Balance Sheet Related Disclosures [Abstract]
Balance Sheet Details
Supplemental Balance Sheet Disclosures [Text Block]
Income Tax Disclosure [Abstract]
Current:
Current Income Tax Expense (Benefit), Continuing Operations [Abstract]
Federal
Current Federal Tax Expense (Benefit)
State
Current State and Local Tax Expense (Benefit)
Foreign
Current Foreign Tax Expense (Benefit)
Total
Current Income Tax Expense (Benefit)
Deferred:
Deferred Income Tax Expense (Benefit), Continuing Operations [Abstract]
Federal
Deferred Federal Income Tax Expense (Benefit)
State
Deferred State and Local Income Tax Expense (Benefit)
Foreign
Deferred Foreign Income Tax Expense (Benefit)
Total
Deferred Income Tax Expense (Benefit)
Income tax benefit
Income Tax Expense (Benefit)
Accounting Policies [Abstract]
Concentration Risk [Table]
Concentration Risk [Table]
Range [Axis]
Range [Axis]
Range [Domain]
Range [Domain]
Minimum
Minimum [Member]
Maximum
Maximum [Member]
Product and Service [Axis]
Product and Service [Axis]
Product and Service [Domain]
Product and Service [Domain]
Temporary Staffing Services
Temporary Staffing Services [Member]
Temporary Staffing Services [Member]
Concentration Risk Type [Axis]
Concentration Risk Type [Axis]
Concentration Risk Type [Domain]
Concentration Risk Type [Domain]
Services
Product Concentration Risk [Member]
Concentration Risk Benchmark [Axis]
Concentration Risk Benchmark [Axis]
Concentration Risk Benchmark [Domain]
Concentration Risk Benchmark [Domain]
Revenue
Sales Revenue, Net [Member]
Concentration Risk [Line Items]
Concentration Risk [Line Items]
Contract terms
Contractual Term
The amount of time the payments are typically required to be made from the date services are provided.
Unbilled contracts receivable
Unbilled Contracts Receivable
Concentration risk percentage
Concentration Risk, Percentage
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]
SEC Schedule, 12-09, Valuation and Qualifying Accounts Disclosure [Table]
SEC Schedule, 12-09, Valuation and Qualifying Accounts Disclosure [Table]
SEC Schedule, 12-09, Valuation Allowances and Reserves Type [Axis]
SEC Schedule, 12-09, Valuation Allowances and Reserves Type [Axis]
SEC Schedule, 12-09, Valuation Allowances and Reserves [Domain]
SEC Schedule, 12-09, Valuation Allowances and Reserves [Domain]
Allowances for Accounts Receivable
SEC Schedule, 12-09, Allowance, Credit Loss [Member]
Valuation Allowance for Deferred Tax Assets
SEC Schedule, 12-09, Valuation Allowance, Deferred Tax Asset [Member]
SEC Schedule, 12-09, Valuation and Qualifying Accounts Disclosure [Line Items]
SEC Schedule, 12-09, Valuation and Qualifying Accounts Disclosure [Line Items]
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period
SEC Schedule, 12-09, Valuation Allowances and Reserves, Amount
Charged to Operations
SEC Schedule, 12-09, Valuation Allowances and Reserves, Additions, Charge to Cost and Expense
Write-Offs, net of recoveries
SEC Schedule, 12-09, Valuation Allowances and Reserves, Deduction
Other Changes
SEC Schedule, 12-09, Valuation Allowances and Reserves, Increase (Decrease) Adjustment
Balance at End of Period
United States
Income (Loss) from Continuing Operations before Income Taxes, Domestic
Foreign
Income (Loss) from Continuing Operations before Income Taxes, Foreign
(Loss) income before income taxes
Income (Loss) from Continuing Operations before Equity Method Investments, Income Taxes, Noncontrolling Interest
Revenue from Contract with Customer [Abstract]
Revenue Recognition
Revenue from Contract with Customer [Text Block]
Use of Estimates
Use of Estimates, Policy [Policy Text Block]
Cash and Cash Equivalents
Cash and Cash Equivalents, Policy [Policy Text Block]
Accounts Receivable, Allowance for Doubtful Accounts, and Concentration of Credit Risk
Receivables, Policy [Policy Text Block]
Prepaid Rent and Deposits
Prepaid Rent And Deposits Policy [Text Block]
Disclosure of accounting policy for prepaid rent and deposits on field employees' apartments related to short-term agreements.
Property and Equipment
Property, Plant and Equipment, Policy [Policy Text Block]
Business Combinations
Business Combinations Policy [Policy Text Block]
Goodwill, Trade Names, and Other Intangible Assets
Goodwill and Intangible Assets, Intangible Assets, Policy [Policy Text Block]
Debt Discount and Debt Issuance Costs
Debt, Policy [Policy Text Block]
Derivative Financial Instruments
Derivatives, Policy [Policy Text Block]
Sales and Other State Non-income Tax Liabilities
Sales And Other State Non Income Tax Liabilities Policy [Text Block]
Disclosure of accounting policy for sales and other state non-income tax liabilities.
Insurance Claims
Liability Reserve Estimate, Policy [Policy Text Block]
Revenue Recognition
Revenue Recognition, Policy [Policy Text Block]
Share-Based Compensation
Share-based Compensation, Option and Incentive Plans Policy [Policy Text Block]
Advertising
Advertising Costs, Policy [Policy Text Block]
Restructuring Costs
Costs Associated with Exit or Disposal Activities or Restructurings, Policy [Policy Text Block]
Deferred Rent
Lessee, Leases [Policy Text Block]
Income Taxes
Income Tax, Policy [Policy Text Block]
Comprehensive Income (Loss)
Comprehensive Income, Policy [Policy Text Block]
Fair Value Measurements
Fair Value Measurement, Policy [Policy Text Block]
Earnings Per Share
Earnings Per Share, Policy [Policy Text Block]
Recent Accounting Pronouncements
New Accounting Pronouncements, Policy [Policy Text Block]
Equity [Abstract]
Total intrinsic value of options exercised
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period, Intrinsic Value
Schedule of Restructuring and Related Costs [Table]
Schedule of Restructuring and Related Costs [Table]
Restructuring Plan [Axis]
Restructuring Plan [Axis]
Restructuring Plan [Domain]
Restructuring Plan [Domain]
Cost Optimization Project
Cost Optimization Project [Member]
Cost Optimization Project [Member]
Restructuring Type [Axis]
Restructuring Type [Axis]
Type of Restructuring [Domain]
Type of Restructuring [Domain]
On-Going Benefit Costs
Employee Severance [Member]
Exit Costs
Exit Costs [Member]
Exit Costs [Member]
Other costs
Other Restructuring [Member]
Restructuring Cost and Reserve [Line Items]
Restructuring Cost and Reserve [Line Items]
Restructuring Reserve [Roll Forward]
Restructuring Reserve [Roll Forward]
Balance at beginning of period
Restructuring Reserve
Charged to restructuring costs (a)
Restructuring Charges
Payments
Payments for Restructuring
Balance at end of period
Direct write offs related to abandoned locations
Restructuring Charges, Write Off Related To Abandonment
Restructuring Charges, Write Off Related To Abandonment
Commitments and Contingencies Disclosure [Abstract]
Future Minimum Lease Payments
Schedule of Future Minimum Rental Payments for Operating Leases [Table Text Block]
Statement of Cash Flows [Abstract]
Cash flows from operating activities
Net Cash Provided by (Used in) Operating Activities [Abstract]
Consolidated net (loss) income
Net Income (Loss), Including Portion Attributable to Noncontrolling Interest
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Adjustments to Reconcile Net Income (Loss) to Cash Provided by (Used in) Operating Activities [Abstract]
Depreciation and amortization
Depreciation, Depletion and Amortization
Amortization of debt discount and debt issuance costs
Amortization of Debt Issuance Costs
Provision for allowances
Provision for Doubtful Accounts and Other Allowances
Provision for Doubtful Accounts and Other Allowances
Deferred income tax benefit
Gain on derivative liability
Derivative, Gain (Loss) on Derivative, Net
Impairment charges
Asset Impairment Charges
Loss on early extinguishment of debt
Gain (Loss) on Extinguishment of Debt
Equity compensation
Share-based Compensation
Other non-cash costs
Other Noncash Income (Expense)
Changes in operating assets and liabilities:
Increase (Decrease) in Operating Capital [Abstract]
Accounts receivable
Increase (Decrease) in Accounts Receivable
Prepaid expenses and other assets
Increase (Decrease) in Other Operating Assets
Accounts payable and accrued expenses
Increase (Decrease) in Accounts Payable and Accrued Liabilities
Other liabilities
Increase (Decrease) in Other Operating Liabilities
Net cash provided by operating activities
Net Cash Provided by (Used in) Operating Activities
Cash flows from investing activities
Net Cash Provided by (Used in) Investing Activities [Abstract]
Proceeds from sale of business
Proceeds from Divestiture of Businesses, Net of Cash Divested
Acquisitions, net of cash acquired
Payments to Acquire Businesses, Net of Cash Acquired
Acquisition-related settlements
