following equity ownership guidelines for its named executive officers and directors:

Level Ownership Requirements

Chief Executive Officer 3X Base Salary

Named Executive Officers other than the Chief Executive Officer

2X Base Salary

Board of Directors 3X Cash Retainer


36

Appendix A: GRI Content IndexTHIS REPORT WAS PREPARED AS A CORE “IN ACCORDANCE” REPORT USING THE GLOBAL REPORTING INITIATIVE (GRI) G4 GUIDELINES INTRODUCED IN 2013.

Indicator Description Reported Status

Page Notes and Omissions

STRATEGY AND ANALYSIS

G4-1 CEO Statement Fully 3

ORGANIZATIONAL PROFILE

G4-3 Name of the organization Fully - AMN Healthcare Services, Inc.

G4-4 Primary brands, products, services Fully 6 Healthcare workforce solutions and staffing services

G4-5 Location of headquarters Fully 2 San Diego, CA, USA

G4-6 Number and name of countries where the organization operates

Fully 22 USA

G4-7 Nature of ownership and legal form Fully - AMN Healthcare Services, Inc. is incorporated in Delaware and publicly traded on the NYSE as AHS

G4-8 Nature of markets served (including geographic breakdown, sectors served and types of beneficiaries)

Fully 22

G4-9 Scale of the reporting organization (team members, operations, net sales, capitalization, quantity of products/services)

Fully 5, 6, 33, 34

G4-10 Total workforce by employment type, employment contract, and region, broken down by gender

Fully 14, 15

G4-11 Percentage of team members covered by collective bargaining agreements

Fully - No AMN team members are covered by collective bargaining agreements

G4-12 Describe supply chain Partially 6 As a first time reporting organization, our mapping exercise was limited. We will continue to develop our map and integrate next year as we expand the scope of our reporting.


37

IDENTIFIED MATERIAL ASPECTS AND BOUNDARIES

G4-17 Entities included in financial statements, and specify which are included/excluded from this report.

Fully 6 Financials included in this report reflects all brands that fold into our corporate accounting. Information related to our workforce relates to our headquarters in San Diego, California, our Irving, Texas office and remote employees that report to each. All other impact areas are limited to activities occurring at our headquarters in San Diego. Detail does not include Clinicians and Physicians at this time.

G4-18 Process for defining report content and aspect boundaries.

Fully 9 In this first year our materiality process was limited to 1) aligning impacts to key risks and opportunities, 2) aligning to customer interests and 3) issues determined as relevant by our cross-functional CSR Committee. Going forward, we will continue to expand this process.

G4-19 List all material Aspects identified in the process for defining report content.

Fully 10

G4-20 Boundary of the report within the organization.

Fully 2, 9 Our People Section includes our headquarters in San Diego, CA, our office in Irving, TX branch locations and remote employees that report to each

G4-21 Boundary of the report outside the organization.

G4-22 Explanation of the effect of an re-statements of information provided in earlier reports.

N/A

G4-23 Significant changes from previous reporting periods in the scope, boundary or measurement methods applied in the report

N/A



G4-13 Significant changes from previous report regarding size, structure, and ownership

N/A

G4-14 Explanation of whether and how the precautionary approach or principle is addressed by the organization

Fully 8

G4-15 External charters, principles, initiatives

Fully 12, 13

G4-16 Memberships in associations Fully 12, 13


38



STAKEHOLDER ENGAGEMENT

G4-24 Provide a list of stakeholder groups engaged by the organization

Fully 11

G4-25 Basis for identification and selection of stakeholders with whom to engage.

Fully 11

G4-26 The organization's approach to stakeholder engagement, including frequency of engagement by type and by stakeholder group, and an indication of whether any of the engagement was undertaken specifically as part of the report preparation process.

Fully 11, 12

G4-27 Key topics and concerns that have been raised through stakeholder engagement, and how the organization has responded to those key topics and concerns, including its reporting.

Partially 10, 32 One of the primary impetus for this reporting process was GSA requirements. Alignment to direct stakeholder engagement for the purpose of reporting will be expanded in years to come.

REPORT PROFILE

G4-28 Reporting period (such as fiscal or calendar year) for information provided.

Fully 2 Reporting period is the calendar year: January 1, 2013 - December 31, 2013

G4-29 Date of most recent previous report (if any).

