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 of continuing operations:
Net income	$ 461,466	$ 200,802	$ 152,530
Adjustments to reconcile net income to net cash provided by operating activities:
Loss (Income) from discontinued operations	515	(4,370)	2,733
Depreciation expense	64,088	60,494	56,497
Amortization expense of intangible assets	149,974	149,486	98,766
Amortization expense of deferred financing costs and debt discount	4,307	4,734	5,075
Loss on extinguishment of debt	8,822	0	5,593
Fair value step up of acquired inventory sold	0	0	10,442
Changes in contingent consideration	53,915	52,977	3,575
Impairment of long-lived assets	6,966	19,110	0
Stock-based compensation	26,940	22,438	19,407
Net gain on sales of businesses and assets	(6,077)	(1,388)	0
Deferred income taxes, net	(168,594)	(6,097)	(41,822)
Payments for contingent consideration	(26,092)	(2,100)	0
Interest benefit on swaps designated as net investment hedges	(18,866)	(3,277)	0
Other	(5,800)	(13,426)	(18,469)
Changes in operating assets and liabilities, net of effects of acquisitions and disposals:
Accounts receivable	(59,793)	(23,412)	(11,039)
Inventories	(53,170)	(37,198)	(22,363)
Prepaid expenses and other current assets	(31,023)	(10,351)	547
Accounts payable, accrued expenses and other liabilities	36,021	62,404	39,001
Income taxes receivable and payable, net	(6,531)	(35,740)	125,828
Net cash provided by operating activities from continuing operations	437,068	435,086	426,301
Cash flows from investing activities of continuing operations:
Expenditures for property, plant and equipment	(102,695)	(80,795)	(70,903)
Payments for businesses and intangibles acquired, net of cash acquired	(3,462)	(121,025)	(1,768,284)
Proceeds from sales of businesses and assets	14,345	3,878	6,332
Net interest proceeds on swaps designated as net investment hedges	18,331	1,548	0
Net cash used in investing activities from continuing operations	(73,481)	(196,394)	(1,832,855)
Cash flows from financing activities of continuing operations:
Proceeds from new borrowings	275,000	35,000	2,463,500
Reduction in borrowings	(528,500)	(128,500)	(1,239,576)
Debt extinguishment, issuance and amendment fees	(11,635)	(188)	(26,664)
Proceeds from share based compensation plans and the related tax impacts	21,206	22,655	5,571
Payments for contingent consideration	(112,079)	(73,235)	(335)
Dividends	(62,828)	(62,165)	(61,237)
Net cash (used in) provided by financing activities from continuing operations	(418,836)	(206,433)	1,141,259
Cash flows from discontinued operations:
Net cash provided by (used in) operating activities	2,457	2,292	(6,416)
Net cash provided by (used in) discontinued operations	2,457	2,292	(6,416)
Effect of exchange rate changes on cash and cash equivalents	(3,286)	(10,948)	61,480
Net (decrease) increase in cash and cash equivalents	(56,078)	23,603	(210,231)
Cash and cash equivalents at the beginning of the year	357,161	333,558	543,789
Cash and cash equivalents at the end of the year	$ 301,083	$ 357,161	$ 333,558