Natus Medical (NTUS) 10-Q 9 May 18 2018 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2018	May 02, 2018
Document and Entity Information [Abstract]
Entity Registrant Name	NATUS MEDICAL INC
Entity Central Index Key	878,526
Document Type	10-Q
Document Period End Date	Mar. 31, 2018
Amendment Flag	false
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q1
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		33,302,866

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (unaudited) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 64,471	$ 88,950
Accounts receivable, net of allowance for doubtful accounts of $8,200 in 2018 and $8,978 in 2017	128,056	126,809
Inventories	74,543	71,529
Prepaid expenses and other current assets	23,863	18,340
Total current assets	290,933	305,628
Property and equipment, net	22,618	22,071
Intangible assets, net	167,489	172,582
Goodwill	173,297	172,998
Deferred income tax	10,632	10,709
Other assets	17,949	25,931
Total assets	682,918	709,919
Current liabilities:
Accounts payable	24,388	25,242
Accrued liabilities	54,066	51,738
Deferred revenue	16,615	15,157
Total current liabilities	95,069	92,137
Long-term liabilities:
Other liabilities	21,925	21,995
Long-term debt, net	129,331	154,283
Deferred income tax	19,763	19,407
Total liabilities	266,088	287,822
Stockholders’ equity:
Common stock, $0.001 par value, 120,000,000 shares authorized; shares issued and outstanding 33,271,530 in 2018 and 33,134,101 in 2017	314,760	316,577
Preferred stock, $0.001 par value; 10,000,000 shares authorized; no shares issued and outstanding in 2018 and 2017	0	0
Retained earnings	122,048	129,115
Accumulated other comprehensive loss	(19,978)	(23,595)
Total stockholders’ equity	416,830	422,097
Total liabilities and stockholders’ equity	$ 682,918	$ 709,919

Consolidated Balance Sheets (un

Consolidated Balance Sheets (unaudited) (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Statement of Financial Position [Abstract]
Allowance for doubtful accounts	$ 8,200	$ 8,978
Common Stock, par value (dollars per share)	$ 0.001	$ 0.001
Common Stock, shares authorized (in shares)	120,000,000	120,000,000
Common Stock, shares issued (in shares)	33,271,530	33,134,101
Common Stock, shares outstanding (in shares)	33,271,530	33,134,101
Preferred Stock, par value (dollars per share)	$ 0.001	$ 0.001
Preferred Stock, shares authorized (in shares)	10,000,000	10,000,000
Preferred Stock, shares issued (in shares)	0	0
Preferred Stock, shares outstanding (in shares)	0	0

Condensed Consolidated Statemen

Condensed Consolidated Statements of Income and Comprehensive Income (unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Income Statement [Abstract]
Revenue	$ 128,609	$ 124,660
Cost of revenue	55,369	56,913
Intangibles amortization	1,587	1,000
Gross profit	71,653	66,747
Operating expenses:
Marketing and selling	35,872	32,215
Research and development	15,443	12,753
General and administrative	17,448	16,016
Intangibles amortization	4,806	4,074
Restructuring	812	286
Total operating expenses	74,381	65,344
Income (loss) from operations	(2,728)	1,403
Other income (expense), net	(1,821)	(1,039)
Income (loss) before provision for income tax	(4,549)	364
Provision for income tax	(1,401)	16
Net income (loss)	$ (3,148)	$ 348
Earnings (loss) per share:
Basic (dollars per share)	$ (0.10)	$ 0.01
Diluted (dollars per share)	$ (0.10)	$ 0.01
Weighted average shares used in the calculation of earnings (loss) per share:
Basic (in shares)	32,760	32,485
Diluted (in shares)	32,760	33,040
Other comprehensive income (loss):
Unrealized loss on available-for-sale investments	$ 0	$ (57)
Foreign currency translation adjustment	3,617	3,647
Total other comprehensive income	3,617	3,590
Comprehensive income	$ 469	$ 3,938

Condensed Consolidated Stateme5

Condensed Consolidated Statements of Cash Flows (unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Operating activities:
Net income (loss)	$ (3,148)	$ 348
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Provision for losses on accounts receivable	918	1,719
Depreciation and amortization	7,915	6,744
Loss (gain) on disposal of property and equipment	52	5
Warranty reserve	(1,125)	2,806
Share-based compensation	2,362	2,756
Changes in operating assets and liabilities:
Accounts receivable	(2,242)	(2,366)
Inventories	2,885	4,622
Prepaid expenses and other assets	(5,390)	2,386
Accounts payable	(622)	(1,148)
Accrued liabilities	3,319	(8,259)
Deferred revenue	1,314	(9,329)
Deferred income tax	87	992
Net cash provided by operating activities	6,325	1,276
Investing activities:
Acquisition of businesses, net of cash acquired	0	(141,705)
Purchase of property and equipment	(2,473)	(971)
Sale of short-term investments	0	24,935
Net cash used in investing activities	(2,473)	(117,741)
Financing activities:
Proceeds from stock option exercises and Employee Stock Purchase Program purchases	577	248
Repurchase of common stock	(4,736)	(1,308)
Taxes paid related to net share settlement of equity awards	(19)	(2,597)
Contingent consideration	(147)	(2,000)
Proceeds from borrowings	0	10,000
Deferred debt issuance costs	0	(38)
Payments on borrowings	(25,000)	0
Net cash provided by (used in) financing activities	(29,325)	4,305
Exchange rate changes effect on cash and cash equivalents	994	2,387
Net decrease in cash and cash equivalents	(24,479)	(109,773)
Cash and cash equivalents, beginning of period	88,950	213,551
Cash and cash equivalents, end of period	64,471	103,778
Supplemental disclosure of cash flow information:
Cash paid for interest	1,482	980
Cash paid for income taxes	1,657	286
Non-cash investing activities:
Property and equipment included in accounts payable	349	230
Inventory transferred to property and equipment	$ 161	$ 245