Payments for (Proceeds from) Previous Acquisition
Purchases of property and equipment
Payments to Acquire Property, Plant, and Equipment
Net cash used in investing activities
Net Cash Provided by (Used in) Investing Activities
Cash flows from financing activities
Net Cash Provided by (Used in) Financing Activities [Abstract]
Proceeds from Term Loans
Proceeds from Issuance of Long-term Debt
Principal payments on Term Loans
Repayments of Long-term Debt
Convertible Note cash payment
Repayments of Convertible Debt
Borrowings on revolving credit facility
Proceeds from Lines of Credit
Repayments on revolving credit facility
Repayments of Lines of Credit
Debt issuance costs
Payments of Debt Issuance Costs
Extinguishment fees
Payment for Debt Extinguishment or Debt Prepayment Cost
Stock repurchase and retirement
Payments for Repurchase of Common Stock
Other
Proceeds from (Payments for) Other Financing Activities
Net cash (used in) provided by financing activities
Net Cash Provided by (Used in) Financing Activities
Effect of exchange rate changes on cash
Effect of Exchange Rate on Cash and Cash Equivalents
Change in cash and cash equivalents
Cash and Cash Equivalents, Period Increase (Decrease)
Cash and cash equivalents at beginning of year
Cash and Cash Equivalents, at Carrying Value
Cash and cash equivalents at end of year
Supplemental disclosure of cash flow information:
Supplemental Cash Flow Information [Abstract]
Interest paid
Interest Paid, Excluding Capitalized Interest, Operating Activities
Income taxes paid
Income Taxes Paid
Stockholders' Equity
Shareholders' Equity and Share-based Payments [Text Block]
Statement of Comprehensive Income [Abstract]
Consolidated net (loss) income
Other comprehensive (loss) income, before income tax:
Other Comprehensive Income (Loss), before Tax, Portion Attributable to Parent [Abstract]
Unrealized foreign currency translation (loss) gain
Other Comprehensive Income (Loss), Foreign Currency Transaction and Translation Adjustment, before Tax, Portion Attributable to Parent
Unrealized loss on interest rate contracts
Other Comprehensive Income (Loss), Derivatives Qualifying as Hedges, before Tax
Reclassification adjustment to interest expense
Other Comprehensive Income (Loss), Reclassification Adjustment from AOCI on Derivatives, before Tax
Other comprehensive (loss) income, before income tax:
Other Comprehensive Income (Loss), before Tax
Other Comprehensive Income (Loss), Tax1 [Abstract]
Other Comprehensive Income (Loss), Tax1 [Abstract]
Other Comprehensive Income (Loss), Tax1 [Abstract]
Income tax benefit related to foreign currency translation adjustments
Other Comprehensive Income (Loss), Foreign Currency Translation Adjustment, Tax
Income tax benefit related to unrealized loss on interest rate contracts
Other Comprehensive Income (Loss), Derivatives Qualifying as Hedges, Tax
Income tax expense related to reclassification adjustment to interest expense
Other Comprehensive Income (Loss), Reclassification Adjustment from AOCI on Derivatives, Tax
Taxes on other comprehensive (loss) income:
Other Comprehensive Income (Loss), Tax
Other comprehensive (loss) income, net of tax
Other Comprehensive Income (Loss), Net of Tax, Portion Attributable to Parent
Comprehensive (loss) income
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest
Less: Net income attributable to noncontrolling interest in subsidiary
Net Income (Loss) Attributable to Noncontrolling Interest
Comprehensive (loss) income attributable to common shareholders
Comprehensive Income (Loss), Net of Tax, Attributable to Parent
Summary of Restricted Stock Award Activity
Schedule of Share-based Compensation, Restricted Stock and Restricted Stock Units Activity [Table Text Block]
Stock Options and Stock Appreciation Rights Granted and Exercised
Intrinsic Value Of Options Exercised And Weighted Average Grant Date Fair Value Of Stock Options Granted Table [Text Block]
Tabular disclosure of the total intrinsic value of options exercised and the weighted average grant date fair value of options granted during the period.
Summary of Share Option Plans Activities
Share-based Compensation, Stock Options, Activity [Table Text Block]
Fair Value Disclosures [Abstract]
Summary of Estimated Fair Values of Financial Assets and Liabilities Measured on a Recurring Basis
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis [Table Text Block]
Fair Value, Liabilities Measured on recurring Basis, Unobservable Input Reconciliation
Fair Value, Liabilities Measured on Recurring Basis [Table Text Block]
Carrying Amounts and Estimated Fair Values of Significant Financial Instrument that were not Measured at Fair Value
Fair Value, by Balance Sheet Grouping [Table Text Block]
Income Taxes
Income Tax Disclosure [Text Block]
Related Party Transactions [Abstract]
Related Party Transactions
Related Party Transactions Disclosure [Text Block]
Tax at U.S. statutory rate
Effective Income Tax Rate Reconciliation at Federal Statutory Income Tax Rate, Amount
State taxes, net of federal benefit
Effective Income Tax Rate Reconciliation, State and Local Income Taxes, Amount
Noncontrolling interest
Effective Income Tax Rate Reconciliation, Noncontrolling Interest Income (Loss), Amount
Non-deductible items
Effective Income Tax Rate Reconciliation, Nondeductible Expense, Amount
Foreign tax expense
Effective Income Tax Rate Reconciliation, Foreign Income Tax Rate Differential, Amount
Valuation allowances
Effective Income Tax Rate Reconciliation, Change in Deferred Tax Assets Valuation Allowance, Amount
Uncertain tax positions
Effective Income Tax Rate Reconciliation, Tax Contingency, Amount
Return to provision
Effective Income Tax Rate Reconciliation, Return To Provision, Amount
Effective Income Tax Rate Reconciliation, Return To Provision, Amount
Federal rate change
Effective Income Tax Rate Reconciliation, Change in Enacted Tax Rate, Amount
Other
Effective Income Tax Rate Reconciliation, Other Adjustments, Amount
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Table]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Table]
Liability Class [Axis]
Liability Class [Axis]
Fair Value by Liability Class [Domain]
Fair Value by Liability Class [Domain]
Contingent Purchase Liabilities
Contingent Consideration Liability [Member]
Contingent Consideration Liability [Member]
Convertible Notes Derivative Liability
Derivative Financial Instruments, Liabilities [Member]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Liability Value
Payments/Settlements
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Liability, Settlements
Accretion expense
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Liability, Accretion Expense
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Liability, Accretion Expense
Valuation gain (loss) for the period
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Liability, Gain (Loss) Included in Earnings
Ending balance
Components of Income (Loss) Before Income Taxes
Schedule of Income before Income Tax, Domestic and Foreign [Table Text Block]
Components of Income Tax Expense (Benefit)
Schedule of Components of Income Tax Expense (Benefit) [Table Text Block]
Significant Components of Deferred Tax Assets and Liabilities
Schedule of Deferred Tax Assets and Liabilities [Table Text Block]
Reconciliation of Income Tax Computed At U. S. Federal Statutory Rate to Income Tax (Benefit) Expense
Schedule of Effective Income Tax Rate Reconciliation [Table Text Block]
Reconciliation of Beginning and Ending Amounts of Unrecognized Tax Benefits
Schedule of Unrecognized Tax Benefits Roll Forward [Table Text Block]
Quarterly Financial Information Disclosure [Abstract]
Quarterly Financial Data (Unaudited)
Quarterly Financial Information [Text Block]
Segment Reporting [Abstract]
Information on Operating Segments and Reconciliation to Income From Operations
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Table Text Block]
Income Tax Contingency [Table]
Income Tax Contingency [Table]
Valuation Allowance by Deferred Tax Asset [Axis]
Valuation Allowance by Deferred Tax Asset [Axis]
Deferred Tax Asset [Domain]
Deferred Tax Asset [Domain]
Net Operating Losses
Net Operating Losses [Member]
Net Operating Losses [Member]
Other Net Deferred Tax Assets
Other Net Deferred Tax Assets [Member]
Other Net Deferred Tax Assets [Member]
Balance Sheet Location [Axis]
Balance Sheet Location [Axis]
Balance Sheet Location [Domain]
Balance Sheet Location [Domain]
Other Current Liabilities
Other Current Liabilities [Member]
Other Noncurrent Liabilities
Other Noncurrent Liabilities [Member]
Income Tax Authority [Axis]
Income Tax Authority [Axis]
Income Tax Authority [Domain]
Income Tax Authority [Domain]
U.S.
