Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
CASH FLOWS FROM OPERATING ACTIVITIES:
Net Income	$ 101,035	$ 28,793	$ 68,644
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	76,916	74,735	66,569
Operatingleaserightofuseassetamortization	8,294	0	0
Provision for doubtful accounts	14,882	781	2,308
Provision for warranty and returns	(134)	5,353	845
Stock compensation	21,918	24,241	19,352
Loss (gain) on disposal of property and equipment	12,872	8,867	3,778
Productrationalization	0	12,696	0
Impairment of Intangible Assets, Finite-lived	0	5,000	0
Bond premium amortization	135	342	103
Debt issuance cost amortization	288	288	48
Impairment of assets held for sale	0	269
Impairment of assets held for sale			0
Bargain Purchase Gain	0	0	(70,890)
Change in fair value of contingent earn-out	(47,400)	20,400	8,000
Sparepartsusage	24,301	7,310	4,820
Other	447	3,856	(220)
Changes in operating assets and liabilities
Accounts receivable	(23,684)	(76,742)	(54,533)
Inventories	(24,997)	(21,770)	181,699
Prepaid expenses and other assets	8,588	3,719	(29,652)
Increase (Decrease) in Due from Related Parties, Current	0	97,443	(95,309)
Increase (Decrease) in Other Operating Assets	(29,837)	(9,086)	(6,975)
Accounts payable	(2,697)	23,270	46,648
Accrued liabilities	(43,689)	(29,553)	33,813
Income taxes, including excess tax benefits and deferred income taxes	4,680	(19,997)	(24,625)
Net cash provided by operating activities	101,918	160,215	154,423
CASH FLOWS FROM INVESTING ACTIVITIES:
Purchases of property and equipment	(97,312)	(92,720)	(74,479)
Proceeds from sale of assets	33	765	2
Proceeds from the disposal of assets held for sale	0	13,000	0
Intangible asset additions	(8,728)	(8,059)	(5,203)
Business acquisitions, net of cash acquired	(76,133)	(1,300)	(162,448)
Purchases of investment securities	(26,040)	(30,496)	(24,743)
Proceeds from sale of investment securities	41,292	15,440	0
Net cash (used in) provided by investing activities	(166,888)	(103,370)	(266,871)
CASH FLOWS FROM FINANCING ACTIVITIES:
Repayments of Long-term obligations	0	0	(75,000)
Proceeds from exercise of stock options	7,732	14,275	32,003
Proceeds from employee stock purchase plan	0	0	2,705
Purchase of treasury stock	(18,639)	(6,252)	(4,057)
Net cash (used in) provided by financing activities	(10,907)	8,023	(44,349)
Effect of exchange rate changes on cash	(234)	(10,159)	1,787
NET (DECREASE) INCREASE IN CASH AND CASH EQUIVALENTS	(76,111)	54,709	(155,010)
CASH AND CASH EQUIVALENTS, beginning of period	344,781	290,072	445,082
CASH AND CASH EQUIVALENTS, end of period	268,670	344,781	290,072
SUPPLEMENTAL DISCLSOURE OF CASH FLOW INFORMATION
Cash paid during the year for income taxes	9,675	12,598	5,109
Interest Paid, Excluding Capitalized Interest, Operating Activities	549	709	2,047
SUPPLEMENTAL DISCLOSURE OF NON-CASH INVESTING ACTIVITIES
Accounts payable for property and equipment	13,912	26,522	5,376
Fair value of assets acquired	91,019		886,569
Cash paid for acquisitions, net of cash acquired	(76,133)		(162,448)
Proceeds from Issuance of Debt			(75,000)
Estimated working capital adjustment	0		4,253
Contingent consideration	(17,300)		(19,000)
Issuance of common stock for acquisitions	0		(413,139)
Bargain Purchase Gain	0	0	(70,890)
Goodwill, Acquired During Period	20,026	$ 1,300	6,536
Liabilities Assumed	$ (17,612)		(156,881)
Hospira [Member]
Adjustments to reconcile net income to net cash provided by operating activities:
Bargain Purchase Gain			(70,890)
SUPPLEMENTAL DISCLOSURE OF NON-CASH INVESTING ACTIVITIES
Proceeds from Issuance of Debt			(75,000)
Contingent consideration			(19,000)
Issuance of common stock for acquisitions			(413,139)
Bargain Purchase Gain			$ (70,890)