Basis of Presentation

Basis of Presentation	3 Months Ended
	Mar. 31, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation	Basis of Presentation and Significant Accounting Policies The accompanying interim condensed consolidated financial statements of Natus Medical Incorporated (“Natus,” or the “Company”) have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”). Effective January 1, 2018 the Company adopted the requirements of Accounting Standards Update (“ASU”) No. 2014-09, Revenue from Contracts with Customers as discussed below. All amounts and disclosures set forth in this Form 10-Q have been updated to comply with the new standards. All of the remaining accounting policies followed in the preparation of the interim condensed consolidated financial statements are consistent in all material respects with those presented in Note 1 to the consolidated financial statements included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2017 . Interim financial reports are prepared in accordance with the rules and regulations of the Securities and Exchange Commission; accordingly, the reports do not include all of the information and notes required by GAAP for annual financial statements. The interim financial information is unaudited, and reflects all normal adjustments that are, in the opinion of management, necessary for the fair presentation of our financial position, results of operations, and cash flows for the interim periods presented. The consolidated balance sheet as of December 31, 2017 was derived from audited financial statements, but does not include all disclosures required by GAAP. The accompanying financial statements should be read in conjunction with the financial statements included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2017 . Operating results for the three months ended March 31, 2018 are not necessarily indicative of the results that may be expected for the year ending December 31, 2018 . The accompanying condensed consolidated financial statements include the accounts of the Company and its wholly owned subsidiaries. All intercompany accounts and transactions have been eliminated in consolidation. Recent Adopted Accounting Pronouncements In May 2014, the Financial Accounting Standards Board (“FASB”) issued Accounting Standard Update No. 2014-09, Revenue from Contracts with Customers (Topic 606) (“ASU 2014-09”), which supersedes nearly all existing revenue recognition guidance. The standard's core principle is that an entity should recognize revenue when it transfers promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. The standard creates a five-step model to achieve its core principle: (i) identify the contract(s) with a customer; (ii) identify the performance obligations in the contract; (iii) determine the transaction price; (iv) allocate the transaction's price to the separate performance obligations in the contract; and (v) recognize revenue when (or as) the entity satisfies a performance obligation. In addition, entities must disclose sufficient information to enable users of financial statements to understand the nature, amount, timing, and uncertainty of revenue and cash flows arising from contracts with customers. Qualitative and quantitative disclosures are required about: (i) the entity's contracts with customers; (ii) the significant judgments, and changes in judgments, made in applying the guidance to those contracts; and (iii) any assets recognized from the costs to obtain or fulfill a contract with a customer. The Company adopted the new revenue standard on January 1, 2018, without any material impact to its accounting policies or its reported results. The Company utilized the modified retrospective method of transition and applied a practical expedient permitting the Company to not disclose the consideration allocated to the remaining performance obligations or an explanation of when the Company expects to recognize revenue for all reporting periods presented before January 1, 2018, the date of initial application. In October 2016, the FASB issued ASU 2016-16, Income Taxes (Topic 740). This update is to remove the prohibition in ASC 740 against the immediate recognition of the current and deferred income tax effects of intra-entity transfers of assets other than inventory. Under the ASU, the selling entity is required to recognize any current tax expense or benefit upon transfer of the asset. Similarly, the purchasing entity is required to recognize a deferred tax asset or deferred tax liability, as well as the related deferred tax benefit or expense, upon receipt of the asset. The Company adopted this guidance on a modified retrospective basis on January 1, 2018, recognizing a charge to retained earnings of approximately $3.9 million which reflects the unamortized portion of the deferred tax asset for both the consideration as well as the reserve. In January 2017, the FASB issued ASU 2017-01, Business Combinations (Topic 805). This update is to clarify the definition of a business with the objective of adding guidance to assist entities with evaluating whether transactions should be accounted for as acquisition (or disposals) of assets or businesses. The definition of a business affected many areas of accounting including acquisitions, disposals, goodwill, and consolidation. The adoption of this guidance prospectively on January 1, 2018 had no impact to the Company. In May 2017, the FASB issued ASU 2017-09, Compensation - Stock Compensation (Topic 718): Scope of Modification Accounting. This update provides guidance about which changes to the terms or conditions of a share-based payment award require an entity to apply modification accounting in Topic 718. The adoption of this guidance prospectively on January 1, 2018 had no impact to the Company. Recent Issued Accounting Pronouncements In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842). This standard requires a lessee to recognize the lease assets and lease liabilities arising from operating leases in the statement of financial position. Qualitative along with specific quantitative disclosures are required by lessees and lessors to meet the objective of enabling users of financial statements to assess the amount, timing, and uncertainty of cash flows arising from leases. ASU 2016-02 is effective for fiscal years beginning after December 15, 2018 including interim periods within those fiscal years. The Company is currently evaluating the impact that will result from adopting ASU 2016-02. In January 2017, the FASB issued ASU 2017-04, Intangibles - Goodwill and Other (Topic 350). This update modifies the concept of impairment from the condition that exists when the carrying amount of goodwill exceeds its implied fair value to the condition that exists when the carrying amount of a reporting unit exceeds its fair value. An entity no longer will determine goodwill impairment by calculating the implied fair value of goodwill by assigning the fair value of a reporting unit to all of its assets and liabilities as if that reporting unit had been acquired in a business combination. Because these amendments eliminate Step 2 from the goodwill impairment test, they should reduce the cost and complexity of evaluating goodwill for impairment. ASU 2017-04 is effective for the Company's annual and any interim goodwill impairment tests performed on or after January 1, 2020. The Company does not expect the adoption of ASU 2017-04 to have a material impact. In February 2018, the FASB issued ASU 2018-02, Income Statement - Reporting Comprehensive Income (Topic 220). This update permits a company to reclassify its disproportionate income tax effects of the Tax Cuts and Jobs Act of 2017 (the “2017 Act”) on items within accumulated other comprehensive income (“AOCI”) to retained earnings (termed “stranded tax effects”). Only the stranded tax effects resulting from the 2017 Act are eligible for reclassification. The ASU also requires certain new disclosures, some of which are applicable for all companies. The ASU is effective for the Company on January 1, 2019. The Company is currently evaluating the impact that will result from adopting ASU 2018-02. Significant Accounting Policies Revenue Recognition Revenue is recognized when obligations under the terms of a contract with a customer are satisfied; generally this occurs with the transfer of control of devices, supplies, or services. Revenue is measured as the amount of consideration the Company expects to receive in exchange for transferring goods or providing services. For the majority of devices and supplies, the Company transfers control and recognizes revenue when products ship from the warehouse to the customer. The Company generally does not provide rights of return on devices and supplies. Freight charges billed to customers are included in revenue and freight-related expenses are charged to cost of revenue. Depending on the terms of the arrangement, the Company may also defer the recognition of a portion of the consideration received because it has to satisfy a future obligation (e.g. installation). Judgment is required to determine the standalone selling price (SSP) for each distinct performance obligation. The Company uses a single amount to estimate SSP for items that are not sold separately. In instances where SSP is not directly observable, such as when the Company does not sell the product or service separately, the SSP is determined using information that may include market conditions and other observable inputs. The Company sells separately-priced service contracts that extend maintenance coverages for both medical devices and data management systems beyond the base agreements to customer. The separately priced service contracts range from 12 months to 36 months. The Company receives payment at the inception of the contract and recognizes revenue ratably over the service period. For products containing embedded software, the Company determined the hardware and software components function together to deliver the products' essential functionality and are considered a combined performance obligation. Revenue recognition policies for sales of these products are substantially the same as for other tangible products.

