CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$ 12,615	$ 17,393
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	31,594	27,745
Losses on sales and/or abandonment of property and equipment	102	121
Write-off of patents and intangible assets	90	99
Acquired in-process research and development	400	1,000
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration, Liability	99	0
Amortization of deferred credits	(128)	(129)
Amortization of long-term debt issuance costs	779	741
Deferred income taxes	187	956
Excess tax benefits from stock-based compensation	(527)	(1,972)
Stock-based compensation expense	1,913	1,643
Changes in operating assets and liabilities, net of effects from acquisitions:
Trade receivables	(5,166)	(3,524)
Employee receivables	42	(37)
Other receivables	3,385	776
Inventories	220	(7,432)
Prepaid expenses	(452)	(499)
Prepaid income taxes	(63)	(43)
Income tax refund receivables	514	(218)
Other assets	(1,591)	(776)
Trade payables	(9,018)	9,738
Accrued expenses	1,693	7,017
Advances from employees	(50)	164
Income taxes payable	(183)	4,046
Liabilities related to unrecognized tax benefits	(366)	(704)
Deferred compensation payable	500	298
Other long-term obligations	(251)	602
Total adjustments	23,723	39,612
Net cash provided by operating activities	36,338	57,005
Capital expenditures for:
Property and equipment	(26,492)	(39,501)
Intangible assets	(1,594)	(1,385)
Proceeds from sale-leaseback transactions	0	2,017
Proceeds from the sale of property and equipment	5	42
Proceeds from sale of cost method investment	1,089	0
Cash paid in acquisitions, net of cash acquired	(119,808)	(11,868)
Net cash used in investing activities	(146,800)	(50,695)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from issuance of common stock	4,422	5,924
Proceeds from issuance of long-term debt	203,478	109,905
Payments on long-term debt	(82,658)	(124,177)
Excess tax benefits from stock-based compensation	527	1,972
Long-term debt issuance costs	1,948	0
Contingent payments related to acquisitions	(199)	(194)
Payment of taxes related to an exchange of common stock	(86)	(918)
Net cash provided by (used in) financing activities	123,536	(7,488)
EFFECT OF EXCHANGE RATES ON CASH	67	(318)
NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS	13,141	(1,496)
CASH AND CASH EQUIVALENTS:
Beginning of period	4,177	7,355
End of period	17,318	5,859
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION
Interest (net of capitalized interest of $337 and $256, respectively)	6,223	4,713
Income taxes	2,237	2,905
Property and equipment purchases in accounts payable	2,709	2,321
Cost method investment converted to intangible asset in acquisition in lieu of additional cash payment	0	1,010
Contingent receivable received in exchange for sale of cost method investment	711	0
Acquisition purchases in accrued expenses and other long-term obligations	293	1,300
Merit common stock surrendered (14 and 185 shares, respectively) in exchange for exercise of stock options	$ 346	$ 3,802