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Goodwill, Trade Names, and Other Intangible Assets
 12 Months Ended
Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]  
Goodwill, Trade Names, and Other Intangible Assets Goodwill, Trade Names, and Other Intangible Assets
The Company had the following acquired intangible assets:
 December 31, 2023December 31, 2022
 Gross
Carrying
Amount		Accumulated
Amortization		Net
Carrying
Amount		Gross
Carrying
Amount		Accumulated
Amortization		Net
Carrying
Amount
(amounts in thousands)
Intangible assets subject to amortization:
Databases$45,930 $24,971 $20,959 $33,430 $22,033 $11,397 
Customer relationships52,538 26,286 26,252 47,738 21,672 26,066 
Non-compete agreements— — — 4 3 1 
Trade names900 548 352 30 16 14 
Software1,700 695 1,005 1,700 355 1,345 
Other intangible assets, net$101,068 $52,500 $48,568 $82,902 $44,079 $38,823 
Intangible assets not subject to amortization:
Trade names, indefinite-lived$5,900   $5,900 
 
During 2023, fully amortized intangible assets of $3.4 million related to databases, and immaterial amounts related to non-compete agreements and trade names, along with the related accumulated amortization, were removed from the table above.
As of December 31, 2023, estimated annual amortization expense was as follows:
Years Ending December 31:(amounts in thousands)
2024$10,481 
20259,570 
20268,362 
20276,191 
20284,790 
Thereafter9,174 
 $48,568 
 
The changes in the carrying amount of goodwill by reportable segment are as follows: 
 Nurse
And Allied
Staffing		Physician
Staffing		Total
(amounts in thousands)
Balances as of December 31, 2022   
Aggregate goodwill acquired$395,119 $78,621 $473,740 
Accumulated impairment loss(269,874)(40,598)(310,472)
Goodwill, net of impairment loss125,245 38,023 163,268 
Changes to aggregate goodwill in 2023
Goodwill acquisition adjustments(a)
(12,738)(15,100)(27,838)
Balances as of December 31, 2023
Aggregate goodwill acquired382,381 63,521 445,902 
Accumulated impairment loss(269,874)(40,598)(310,472)
Goodwill, net of impairment loss$112,507 $22,923 $135,430 
________________

(a) Represents adjustments to the fair value of the identifiable net assets acquired, with a corresponding offset to goodwill, made during the measurement periods related to the acquisitions of HireUp, Mint, and a local business. The measurement periods have concluded, and no further adjustments are anticipated. See Note 4 - Acquisitions.

Goodwill, Trade Names, and Other Intangible Assets Impairment

The Company tests reporting units’ goodwill and intangible assets with indefinite lives for impairment annually during the fourth quarter and more frequently if impairment indicators exist. The Company performs quarterly qualitative assessments of significant events and circumstances such as reporting units’ historical and current results, assumptions regarding future performance, strategic initiatives and overall economic factors, and macro-economic developments, to determine the existence of potential indicators of impairment and assess if it is more likely than not that the fair value of reporting units or intangible assets is less than their carrying value. If indicators of impairments are identified a quantitative impairment test is performed.

The Company performed its annual quantitative impairment test of goodwill and its indefinite-lived trade name as of October 1, 2023 and 2022 and determined that the estimated fair value of its reporting units and its indefinite-lived trade name exceeded their respective carrying values. Although management believes that the Company’s current estimates and assumptions utilized in its quantitative testing are reasonable and supportable, there can be no assurance that the estimates and assumptions management used for purposes of its assessment as of December 31, 2023 will prove to be accurate predictions of future performance.

For its long-lived assets and definite-lived intangible assets, the Company reviews for impairment whenever events or changes in circumstances indicate the carrying amount may not be recoverable. The Company wrote off certain IT projects and recorded immaterial impairment charges during the year ended December 31, 2023, and impairment charges of $1.9 million during the year ended December 31, 2022.