Business Combinations

Business Combinations	3 Months Ended
	Mar. 31, 2018
Business Combinations [Abstract]
Business Combinations	Business Combinations Integra On October 6, 2017, the Company acquired certain neurosurgery business assets from Integra LifeSciences (“Integra” or “Neurosurgery”) for $46.4 million in cash. As part of the acquisition, the Company acquired a global product line, including the manufacturing facility, it leases from a third party and the U.S. rights related to four other product lines. The total purchase price has been preliminarily allocated to $13.1 million of tangible assets, $19.5 million of intangible assets with an associated weighted average life of 9 years being amortized on the straight line method, and $14.9 million of goodwill, offset by $1.1 million of net liabilities. Purchase price allocation is considered preliminary at this time although no material adjustments are anticipated. Pro forma financial information for the Integra acquisition is not presented as certain Integra expense data necessary to present pro forma net income and pro forma earnings per share is not available. However, pro forma revenue assuming the acquisition occurred on January 1, 2017 would be $136.5 million for the three months ended March 31, 2017 . Otometrics On January 3, 2017, the Company acquired the Otometrics business from GN Store Nord A/S for a cash purchase price of $149.2 million , which includes a $4.2 million net working capital adjustment. Otometrics is a manufacturer of hearing diagnostics and balance assessment equipment, disposables and software. Otometrics provides computer-based audiological, otoneurologic and vestibular instrumentation and sound rooms to hearing and balance care professionals worldwide. Otometrics has a complete product and brand portfolio known for its sophisticated design technology in the hearing and balance assessment markets. The Company accounted for the acquisition under the acquisition method of accounting for business combinations. Under the acquisition method of accounting, the assets acquired and liabilities assumed from Otometrics are recorded in the condensed consolidated financial statements at their respective fair values as of the acquisition date. The excess of the purchase price over the fair value of the acquired net assets is recorded as goodwill. The results of Otometrics are included in the condensed consolidated financial statements since the date of the acquisition.

