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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 9 Months Ended
--- | ---
Sep. 30, 2019 | Sep. 30, 2018
OPERATING ACTIVITIES: |  |
Net loss | $ 34,882 | $ 35,663
Adjustments to reconcile net income to net cash provided by operating activities: |  |
Depreciation and amortization | 81,584 | 83,053
Non-cash in-process research and development expense | 59,889 | 0
Non-cash impairment charges | 5,764 | 4,941
Deferred income tax | (10,536) | 789
Amortization of debt issuance costs | 4,084 | 4,953
Loss on disposal of property and equipment | 844 | 969
Change in fair value of contingent consideration and other | 10 | 1,214
Share-based compensation | 15,744 | 15,786
Changes in assets and liabilities, net of business acquisitions: |  |
Accounts receivable | (17,519) | 1,180
Inventories | (30,553) | (3,441)
Prepaid expenses and other current assets | (8,162) | 3,432
Other non-current assets | 6,650 | (1,397)
Accounts payable, accrued expenses and other current liabilities | 366 | 9,418
Contract liabilities | (1,395) | (111)
Other non-current liabilities | 597 | 546
Net cash provided by operating activities | 142,249 | 156,995
INVESTING ACTIVITIES: |  |
Purchases of property and equipment | (47,343) | (52,056)
Proceeds from note receivable | 752 | 679
Proceeds from sale of property and equipment | 36 | 298
Cash (paid) provided for business acquisitions, net of cash acquired | (30,509) | 26,704
Acquired in-process research and development | (64,995) | 0
Net cash used in investing activities | (142,059) | (24,375)
FINANCING ACTIVITIES: |  |
Proceeds from borrowings of long-term indebtedness | 215,800 | 50,000
Payments on debt | (143,250) | (460,000)
Payment of debt issuance costs | 0 | (4,388)
Proceeds from the issuance of common stock, net of issuance costs | 0 | 349,590
Net cash paid for financing liabilities from business acquisitions | 0 | (33,843)
Proceeds from exercised stock options | 6,948 | 9,239
Cash taxes paid in net equity settlement | (6,272) | (7,415)
Net cash (used in) / provided by financing activities | 73,226 | (96,817)
Effect of exchange rate changes on cash and cash equivalents | (4,273) | (4,747)
Net increase in cash and cash equivalents | 69,143 | 31,056
Cash and cash equivalents at beginning of period | 138,838 | 174,935
Cash and cash equivalents at end of period | $ 207,981 | $ 205,991

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- Definition The cash inflow from the additional capital contribution to the 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 14 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3255-108585 + Details
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- Definition The cash inflow from amounts received from issuance of long-term debt that is wholly or partially secured by collateral. Excludes proceeds from tax exempt secured debt. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 14 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3255-108585 + Details
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- Definition The cash inflow from the sale of long-lived, physical assets that are used in the normal conduct of business to produce goods and services and not intended for resale. + 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 (c) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3179-108585 + Details
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- Definition Amount of cash inflow from exercise of option under share-based payment arrangement. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2A -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=116856206&loc=SL79508275-113901 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 14 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3255-108585 + Details
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- Definition The cash outflow to repay long-term debt that is wholly or partially secured by collateral. Excludes repayments of tax exempt secured debt. + 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 (b) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3291-108585 + Details
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- Definition Amount of noncash expense for share-based payment arrangement. + 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=118932676&loc=d3e3602-108585 + Details
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