CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Cash flows from operating activities of continuing operations:
Net income	$ 335,324	$ 461,466	$ 200,802
Adjustments to reconcile net income to net cash provided by operating activities:
Loss (Income) from discontinued operations	477	515	(4,370)
Depreciation expense	68,567	64,088	60,494
Intangible asset amortization expense	158,685	149,974	149,486
Deferred financing costs and debt discount amortization expense	4,430	4,307	4,734
Loss on extinguishment of debt	0	8,822	0
Fair value step up of acquired inventory sold	1,707	0	0
Changes in contingent consideration	(38,164)	53,915	52,977
Asset impairment charges	21,388	6,966	19,110
Stock-based compensation	20,739	26,940	22,438
Net gain on sales of businesses and assets	0	(6,077)	(1,388)
Deferred income taxes, net	(32,675)	(168,594)	(6,097)
Payments for contingent consideration	(79,801)	(26,092)	(2,100)
Interest benefit on swaps designated as net investment hedges	(19,178)	(18,866)	(3,277)
Other	(26,636)	(5,800)	(13,426)
Changes in operating assets and liabilities, net of effects of acquisitions and disposals:
Accounts receivable	44,748	(59,793)	(23,412)
Inventories	(5,497)	(53,170)	(37,198)
Prepaid expenses and other current assets	(4,323)	(31,023)	(10,351)
Accounts payable, accrued expenses and other liabilities	646	36,021	62,404
Income taxes receivable and payable, net	(13,294)	(6,531)	(35,740)
Net cash provided by operating activities from continuing operations	437,143	437,068	435,086
Cash flows from investing activities of continuing operations:
Expenditures for property, plant and equipment	(90,694)	(102,695)	(80,795)
Payments for businesses and intangibles acquired, net of cash acquired	(767,830)	(3,462)	(121,025)
Proceeds from sales of businesses and assets	1,400	14,345	3,878
Net interest proceeds on swaps designated as net investment hedges	19,341	18,331	1,548
Net cash used in investing activities from continuing operations	(837,783)	(73,481)	(196,394)
Cash flows from financing activities of continuing operations:
Proceeds from new borrowings	1,513,807	275,000	35,000
Reduction in borrowings	(938,807)	(528,500)	(128,500)
Debt extinguishment, issuance and amendment fees	(8,440)	(11,635)	(188)
Proceeds from share based compensation plans and the related tax impacts	18,994	21,206	22,655
Payments for contingent consideration	(67,170)	(112,079)	(73,235)
Dividends	(63,221)	(62,828)	(62,165)
Net cash provided by (used in) financing activities from continuing operations	455,163	(418,836)	(206,433)
Cash flows from discontinued operations:
Net cash (used in) provided by operating activities	(737)	2,457	2,292
Net cash (used in) provided by discontinued operations	(737)	2,457	2,292
Effect of exchange rate changes on cash and cash equivalents	21,011	(3,286)	(10,948)
Net increase (decrease) in cash and cash equivalents	74,797	(56,078)	23,603
Cash and cash equivalents at the beginning of the year	301,083	357,161	333,558
Cash and cash equivalents at the end of the year	$ 375,880	$ 301,083	$ 357,161