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Condensed Consolidated Statements Of Cash Flows - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2021
Mar. 31, 2020
Net income including noncontrolling interests $ 84,945 $ 75,665
Adjustments to reconcile net income to net cash used in operating activities:    
Depreciation and amortization 12,001 11,767
Amortization of identifiable intangible assets 14,989 14,747
Provision for credit losses 507 2,614
Deferred income taxes 14 4,375
Non-cash share-based compensation expense 3,193 3,291
Other reconciling items (739) 42
Changes in operating assets and liabilities, excluding the effect of businesses acquired (203,899) (191,314)
Net cash used in operating activities (88,989) (78,813)
Cash flows - investing activities:    
Payments for acquisitions of businesses, net of cash acquired (24,326) (2,582)
Proceeds from sale or disposal of property, plant and equipment 766 196
Purchases of property, plant and equipment (8,204) (12,035)
Net cash used in investing activities (31,764) (14,421)
Cash flows - financing activities:    
Proceeds from revolving credit facility 0 200,000
Repayments of revolving credit facility 0 (50,000)
Proceeds from long-term debt 0 300,000
Repayments of long-term debt and debt issuance costs 0 (257,549)
Repayments of finance lease liabilities (1,145) (1,277)
Dividends paid to stockholders (7,121) (4,500)
Repurchases of common stock (12,917) (99,048)
Taxes paid related to net share settlements of equity awards (3,750) (2,492)
Issuances of common stock under employee stock purchase plan 1,731 1,638
Payments for contingent consideration arrangements (693) (653)
Distributions to noncontrolling interests (43) 0
Net cash (used in) provided by financing activities (23,938) 86,119
Effect of exchange rate changes on cash, cash equivalents, and restricted cash 886 (4,678)
Decrease in cash, cash equivalents, and restricted cash (143,805) (11,793)
Cash, cash equivalents, and restricted cash at beginning of year (1) [1] 903,562 359,920
Cash, cash equivalents, and restricted cash at end of period (2) [2] $ 759,757 $ 348,127
[1] Includes $0.7 million and $1.1 million of restricted cash classified as “Prepaid expenses and other” in the Consolidated Balance Sheets as of December 31, 2020 and 2019, respectively.
[2] Includes $0.9 million and $1.0 million of restricted cash classified as “Prepaid expenses and other” in the Consolidated Balance Sheets as of March 31, 2021 and 2020, respectively.