| Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | |
|---|---|---|---|---|---|---|
Cash flows from operating activities: | ||||||
Net income | ||||||
243,119 | 154,458 | 87,293 | 68,175 | 81,765 | -35,742 | |
Adjustments to reconcile net income to net cash provided by operating activities: | ||||||
Depreciation and amortization expense | ||||||
114,898 | 112,247 | 78,227 | 69,506 | 77,952 | 96,564 | |
Amortization of debt issuance costs | ||||||
1,814 | 2,111 | 2,108 | 4,433 | 5,983 | 5,737 | |
Amortization of terminated interest rate swaps | ||||||
6,538 | 7,146 | 6,684 | 4,961 | 731 | - | |
Stock-based compensation expense | ||||||
45,834 | 29,143 | 12,616 | 7,067 | 5,276 | 3,467 | |
Gain (Loss) on Extinguishment of Debt | ||||||
-519 | -952 | -15,023 | -38,178 | 0 | -25,036 | |
Loss on disposal of fixed assets | ||||||
-1,058 | -120 | -358 | -753 | -652 | -5 | |
Change in fair value of acquisition-related contingent consideration | ||||||
0 | 34,538 | 74,969 | -527 | 89 | 504 | |
Non-cash transaction related stock-based compensation expense | ||||||
0 | 773 | 5,294 | 42,166 | 0 | - | |
Unrealized foreign currency gains, net | ||||||
6,467 | 3,307 | -39,700 | 24,499 | 16,464 | 12,222 | |
Equity in income of unconsolidated joint ventures | ||||||
0 | 143 | 123 | 2,775 | -3,396 | -2,044 | |
Unrealized loss on derivatives | ||||||
- | - | - | - | -1,787 | -1,731 | |
Excess tax benefit from stock-based compensation | ||||||
- | - | - | 846 | 0 | - | |
Deferred income tax benefit | ||||||
-23,907 | 11,665 | -75,915 | -10,469 | -3,219 | -31,968 | |
Other reconciling items | ||||||
-606 | -30 | -763 | 605 | -443 | -978 | |
Changes in operating assets and liabilities, net of acquired assets and assumed liabilities: | ||||||
Prepaid expenses and other assets | ||||||
13,660 | 18,931 | -1,762 | 10,071 | 11,675 | 10,944 | |
Accounts payable and other liabilities | ||||||
21,584 | 31,579 | 35,792 | -1,474 | 36,135 | 19,727 | |
Income taxes | ||||||
-31,029 | 5,241 | 10,640 | 7,308 | 9,958 | 15,634 | |
Advanced billings | ||||||
65,213 | 14,216 | 61,547 | 79 | 42,830 | -13,736 | |
Accounts receivable, unbilled services and advanced billings | ||||||
89,304 | 17,017 | 136,330 | 31,313 | 83,211 | 32,781 | |
Payment of acquisition-related contingent consideration | ||||||
83,249 | 35,029 | 0 | 0 | 2,000 | 1,589 | |
Net cash provided by operating activities | ||||||
253,567 | 329,792 | 220,408 | 160,047 | 152,428 | 34,034 | |
Purchase of fixed assets | ||||||
74,294 | 55,880 | 61,318 | 33,143 | 32,814 | 27,323 | |
Proceeds from the sale of fixed assets | ||||||
26 | 43 | 56 | 10 | 44 | - | |
(Cash paid) proceeds received for interest on interest rate swap, net | ||||||
-667 | -181 | 874 | 913 | 302 | - | |
Acquisition of Nextrials, Inc., net of cash acquired | ||||||
- | - | - | 4,268 | 0 | - | |
Proceeds from RPS Parent Holding Corp. working capital settlement | ||||||
- | - | - | - | - | 15,000 | |
Proceeds from CRI Holding Company, LLC working capital adjustment | ||||||
- | - | - | - | - | 851 | |
Payment of ClinStar, LLC working capital settlement | ||||||
- | - | - | - | 1,693 | - | |
