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Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2019
Dec. 31, 2018
Dec. 31, 2017
Operating Activities      
Net income $ 62,906 $ 73,486 $ 44,315
Adjustments to reconcile net income to cash provided by     operating activities:      
Provision for doubtful accounts 575 71 187
Depreciation - PP&E 14,934 12,884 11,616
Depreciation - Rental 9,373 6,725 5,531
Amortization of intangibles 5,658 3,505 3,317
Amortization of debt issuance 295 221 203
Stock-based compensation expense 3,269 2,450 1,869
Provision for deferred income tax expense 3,316 2,052 1,328
Gain on sale of property, plant and equipment (912) (361) (341)
Changes in operating assets and liabilities, net of acquisitions:      
       Accounts receivable 11,447 (27,029) (23,134)
Inventories 657 (25,991) 142
Rental equipment (20,729) (22,424) (3,054)
Prepaid expenses and other (4,633) (583) 2,845
Trade accounts payable and accrued liabilities 6,397 4,130 11,688
Income taxes payable (4,861) (10,332) 2,357
Long term tax payable (1,082) (6,196) 12,478
Other assets and liabilities, net 2,203 302 (543)
Net cash provided by operating activities 88,813 12,910 70,804
Investing Activities      
Acquisitions, net of cash acquired (400,784) 0 (38,553)
Purchase of property, plant and equipment (31,337) (26,587) (13,490)
Proceeds from sale of property, plant and equipment 2,277 1,341 767
Purchase of patents (96) (112) 0
Net cash used in investing activities (429,940) (25,358) (51,276)
Financing Activities      
Borrowings on bank revolving credit facility 217,000 159,000 143,000
Repayment on bank revolving credit facility (157,000) (134,000) (153,000)
Principal payments on long-term debt and capital leases (122) 216 (17)
Proceeds from issuance of long-term debt 300,002 0 0
Debt issuance cost (2,875) 0 0
Dividends paid (5,626) (5,124) (4,614)
Proceeds from exercise of stock options 2,573 2,552 2,397
Treasury stock repurchased (4,140) 0 0
Common stock repurchased (589) (436) (166)
Net cash provided (used in) in financing activities 349,223 22,208 (12,400)
Effect of exchange rate changes on cash 172 (1,090) 1,452
Net change in cash and cash equivalents 8,268 8,670 8,580
Cash and cash equivalents at beginning of the year 34,043 25,373 16,793
Cash and cash equivalents at end of the year 42,311 34,043 25,373
Cash paid during the year for:      
Interest 9,455 5,199 5,217
Income taxes $ 23,099 $ 30,295 $ 23,175