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Consolidated Statements of Cash Flows - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020
CASH FLOWS FROM OPERATING ACTIVITIES: |  |  |
Net Income | $ (74,286) | $ 103,135 | $ 86,870
Depreciation and amortization | 235,151 | 89,698 | 85,631
Amortization of Inventory Step-up | 26,519 | 0 | 0
Operating Lease, Right-of-Use Asset, Amortization Expense | 23,651 | 9,594 | 9,216
Provision for doubtful accounts | 1,036 | 345 | 7,137
Provision for warranty and returns | 4,902 | 831 | (1,576)
Stock compensation | 36,025 | 27,341 | 23,954
Gain (Loss) on Disposition of Property Plant Equipment | 2,010 | 1,652 | (1,789)
Gain (Loss) on Disposition of Business | 374 | 0 | 0
Bond premium amortization | 264 | 655 | 231
Debt issuance cost amortization | 6,972 | 240 | 288
Change in fair value of contingent earn-out | (32,091) | 0 | 9,000
Production Related Impairments or Charges | 0 | 3,380 | 2,626
Sparepartsusage | 11,924 | 13,046 | 11,191
Other | (103) | 2,582 | 6,939
Increase (Decrease) in Accounts Receivable | (19,151) | 13,755 | 78,049
Increase (Decrease) in Inventories | (201,095) | 20,815 | 19,196
Increase (Decrease) in Prepaid Expense and Other Assets | 22,903 | (7,973) | (4,311)
Increase (Decrease) in Other Operating Assets | (21,290) | (21,038) | (16,069)
Accounts payable | 37,472 | 2,347 | (46,415)
Accrued liabilities | (55,834) | 6,259 | (29,379)
Income taxes, including excess tax benefits and deferred income taxes | (66,734) | 874 | (18,037)
Net cash provided by operating activities | (62,129) | 267,538 | 222,752
CASH FLOWS FROM INVESTING ACTIVITIES: |  |  |
Purchases of property and equipment | (90,311) | (68,542) | (92,005)
Proceeds from Sale of Other Property, Plant, and Equipment | 989 | 218 | 6,176
Intangible asset additions | (9,018) | (12,627) | (8,385)
Business acquisitions, net of cash acquired | (1,844,164) | (14,452) | 0
Payments to Acquire Equity Method Investments | 0 | (3,250) | 0
Purchases of investment securities | (3,397) | (10,034) | (32,825)
Proceeds from sale of investment securities | 36,433 | 18,000 | 28,900
Net cash (used in) provided by investing activities | (1,909,468) | (90,687) | (98,139)
CASH FLOWS FROM FINANCING ACTIVITIES: |  |  |
Proceeds from issuance of long-term debt, net of lender debt issuance costs | 1,664,362 | 0 | 0
Repayments of Long-term obligations | (22,375) | 0 | 0
Payments of Debt Issuance Costs | (2,177) | 0 | 0
Proceeds from Long-term Lines of Credit | 0 | 0 | 150,000
Repayments of Short-Term Debt | 0 | 0 | 150,000
Proceeds from exercise of stock options | 8,785 | 9,372 | 13,193
Finance Lease, Principal Payments | (680) | (607) | (357)
Payment for Contingent Consideration Liability, Financing Activities | 0 | (17,300) | 0
Purchase of treasury stock | (10,883) | (8,335) | (12,876)
Net cash (used in) provided by financing activities | 1,637,032 | (16,870) | (40)
Effect of Exchange Rate on Cash [Abstract] |  |  |
Effect of Exchange Rate on Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Continuing Operations | (9,478) | (3,251) | 2,854
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents, Period Increase (Decrease), Including Exchange Rate Effect, Total | (344,043) | 156,730 | 127,427
Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents | 208,784 | 552,827 | 396,097
SUPPLEMENTAL DISCLSOURE OF CASH FLOW INFORMATION |  |  |
Cash paid during the year for income taxes | 27,504 | 19,562 | 31,628
Interest Paid, Excluding Capitalized Interest, Operating Activities | 63,713 | 858 | 1,753
SUPPLEMENTAL DISCLOSURE OF NON-CASH INVESTING ACTIVITIES |  |  |
Accounts payable for property and equipment | 4,854 | 9,338 | 2,211
Business Combination, Consideration Transferred, Equity Interests Issued and Issuable |  | 0 |
Smiths Medical |  |  |
SUPPLEMENTAL DISCLOSURE OF NON-CASH INVESTING ACTIVITIES |  |  |
Fair value of assets acquired | 1,606,300 |  |
Cash paid for acquisitions, net of cash acquired | (1,844,164) |  |
Business Combination, Consideration Transferred, Equity Interests Issued and Issuable | (575,975) |  |
Contingent consideration | (55,158) |  |
Goodwill, Period Increase (Decrease) | 1,462,752 |  |
Liabilities Assumed | 593,755 |  |
International Distributor |  |  |
SUPPLEMENTAL DISCLOSURE OF NON-CASH INVESTING ACTIVITIES |  |  |
Noncash Non-compete agreement with associated contingent earn-out liability | $ 0 | 2,589 | $ 0
Foreign Infusion System Supplier |  |  |
SUPPLEMENTAL DISCLOSURE OF NON-CASH INVESTING ACTIVITIES |  |  |
Fair value of assets acquired |  | 4,592 |
Cash paid for acquisitions, net of cash acquired |  | (14,452) |
Contingent consideration |  | 0 |
Goodwill, Period Increase (Decrease) |  | 10,626 |
Liabilities Assumed |  | $ 766 |

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