Distributions from unconsolidated joint ventures | ||||||
418 | 0 | 0 | 3,700 | 19,529 | - | |
Cash received from the sale of marketable securities | ||||||
0 | 183 | 0 | 0 | - | - | |
Acquisition of Care Innovations, Inc., net of cash acquired | ||||||
- | - | - | - | 543 | - | |
Cash paid to terminate interest rate swaps | ||||||
- | - | - | - | 32,907 | - | |
Acquisition of Symphony Health Solutions Corporation, net of cash acquired | ||||||
0 | 0 | 521,182 | 0 | 0 | - | |
Payment of Symphony Health Solutions Corporation contingent consideration | ||||||
0 | 0 | 67,781 | 0 | 0 | - | |
Acquisition of Parallel 6, Inc., net of cash acquired | ||||||
0 | 0 | 38,859 | 0 | 0 | - | |
Acquisition of Takeda PRA Development Center KK, net of cash acquired | ||||||
0 | 0 | -2,680 | 0 | 0 | - | |
Acquisition of Takeda Pharmaceutical Data Services, Ltd., net of cash acquired | ||||||
0 | 0 | 142 | 0 | 0 | - | |
Contributions to unconsolidated joint ventures | ||||||
- | - | - | - | 23,000 | - | |
Net cash used in investing activities | ||||||
-73,183 | -55,473 | -687,420 | -34,614 | -71,686 | -11,472 | |
Cash flows from financing activities: | ||||||
Proceeds from issuance of long-term debt | ||||||
1,300,000 | 0 | 550,000 | 625,000 | 0 | - | |
Proceeds from accounts receivable financing agreement | ||||||
30,000 | 60,000 | 20,000 | 120,000 | 0 | - | |
Repayment on accounts receivable financing agreement | ||||||
30,000 | 10,000 | 20,000 | 0 | 0 | - | |
Borrowings on line of credit | ||||||
233,800 | 0 | 121,500 | 110,000 | 90,000 | 105,000 | |
Repayments of line of credit | ||||||
145,000 | 91,500 | 30,000 | 110,000 | 90,000 | 115,000 | |
Repayments of long-term debt | ||||||
1,216,533 | 224,394 | 125,513 | 822,559 | 40,000 | 308,775 | |
Payments to Acquire Interest in Subsidiaries and Affiliates | ||||||
4,138 | 0 | 0 | - | - | - | |
Proceeds from common stock issued, net of underwriters discount | ||||||
- | - | - | - | - | 333,950 | |
Payment of common stock issuance costs | ||||||
- | - | - | - | 525 | 5,325 | |
Excess tax benefit from stock-based compensation | ||||||
- | - | - | 846 | 0 | - | |
Proceeds from stock issued under employee stock purchase plan and stock option exercises | ||||||
45,819 | 31,382 | 7,236 | 655 | 81 | 33 | |
Payment of debt prepayment and debt extinguishment costs | ||||||
0 | 0 | 9,226 | 17,824 | 0 | 14,250 | |
Payments for debt issuance costs | ||||||
4,541 | 0 | 6,588 | 7,713 | 0 | - | |
Taxes paid related to net shares settlement of equity awards | ||||||
114 | 5,337 | 0 | 0 | - | - | |
Repurchase and retirement of common stock | ||||||
300,000 | 0 | 0 | - | - | - | |
Payment of acquisition-related contingent consideration | ||||||
0 | 79,663 | 400 | 0 | - | - | |
Net cash provided by financing activities | ||||||
-90,707 | -319,512 | 507,009 | -101,595 | -42,444 | -5,956 | |
Effects of foreign exchange changes on cash, cash equivalents, and restricted cash | ||||||
1,884 | -2,988 | 3,555 | -625 | -3,702 | -5,992 | |
Change in cash, cash equivalents, and restricted cash | ||||||
91,561 | -48,181 | 43,552 | 23,213 | 34,596 | 10,614 | |