Domestic Tax Authority [Member]
State
State and Local Jurisdiction [Member]
India
Foreign Tax Authority [Member]
Income Tax Contingency [Line Items]
Income Tax Contingency [Line Items]
Provision income tax expense related to deferred tax asset
Income tax expense related to deferred tax asset
Tax Cuts and Jobs Act, Change in Tax Rate, Deferred Tax Asset, Income Tax Expense
Tax Cuts and Jobs Act, Change in Tax Rate, Deferred Tax Asset, Income Tax Expense
Reduction in valuation allowance
Valuation Allowance, Deferred Tax Asset, Increase (Decrease), Amount
Valuation allowance
Deferred Tax Assets, Valuation Allowance
Federal, state and foreign net operating loss carryforwards
Operating Loss Carryforwards
Deferred liabilities on undistributed foreign earnings
Deferred Tax Liabilities, Undistributed Foreign Earnings
Repatriated amount of foreign earnings
Repatriation Of Foreign Earnings Amount
Repatriated amount of foreign earnings.
Unrecognized tax benefits
Unrecognized Tax Benefits
Unrecognized tax benefits, which would affect the effective tax rate
Unrecognized Tax Benefits that Would Impact Effective Tax Rate
Gross increases in current year unrecognized tax
Unrecognized Tax Benefits Period Gross Increases
The gross amount of increases in unrecognized tax benefits related to federal and state tax issues.
Increase (decrease) in recognized interest and penalties
Income Tax Examination, Penalties and Interest Expense
Unrecognized tax benefit accrued interest and penalties
Unrecognized Tax Benefits, Income Tax Penalties and Interest Accrued
Business Combinations [Abstract]
Schedule of Business Acquisitions, by Acquisition [Table]
Schedule of Business Acquisitions, by Acquisition [Table]
Contingent Consideration by Type [Axis]
Contingent Consideration by Type [Axis]
Contingent Consideration Type [Domain]
Contingent Consideration Type [Domain]
Potential Earnout, Attainment of Specific Performance Criteria in 2017
Potential Earnout, Attainment of Specific Performance Criteria in 2017 [Member]
Potential Earnout, Attainment of Specific Performance Criteria in 2017 [Member]
Potential Earnout, Attainment of Specific Performance Criteria in 2018
Potential Earnout, Attainment of Specific Performance Criteria in 2018 [Member]
Potential Earnout, Attainment of Specific Performance Criteria in 2018 [Member]
Potential Earnout, Attainment of Specific Performance Criteria in 2019
Potential Earnout, Attainment of Specific Performance Criteria in 2019 [Member]
Potential Earnout, Attainment of Specific Performance Criteria in 2019 [Member]
Acquisition-Related Contingent Consideration
Acquisition-Related Contingent Consideration [Member]
Acquisition-Related Contingent Consideration [Member]
Assumed Additional Contingent Purchase Price Liabilities
Assumed Additional Contingent Purchase Price Liabilities [Member]
Assumed Additional Contingent Purchase Price Liabilities [Member]
Potential Earnout, Attainment of Specific Performance Criteria in 2016
Potential Earnout, Attainment of Specific Performance Criteria in 2016 [Member]
Potential Earnout, Attainment of Specific Performance Criteria in 2016 [Member]
Deferred Consideration Transferred
Deferred Consideration Transferred [Member]
Deferred Consideration Transferred [Member]
Business Acquisition [Axis]
Business Acquisition [Axis]
Business Acquisition, Acquiree [Domain]
Business Acquisition, Acquiree [Domain]
US Resources Healthcare, LLC
US Resources Healthcare, LLC [Member]
US Resources Healthcare, LLC [Member]
Mediscan
Mediscan [Member]
Mediscan [Member]
Medical Staffing Network
Medical Staffing Network [Member]
Medical Staffing Network [Member]
Business Acquisition [Line Items]
Business Acquisition [Line Items]
Contingent consideration, range of outcomes, high
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High
Release of remaining contingent liability
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration, Liability
Cash purchase price paid at closing
Payments to Acquire Businesses, Gross
Cash consideration plus working capital estimate
Business Combination, Consideration Transferred, Cash Consideration Negotiated
Business Combination, Consideration Transferred, Cash Consideration Negotiated
Fair value of shares
Business Combination, Consideration Transferred, Equity Interests Issued and Issuable
Fair value of shares (in shares)
Business Acquisition, Equity Interest Issued or Issuable, Number of Shares
Net working capital adjustment
Business Combination, Consideration Transferred, Net Working Capital Adjustment
Business Combination, Consideration Transferred, Net Working Capital Adjustment
Release of escrow to seller
Business Combination, Escrow Deposit Release
Business Combination, Escrow Deposit Release
Contingent consideration liabilities
Business Combination, Contingent Consideration, Liability
Period of deferred consideration
Business Combination, Consideration Deferred, Period
Business Combination, Consideration Deferred, Period
Property, Plant and Equipment [Abstract]
Property and Equipment
Property, Plant and Equipment [Table Text Block]
Quarterly Financial Data
Quarterly Financial Information [Table Text Block]
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule Of Indefinite Lived And Finite Lived Intangible Assets [Table]
Schedule Of Indefinite Lived And Finite Lived Intangible Assets [Table]
Schedule Of Indefinite Lived And Finite Lived Intangible Assets [Table]
Finite-Lived Intangible Assets by Major Class [Axis]
Finite-Lived Intangible Assets by Major Class [Axis]
Finite-Lived Intangible Assets, Major Class Name [Domain]
Finite-Lived Intangible Assets, Major Class Name [Domain]
Databases
Database Rights [Member]
Customer relationships
Customer Relationships [Member]
Non-compete agreements
Noncompete Agreements [Member]
Trade names
Trade Names [Member]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Finite Lived And Indefinite Lived Intangible Assets [Line Items]
Finite-Lived and Indefinite-Lived Intangible Assets [Line Items]
Gross Carrying Amount
Finite-Lived Intangible Assets, Gross
Accumulated Amortization
Finite-Lived Intangible Assets, Accumulated Amortization
Net Carrying Amount
Finite-Lived Intangible Assets, Net
Trade names
Indefinite-Lived Trade Names
Intangible assets not subject to amortization, net
Intangible Assets, Net (Excluding Goodwill)
Schedule of restructuring costs
Restructuring and Related Costs [Table Text Block]
Fair Value Measurements, Recurring and Nonrecurring [Table]
Fair Value Measurements, Recurring and Nonrecurring [Table]
Derivative Instrument [Axis]
Derivative Instrument [Axis]
Derivative Contract [Domain]
Derivative Contract [Domain]
Interest rate swaps
Interest Rate Swap [Member]
Deferred compensation
Deferred Compensation [Member]
Deferred Compensation [Member]
Fair Value Hierarchy and NAV [Axis]
Fair Value Hierarchy and NAV [Axis]
Fair Value, Measurements, Fair Value Hierarchy [Domain]
Fair Value Hierarchy and NAV [Domain]
Level 1
Fair Value, Inputs, Level 1 [Member]
Level 2
Fair Value, Inputs, Level 2 [Member]
Level 3
Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Deferred compensation
Obligations, Fair Value Disclosure
Interest rate swaps
Derivative Liability
Contingent consideration liabilities
Retirement Benefits [Abstract]
Employee Benefit Plans
Pension and Other Postretirement Benefits Disclosure [Text Block]
Statement of Stockholders' Equity [Abstract]
Statement [Table]
Statement [Table]
Equity Components [Axis]
Equity Components [Axis]
Equity Component [Domain]
Equity Component [Domain]
Common Stock
Common Stock [Member]
Additional Paid-In Capital
Additional Paid-in Capital [Member]
Accumulated Other Total Comprehensive Loss, net
AOCI Attributable to Parent [Member]
(Accumulated Deficit) Retained Earnings
Retained Earnings [Member]
Noncontrolling Interest in Subsidiary
Noncontrolling Interest [Member]
Statement [Line Items]
Statement [Line Items]
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning Balance (in shares)
Shares, Outstanding
Beginning Balance
Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest
Exercise of share options (in shares)
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period
Vesting of restricted stock and performance stock awards (in shares)
Stock Issued During Period, Shares, Share-based Compensation, Net of Forfeitures
Vesting of restricted stock and performance stock awards
Stock Issued During Period, Value, Share-based Compensation, Net of Forfeitures
Shares issued for Convertible Notes (in shares)
Stock Issued During Period, Shares, New Issues
Shares issued for Convertible Notes
Stock Issued During Period, Value, New Issues
Equity compensation
Adjustments to Additional Paid in Capital, Share-based Compensation, Requisite Service Period Recognition
Stock repurchase and retirement (in shares)
Stock Repurchased and Retired During Period, Shares
Stock repurchase and retirement
Stock Repurchased and Retired During Period, Value
Cumulative-effect adjustment - share-based compensation
Cumulative Effect on Retained Earnings, Net of Tax
Foreign currency translation adjustment, net of taxes
Other Comprehensive Income (Loss), Foreign Currency Transaction and Translation Adjustment, Net of Tax
Net change in hedging transaction, net of taxes
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), after Reclassification and Tax
Distribution to noncontrolling shareholder
Noncontrolling Interest, Decrease from Distributions to Noncontrolling Interest Holders
Net (loss) income
Ending Balance (in shares)
Ending Balance
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Balance at January 1
Additions based on tax positions related to the current year
Unrecognized Tax Benefits, Increase Resulting from Current Period Tax Positions
Additions based on tax positions related to prior years
Unrecognized Tax Benefits, Increase Resulting from Prior Period Tax Positions
Reductions based on settlements of tax positions related to prior years
Unrecognized Tax Benefits, Decrease Resulting from Prior Period Tax Positions
2017 Tax Act federal tax rate change
Unrecognized Tax Benefits, Reduction Resulting From Federal Tax Rate Change
Unrecognized Tax Benefits, Reduction Resulting From Federal Tax Rate Change
Other
Unrecognized Tax Benefits, Increases (Decreases) Resulting From Other Deductions
The gross amount of increases ( decreases) in unrecognized tax benefits resulting from other items.
