Annual report pursuant to Section 13 and 15(d)

Composition of Certain Financial Statement Captions (Details)

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Composition of Certain Financial Statement Captions (Details) - USD ($)
$ in Thousands
Dec. 31, 2016
Dec. 31, 2015
Accounts receivable, net    
Accounts receivable $ 256,552 $ 219,043
Less: allowance for doubtful accounts (36,268) (25,168)
Accounts receivable, net 220,284 193,875
Inventories, net    
Consumable supplies 23,448 22,265
Finished products 16,143 13,404
Work in-process 3,896 1,215
Raw materials 4,686 3,848
Less: inventory reserve (945) (1,051)
Inventory, net 47,228 39,681
Other current assets and prepaid expenses    
Other receivables 13,021 11,946
Taxes recoverable 16,187 3,076
Prepaid supplies 6,952 8,773
Prepaid insurance 3,688 2,206
Other 7,508 903
Prepaid expenses and other current assets 47,356 26,904
Property, plant and equipment, net:    
Machinery, medical and other equipment 100,100 89,936
Leasehold improvements 30,122 27,949
Furniture and fixtures 11,247 11,403
Automobiles and aircraft 13,342 10,271
Software 10,990 10,497
Building 5,696 5,965
Land 2,264 2,394
Construction in process 5,848 425
Less: accumulated depreciation (56,778) (27,042)
Property, plant and equipment, net 122,831 131,798
Intangible assets, net:    
Less: accumulated amortization (123,207) (59,101)
Intangible assets, net 763,976 638,152
Accrued expenses:    
Deferred revenue 73,434 70,246
Employee benefits 43,792 29,751
Taxes payable 4,430 7,605
Contingent consideration 259 22,164
Clinical trials 5,935 2,505
Capital leases short-term 3,025 5,373
Milestone payment 4,865 5,000
Professional fees 4,035 1,506
Other 58,180 23,749
Accrued expenses 197,955 167,899
Other long-term liabilities:    
Deferred revenue 89,016 162,634
Line of credit 38,809 72,107
Contingent consideration 44,817 32,258
Capital leases long-term 7,216 9,285
Mortgages and other debts payable 717 2,523
Other 21,908 13,663
Other long-term liabilities 202,483 292,470
Customer relationships    
Intangible assets, net:    
Intangible assets 443,560 449,972
Technologies    
Intangible assets, net:    
Intangible assets 340,397 151,709
Trade names    
Intangible assets, net:    
Intangible assets 50,442 50,416
Covenants not to compete    
Intangible assets, net:    
Intangible assets 16,348 8,612
Licenses    
Intangible assets, net:    
Intangible assets 23,506 23,432
Product registrations    
Intangible assets, net:    
Intangible assets 7,641 7,512
Other    
Intangible assets, net:    
Intangible assets $ 5,289 $ 5,600