Earnings Per Share

Earnings Per Share	3 Months Ended
	Mar. 31, 2018
Earnings Per Share [Abstract]
Earnings Per Share	Earnings Per Share The components of basic and diluted EPS are as follows (in thousands, except per share amounts): Three Months Ended 2018 2017 Net income (loss) $ (3,148 ) $ 348 Weighted average common shares 32,760 32,485 Dilutive effect of stock based awards — 555 Diluted Shares 32,760 33,040 Basic earnings (loss) per share $ (0.10 ) $ 0.01 Diluted earnings (loss) per share $ (0.10 ) $ 0.01 Shares excluded from calculation of diluted EPS 390 —

Inventories

Inventories	3 Months Ended
	Mar. 31, 2018
Inventory Disclosure [Abstract]
Inventories	Inventories Inventories consist of the following (in thousands): March 31, 2018 December 31, 2017 Raw materials and subassemblies $ 32,942 $ 44,699 Work in process 3,891 3,788 Finished goods 54,061 43,488 Total inventories 90,894 91,975 Less: Non-current inventories (16,351 ) (20,446 ) Inventories, current $ 74,543 $ 71,529 At March 31, 2018 and December 31, 2017 , the Company has classified $16.4 million and $20.4 million , respectively, of inventories as other assets. This inventory consists primarily of service components used to repair products held by customers pursuant to warranty obligations and extended service contracts, including service components for products the Company no longer sells, inventory purchased for lifetime buys, and inventory impacted by ship holds. The Company believes these inventories will be utilized for their intended purpose.

Intangible Assets

Intangible Assets	3 Months Ended
	Mar. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Intangible Assets	Intangible Assets The following table summarizes the components of gross and net intangible asset balances (in thousands): March 31, 2018 December 31, 2017 Gross Accumulated Accumulated Net Book Gross Accumulated Accumulated Net Book Intangible assets with definite lives: Technology $ 102,114 $ (1,070 ) $ (44,108 ) $ 56,936 $ 101,045 $ (1,058 ) $ (42,048 ) $ 57,939 Customer related 109,025 (50 ) (32,019 ) 76,956 108,074 (50 ) (28,972 ) 79,052 Trade names 49,579 (3,957 ) (14,943 ) 30,679 49,313 (3,916 ) (13,273 ) 32,124 Internally developed software 15,606 — (12,820 ) 2,786 15,610 — (12,293 ) 3,317 Patents 2,812 (132 ) (2,548 ) 132 2,778 (133 ) (2,495 ) 150 Definite-lived intangible assets $ 279,136 $ (5,209 ) $ (106,438 ) $ 167,489 $ 276,820 $ (5,157 ) $ (99,081 ) $ 172,582 Finite-lived intangible assets are amortized over their weighted average lives, which are 14 years for technology, 10 years for customer related intangibles, 6 years for internally developed software, 10 years for trade names, 13 years for patents, and 11 years in total. Internally developed software consists of $13.4 million relating to costs incurred for development of internal use computer software and $2.2 million for development of software to be sold. Amortization expense related to intangible assets with definite lives was as follows (in thousands): Three Months Ended 2018 2017 Technology $ 1,819 $ 1,326 Customer related 2,881 2,208 Trade names 1,626 1,587 Internally developed software 530 504 Patents 22 27 Total amortization $ 6,878 $ 5,652 Expected amortization expense related to amortizable intangible assets is as follows (in thousands): Nine months ending December 31, 2018 $ 20,367 2019 26,061 2020 23,857 2021 22,436 2022 18,785 2023 17,785 Thereafter 38,198 Total expected amortization expense $ 167,489

Goodwill

Goodwill	3 Months Ended
	Mar. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	Goodwill The carrying amount of goodwill and the changes in the balance are as follows (in thousands): December 31, 2017 $ 172,998 Purchase accounting adjustments (595 ) Foreign currency translation 894 March 31, 2018 $ 173,297

Property and Equipment, net

Property and Equipment, net	3 Months Ended
	Mar. 31, 2018
Property, Plant and Equipment [Abstract]
Property and Equipment, net	Property and Equipment, net Property and equipment, net consist of the following (in thousands): March 31, 2018 December 31, 2017 Land $ 2,797 $ 2,815 Buildings 5,021 5,096 Leasehold improvements 3,362 3,295 Equipment and furniture 26,978 25,612 Computer software and hardware 9,792 9,760 Demonstration and loaned equipment 12,186 11,932 60,136 58,510 Accumulated depreciation (37,518 ) (36,439 ) Total $ 22,618 $ 22,071 Depreciation expense of property and equipment was approximately $1.0 million for the three months ended March 31, 2018 and approximately $1.1 million for the three months ended March 31, 2017 .

Reserve for Product Warranties

Reserve for Product Warranties	3 Months Ended
	Mar. 31, 2018
Product Warranties Disclosures [Abstract]
Reserve for Product Warranties	Reserve for Product Warranties The Company provides a warranty for products that is generally one year in length, but in some cases regulations may require them to provide repair or remediation beyond the typical warranty period. If any of the products contain defects, the Company may be required to incur additional repair and remediation costs. Service for domestic customers is provided by Company-owned service centers that perform all service, repair, and calibration services. Service for international customers is provided by a combination of Company-owned facilities, vendors on a contract basis, and distributors. A warranty reserve is included in accrued liabilities for the expected future costs of servicing products. Additions to the reserve are based on management’s best estimate of probable liability. The Company considers a combination of factors including material and labor costs, regulatory requirements, and other judgments in determining the amount of the reserve. The reserve is reduced as costs are incurred to honor existing warranty and regulatory obligations. As of March 31, 2018 , the Company had accrued $3.9 million of estimated costs to bring certain NeoBLUE® phototherapy products into U.S. regulatory compliance. The Company's estimate of these costs associated with brining the NeoBLUE® phototherapy products into compliance is primarily based upon the number of units outstanding that may require repair, costs associated with shipping, and the assumption the FDA will approve the Company's plan for compliance. The details of activity in the warranty reserve are as follows (in thousands): Three Months Ended 2018 2017 Balance, beginning of period $ 10,995 $ 10,670 Assumed through acquisitions — 1,176 Additions (decreases) charged to expense (1,125 ) 2,806 Reductions (802 ) (1,931 ) Balance, end of period $ 9,068 $ 12,721 The estimates the Company uses in projecting future product warranty costs may prove to be incorrect. Any future determination that product warranty reserves are understated could result in increases to cost of sales and reductions in operating profits and results of operations.