Balance at December 31
2019
Operating Leases, Future Minimum Payments Due, Next Twelve Months
2020
Operating Leases, Future Minimum Payments, Due in Two Years
2021
Operating Leases, Future Minimum Payments, Due in Three Years
2022
Operating Leases, Future Minimum Payments, Due in Four Years
2023
Operating Leases, Future Minimum Payments, Due in Five Years
Thereafter
Operating Leases, Future Minimum Payments, Due Thereafter
Total
Operating Leases, Future Minimum Payments Due
Document Documentand Entity Information [Abstract]
Document Documentand Entity Information [Abstract]
Document Type
Document Type
Amendment Flag
Amendment Flag
Document Period End Date
Document Period End Date
Document Fiscal Year Focus
Document Fiscal Year Focus
Document Fiscal Period Focus
Document Fiscal Period Focus
Trading Symbol
Trading Symbol
Entity Registrant Name
Entity Registrant Name
Entity Central Index Key
Entity Central Index Key
Current Fiscal Year End Date
Current Fiscal Year End Date
Entity Well-known Seasoned Issuer
Entity Well-known Seasoned Issuer
Entity Shell Company
Entity Shell Company
Entity Small Business
Entity Small Business
Entity Emerging Growth Company
Entity Emerging Growth Company
Entity Current Reporting Status
Entity Current Reporting Status
Entity Voluntary Filers
Entity Voluntary Filers
Entity Filer Category
Entity Filer Category
Entity Common Stock, Shares Outstanding
Entity Common Stock, Shares Outstanding
Entity Public Float
Entity Public Float
Income Statement [Abstract]
Revenue from services
Revenues
Operating expenses:
Operating Expenses [Abstract]
Direct operating expenses
Direct Operating Costs
Selling, general, and administrative expenses
Selling, General and Administrative Expense
Bad debt expense
Provision for Doubtful Accounts
Acquisition-related contingent consideration
Business Combination, Contingent Consideration Arrangements, Expense
Business Combination, Contingent Consideration Arrangements, Expense
Acquisition and integration costs
Business Combination, Acquisition Related Costs
Restructuring costs
Total operating expenses
Costs and Expenses
(Loss) income from operations
Operating Income (Loss)
Other expenses (income):
Nonoperating Income (Expense) [Abstract]
Interest expense
Interest Expense
Gain on derivative liability
Other income, net
Other Nonoperating Income (Expense)
Income tax benefit
Consolidated net (loss) income
Less: Net income attributable to noncontrolling interest in subsidiary
Income (Loss) from Continuing Operations, Net of Tax, Attributable to Noncontrolling Interest
Net (loss) income attributable to common shareholders
Net Income (Loss) Attributable to Parent
Net (loss) income per share attributable to common shareholders - Basic (usd per share)
Earnings Per Share, Basic
Net (loss) income per share attributable to common shareholders - Diluted (usd per share)
Earnings Per Share, Diluted
Weighted average common shares outstanding—basic (shares)
Weighted Average Number of Shares Outstanding, Basic
Weighted average common shares outstanding—diluted (shares)
Weighted Average Number of Shares Outstanding, Diluted
Debt Disclosure [Abstract]
Schedule of Long-term Debt Instruments [Table]
Schedule of Long-term Debt Instruments [Table]
Debt Instrument [Axis]
Debt Instrument [Axis]
Debt Instrument, Name [Domain]
Debt Instrument, Name [Domain]
8% Convertible Notes
8% Convertible Notes [Member]
8% Convertible Notes [Member]
Convertible Note Derivative Liability
Convertible Note Derivative Liability [Member]
Convertible Note Derivative Liability [Member]
Long-term Debt, Type [Axis]
Long-term Debt, Type [Axis]
Long-term Debt, Type [Domain]
Long-term Debt, Type [Domain]
Convertible Notes
Convertible Debt [Member]
Debt Instrument [Line Items]
Debt Instrument [Line Items]
Face amount
Debt Instrument, Face Amount
Shares issued (in shares)
Debt Conversion, Converted Instrument, Shares Issued
Common stock, par value (usd per share)
Common Stock, Par or Stated Value Per Share
Payment of debt and extinguishment fees
Payments For Debt Extinguishment Costs And Repayment Of Long Term Debt
Payments For Debt Extinguishment Costs And Repayment Of Long Term Debt
Repayments of debt
Extinguishment fees
Original debt amount in debt conversion
Debt Conversion, Original Debt, Amount
Non-cash write off related to settlement of convertible notes
Debt Conversion, Converted Instrument, Amount
Debt conversion price (in usd per share)
Debt Instrument, Convertible, Conversion Price
Debt instrument, convertible, number of equity instruments
Debt Instrument, Convertible, Number of Equity Instruments
Debt Instrument, convertible, threshold period following issuance date (in years)
Debt Instrument, Convertible,Threshold Period Following Issuance Date
Debt Instrument, Convertible,Threshold Period Following Issuance Date
Debt instrument, convertible, threshold percentage of stock price trigger
Debt Instrument, Convertible, Threshold Percentage of Stock Price Trigger
Debt instrument, convertible, threshold trading days
Debt Instrument, Convertible, Threshold Trading Days
Debt instrument, convertible, threshold consecutive trading days
Debt Instrument, Convertible, Threshold Consecutive Trading Days
Interest rate (percent)
Debt Instrument, Interest Rate, Stated Percentage
Earnings Per Share [Abstract]
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share [Table]
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share [Table]
Antidilutive Securities [Axis]
Antidilutive Securities [Axis]
Antidilutive Securities, Name [Domain]
Antidilutive Securities, Name [Domain]
Share-based awards
Convertible Notes and Share-based Payment Awards [Member]
Convertible Notes and Share-based Payment Awards [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount
Schedule of Share-based Compensation Arrangements by Share-based Payment Award [Table]
Schedule of Share-based Compensation Arrangements by Share-based Payment Award [Table]
Award Type [Axis]
Award Type [Axis]
Award Type [Domain]
Equity Award [Domain]
Restricted Stock Awards
Restricted Stock [Member]
Performance Stock Awards
Performance Shares [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of Shares
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Number of Shares [Roll Forward]
Unvested restricted stock awards, beginning balance (in shares)
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Number
Granted (in shares)
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period
Vested (in shares)
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Vested in Period
Forfeited (in shares)
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Forfeited in Period
Unvested restricted stock awards, ending balance (in shares)
Weighted average grant date fair value
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Weighted Average Grant Date Fair Value [Abstract]
Unvested restricted stock awards, beginning balance (usd per share)
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Weighted Average Grant Date Fair Value
Granted (usd per share)
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period, Weighted Average Grant Date Fair Value
Vested (usd per share)
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Vested in Period, Weighted Average Grant Date Fair Value
Forfeited (usd per share)
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Forfeitures, Weighted Average Grant Date Fair Value
Unvested restricted stock awards, ending balance (usd per share)
Significant Accounting Policies [Table]
Significant Accounting Policies [Table]
Significant Accounting Policies [Table]
Property, Plant and Equipment, Type [Axis]
Property, Plant and Equipment, Type [Axis]
Property, Plant and Equipment, Type [Domain]
Property, Plant and Equipment, Type [Domain]
Computer software
Software Development [Member]
Insurance Type and Tier Identifier [Axis]
Insurance Type and Tier Identifier [Axis]
Type and Tier Identifier [Domain]
Type and Tier Identifier [Domain]
Occurrence-Based Professional Liability Insurance
Occurrence Based Professional Liability Insurance [Member]
Occurrence-Based Professional Liability Insurance [Member]
Claims-Based Liability Insurance
Claims-Based Liability Insurance [Member]
Claims-Based Liability Insurance [Member]
Legal Entity [Axis]
Legal Entity [Axis]
Entity [Domain]
Entity [Domain]
MDA Holdings Inc
M D A Holdings Inc [Member]
MDA Holdings Inc [Member]
Significant Accounting Policies [Line Items]
Significant Accounting Policies [Line Items]
Significant Accounting Policies [Line Items]
Interest income
Interest Income, Other
Short term leases period
Lease Expiration Period
Apartments lease period for field employees under short-term agreements.