N/A -

G4-30 Reporting cycle. Fully 2 AMN intends to publish updates to this CSR Report annually.

G4-31 Provide the contact point for questions regarding the report or its contents.

Fully 2

G4-32 "In accordance" option the organization has chosen and GRI Content Index for the chosen option.

Fully 36-38

G4-33 External assurance. Fully 2 This inaugural report was not externally assured, aside from measures audited annually in SEC filings.


39



GOVERNANCE

G4-34 Governance structure of the organization, including committees under the highest governance body responsible for specific tasks, such as setting strategy or organizational oversight.

Fully 35

ETHICS AND INTEGRITY

G4-56 Internally developed statements of mission or values, codes of conduct, and principles relevant to sustainable development.

Fully 34


40

SPECIFIC STANDARD DISCLOSURES



ENVIRONMENTAL

BOUNDARY FOR ENVIRONMENTAL IMPACTS: SAN DIEGO, CA (HEADQUARTERS)

ENERGY

DMADisclosure on management approach

Fully 29, 41

G4-EN3Energy consumption within the organization

Fully 28

G4-EN6Reduction of energy consumption

Fully 29

WATER


Fully10, 31, 41

G4-EN8Total water withdrawal by source

Fully 31

EMISSIONS


Fully 29, 41

G4-EN16Energy indirect greenhouse gas (GHG) emissions scope 2

Fully 28

EFFLUENTS AND WASTE


Fully 31, 41

G4-EN23Total weight of waste and disposal method

Partially 28, 30

Weight of recycling has been reported for 2013. A complete waste profile Including other disposal methods will be developed in the future.

LABOR PRACTICES AND DECENT WORK

BOUNDARY FOR LABOR PRACTICES AND DE-CENT WORK: SAN DIEGO, CA AND IRVING, TX

EMPLOYMENT


Fully14, 39, 40

G4-LA1

Total number and rates of new employee hires and employee turnover by age group, gender, and region

Fully 14

G4-LA2

Benefits provided to full-time employees that are not provided to temporary or part-time employees, by significant locations of operation

Fully 19


41



LABOR PRACTICES AND DECENT WORK (CONTINUED)

OCCUPATIONAL HEALTH AND SAFETY


Fully20, 39, 40

G4-LA6

Type of injury and rates of injury, occupational diseases, lost days, and absenteeism, and total number of work-related fatalities, by region and by gender

Partially 20Workers compensation rates are reported as a proxy for total injury rates.

TRAINING AND EDUCATION


Fully 16, 40

G4-LA9

Average hours of training per year per employee by gender, and by employee category

Partially 16

G4-LA10

Programs for skills management and lifelong learning that support the continued employability of employees and assist them in managing career endings

Fully 17

G4-LA11

Percentages of employees receiving regular performance and career development reviews, by gender and by employee category

Fully 18All employees receive annual performance reviews

DIVERSITY AND EQUAL OPPORTUNITY


Fully 19, 40

G4-LA12

Composition of governance bodies and breakdown of employees per category according to gender, age group, minority group membership, and other indicators of diversity

Fully 15, 35

For more information on our governance and board of directors see: http://amnhealthcare.investorroom.com/boardofdirectors

HUMAN RIGHTS

BOUNDARY FOR HUMAN RIGHTS: SAN DIEGO, CA AND IRVING, TX

NON-DISCRIMINATION


Fully 21, 40

G4-HR3Total number of incidents of discrimination and corrective actions taken

Fully 21


42



SOCIETY

BOUNDARY FOR SOCIETY: IS SAN DIEGO, CA AND IRVING, TX

ANTI-CORRUPTION


Fully 34, 39

G4-SO4Communication and training on anti-corruption policies and procedures

Fully 34

PRODUCT RESPONSIBILITY

BOUNDARY FOR PRODUCT RESPONSIBILITY: SAN DIEGO, CA, IRVING, TX AND OUTSIDE OUR OPERATIONAL CONTROL TO CUS-TOMERS

PRODUCT AND SERVICE LABELING


Fully22- 24, 39

G4-PR5Results of survey measuring customer satisfaction

Fully 24Survey described in report, specific results to be included in future reporting cycles