Share-Based Compensation

Share-Based Compensation	3 Months Ended
	Mar. 31, 2018
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Share-Based Compensation	Share-Based Compensation As of March 31, 2018 , the Company has two active share-based compensation plans, the 2011 Stock Awards Plan and the 2011 Employee Stock Purchase Plan. The terms of awards granted during the three months ended March 31, 2018 and the methods for determining grant-date fair value of the awards are consistent with those described in the consolidated financial statements included in our Annual Report on Form 10-K for the year ended December 31, 2017 . Details of share-based compensation expense are as follows (in thousands): Three Months Ended 2018 2017 Cost of revenue $ 68 $ 81 Marketing and selling 198 69 Research and development 276 467 General and administrative 1,820 2,139 Total $ 2,362 $ 2,756 As of March 31, 2018 , unrecognized compensation expense related to the unvested portion of stock options and other stock awards was approximately $19.8 million , which is expected to be recognized over a weighted average period of 2.6 years .

Other Income (Expense), net

Other Income (Expense), net	3 Months Ended
	Mar. 31, 2018
Other Income and Expenses [Abstract]
Other Income (Expense), net	Other Income (Expense), net Other income (expense), net consists of (in thousands): Three Months Ended 2018 2017 Interest income $ 10 $ 332 Interest expense (1,960 ) (980 ) Foreign currency gain (loss) 604 (428 ) Other income (475 ) 37 Total other income (expense), net $ (1,821 ) $ (1,039 )

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2018
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The Company recorded a benefit from income tax of $1.4 million and expense for income tax of $16.0 thousand for the three months ended March 31, 2018 and March 31, 2017 , respectively. The effective tax rate was 30.8% and 4.4% for the three months ended March 31, 2018 and March 31, 2017 , respectively. On December 22, 2017, the Tax Cuts and Jobs Act of 2017 was signed into law making significant changes to the Internal Revenue Code. These changes include a federal statutory rate reduction from 35% to 21% , the transition of U.S. international taxation from a worldwide tax system to a territorial system, and a one-time transition tax on the mandatory deemed repatriation of cumulative foreign earnings as of December 31, 2017. The increase in the effective tax rate for the three months ended March 31, 2018 compared with the three months ended March 31, 2017 is primarily attributable to the changes enacted by the 2017 Act. The Company's effective tax rate for the three months ended March 31, 2018 differed from the federal statutory tax rate of 21% primarily due to the recognition of excess tax benefits of stock-based compensation and Federal and California research and development credits (“R&D”), non-deductible expenses, and the international provisions from the 2017 Act. The changes attributable to the 2017 Act which impacted the effective tax rate directly increased the amount of non-deductible executive compensation and introduced a new type of deemed inclusion related to global intangible low taxed income (“GILTI”). The percentage impact to the tax rate related to the changes from the 2017 Act for the three months ended March 31, 2018 was significantly greater than the impact to the tax rate related to shifts in geographical mix and discrete events for the three months ended March 31, 2017 . On December 22, 2017, Staff Accounting Bulletin No. 118 (“SAB 118”) was issued to address the application of U.S. GAAP in situations when a registrant does not have the necessary information available, prepared, or analyzed (including computations) in reasonable detail to complete the accounting for certain income tax effects of the 2017 Act. In the fourth quarter of 2017, the Company recorded a provisional amount of $16.6 million related to the one-time transition tax on the mandatory deemed repatriation of foreign earnings, net of foreign tax credits. The transition tax will be paid in installments over an eight-year period, which started in 2018, and will not accrue interest. For the three months ended March 31, 2018 , there were no significant adjustments to this amount although it remains provisional. Additional work is still necessary for a more detailed analysis of the Company's deferred tax assets and liabilities and its historical foreign earnings as well as potential correlative adjustments. The future issuance of U.S. Treasury Regulations, administrative interpretations or court decisions interpreting the 2017 Act may require further adjustments and changes in the Company's estimate. The final determination of the transition tax and remeasurement of the Company's deferred assets and liabilities will be completed as additional information becomes available, but no later than one year from the enactment of the 2017 Act. Any subsequent adjustment to these amounts will be recorded to current tax expense in the quarter of 2018 when the analysis is complete. For the three months ended March 31, 2018 , the Company has calculated its best estimate of the impact of the GILTI in its income tax provision in accordance with its understanding of the Act and guidance available as of the date of this filing. The Company has made a policy election to treat the GILTI as a period cost and does not recognize deferred taxes when basis differences exist that are expected to affect the amount of the GILTI inclusion upon reversal. The Company recorded $12.0 thousand of net tax benefit related to unrecognized tax benefits for the three months ended March 31, 2018 , primarily due to the lapse of the applicable statute of limitations. Within the next twelve months, it is possible that uncertain tax benefit may change with a range of approximately zero to $1.0 million . The Company's tax returns remain open to examination as follows: U.S Federal, 2014 through 2017, U.S. States, 2013 through 2017, and significant foreign jurisdictions, 2013 through 2017.