Estimated useful life of assets
Property, Plant and Equipment, Useful Life
Intangible assets- useful life
Finite-Lived Intangible Asset, Useful Life
Outstanding standby letters of credit as collateral
Outstanding Letters Of Credit, Collateral to Guarantee Payments Under Self Insured Plan
Amount of standby letters of credit issued as collateral to guarantee payments of workers compensation claims.
Self insured retention per claim
Malpractice Insurance, Policy, Self Insured Retention Per Claim
Malpractice Insurance, Policy, Self Insured Retention Per Claim
Coverage for professional liability claims
Malpractice Insurance, Maximum Coverage Per Incident
Letter of credit for malpractice claims
Malpractice Loss Contingency, Letters of Credit and Surety Bonds
Equity compensation
Allocated Share-based Compensation Expense
Advertising costs
Advertising Expense
Cumulative impact of currency fluctuations
Accumulated Other Comprehensive Income (Loss), Foreign Currency Translation Adjustment, Net of Tax
Net change in derivative instruments
AOCI, Cash Flow Hedge, Cumulative Gain (Loss), after Tax
Income tax expense (benefit) related to items of other comprehensive (loss) income
Other Comprehensive Income (Loss), Tax, Portion Attributable to Parent
Balance Sheet Details
Condensed Balance Sheet [Table Text Block]
Operating lease expense
Operating Leases, Rent Expense, Net
Credit Facility [Axis]
Credit Facility [Axis]
Credit Facility [Domain]
Credit Facility [Domain]
Revolving Credit Facility
Revolving Credit Facility [Member]
Term Loan, net
Term Loan [Member]
Term Loan [Member]
Line of Credit
Line of Credit [Member]
Amended And Restated Credit Agreement
Amended And Restated Credit Agreement [Member]
Amended And Restated Credit Agreement [Member]
First Amendment, Amended And Restated Credit Agreement
First Amendment, Amended And Restated Credit Agreement [Member]
First Amendment, Amended And Restated Credit Agreement [Member]
Variable Rate [Axis]
Variable Rate [Axis]
Variable Rate [Domain]
Variable Rate [Domain]
LIBOR
London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Redemption, Period [Axis]
Debt Instrument, Redemption, Period [Axis]
Debt Instrument, Redemption, Period [Domain]
Debt Instrument, Redemption, Period [Domain]
Fiscal Quarters Ending September 30, 2018 through June 30, 2019
Fiscal Quarters Ending September 30, 2018 through June 30, 2019 [Member]
Fiscal Quarters Ending September 30, 2018 through June 30, 2019 [Member]
Fiscal Quarter Ending September 30, 2019
Fiscal Quarter Ending September 30, 2019 [Member]
Fiscal Quarter Ending September 30, 2019 [Member]
Fiscal Quarter Ending December 31, 2019
Fiscal Quarter Ending December 31, 2019 [Member]
Fiscal Quarter Ending December 31, 2019 [Member]
Each Fiscal Quarter Ending Thereafter
Each Fiscal Quarter Ending Thereafter [Member]
Each Fiscal Quarter Ending Thereafter [Member]
Maximum borrowing capacity
Line of Credit Facility, Maximum Borrowing Capacity
Sub facility for swingline loans
Line Of Credit Facility, Sub Facility For Swingline Loans
Line Of Credit Facility, Sub Facility For Swingline Loans
Line of credit, subfacility for standby letters of credit
Line Of Credit Facility Sub Limit For Letters Of Credit
Line of credit, subfacility for standby letters of credit.
Proceeds from issuance of debt
Additional capacity
Line Of Credit Facility, Additional Capacity
Line Of Credit Facility, Additional Capacity
Payment for debt prepayment
Payment For Debt Prepayment
Payment For Debt Prepayment
Interest margin
Debt Instrument, Basis Spread on Variable Rate
Interest rate increase (decrease) (percent)
Debt Instrument, Interest Rate, Increase (Decrease) in Event of Default
Debt Instrument, Interest Rate, Increase (Decrease) in Event of Default
Quarterly commitment fee on the average daily unused portion (percent)
Line of Credit Facility, Unused Capacity, Commitment Fee Percentage
Number of financial covenants
Number of Financial Covenants
Number of Financial Covenants
Consolidated fixed charge coverage ratio
Debt Covenant, Consolidated Fixed Charge Coverage Ratio
Debt Covenant, Consolidated Fixed Charge Coverage Ratio
Consolidated total leverage ratio
Debt Covenant, Consolidated Total Leverage Ratio
calculated as total Indebtedness, as defined divided by Adjusted EBITDA as defined
Debt issuance costs
Letters of credit outstanding
Letters of Credit Outstanding, Amount
American Personnel, Inc.
American Personnel, Inc. [Member]
American Personnel, Inc. [Member]
Purchase price
Business Combination, Consideration Transferred
Assets acquired
Finite-lived Intangible Assets Acquired
Weighted average useful life of assets acquired
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life
Goodwill
Goodwill
Acquisition related costs
Insurance recovery for workers’ compensation
Insurance Recovery For Workers Compensation Current
The current portion of the amount receivable from insurance for recovery for workers compensation.
Insurance recovery for professional liability
Insurance Receivable for Malpractice, Current
Insurance recovery receivable
Insurance Settlements Receivable, Current
Insurance recovery for workers’ compensation claims
Insurance Recovery For Workers Compensation Noncurrent
The long term portion of the amount receivable from insurance for recovery for workers compensation.
Insurance recovery for professional liability claims
Insurance Receivable for Malpractice, Noncurrent
Non-current security deposits
Deposits Assets, Noncurrent
Non-current income tax receivable
Income Taxes Receivable, Noncurrent
Deferred compensation assets
Deferred Compensation Plan Assets
Net debt issuance costs
Debt Issuance Costs, Noncurrent, Net
Other non-current assets
Other Assets, Noncurrent
Salaries and payroll taxes
Accrued Salaries, Current
Bonuses
Accrued Bonuses, Current
Accrual for workers’ compensation claims
Workers' Compensation Liability, Current
Accrual for professional liability claims
Malpractice Loss Contingency, Accrual, Undiscounted, Current
Accrual for healthcare benefits
Other Employee-related Liabilities, Current
Accrual for vacation
Accrued Vacation, Current
Accrued compensation and benefits
Employee-related Liabilities, Current
Accrual for workers’ compensation claims
Workers' Compensation Liability, Noncurrent
Accrual for professional liability claims
Malpractice Loss Contingency, Accrual, Undiscounted, Noncurrent
Long-term accrued claims
Liability for Claims and Claims Adjustment Expense
Non-current deferred tax liabilities
Deferred Tax Liabilities, Net, Noncurrent
Deferred compensation
Deferred Compensation Liability, Classified, Noncurrent
Deferred rent
Deferred Rent Credit, Noncurrent
Long-term unrecognized tax benefits
Liability for Uncertainty in Income Taxes, Noncurrent
Other
Other Liabilities, Miscellaneous, Noncurrent
Other Liabilities, Miscellaneous, Noncurrent
Other long-term liabilities
Other Liabilities, Noncurrent
Commitments and Contingencies
Commitments and Contingencies Disclosure [Text Block]
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Table]
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Table]
Consolidation Items [Axis]
Consolidation Items [Axis]
Consolidation Items [Domain]
Consolidation Items [Domain]
Operating Segments
Operating Segments [Member]
Segments [Axis]
Segments [Axis]
Segments [Domain]
Segments [Domain]
Nurse and Allied Staffing Segment
Nurse And Allied Staffing [Member]
Nurse and allied staffing [Member]
Physician Staffing Segment
Physician Staffing [Member]
Physician staffing [Member]
Other Human Capital Management Services Segment
Other Human Capital Management Services [Member]
Other human capital management services [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Revenues
Contribution income
Operating Income (Loss) Before Depreciation Amortization Acquisition and Integration Cost Contingent Consideration Restructuring Costs Impairment Charges And Corporate Expenses
Operating Income (Loss) Before Depreciation Amortization Acquisition and Integration Cost Contingent Consideration Restructuring Costs Impairment Charges And Corporate Expenses
Unallocated corporate overhead
Segment Reporting Unallocated Corporate Expenses
Segment Reporting Unallocated Corporate Expenses
Term Loan
Senior Debt Obligations [Member]
Long-term Debt, Fiscal Year Maturity [Abstract]
Long-term Debt, Fiscal Year Maturity [Abstract]
2019
Long-term Debt, Maturities, Repayments of Principal in Next Twelve Months
2020
Long-term Debt, Maturities, Repayments of Principal in Year Two
2021
Long-term Debt, Maturities, Repayments of Principal in Year Three
2022
Long-term Debt, Maturities, Repayments of Principal in Year Four
2023
Long-term Debt, Maturities, Repayments of Principal in Year Five
Total
Long-term Debt
Advantage RN, LLC
Advantage RN, LLC [Member]
Advantage RN, LLC [Member]
Goodwill expected to be deductible
Business Acquisition, Goodwill, Expected Tax Deductible Amount
Exercise Price Range [Axis]
