Condensed Consolidated Statements Of Cash Flows - USD ($) $ in Thousands		9 Months Ended
		Sep. 30, 2019	Sep. 30, 2018
Cash flows - operating activities:
Net income including noncontrolling interests		$ 238,216	$ 205,611
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization		32,412	28,685
Amortization of identifiable intangible assets		34,500	31,482
Provision for doubtful accounts		1,621	261
Deferred income taxes		(913)	4,685
Excess tax benefits from share-based compensation		(601)	(1,065)
Equity loss (income) from unconsolidated entities		1,213	(247)
Non-cash expense from contingent consideration arrangements		1,203	186
Non-cash expense for impairment of identifiable intangible assets		0	907
Non-cash share-based compensation expense		8,840	8,502
Distributions from unconsolidated entities		916	2,442
Other reconciling items		364	446
Changes in operating assets and liabilities, excluding the effect of businesses acquired		(140,850)	(216,003)
Net cash provided by operating activities		176,921	65,892
Cash flows - investing activities:
Payments for acquisitions of businesses, net of cash acquired		(79,984)	(25,710)
Proceeds from sale of property, plant and equipment		1,612	915
Purchase of property, plant and equipment		(35,829)	(28,674)
Investments in and advances to unconsolidated entities		(794)	(3,484)
Distributions from unconsolidated entities		38	82
Net cash used in investing activities		(114,957)	(56,871)
Cash flows - financing activities:
Repayments of revolving credit facility		(25,000)	0
Repayments of long-term debt and debt issuance costs		(11,400)	(11,434)
Repayments of finance lease liabilities		(3,357)	(1,050)
Dividends paid to stockholders		(13,458)	(14,036)
Repurchase of common stock		0	(90,804)
Taxes paid related to net share settlements of equity awards		(3,771)	(3,745)
Issuance of common stock under employee stock purchase plan		4,501	4,286
Payments for contingent consideration arrangements		(3,589)	(3,300)
Distributions to noncontrolling interests		(250)	0
Net cash used in financing activities		(56,324)	(120,083)
Effect of exchange rate changes on cash, cash equivalents and restricted cash		(2,047)	(1,985)
Increase (decrease) in cash, cash equivalents and restricted cash		3,593	(113,047)
Cash, cash equivalents and restricted cash at beginning of year (1)	[1]	366,214	469,388
Cash, cash equivalents and restricted cash at end of period (2)	[2]	369,807	356,341
Cash paid for:
Interest		9,891	9,078
Income taxes		$ 94,514	$ 95,330

[1] Includes $2.3 million and $2.0 million of restricted cash classified as “Prepaid expenses and other” in the Consolidated Balance Sheets as of December 31, 2018 and 2017, respectively.

[2] Includes $1.7 million and $2.4 million of restricted cash classified as “Prepaid expenses and other” in the Consolidated Balance Sheets as of September 30, 2019 and 2018, respectively.