Debt and Credit Arrangements

Debt and Credit Arrangements	3 Months Ended
	Mar. 31, 2018
Debt Disclosure [Abstract]
Debt and Credit Arrangements	Debt and Credit Arrangements The Company has a Credit Agreement with JP Morgan Chase Bank ("JP Morgan") and Citibank, NA (“Citibank”). The Credit Agreement provides for an aggregate $150.0 million of secured revolving credit facility. In the third quarter of 2017, the Company exercised the right to increase the amount available under the facility by $75.0 million , bringing the aggregate revolving credit facility to $225.0 million . The Credit Agreement contains covenants, including covenants relating to maintenance of books and records, financial reporting and notification, compliance with laws, maintenance of properties and insurance, and limitations on guaranties, investments, issuance of debt, lease obligations and capital expenditures, and is secured by virtually all of the Company's assets. The Credit Agreement provides for events of default, including failure to pay any principal or interest when due, failure to perform or observe covenants, bankruptcy or insolvency events and the occurrence of a material adverse effect. The Company has no other significant credit facilities. In addition to the customary restrictive covenants listed above, the Credit Agreement also contains financial covenants that require the Company to maintain a certain leverage ratio and fixed charge coverage ratio, each as defined in the Credit Agreement: • Leverage Ratio, as defined, to be no higher than 2.75 to 1.00 . • Interest Coverage Ratio, as defined, to be at least 1.75 to 1.00 at all times. At March 31, 2018 , the Company was in compliance with the Leverage Ratio at 2.24 to 1.00 and the Interest Coverage Ratio at 6.58 to 1.00 . At March 31, 2018 , the Company had $130.0 million outstanding under the Credit Agreement. Pursuant to the terms of the Credit Agreement, the outstanding principal balance will bear interest at either (a) a fluctuating rate per annum equal to the Applicable Rate, as defined in the Credit Agreement, depending on our leverage ratio plus the higher of (i) the federal funds rate plus one-half of one percent per annum; (ii) the prime rate in effect on such a day; and (iii) the LIBOR rate plus one percent, or (b) a fluctuating rate per annum of LIBOR Rate plus the Applicable Rate, which ranges between 1.75 % to 2.75 %. The effective interest rate during the three months ended March 31, 2018 was 4.10% . The Credit Agreement matures on September 23, 2021, at which time all principal amounts outstanding under the Credit Agreement will be due and payable. Long-term debt consists of (in thousands): March 31, 2018 December 31, 2017 Revolving credit facility $ 130,000 $ 155,000 Debt issuance costs (669 ) (717 ) Less: current portion of long-term debt — — Total long-term debt $ 129,331 $ 154,283 As of March 31, 2018 , the carrying value of total debt approximated fair market value.

Segment, Customer and Geographi

Segment, Customer and Geographic Information	3 Months Ended
	Mar. 31, 2018
Segment Reporting [Abstract]
Segment, Customer and Geographic Information	Segment, Customer and Geographic Information The Company operates in one reportable segment in which the Company provides healthcare products and services used for the screening, detection, treatment, monitoring and tracking of common medical ailments. End-user customer base includes hospitals, clinics, laboratories, physicians, nurses, audiologists, and governmental agencies. Most of the Company's international sales are to distributors who resell products to end users or sub-distributors. Revenue and long-lived asset information are as follows (in thousands): Three Months Ended 2018 2017 Consolidated Revenue: United States $ 68,671 $ 64,710 Foreign countries 59,938 59,950 Totals $ 128,609 $ 124,660 Three Months Ended 2018 2017 Revenue by End Market: Neurology Products Devices and Systems $ 47,595 $ 38,190 Supplies 15,615 14,886 Services 2,737 3,193 Total Neurology Revenue 65,947 56,269 Newborn Care Products Devices and Systems 15,966 24,137 Supplies 9,522 11,446 Services 5,403 5,050 Total Newborn Care Revenue 30,891 40,633 Otometrics Products Devices and Systems 26,785 21,378 Supplies 4,986 6,380 Total Otometrics Revenue 31,771 27,758 Total Revenue $ 128,609 $ 124,660 March 31, 2018 December 31, 2017 Property and equipment, net: United States $ 10,678 $ 10,128 Canada 5,110 5,068 Argentina 1,495 1,591 Ireland 3,245 3,178 Denmark 1,190 1,158 Other foreign countries 900 948 Totals $ 22,618 $ 22,071 During the three months ended March 31, 2018 and 2017 , no single customer or foreign country contributed to more than 10% of revenue.