Exercise Price Range [Axis]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Domain]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Domain]
Exercise Price Range One
Exercise Price Range One [Member]
Exercise Price Range One [Member]
Exercise Price Range Two
Exercise Price Range Two [Member]
Exercise Price Range Two [Member]
Exercise Price Range Three
Exercise Price Range Three [Member]
Exercise Price Range Three [Member]
Exercise Price Range Four
Exercise Price Range Four [Member]
Exercise Price Range Four [Member]
Exercise Price Range Five
Exercise Price Range Five [Member]
Exercise Price Range Five [Member]
Number of Shares
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding [Roll Forward]
Share options outstanding at beginning of year (in shares)
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Number
Granted (in shares)
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Net of Forfeitures
Exercised (in shares)
Forfeited/expired (in shares)
Share-based Compensation Arrangement by Share-based Payment Award, Options, Forfeitures in Period
Share options outstanding at end of year (in shares)
Exercise Price, Lower Limit (usd per share)
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range, Lower Range Limit
Exercise Price, Upper Limit (usd pre share)
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range, Upper Range Limit
Weighted Average Exercise Price
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract]
Share options outstanding at beginning of year, weighted average exercise price (usd per share)
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price
Granted, weighted average exercise price (usd per share)
Share-based Compensation Arrangements by Share-based Payment Award, Options, Grants in Period, Weighted Average Exercise Price
Exercised, weighted average exercise price (usd per share)
Share-based Compensation Arrangements by Share-based Payment Award, Options, Exercises in Period, Weighted Average Exercise Price
Forfeited/expired, weighted average exercise price (usd per share)
Share-based Compensation Arrangement by Share-based Payment Award, Options, Forfeitures and Expirations in Period, Weighted Average Exercise Price
Share options outstanding at end of year, weighted average exercise price (usd per share)
Share options outstanding at end of year, weighted-average remaining contractual life
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Remaining Contractual Term
Share options outstanding at end of year
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Intrinsic Value
Schedule of business acquisitions
Schedule of Business Acquisitions, by Acquisition [Table Text Block]
Schedule of assets acquired and liabilities assumed
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed [Table Text Block]
Pro forma information
Business Acquisition, Pro Forma Information [Table Text Block]
Long-term Debt
Schedule of Debt [Table Text Block]
Aggregate scheduled maturities of debt
Schedule of Maturities of Long-term Debt [Table Text Block]
Goodwill and Intangible Assets Disclosure [Table]
Goodwill And Intangible Assets Disclosure [Table]
Goodwill and Intangible Assets Disclosure [Table]
Measurement Input Type [Axis]
Measurement Input Type [Axis]
Measurement Input Type [Domain]
Measurement Input Type [Domain]
Discount Rate
Measurement Input, Discount Rate [Member]
Indefinite-lived Intangible Assets [Axis]
Indefinite-lived Intangible Assets [Axis]
Indefinite-lived Intangible Assets, Major Class Name [Domain]
Indefinite-lived Intangible Assets, Major Class Name [Domain]
Trade Names
Valuation Approach and Technique [Axis]
Valuation Approach and Technique [Axis]
Valuation Approach and Technique [Domain]
Valuation Approach and Technique [Domain]
Income Approach Valuation Technique
Valuation, Income Approach [Member]
Income and Market Approach Valuation Technique
Income and Market Approach Valuation Technique [Member]
Income and Market Approach Valuation Technique [Member]
Market Approach Valuation Technique
Valuation, Market Approach [Member]
Search Reporting Unit [Member]
Search Reporting Unit [Member]
Search Reporting Unit [Member]
Goodwill and Intangible Assets Disclosure [Line Items]
Goodwill And Intangible Assets Disclosure [Line Items]
Goodwill and Intangible Assets Disclosure [Line Items]
Impairment of intangibles indefinite lived
Impairment of Intangible Assets, Indefinite-lived (Excluding Goodwill)
Goodwill impairment charge
Goodwill, Impairment Loss
Carrying amount
Amortization of assets
Amortization of Intangible Assets
Impairment of intangibles finite lived
Impairment of Intangible Assets, Finite-lived
Discount rate percentage
Goodwill, Impairment Test, Measurement Input
Goodwill, Impairment Test, Measurement Input
Terminal value growth rate percentage
Fair Value Inputs, Terminal Value Growth Rate
Fair Value Inputs, Terminal Value Growth Rate
Forecast period
Fair Value Inputs, Forecast Period
Fair Value Inputs, Forecast Period
Ratio of total enterprise value by EBITDA
Fair Value Inputs, Ratio of Total Enterprise Value by EBITDA
Fair Value Inputs, Ratio of Total Enterprise Value by EBITDA
Weighted applied percentage
Fair Value Inputs, Weighting Applied
Fair Value Inputs, Weighting Applied
Gross profit
Gross Profit
Net income (loss) attributable to common shareholders
Net income (loss) per share attributable to common shareholders - Basic (usd per share)
Net income (loss) per share attributable to common shareholders - Diluted (usd per share)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Table]
Disposal Groups, Including Discontinued Operations [Table]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Loss on extinguishment of debt
Income tax expense related to deferred tax asset
Fair Value Measurements
Fair Value Disclosures [Text Block]
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative [Table]
Derivative [Table]
Senior Debt
Derivative [Line Items]
Derivative [Line Items]
Derivative fixed interest rate
Derivative, Fixed Interest Rate
Notional amount
Derivative, Notional Amount
Debt fixed interest rate
Long-term Debt, Percentage Bearing Fixed Interest, Percentage Rate
Statement of Financial Position [Abstract]
Accounts receivable, allowance for doubtful accounts
Allowance for Doubtful Accounts Receivable, Current
Common stock, shares authorized
Common Stock, Shares Authorized
Common stock, shares issued
Common Stock, Shares, Issued
Common stock, shares outstanding
Common Stock, Shares, Outstanding
Schedule II - Valuation and Qualifying Accounts
SEC Schedule, 12-09, Schedule of Valuation and Qualifying Accounts Disclosure [Text Block]
Business Combination, Consideration Transferred [Axis]
Business Combination, Consideration Transferred [Axis]
Business Combination, Consideration Transferred [Axis]
Business Combination, Consideration Transferred [Domain]
Business Combination, Consideration Transferred [Domain]
[Domain] for Business Combination, Consideration Transferred [Axis]
Purchase Price
Purchase Price [Member]
Purchase Price [Member]
Net Working Capital Adjustments
Net Working Capital Adjustments [Member]
Net Working Capital Adjustments [Member]
Cash consideration
Cash acquired
Cash Acquired from Acquisition
Total consideration
Segment Data
Segment Reporting Disclosure [Text Block]
Business Acquisition, Pro Forma Information, Nonrecurring Adjustments [Table]
Business Acquisition, Pro Forma Information, Nonrecurring Adjustments [Table]
Nonrecurring Adjustment [Axis]
Nonrecurring Adjustment [Axis]
Nonrecurring Adjustment [Domain]
Nonrecurring Adjustment [Domain]
Acquisition-related costs
Acquisition-related Costs [Member]
Business Acquisition, Pro Forma Information, Nonrecurring Adjustment [Line Items]
Business Acquisition, Pro Forma Information, Nonrecurring Adjustment [Line Items]
Revenue from services
Business Acquisition, Pro Forma Revenue
Net income attributable to common shareholders
Business Acquisition, Pro Forma Net Income (Loss)
Net income per share attributable to common shareholders - Basic (in dollars per share)
Business Acquisition, Pro Forma Earnings Per Share, Basic
Net income per share attributable to common shareholders - Diluted (in dollars per share)
Business Acquisition, Pro Forma Earnings Per Share, Diluted
Acquired Intangible Assets
Schedule of Intangible Assets and Goodwill [Table Text Block]
Estimated Annual Amortization Expense
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense [Table Text Block]
Changes in Carrying Amount of Goodwill by Segment
Schedule of Goodwill [Table Text Block]
Term Loan, interest of 4.80% and 3.61% at December 31, 2018 and 2017, respectively
Long-term Debt, Gross
Less current portion
Long-term Debt, Current Maturities
Long-term debt
Debt Issuance Costs
Debt Issuance Costs, Net
Interest Rate
Goodwill, Trade Names, and Other Intangible Assets
Goodwill and Intangible Assets Disclosure [Text Block]
Earnings Per Share
Earnings Per Share [Text Block]
2019
Finite-Lived Intangible Assets, Amortization Expense, Next Twelve Months