MARKETING COMMUNICATIONS


Fully 24, 39

G4-PR7

Total number of incidents of non-compliance with regulations and voluntary codes concerning marketing communications, including advertising, promotion, and sponsorship, by type of outcomes

Fully 24

ECONOMIC

BOUNDARY FOR ECONOMIC: ALL CORPORATE OPERATIONS

ECONOMIC PERFORMANCE


Fully 33, 34, 39

G4-EC1Direct economic value generated and distributed

Fully 34

INDIRECT ECONOMIC IMPACTS

BOUNDARY FOR INDIRECT ECONOMIC IMPACTS: ALL CORPORATE OPERATIONS

G4-EC8

Development and impact of infrastructure investments and services provided primarily for public benefit through commercial, inkind, or probono engagement

Partially 25-27

Investments equating to impact have not been provided. In the future, we intend to scale our ability to track these very important impacts.


43

Appendix B: Impact Areas

CORPORATE SOCIAL RESPONSIBILITY AT AMN

Appendix A provides a list of issues determined most relevant for AMN. It describes our current understanding of each, our strategy for managing it, and how we measure performance. Internal dialogue and further stakeholder engagement following publication of this report will consider ways in which AMN may strengthen our performance in these impact areas by setting strategic goals.

Impact Area What this means to us Our Strategy Performance Measures

ECONOMIC AND GOVERNANCE

Financial Integrity Maintaining the financial health of our company allows us to continue to serve our customers.

Expand our service offerings, increase customer loyalty and trust to secure long-term diverse revenue streams.

Total shareholder return and profit

Governance, Ethics & Accountability

Operating our company in an ethical manner with integrity.

Provide ethical workplace for all team members by making expectations clear and empowering employees to report issues.

Avoidance of fines, charges and/or lawsuits.

Healthcare Accessibility We support enhanced access to healthcare for those in need.

Allow our clients to reduce costs by outsourcing staffing functions to AMN and focus on patient care.

Cost benefits and efficiencies for clients that translate to greater access to quality care

Economic Development As a responsible corporate citizen, AMN can have a positive impact on the communities in which we operate and live.

Create alignment between the core purpose of our business and our CSR activities to make the biggest impact on our business, while making a meaningful impact on the health and human services in communities that our team members call home.

Corporate giving program donations, sponsorships, scholarships, volunteer participation as a percent of workforce.

Trust & Credibility We take pride in knowing our clients trust us, and we have credibility in the marketplace.

Meet our commitments with clients , clinicians, physicians, team members and all community stakeholders.

Corporate citizenship awards, recognition and accolades.

SOCIAL-OUR PEOPLE

Talent Recruitment and Retention It all starts with talent. We are committed to hiring the best and brightest available candidates to join our team so we can deploy a skilled workforce dedicated to exceeding our customers’ expectations.

The AMN Talent Acquisition team uses a robust set of sourcing strategies to reach a broad base of candidates including team member referrals, internet job boards, print advertising, social networks, university campuses and job fairs. We also incentivize our own team members to refer candidates.

We measure our hiring results on a monthly basis to understand where we have been successful identifying new talent and are constantly monitoring what is working well and what needs improvement. We have a number of commonly used metrics to support our sourcing decisions and recruiting efforts as well as share them with our leadership team. In 2014, we are beginning to survey hiring managers, candidates who were hired and candidates not selected for employment in an effort to enhance our candidate experience and continuously improve our process.


44


SOCIAL-OUR PEOPLE

Talent retention Our employees are our greatest asset so we work hard on developing and retaining our workforce. The AMN Purpose is to help our team members achieve professional and personal goals every day.

AMN strongly supports career growth and development while striving to promote from within so team members may navigate their own future and grow with the company.

We review our attrition rates monthly and perform exit interviews with departing employees so we can use the feedback for continuous improvement and coaching opportunities with business leaders. We conduct employee engagement surveys to develop plans based on results.

Training & Development Our development efforts focus on our strategic initiatives, purpose and core values to help our business grow and develop in many ways.

We have built an enterprise-wide framework with best-in-class learning tools, programs, resources and products that deliver cost-effective solutions at all levels of AMN. This framework is also flexible enough to allow for local customization when needed.

Reactions to workshops, Needs surveys, Cost-effectiveness of our investments.

Diversity We recognize diversity is the strength of our team and offer a broad range of opportunities to external and internal candidates that foster a welcoming environment.

