AMN Healthcare Services Inc. (NYSE: AHS), the largest U.S. healthcare staffing firm, reported fourth-quarter revenue fell 51.1% on a year-over-year basis to $144.7 million. However, gross margin improved.

Fourth-quarter nurse and allied healthcare staffing revenue fell 64.3% to $74.0 million from $207.3 million in the year-ago quarter. Revenue in the segment fell 9.9% sequentially from the third quarter.

Locum tenens revenue fell 18.3% to $62.4 million in the fourth quarter from $76.4 million in the same period in the previous year. Sequentially revenue fell 17.3%.

Physician permanent placement revenue fell 32.2% to $8.3 million on a year-over-year basis. It fell 5.5% from the third quarter.

AMN's fourth quarter gross margin improved to 28.4% from 25.7% in the year-ago quarter.

Nurse and allied healthcare staffing gross margin rose to 27.0% from 23.6%, and physician permanent placement gross margin improved to 60.0% from 58.7%. Locum tenens gross margin remained unchanged year-over-year at 26.0%

AMN posted a fourth-quarter net loss of $2.7 million compared with net income of $7.6 million in the fourth quarter of 2008.

Full-year 2009 revenue fell 37.6% to $759.8 million, and full-year gross margin improved to 26.9% from 26.0%.

AMN posted a 2009 net loss of $122.2 million compared with 2008 net income of $34.4 million. 2009 included an impairment charge of $175.7 million and restructuring charges of $11.3 million.

"I'm certain most would agree that 2009 represented the most challenging year in the history of the healthcare staffing industry," President and CEO Susan Nowakowski said. "The unprecedented rise in unemployment and severe economic contraction wreaked havoc and resulted in precipitous drops in demand volumes unlike any other time."

AMN Healthcare Services Inc. (NYSE: AHS)
For the fourth quarter ended Dec. 31, 2009, compared with the same period in the previous year.
Revenue: $144.7 million, -51.1%
Net loss: $2.7 million vs. net income of $7.6 million

For the full year ended Dec. 31, 2009, compared with the previous year.
Revenue: $759.8 million, -37.6%
Net loss: $122.2 million vs. net income of $34.4 million