2020
Finite-Lived Intangible Assets, Amortization Expense, Year Two
2021
Finite-Lived Intangible Assets, Amortization Expense, Year Three
2022
Finite-Lived Intangible Assets, Amortization Expense, Year Four
2023
Finite-Lived Intangible Assets, Amortization Expense, Year Five
Thereafter
Finite-Lived Intangible Assets, Amortization Expense, after Year Five
Number of operating segments
Number of Operating Segments
Stock repurchase and retirement (in shares)
Stock repurchase and retirement
Stock repurchase and retirement (in dollars per share)
Stock Repurchased During Period, Price Per Share
Stock Repurchased During Period, Price Per Share
Common stock left remaining to repurchase under the plan (in shares)
Stock Repurchase Program, Remaining Number of Shares Authorized to be Repurchased
Shares converted (in shares)
Summary of Significant Accounting Policies
Significant Accounting Policies [Text Block]
Property and Equipment
Property, Plant and Equipment Disclosure [Text Block]
Threshold period, past due for payment of services provided
Threshold Period, Past Due for Payment of Services Provided
Threshold Period, Past Due for Payment of Services Provided
Line of Credit Facility [Table]
Line of Credit Facility [Table]
Debt Covenant Terms [Axis]
Debt Covenant Terms [Axis]
Debt Covenant Terms [Axis]
Debt Covenant Terms [Domain]
Debt Covenant Terms [Domain]
[Domain] for Debt Covenant Terms [Axis]
Covenant Term 1
Covenant Term 1 [Member]
Covenant Term 1 [Member]
Covenant Term 2
Covenant Term 2 [Member]
Covenant Term 2 [Member]
Covenant Term 3
Covenant Term 3 [Member]
Covenant Term 3 [Member]
Covenant Term 4
Covenant Term 4 [Member]
Covenant Term 4 [Member]
Covenant Term 5
Covenant Term 5 [Member]
Covenant Term 5 [Member]
Credit Agreement
Credit Agreement [Member]
Credit Agreement [Member]
Eurodollar Loans
Eurodollar [Member]
LIBOR Index Rate Loans
Letter of Credit Fee
Letter of Credit Fee [Member]
Letter of Credit Fee [Member]
Base Rate Loans
Base Rate [Member]
Line of Credit Facility [Line Items]
Line of Credit Facility [Line Items]
Consolidated Net Leverage Ratio
Consolidated Net Leverage Ratio
Consolidated Net Leverage Ratio
Commitment fee percentage
Line of Credit Facility, Commitment Fee Percentage
Assets
Assets [Abstract]
Current assets:
Assets, Current [Abstract]
Cash and cash equivalents
Accounts receivable, net of allowances of $3,705 in 2018 and $3,688 in 2017
Accounts Receivable, Net, Current
Prepaid expenses
Prepaid Expense, Current
Insurance recovery receivable
Other current assets
Other Assets, Current
Total current assets
Assets, Current
Property and equipment, net
Property, Plant and Equipment, Net
Trade names
Other intangible assets, net
Non-current deferred tax assets
Deferred Tax Assets, Net, Noncurrent
Other non-current assets
Total assets
Assets
Liabilities and Stockholders' Equity
Liabilities and Equity [Abstract]
Current liabilities:
Liabilities, Current [Abstract]
Accounts payable and accrued expenses
Accounts Payable and Other Accrued Liabilities, Current
Accrued compensation and benefits
Current portion of long-term debt
Other current liabilities
Other Liabilities, Current
Total current liabilities
Liabilities, Current
Long-term debt, less current portion
Long-term Debt, Excluding Current Maturities
Long-term accrued claims
Contingent consideration
Business Combination, Contingent Consideration, Liability, Noncurrent
Other long-term liabilities
Total liabilities
Liabilities
Commitments and contingencies
Commitments and Contingencies
Stockholders' equity:
Stockholders' Equity Attributable to Parent [Abstract]
Common stock—$0.0001 par value; 100,000,000 shares authorized; 35,625,692 and 35,838,108 shares issued and outstanding at December 31, 2018 and 2017, respectively
Common Stock, Value, Issued
Additional paid-in capital
Additional Paid in Capital, Common Stock
Accumulated other comprehensive loss
Accumulated Other Comprehensive Income (Loss), Net of Tax
Accumulated deficit
Retained Earnings (Accumulated Deficit)
Total Cross Country Healthcare, Inc. stockholders' equity
Stockholders' Equity Attributable to Parent
Noncontrolling interest in subsidiary
Stockholders' Equity Attributable to Noncontrolling Interest
Total stockholders' equity
Total liabilities and stockholders' equity
Liabilities and Equity
Scenario [Axis]
Scenario [Axis]
Scenario, Unspecified [Domain]
Scenario, Unspecified [Domain]
Forecast
Scenario, Forecast [Member]
Incremental Term Loan
Incremental Term Loan [Member]
Incremental Term Loan [Member]
Cash consideration
Reimbursement from working capital adjustment settled
Business Combination, Consideration Transferred, Net Working Capital Adjustment, Reimbursement
Business Combination, Consideration Transferred, Net Working Capital Adjustment, Reimbursement
Contingent liability
Escrow payment related to tax liabilities
Payments To Acquire Businesses, Escrow, Portion Related To Tax Liabilities
Payments To Acquire Businesses, Escrow, Portion Related To Tax Liabilities
Escrow payment related to post-close liabilities
Payments To Acquire Businesses, Escrow, Portion Related To Post-Close Liabilities
Payments To Acquire Businesses, Escrow, Portion Related To Post-Close Liabilities
Escrow deposit related to tax liabilities
Business Combination, Escrow Deposit Related To Tax Liabilities
Business Combination, Escrow Deposit Related To Tax Liabilities
Escrow deposit related to post close liabilities
Business Combination, Escrow Deposit Related To Post Close Liabilities
Business Combination, Escrow Deposit Related To Post Close Liabilities
Consideration transferred, available cash
Business Combination, Consideration Transferred, Portion Funded With Cash On Hand
Business Combination, Consideration Transferred, Portion Funded With Cash On Hand
Revenue since acquisition
Business Combination, Pro Forma Information, Revenue of Acquiree since Acquisition Date, Actual
Net income since acquisition
Business Combination, Pro Forma Information, Earnings or Loss of Acquiree since Acquisition Date, Actual
Subordinated Debt
Subordinated Debt [Member]
Second Lien Term Loan, net
Second Lien Term Loan [Member]
Second Lien Term Loan [Member]
Eurodollar
First Eight Installments
First Eight Installments [Member]
First Eight Installments [Member]
Remaining Installments
Remaining Installments [Member]
Remaining Installments [Member]
Prepayment penalty
Debt Instrument, Prepayment Penalty
Debt Instrument, Prepayment Penalty
Periodic payment, percentage of principal
Debt Instrument, Periodic Payment, Percentage Of Principal
Debt Instrument, Periodic Payment, Percentage Of Principal
Stock Appreciation Rights
Stock Appreciation Rights (SARs) [Member]
Title of Individual [Axis]
Title of Individual [Axis]
Relationship to Entity [Domain]
Relationship to Entity [Domain]
Ten Percent Or More Stockholders
Ten Percent Or More Stockholders [Member]
Ten Percent Or More Stockholders [Member]
Plan Name [Axis]
Plan Name [Axis]
Plan Name [Domain]
Plan Name [Domain]
Omnibus Plan
Omnibus Plan [Member]
Omnibus Plan [Member]
2007 Stock Incentive Plan
Incentive Compensation Plan 2007 [Member]
Incentive Compensation Plan 2007 [Member]
Additional shares authorized (in shares)
Share-based Compensation Arrangement by Share-based Payment Award, Number of Additional Shares Authorized
Shares reserved for future issuance (in shares)
Common Stock, Capital Shares Reserved for Future Issuance
Exercise price percentage of the fair market value of common stock
Share-based Compensation Arrangement by Share-based Payment Award, Purchase Price of Common Stock, Percent
Stock expiration period
Share Based Compensation Arrangement By Share Based Payment Award Options Expiration Period
Share based compensation arrangement by share based payment award options expiration period.
Stock vesting period
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period
Shares issued (in shares)
Share-based Compensation Arrangement by Share-based Payment Award, Shares Issued in Period
Percentage of performance attained
Share-based Compensation Arrangement by Share-based Payment Award, Level of Performance Attained, Percentage
Share-based Compensation Arrangement by Share-based Payment Award, Level of Performance Attained, Percentage
Pretax of total unrecognized compensation cost related to non-vested restricted stock awards
Employee Service Share-based Compensation, Nonvested Awards, Compensation Not yet Recognized, Share-based Awards Other than Options
Pretax total unrecognized compensation cost related to share options- period
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized, Period for Recognition
Fair value of shares vested
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Vested in Period, Fair Value
Stock vesting percentage per year
Share Based Compensation Arrangement By Share Based Payment Award Percentage Of Shares Vested
Share based compensation arrangement by share based payment award stock award and option vesting rate per year.
