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Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Operating Activities      
Net income $ 101,928 $ 80,245 $ 57,804
Adjustments to reconcile net income to cash provided by operating activities:      
Provision for doubtful accounts 424 506 860
Depreciation - PP&E 23,673 21,229 19,264
Depreciation - Rental 7,739 8,613 9,830
Amortization of intangibles 15,277 14,637 14,746
Amortization of debt issuance 667 667 634
Stock-based compensation expense 5,561 5,987 4,119
Provision for deferred income tax (benefit) expense (2,337) (1,182) (855)
Gain on sale of property, plant and equipment (161) (3,779) (1,094)
Changes in operating assets and liabilities, net of acquisitions:      
       Accounts receivable (85,055) (27,571) 28,064
Inventories (37,739) (78,463) 38,275
Rental equipment (9,196) 1,138 4,542
Prepaid expenses and other (6,146) (6,994) 6,373
Trade accounts payable and accrued liabilities (2,879) 32,532 (3,783)
Income taxes payable 2,934 4,648 6,601
Long term tax payable (635) 462 (3,478)
Other assets and liabilities, net 475 (3,008) 2,431
Net cash provided by operating activities 14,530 49,667 184,333
Investing Activities      
Acquisitions, net of cash acquired (2,000) (17,798) 0
Purchase of property, plant and equipment (31,141) (25,263) (17,874)
Proceeds from sale of property, plant and equipment 1,566 9,667 3,703
Purchase of patents (163) (44) 0
Net cash used in investing activities (31,738) (33,438) (14,171)
Financing Activities      
Borrowings on bank revolving credit facility 222,000 188,000 115,000
Repayment on bank revolving credit facility (174,000) (189,000) (255,000)
Principal payments on long-term debt and capital leases (15,031) (15,093) (18,867)
Dividends paid (8,549) (6,627) (6,124)
Proceeds from exercise of stock options 803 1,676 1,459
Common stock repurchased (768) (1,957) (710)
Net cash provided (used) in financing activities 24,455 (23,001) (164,242)
Effect of exchange rate changes on cash (2,346) (1,308) 1,964
Net change in cash and cash equivalents 4,901 (8,080) 7,884
Cash and cash equivalents at beginning of the year 42,115 50,195 42,311
Cash and cash equivalents at end of the year 47,016 42,115 50,195
Cash paid during the year for:      
Interest 14,575 10,248 17,049
Income taxes $ 35,102 $ 32,865 $ 17,140