Fair Value Measurements

Fair Value Measurements	3 Months Ended
	Mar. 31, 2018
Fair Value Disclosures [Abstract]
Fair Value Measurements	Fair Value Measurements ASC 820 defines fair value, establishes a framework for measuring fair value and expands disclosures about fair value measurements. Fair value is defined under ASC 820 as the exit price associated with the sale of an asset or transfer of a liability in an orderly transaction between market participants at the measurement date. ASC 820 establishes the following three-tier fair value hierarchy, which prioritizes the inputs used in measuring fair value: Level 1 - Quoted prices (unadjusted) in active markets that are accessible at the measurement date for assets or liabilities. The fair value hierarchy gives the highest priority to Level 1 inputs. Level 2 - Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets and liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. Level 3 - Unobservable inputs that are used when little or no market data is available. The fair value hierarchy gives the lowest priority to Level 3 inputs. The Company does not have any financial assets or liabilities measured at fair value on a recurring basis. The following financial instruments are not measured at fair value on the Company’s consolidated balance sheet as of March 31, 2018 and December 31, 2017 , but require disclosure of their fair values: cash and cash equivalents, accounts receivable, and accounts payable. The carrying value of these financial instruments approximates fair values because of their relatively short maturity. In the third quarter of 2014, the Company listed its facility in Mundelein, Illinois for sale. This asset was measured at fair value less cost to sell as of September 30, 2014 based on market price and is classified as a Level 2 asset. The book value of this asset on June 30, 2014 was $3.6 million . The Company expensed $2.2 million during the third quarter of 2014 for this impairment. As of March 31, 2018 , the Company is carrying the asset as held for sale in other current assets on the accompanying condensed consolidated balance sheet at a value of $1.4 million . The Company also has contingent consideration associated with earn-outs from acquisitions. Contingent consideration liabilities are classified as Level 3 liabilities, as the Company uses unobservable inputs to value them, which is a probability-based income approach. Contingent consideration is classified as accrued liabilities on the condensed consolidated balance sheet. Subsequent changes in the fair value of contingent consideration liabilities are recorded within the Company's income statement as an operating expense. Contingent considerations are as follows (in thousands): December 31, 2017 Additions Payments Adjustments March 31, 2018 Liabilities: Contingent consideration $ 147 $ — $ (147 ) $ — $ — Total $ 147 $ — $ (147 ) $ — $ — The significant unobservable inputs used in the fair value measurement of contingent consideration related to the acquisitions are annualized revenue forecasts developed by the Company’s management and the probability of achievement of those revenue forecasts. Significant changes in these unobservable inputs may result in a significant impact to the fair value measurement.

Basis Of Presentation (Policies

Basis Of Presentation (Policies)	3 Months Ended
	Mar. 31, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Recent Accounting Pronouncements	Recent Issued Accounting Pronouncements In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842). This standard requires a lessee to recognize the lease assets and lease liabilities arising from operating leases in the statement of financial position. Qualitative along with specific quantitative disclosures are required by lessees and lessors to meet the objective of enabling users of financial statements to assess the amount, timing, and uncertainty of cash flows arising from leases. ASU 2016-02 is effective for fiscal years beginning after December 15, 2018 including interim periods within those fiscal years. The Company is currently evaluating the impact that will result from adopting ASU 2016-02. In January 2017, the FASB issued ASU 2017-04, Intangibles - Goodwill and Other (Topic 350). This update modifies the concept of impairment from the condition that exists when the carrying amount of goodwill exceeds its implied fair value to the condition that exists when the carrying amount of a reporting unit exceeds its fair value. An entity no longer will determine goodwill impairment by calculating the implied fair value of goodwill by assigning the fair value of a reporting unit to all of its assets and liabilities as if that reporting unit had been acquired in a business combination. Because these amendments eliminate Step 2 from the goodwill impairment test, they should reduce the cost and complexity of evaluating goodwill for impairment. ASU 2017-04 is effective for the Company's annual and any interim goodwill impairment tests performed on or after January 1, 2020. The Company does not expect the adoption of ASU 2017-04 to have a material impact. In February 2018, the FASB issued ASU 2018-02, Income Statement - Reporting Comprehensive Income (Topic 220). This update permits a company to reclassify its disproportionate income tax effects of the Tax Cuts and Jobs Act of 2017 (the “2017 Act”) on items within accumulated other comprehensive income (“AOCI”) to retained earnings (termed “stranded tax effects”). Only the stranded tax effects resulting from the 2017 Act are eligible for reclassification. The ASU also requires certain new disclosures, some of which are applicable for all companies. The ASU is effective for the Company on January 1, 2019. The Company is currently evaluating the impact that will result from adopting ASU 2018-02. Significant Accounting Policies Revenue Recognition Revenue is recognized when obligations under the terms of a contract with a customer are satisfied; generally this occurs with the transfer of control of devices, supplies, or services. Revenue is measured as the amount of consideration the Company expects to receive in exchange for transferring goods or providing services. For the majority of devices and supplies, the Company transfers control and recognizes revenue when products ship from the warehouse to the customer. The Company generally does not provide rights of return on devices and supplies. Freight charges billed to customers are included in revenue and freight-related expenses are charged to cost of revenue. Depending on the terms of the arrangement, the Company may also defer the recognition of a portion of the consideration received because it has to satisfy a future obligation (e.g. installation). Judgment is required to determine the standalone selling price (SSP) for each distinct performance obligation. The Company uses a single amount to estimate SSP for items that are not sold separately. In instances where SSP is not directly observable, such as when the Company does not sell the product or service separately, the SSP is determined using information that may include market conditions and other observable inputs. The Company sells separately-priced service contracts that extend maintenance coverages for both medical devices and data management systems beyond the base agreements to customer. The separately priced service contracts range from 12 months to 36 months. The Company receives payment at the inception of the contract and recognizes revenue ratably over the service period. For products containing embedded software, the Company determined the hardware and software components function together to deliver the products' essential functionality and are considered a combined performance obligation. Revenue recognition policies for sales of these products are substantially the same as for other tangible products.

