CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Cash flows from operating activities of continuing operations:
Net income	$ 485,374	$ 335,324	$ 461,466
Adjustments to reconcile net income to net cash provided by operating activities:
(Income) loss from discontinued operations	(255)	477	515
Depreciation expense	71,758	68,567	64,088
Intangible asset amortization expense	165,604	158,685	149,974
Deferred financing costs and debt discount amortization expense	4,493	4,430	4,307
Loss on extinguishment of debt	12,986	0	8,822
Fair value step up of acquired inventory sold	3,993	1,707	0
Changes in contingent consideration	8,475	(38,164)	53,915
Asset impairment charges	6,739	21,388	6,966
Stock-based compensation	22,937	20,739	26,940
Net gain on sales of business and assets	(91,157)	0	(6,077)
Deferred income taxes, net	(110,239)	(32,675)	(168,594)
Payments for contingent consideration	(230)	(79,801)	(26,092)
Interest benefit on swaps designated as net investment hedges	(19,296)	(19,178)	(18,866)
Other	(36,388)	(26,636)	(5,800)
Changes in operating assets and liabilities, net of effects of acquisitions and disposals:
Accounts receivable	(600)	44,748	(59,793)
Inventories	(11,138)	(5,497)	(53,170)
Prepaid expenses and other current assets	(28,410)	(4,323)	(31,023)
Accounts payable, accrued expenses and other liabilities	94,020	646	36,021
Income taxes receivable and payable, net	73,473	(13,294)	(6,531)
Net cash provided by operating activities from continuing operations	652,139	437,143	437,068
Cash flows from investing activities of continuing operations:
Expenditures for property, plant and equipment	(71,618)	(90,694)	(102,695)
Payments for businesses and intangibles acquired, net of cash acquired	(4,590)	(767,830)	(3,462)
Proceeds from sales of business and assets	224,909	1,400	14,345
Net interest proceeds on swaps designated as net investment hedges	19,154	19,341	18,331
Proceeds from sales of investments	7,300	0	0
Purchase of investments	(18,418)	0	0
Net cash provided by (used in) investing activities from continuing operations	156,737	(837,783)	(73,481)
Cash flows from financing activities of continuing operations:
Proceeds from new borrowings	400,000	1,513,807	275,000
Reduction in borrowings	(1,034,500)	(938,807)	(528,500)
Debt extinguishment, issuance and amendment fees	(9,774)	(8,440)	(11,635)
Net proceeds from share based compensation plans and the related tax impacts	12,451	18,994	21,206
Payments for contingent consideration	(31,448)	(67,170)	(112,079)
Dividends paid	(63,648)	(63,221)	(62,828)
Proceeds from sale of treasury stock	11,097	0	0
Net cash (used in) provided by financing activities from continuing operations	(715,822)	455,163	(418,836)
Cash flows from discontinued operations:
Net cash (used in) provided by operating activities	(720)	(737)	2,457
Net cash (used in) provided by discontinued operations	(720)	(737)	2,457
Effect of exchange rate changes on cash and cash equivalents	(23,130)	21,011	(3,286)
Net increase (decrease) in cash and cash equivalents	69,204	74,797	(56,078)
Cash and cash equivalents at the beginning of the year	375,880	301,083	357,161
Cash and cash equivalents at the end of the year	$ 445,084	$ 375,880	$ 301,083