Financial instruments

Foreign Currency Forward Contracts Designated as Cash Flow Hedges

The Company uses derivative instruments for risk management purposes. Foreign currency forward contracts are used to manage foreign currency transaction exposure. These derivative instruments are designated as cash flow hedges and are recorded on the balance sheet at fair market value. The effective portion of the gains or losses on derivatives is reported as a component of other comprehensive income (loss) and thereafter is recognized in the consolidated statement of income in the period or periods during which the hedged transaction affects earnings. Gains and losses on derivative instruments representing hedge ineffectiveness or hedge components excluded from the assessment of effectiveness, if any, are recognized in the consolidated statement of income in the period in which such gains and losses occur.

The following table presents the location and fair value of derivative instruments designated as hedging instruments in the consolidated balance sheet as of December 31, 2015 and 2014:



	December 31, 2015		December 31, 2014
	Fair Value
	(Dollars in thousands)
Asset derivatives:
Foreign currency forward contracts
Prepaid expenses and other current assets	$	285	$	—
Total asset derivatives	$	285	$	—
Liability derivatives:
Foreign currency forward contracts
Other current liabilities	$	807	$	—
Total liability derivatives	$	807	$	—

The total notional amount for all open foreign currency forward contracts designated as cash flow hedges as of December 31, 2015 is $49.5 million. All open foreign currency forward contracts designated as cash flow hedges as of December 31, 2015 have durations of six months or less. As of December 31, 2014, the Company had no open foreign currency forward contracts designated as cash flow hedges.

The following table provides information as to the gains and losses attributable to derivatives in cash flow hedging relationships that were reported in other comprehensive income (loss) (“OCI”) for the years ended December 31, 2015, 2014 and 2013:



	After Tax Gain (Loss) Recognized in OCI
	2015			2014		2013
	(Dollars in thousands)
Foreign currency exchange contracts	$	(2,491	)	$	—	$	381
Total	$	(2,491	)	$	—	$	381

See Note 11 to the consolidated financial statements for information on the location and amount of gains and losses attributable to derivatives that were reclassified from accumulated other comprehensive income (loss) (“AOCI”) to expense (income), net of tax.

For the years ended December 31, 2015, 2014 and 2013, there was no ineffectiveness related to the Company’s hedging derivatives.

Non-designated Foreign Currency Forward Contracts

During the third quarter 2015, the Company began using foreign currency forward contracts to manage exposure related to near term foreign currency denominated monetary assets and liabilities. These currency forward contracts are not designated as cash flow, fair value or net investment hedges, are marked-to-market (changes in fair value are reflected in selling, general and administrative expenses) and are entered into for periods consistent with currency transaction exposures, approximately one month. The total notional amount for all open non-designated foreign currency forward contracts as of December 31, 2015 is $69.1 million. The non-designated foreign currency forward contract assets and liabilities are reported in prepaid expenses and other current assets and in other current liabilities on the consolidated balance sheet as of December 31, 2015. For the year ended December 31, 2015 the Company recognized a loss related to non-designated foreign currency forward contracts of $1.5 million.

Concentration of Credit Risk

Concentrations of credit risk with respect to trade accounts receivable is generally limited due to the Company’s large number of customers and their diversity across many geographic areas. A portion of the Company’s trade accounts receivable outside the United States, however, include sales to government-owned or supported healthcare systems in several countries which are subject to payment delays. Payment is dependent upon the creditworthiness of the healthcare systems in those countries and the financial stability of their economies.

In the ordinary course of business, the Company grants non-interest bearing trade credit to its customers on normal credit terms. In an effort to reduce its credit risk, the Company (i) establishes credit limits for all of its customer relationships, (ii) performs ongoing credit evaluations of its customers’ financial condition, (iii) monitors the payment history and aging of its customers’ receivables, and (iv) monitors open orders against an individual customer’s outstanding receivable balance.

An allowance for doubtful accounts is maintained for accounts receivable based on the expected collectability of the accounts receivable, considering the Company's historical collection experience with respect to the customer, the length of time an account is outstanding, the financial position of the customer and information provided by credit rating services. The adequacy of this allowance is reviewed each reporting period and adjusted as necessary. The allowance for doubtful accounts was $8.0 million and $8.8 million at December 31, 2015 and 2014, respectively. The current portion of the allowance for doubtful accounts at December 31, 2015 and 2014 of $2.0 million and $2.4 million, respectively, are reflected in accounts receivable, net. The allowance for doubtful accounts on receivables outstanding for greater than one year at December 31, 2015 and 2014 of $6.0 million and $6.4 million, respectively, is presented as part of other assets.

In light of the volatility in global economic markets in recent years, the Company has taken measures, within countries where the Company has collectability concerns, to facilitate customer-by-customer risk assessment when estimating the allowance for doubtful accounts. Such measures include, among others, monthly credit control committee meetings, at which customer credit risks are identified after review of, among other things, accounts that exceed specified credit limits, payment delinquencies and other customer issues. In addition, for some of the Company’s non-government customers, the Company has measures designed to reduce its risk exposures, including issuing dunning letters, reducing credit limits, requiring that payments accompany orders and initiating legal action with respect to delinquent accounts. With respect to government customers, the Company evaluates receivables for potential collection risks associated with the availability of government funding and reimbursement practices.

Certain of the Company’s customers, particularly in Europe, have extended or delayed payments for products and services already provided, raising collectability concerns regarding the Company's accounts receivable from these customers, for the most part in Greece, Italy, Spain and Portugal. As a result, the Company continues to closely monitor the allowance for doubtful accounts in these locations. If the financial condition of these customers or the healthcare systems in these countries deteriorate to the extent that the ability of an increasing number of customers to satisfy their payment obligations is uncertain, additional allowances may be required in future periods. The aggregate net current and long-term accounts receivable for customers in Greece, Italy, Spain and Portugal and the percentage of the Company’s total net current and long-term accounts receivable represented by the net current and long-term accounts receivable for customers in those countries at December 31, 2015 and 2014 are as follows:



	December 31, 2015			December 31, 2014
	(Dollars in thousands)
Current and long-term accounts receivable (net of allowances of $7.2 million and $8.1 million in 2015 and 2014, respectively) in Greece, Italy, Spain and Portugal ⁽¹⁾	$	62,272		$	76,190
Percentage of total net current and long-term accounts receivables	23.9		%	27.3		%

(1) The long-term portion of accounts receivable, net from customers in Greece, Italy, Spain and Portugal at December 31, 2015 and 2014 was $8.1 million and $11.3 million, respectively, and is reported on the consolidated balance sheet in other assets.

For the years ended December 31, 2015, 2014 and 2013, net revenues from customers in Greece, Italy, Spain and Portugal were $126.2 million, $150.5 million and $142.6 million, respectively.