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Consolidated Statements Of Cash Flows - USD ($)
$ in Thousands
 12 Months Ended
Sep. 27, 2019
Sep. 28, 2018
Sep. 29, 2017
Cash flows from operating activities:      
Net income $ 448,466 $ 568,440 $ 374,187
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 592,573 596,182 508,212
Deferred income taxes 40,503 (104,289) (37,856)
Share-based compensation expense 55,280 88,276 65,155
Net gain on sale of Healthcare Technologies (139,165) 0 0
Changes in operating assets and liabilities:      
Accounts Receivable (78,771) (45,891) (111,423)
Inventories (49,732) (40,187) (21,147)
Prepayments and Other Current Assets (37,854) 42,450 95,536
Accounts Payable 17,680 26,658 93,965
Accrued Expenses 193,532 (111,386) 26,804
Payments made to clients on contracts (see Note 7) (40,073) 0 0
Changes in other noncurrent liabilities 18,904 1,576 31,959
Changes in other assets (41,436) (2,225) (9,342)
Other operating activities 4,320 32,271 36,776
Net cash provided by operating activities 984,227 1,051,875 1,052,826
Cash flows from investing activities:      
Purchases of property and equipment and other (503,090) (628,604) (552,729)
Disposals of property and equipment 17,871 10,491 18,906
Proceeds from divestitures 293,711 0 0
Acquisition of certain businesses, net of cash acquired      
Working capital other than cash acquired 10,634 37,985 8,114
Property and equipment (3,320) (283,447) (2,273)
Additions to goodwill, other intangible assets and other assets, net (52,177) (1,994,822) (147,963)
Proceeds from governmental agencies related to property and equipment 23,025 0 0
Other investing activities 3,825 (6,879) (2,539)
Net cash used in investing activities (209,521) (2,865,276) (678,484)
Cash flows from financing activities:      
Proceeds from long-term borrowings 77,630 3,177,313 3,851,417
Payments of long-term borrowings (654,560) (973,689) (3,911,992)
Net change in funding under the Receivables Facility 0 (254,200) (13,800)
Payments of dividends (108,439) (103,115) (100,813)
Proceeds from issuance of common stock 39,087 21,507 28,779
Repurchase of common stock (50,000) (24,410) (100,000)
Other financing activities (38,610) (49,253) (42,277)
Net cash provided by (used in) financing activities (734,892) 1,794,153 (288,686)
Effect of foreign exchange rates on cash and cash equivalents (8,196) (4,524) 561
Increase (decrease) in cash and cash equivalents 31,618 (23,772) 86,217
Cash and cash equivalents, beginning of period 215,025 238,797 152,580
Cash and cash equivalents, end of period $ 246,643 $ 215,025 $ 238,797