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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) | 12 Months Ended
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Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Cash flows from operating activities of continuing operations: |  |  |
Net income | $ 200,802,000 | $ 152,530,000 | $ 237,841,000
Adjustments to reconcile net income to net cash provided by operating activities: |  |  |
(Income) loss from discontinued operations | (4,370,000) | 2,733,000 | (190,000)
Depreciation expense | 60,494,000 | 56,497,000 | 54,415,000
Amortization expense of intangible assets | 149,486,000 | 98,766,000 | 63,491,000
Amortization expense of deferred financing costs and debt discount | 4,734,000 | 5,075,000 | 10,440,000
Loss on extinguishment of debt | 0 | 5,593,000 | 19,261,000
Fair value step up of acquired inventory sold | 0 | 10,442,000 | 0
Changes in contingent consideration | 52,977,000 | 3,575,000 | (6,445,000)
Impairment of long-lived assets | 19,110,000 | 0 | 2,356,000
In-process research and development impairment charge | 0 | 0 | 41,000,000
Stock-based compensation | 22,438,000 | 19,407,000 | 16,871,000
Net gain on sales of businesses and assets | (1,388,000) | 0 | (4,367,000)
Deferred income taxes, net | (6,097,000) | (41,822,000) | (29,346,000)
Other | (18,803,000) | (18,469,000) | (13,311,000)
Changes in operating assets and liabilities, net of effects of acquisitions and disposals: |  |  |
Accounts receivable | (23,412,000) | (11,039,000) | (11,029,000)
Inventories | (37,198,000) | (22,363,000) | 6,408,000
Prepaid expenses and other current assets | (10,351,000) | 547,000 | (3,613,000)
Accounts payable, accrued expenses and other liabilities | 62,404,000 | 39,001,000 | 15,422,000
Income taxes receivable and payable, net | (35,740,000) | 125,828,000 | 11,386,000
Net cash provided by operating activities from continuing operations | 435,086,000 | 426,301,000 | 410,590,000
Cash flows from investing activities of continuing operations: |  |  |
Expenditures for property, plant and equipment | (80,795,000) | (70,903,000) | (53,135,000)
Payments for businesses and intangibles acquired, net of cash acquired | (121,025,000) | (1,768,284,000) | (14,040,000)
Proceeds from sales of businesses and assets | 3,878,000 | 6,332,000 | 10,201,000
Net interest proceeds on swaps designated as net investment hedges | 1,548,000 | 0 | 0
Net cash used in investing activities from continuing operations | (196,394,000) | (1,832,855,000) | (56,974,000)
Cash flows from financing activities of continuing operations: |  |  |
Proceeds from new borrowings | 35,000,000 | 2,463,500,000 | 671,700,000
Reduction in borrowings | (128,500,000) | (1,239,576,000) | (714,565,000)
Debt extinguishment, issuance and amendment fees | (188,000) | (26,664,000) | (8,958,000)
Proceeds from share based compensation plans and the related tax impacts | 22,655,000 | 5,571,000 | 9,068,000
Payments to noncontrolling interest shareholders | 0 |  | (464,000)
Payments for acquisition of noncontrolling interest | 0 | 0 | (9,231,000)
Payments for contingent consideration | (73,235,000) | (335,000) | (7,282,000)
Dividends | (62,165,000) | (61,237,000) | (58,960,000)
Net cash (used in) provided by financing activities from continuing operations | (206,433,000) | 1,141,259,000 | (118,692,000)
Cash flows from discontinued operations: |  |  |
Net cash provided by (used in) operating activities | 2,292,000 | (6,416,000) | (2,110,000)
Net cash provided by (used in) discontinued operations | 2,292,000 | (6,416,000) | (2,110,000)
Effect of exchange rate changes on cash and cash equivalents | (10,948,000) | 61,480,000 | (27,391,000)
Net increase (decrease) in cash and cash equivalents | 23,603,000 | (210,231,000) | 205,423,000
Cash and cash equivalents at the beginning of the year | 333,558,000 | 543,789,000 | 338,366,000
Cash and cash equivalents at the end of the year | 357,161,000 | 333,558,000 | 543,789,000
Supplemental cash flow information: |  |  |
Cash interest paid | 101,790,000 | 74,256,000 | 44,203,000
Income taxes paid, net of refunds | 65,605,000 | 49,144,000 | 23,955,000
Non cash investing and financing activities of continuing operations: |  |  |
Property, plant and equipment additions due to build-to-suit lease transactions | 29,448,000 | 0 | 0
Purchases of businesses and related costs | 54,696,000 | 261,733,000 | 0
Settlement and exchange of convertible notes with common or treasury stock | 0 | 53,207,000 | 35,286,000
Acquisition of treasury stock from settlement and exchange of convertible note hedge and warrants | $ 56,075,000 | $ 141,405,000 | $ 86,046,000

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- Definition Amount of increase (decrease) in prepaid expenses, and assets classified as other. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3602-108585 + Details
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- Definition Amount of cash paid for interest, excluding capitalized interest, classified as operating activity. Includes, but is not limited to, payment to settle zero-coupon bond for accreted interest of debt discount and debt instrument with insignificant coupon interest rate in relation to effective interest rate of borrowing attributable to accreted interest of debt discount. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 50 -Paragraph 2 -URI http://asc.fasb.org/extlink&oid=98513485&loc=d3e4297-108586 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 17 -Subparagraph (d) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3367-108585 Reference 3: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 25 -Subparagraph (e) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3536-108585 + Details
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- Definition Amount of cash inflow (outflow) of financing activities, excluding discontinued operations. Financing activity cash flows include obtaining resources from owners and providing them with a return on, and a return of, their investment; borrowing money and repaying amounts borrowed, or settling the obligation; and obtaining and paying for other resources obtained from creditors on long-term credit. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 24 -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3521-108585 + Details
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- Definition Amount of cash inflow (outflow) of investing activities, excluding discontinued operations. Investing activity cash flows include making and collecting loans and acquiring and disposing of debt or equity instruments and property, plant, and equipment and other productive assets. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 24 -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3521-108585 + Details
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- Definition Amount of cash outflow in the form of ordinary dividends to common shareholders of the parent entity. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3291-108585 + Details
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- Definition The cash outflow for loan and debt issuance costs. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3291-108585 + Details
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- Definition The cash outflow associated with the purchase of noncontrolling interest during the period. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 13 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3213-108585 + Details
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- Definition The cash outflow associated with the acquisition of long-lived, physical assets that are used in the normal conduct of business to produce goods and services and not intended for resale; includes cash outflows to pay for construction of self-constructed assets. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 13 -Subparagraph (c) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3213-108585 + Details
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- Definition Amount of cash outflow to a noncontrolling interest. Includes, but not limited to, reduction of noncontrolling interest ownership. Excludes dividends paid to the noncontrolling interest. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3291-108585 + Details
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- Definition The cash inflow associated with the amount received from the sale of a portion of the company's business, for example a segment, division, branch or other business, during the period. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 12 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3179-108585 + Details
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- Definition The cash inflow for a financial contract that meets the hedge criteria as either a cash flow hedge, fair value hedge, or hedge of a net investment in a foreign operation. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 27 -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3581-108585 Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 12 -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3179-108585 + Details
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