Annual report pursuant to Section 13 and 15(d)

CONSOLIDATED STATEMENTS OF CASH FLOWS

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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2017
Dec. 31, 2016
Dec. 31, 2015
CASH FLOWS FROM OPERATING ACTIVITIES      
Net income (loss) $ 7,774 $ 20,297 $ (15,769)
Reconciling items:      
Depreciation 149,634 139,288 134,148
Amortization 305,900 264,363 263,093
Deferred income tax benefit (71,539) (7,891) (9,611)
Amortization of debt issuance costs, discounts and premium, net 13,174 12,594 10,885
Provision for uncollectible accounts receivable and advances 20,295 21,681 19,505
Loss on extinguishment of debt 1,048 14,049 0
Non-cash compensation expense 42,755 32,723 33,361
Unrealized changes in fair value of contingent consideration 18,011 (5,715) 8,010
Equity in losses (earnings) of nonconsolidated affiliates, net of distributions 6,898 27,498 9,436
Other, net 67 (3,587) (11,525)
Changes in operating assets and liabilities, net of effects of acquisitions and dispositions:      
Increase in accounts receivable (133,020) (146,128) (67,235)
Increase in prepaid expenses and other assets (239,065) (129,748) (122,872)
Increase in accounts payable, accrued expenses and other liabilities 474,301 193,775 3,480
Increase in deferred revenue 26,773 164,291 52,948
Net cash provided by operating activities 623,006 597,490 307,854
CASH FLOWS FROM INVESTING ACTIVITIES      
Advances of notes receivable (19,120) (17,227) (28,288)
Investments made in nonconsolidated affiliates (25,170) (28,922) (21,998)
Purchases of property, plant and equipment (238,435) (173,827) (142,491)
Cash paid for acquisitions, net of cash acquired (47,946) (211,624) (89,780)
Purchases of intangible assets (10,977) (6,234) (12,267)
Other, net 14,062 11,357 3,839
Net cash used in investing activities (327,586) (426,477) (290,985)
CASH FLOWS FROM FINANCING ACTIVITIES      
Proceeds from long-term debt, net of debt issuance costs 60,912 844,451 57,276
Payments on long-term debt including extinguishment costs (110,855) (606,831) (63,569)
Contributions from noncontrolling interests 10,671 88 711
Distributions to noncontrolling interests (46,036) (55,131) (30,645)
Purchases and sales of noncontrolling interests, net (71,509) (69,106) (9,752)
Proceeds from exercise of stock options 51,069 20,299 16,280
Payments for deferred and contingent consideration (15,883) (20,539) (6,770)
Other, net (5,452) (14,019) (7,652)
Net cash provided by (used in) financing activities (127,083) 99,212 (44,121)
Effect of exchange rate changes on cash and cash equivalents 130,394 (46,759) (51,652)
Net increase (decrease) in cash and cash equivalents 298,731 223,466 (78,904)
Cash and cash equivalents at beginning of period 1,526,591 1,303,125 1,382,029
Cash and cash equivalents at end of period 1,825,322 1,526,591 1,303,125
Cash paid during the year for:      
Interest, net of interest income 87,111 96,678 92,620
Income taxes, net of refunds $ 44,871 $ 30,312 $ 44,287