AMN is an Equal Opportunity Employer that actively seeks out diverse candidates from varying race, gender, disability status and vets across the nation.

Affirmative Action Plans, Equal Employment Opportunity and Veterans reporting.

PRODUCT RESPONSIBILITY- OUR SERVICES

Satisfaction Providing top-notch service to our clients is essential to our company’s success. Our longtime clients provide valuable word of mouth advertising and help our business to grow.

We strive to have a personal touch and tailor our solutions to each client and be responsive to their unique needs.

Satisfaction surveys and customer support surveys after each issue we resolve for them.

Business Loyalty Retention of current customers because they value and appreciate our services.

We follow up continuously to ensure that our client relationships are meeting their needs.

Reoccurring and expansion of services being offered at each client


45


SOCIAL-COMMUNITY ENGAGE-MENT

Philanthropy AMN’s Community Relations program includes sustained philanthropic partnerships with organizations that contribute to the quality of healthcare and human services.

Our targeted campaign of partnerships with non-profit organizations includes supporting those who provide basic human services and medical needs, seeking treatment improvements and cures, and promoting public understanding and awareness of particular health risks and diseases.

Community engagement awards, in addition to evaluating our partnerships annually and supporting new organizations that are demonstrating high impact in the populations they are serving.

Volunteerism We are particularly proud of our employee volunteer program, AMN Community Connections, because it reflects the strong philanthropic efforts and spirit of our corporate team members and healthcare professionals.

AMN Community Connections is designed to reinforce our purpose of "Helping Achieve Professional and Personal Goals Everyday" by providing team members opportunities and resources to take an active role in AMN’s community relations. Our team members bridge our company and our communities by giving their time and talent generously to local service projects.

Volunteer hours & span of engagement:

ENVIRONMENTAL

Materials Minimizing material use and appropriately managing disposal in the office is a win-win, reducing environmental impact and business expenses.

Reduce consumption of paper, packaging and equipment while optimizing waste management and promote recycling.

Materials purchased and waste generated.

Resource Conservation In a world of resource scarcity we are doing our part to minimize our footprint.

Conserve water and energy used inside and outside the facility.

Utility-use figures

Emissions Our emissions come indirectly from the electricity purchased so emissions and resource reductions go hand in hand for our business.

Reduce greenhouse gas emissions associated with energy use.

Energy- derived emissions reductions

Travel With people as our primary business driver we are conscious of the impact of employee travel on our total environmental impact.

Encourage employee ride-sharing, and web-based meetings rather than flight travel.

Costs and miles


46

Appendix C: 2013 Awards and Recognitions

Achievers 50 Most Engaged Workplaces (Second Consecutive Honor)

Achievers is an Employee Success software company that hosts this award annually. For the second year in a row, we have won this recognition as a top employer displaying leadership and innovation for our efforts to engage employees.

CEO Susan Salka Recognized as “Top Influential” in San Diego Business Community

The “Top Influentials” award recognizes individuals who have contributed to the public discussion, were news makers throughout the year, have served as opinion leaders within the community and/or led their enterprises to a special accomplishment. This is the second time Susan Salka was nominated.

eHealthcare Leadership Award

The AMN corporate website was recognized as a recipient in the 14th Annual eHealthcare Leadership Awards for “Best Overall Internet Site.”

Best in Category: Healthcare Recruitment Process Outsourcing Program

AHRO Today awarded AMN with the inaugural healthcare Baker’s Dozen Award for our outstanding quality and customer service of our Recruitment Process Outsourcing (RPO) program.

Staffing Industry Analysts (SIA) Staffing 100

Multiple AMN Executives have been included in this list that showcases the 100 most influential people in the staffing industry who have made a difference, not just to the industry but to the millions of people they have helped to find work.

American Staffing Association (ASA) Care Award

AMN Healthcare has been awarded the American Staffing Association’s “Care Award” for our participation in a mission trip to Guatemala in April 2013.

Compliance and Integrity Award

AMN is the proud recipient of the 2014 Compliance and Integrity Award for our high standard business practices to Novation’s 65,000 member healthcare facilities.

Documents

Building on Our Core Values - AMN Healthcare · PDF fileMaintaining Customer Satisfaction ... Recycling & Waste Water Use Promoting Sustainability within our Supply Chain ... such