Schedule of Goodwill [Table]
Schedule of Goodwill [Table]
Goodwill [Line Items]
Goodwill [Line Items]
Goodwill balances
Goodwill [Roll Forward]
Goodwill, net of impairment loss, beginning of period
Sale of business, beginning of period
Goodwill, Write Off Related To Sale Of Business
Goodwill, Write Off Related To Sale Of Business
Accumulated impairment loss, beginning of period
Goodwill, Impaired, Accumulated Impairment Loss
Aggregate goodwill acquired, beginning of period
Goodwill, Gross
Goodwill, Translation and Purchase Accounting Adjustments [Abstract]
Goodwill, Translation and Purchase Accounting Adjustments [Abstract]
Goodwill acquired
Goodwill, Acquired During Period
Impairment charge
Aggregate goodwill acquired, end of period
Sale of business, end of period
Accumulated impairment loss, end of period
Goodwill, net of impairment loss, end of period
Deferred Tax Assets:
Components of Deferred Tax Assets [Abstract]
Accrued other and prepaid expenses
Deferred Tax Assets, Accrued Other Liabilities and Prepaid Expenses
Deferred Tax Assets, Accrued Other Liabilities and Prepaid Expenses
Allowance for doubtful accounts
Deferred Tax Assets, Tax Deferred Expense, Reserves and Accruals, Allowance for Doubtful Accounts
Intangible Assets
Deferred Tax Assets, Goodwill and Intangible Assets
Net operating loss carryforwards
Deferred Tax Assets, Operating Loss Carryforwards
Accrued professional liability claims
Deferred Tax Assets, Tax Deferred Expense, Compensation and Benefits, Other
Accrued workers’ compensation claims
Deferred Tax Assets, Tax Deferred Expense, Compensation and Benefits, Employee Benefits
Share-based compensation
Deferred Tax Assets, Tax Deferred Expense, Compensation and Benefits, Share-based Compensation Cost
Credit carryforwards
Deferred Tax Assets, Tax Credit Carryforwards
Other
Deferred Tax Assets, Other
Gross deferred tax assets
Deferred Tax Assets, Gross
Valuation allowance
Deferred tax assets
Deferred Tax Assets, Net of Valuation Allowance
Deferred Tax Liabilities:
Components of Deferred Tax Liabilities [Abstract]
Depreciation
Deferred Tax Liabilities, Property, Plant and Equipment
Indefinite intangibles
Deferred Tax Liabilities, Intangible Assets
Tax on unrepatriated earnings
Deferred tax liabilities
Deferred Tax Liabilities, Gross
Net deferred taxes
Deferred Tax Assets (Liabilities)
Deferred Tax Assets (Liabilities)
Components of Numerator and Denominator for Computation of Basic and Diluted Earnings per Share
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share [Table Text Block]
Schedule of Related Party Transactions, by Related Party [Table]
Schedule of Related Party Transactions, by Related Party [Table]
Related Party [Axis]
Related Party [Axis]
Related Party [Domain]
Related Party [Domain]
Corporate Joint Venture
Corporate Joint Venture [Member]
Affiliated Entity
Affiliated Entity [Member]
Related Party Transaction [Line Items]
Related Party Transaction [Line Items]
Revenue from related parties
Revenue from Related Parties
Account receivable due from related parties
Accounts Receivable, Related Parties
Percent ownership in joint venture unit
Joint Venture, Percent Ownership
Joint Venture, Percent Ownership
Receivable balance with joint venture
Due from Joint Ventures, Current
Due to joint venture
Due to Related Parties, Current
Rent expense
Payments for Rent
Cash and cash equivalents
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Cash and Equivalents
Accounts receivable
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Assets, Receivables
Other current assets
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Assets, Other
Property and equipment
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Property, Plant, and Equipment
Other intangible assets
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Intangible Assets, Other than Goodwill
Total assets acquired
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Assets
Accounts payable and accrued expenses
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Accounts Payable
Accrued employee compensation and benefits
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Employee Liabilities
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Employee Liabilities
Other current liabilities
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Other
Total liabilities assumed
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Liabilities
Net assets acquired
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Net
Company contribution net of forfeitures
Defined Contribution Plan, Employer Discretionary Contribution Amount
Deferred compensation liabilities
Acquisitions
Business Combination Disclosure [Text Block]
Derivatives
Derivatives and Fair Value [Text Block]
Fair Value Option, Disclosures [Table]
Fair Value Option, Disclosures [Table]
Fair Value Hierarchy and NAV [Domain]
Measurement Basis [Axis]
Measurement Basis [Axis]
Fair Value Measurement [Domain]
Fair Value Measurement [Domain]
Portion at Fair Value Measurement [Member]
Portion at Fair Value Measurement [Member]
Carrying Amount
Reported Value Measurement [Member]
Fair Value
Estimate of Fair Value Measurement [Member]
Fair Value, Option, Quantitative Disclosures [Line Items]
Fair Value, Option, Quantitative Disclosures [Line Items]
Carrying Amount
Fair Value
Debt Instrument, Fair Value Disclosure
Debt
Debt Disclosure [Text Block]
Disaggregation of Revenue [Table]
Disaggregation of Revenue [Table]
Physician Staffing Segment
Other Services
Other Services [Member]
Other Services [Member]
Disaggregation of Revenue [Line Items]
Disaggregation of Revenue [Line Items]
Revenue
Revenue from Contract with Customer, Excluding Assessed Tax
Numerator:
Net Income (Loss) Available to Common Stockholders, Diluted [Abstract]
Net (loss) income attributable to common shareholders - Basic
Net Income (Loss) Available to Common Stockholders, Basic
Interest on Convertible Notes
Interest on Convertible Debt, Net of Tax
Gain on derivative liability
Net (loss) income attributable to common shareholders - Diluted
Net Income (Loss) Available to Common Stockholders, Diluted
Denominator:
Weighted Average Number of Shares Outstanding Reconciliation [Abstract]
Weighted average common shares - Basic (shares)
Effective of diluted shares:
Incremental Weighted Average Shares Attributable to Dilutive Effect [Abstract]
Share-based awards (shares)
Incremental Common Shares Attributable to Dilutive Effect of Share-based Payment Arrangements
Convertible Notes (shares)
Incremental Common Shares Attributable to Dilutive Effect of Conversion of Debt Securities
Weighted average common shares - Diluted (shares)
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Basis of Presentation
Organization, Consolidation and Presentation of Financial Statements Disclosure [Text Block]
Schedule of Property, Plant and Equipment [Table]
Property, Plant and Equipment [Table]
Computer equipment
Computer Equipment [Member]
Computer software
Software and Software Development Costs [Member]
Office equipment
Office Equipment [Member]
Furniture and fixtures
Furniture and Fixtures [Member]
Leasehold improvements
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Property, Plant and Equipment [Line Items]
Property and equipment
Property, Plant and Equipment, Gross
Less accumulated depreciation and amortization
Accumulated Depreciation, Depletion and Amortization, Property, Plant, and Equipment
Property and equipment, net of accumulated depreciation and amortization
Estimated useful life
Disaggregation of Revenue
Disaggregation of Revenue [Table Text Block]
New Accounting Pronouncements or Change in Accounting Principle [Table]
New Accounting Pronouncements or Change in Accounting Principle [Table]
Adjustments for New Accounting Pronouncements [Axis]
Adjustments for New Accounting Pronouncements [Axis]
Type of Adoption [Domain]
Type of Adoption [Domain]
ASU 2016-02
Accounting Standards Update 2016-02 [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Undiscounted future lease payments
Accrued rent
Accrued Rent
The 1999 Plan
Stock Option And Equity Participation Plan 1999 [Member]
Stock Option and Equity Participation Plan 1999 [Member]
Aggregate number of common stock shares authorized for issuance (in shares)
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Authorized
Share options outstanding (in shares)
Shares options outstanding vested or expected to vest -weighted average exercise price (usd per share)
Share-based Compensation Arrangement by Share-based Payment Award, Options, Vested and Expected to Vest, Exercisable, Weighted Average Exercise Price
Shares options outstanding vested or expected to vest ,intrinsic value
Share-based Compensation Arrangement by Share-based Payment Award, Options, Vested and Expected to Vest, Outstanding, Aggregate Intrinsic Value
Shares options outstanding vested or expected to vest -weighted average contractual life
Share-based Compensation Arrangement by Share-based Payment Award, Options, Vested and Expected to Vest, Outstanding, Weighted Average Remaining Contractual Term