Earnings Per Share (Tables)

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2018
Earnings Per Share [Abstract]
Earnings Per Share	The components of basic and diluted EPS are as follows (in thousands, except per share amounts): Three Months Ended 2018 2017 Net income (loss) $ (3,148 ) $ 348 Weighted average common shares 32,760 32,485 Dilutive effect of stock based awards — 555 Diluted Shares 32,760 33,040 Basic earnings (loss) per share $ (0.10 ) $ 0.01 Diluted earnings (loss) per share $ (0.10 ) $ 0.01 Shares excluded from calculation of diluted EPS 390 —

Inventories (Tables)

Inventories (Tables)	3 Months Ended
	Mar. 31, 2018
Inventory Disclosure [Abstract]
Summary of Inventories	Inventories consist of the following (in thousands): March 31, 2018 December 31, 2017 Raw materials and subassemblies $ 32,942 $ 44,699 Work in process 3,891 3,788 Finished goods 54,061 43,488 Total inventories 90,894 91,975 Less: Non-current inventories (16,351 ) (20,446 ) Inventories, current $ 74,543 $ 71,529

Intangible Assets (Tables)

Intangible Assets (Tables)	3 Months Ended
	Mar. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense related to intangible assets with definite lives	The following table summarizes the components of gross and net intangible asset balances (in thousands): March 31, 2018 December 31, 2017 Gross Accumulated Accumulated Net Book Gross Accumulated Accumulated Net Book Intangible assets with definite lives: Technology $ 102,114 $ (1,070 ) $ (44,108 ) $ 56,936 $ 101,045 $ (1,058 ) $ (42,048 ) $ 57,939 Customer related 109,025 (50 ) (32,019 ) 76,956 108,074 (50 ) (28,972 ) 79,052 Trade names 49,579 (3,957 ) (14,943 ) 30,679 49,313 (3,916 ) (13,273 ) 32,124 Internally developed software 15,606 — (12,820 ) 2,786 15,610 — (12,293 ) 3,317 Patents 2,812 (132 ) (2,548 ) 132 2,778 (133 ) (2,495 ) 150 Definite-lived intangible assets $ 279,136 $ (5,209 ) $ (106,438 ) $ 167,489 $ 276,820 $ (5,157 ) $ (99,081 ) $ 172,582
Amortization expense	Amortization expense related to intangible assets with definite lives was as follows (in thousands): Three Months Ended 2018 2017 Technology $ 1,819 $ 1,326 Customer related 2,881 2,208 Trade names 1,626 1,587 Internally developed software 530 504 Patents 22 27 Total amortization $ 6,878 $ 5,652
Expected amortization expense related to amortizable intangible assets	Expected amortization expense related to amortizable intangible assets is as follows (in thousands): Nine months ending December 31, 2018 $ 20,367 2019 26,061 2020 23,857 2021 22,436 2022 18,785 2023 17,785 Thereafter 38,198 Total expected amortization expense $ 167,489

Goodwill (Tables)

Goodwill (Tables)	3 Months Ended
	Mar. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Carrying amount of Goodwill	The carrying amount of goodwill and the changes in the balance are as follows (in thousands): December 31, 2017 $ 172,998 Purchase accounting adjustments (595 ) Foreign currency translation 894 March 31, 2018 $ 173,297

Property and Equipment, net (Ta

Property and Equipment, net (Tables)	3 Months Ended
	Mar. 31, 2018
Property, Plant and Equipment [Abstract]
Property and Equipment net	Property and equipment, net consist of the following (in thousands): March 31, 2018 December 31, 2017 Land $ 2,797 $ 2,815 Buildings 5,021 5,096 Leasehold improvements 3,362 3,295 Equipment and furniture 26,978 25,612 Computer software and hardware 9,792 9,760 Demonstration and loaned equipment 12,186 11,932 60,136 58,510 Accumulated depreciation (37,518 ) (36,439 ) Total $ 22,618 $ 22,071

Reserve for Product Warranties

Reserve for Product Warranties (Tables)	3 Months Ended
	Mar. 31, 2018
Product Warranties Disclosures [Abstract]
Reserve for Product Warranties	The details of activity in the warranty reserve are as follows (in thousands): Three Months Ended 2018 2017 Balance, beginning of period $ 10,995 $ 10,670 Assumed through acquisitions — 1,176 Additions (decreases) charged to expense (1,125 ) 2,806 Reductions (802 ) (1,931 ) Balance, end of period $ 9,068 $ 12,721

Share-Based Compensation (Table

Share-Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2018
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Share-Based Compensation Expense	Details of share-based compensation expense are as follows (in thousands): Three Months Ended 2018 2017 Cost of revenue $ 68 $ 81 Marketing and selling 198 69 Research and development 276 467 General and administrative 1,820 2,139 Total $ 2,362 $ 2,756

Other Income (Expense), net (Ta

Other Income (Expense), net (Tables)	3 Months Ended
	Mar. 31, 2018
Other Income and Expenses [Abstract]
Other Income (Expense), net	Other income (expense), net consists of (in thousands): Three Months Ended 2018 2017 Interest income $ 10 $ 332 Interest expense (1,960 ) (980 ) Foreign currency gain (loss) 604 (428 ) Other income (475 ) 37 Total other income (expense), net $ (1,821 ) $ (1,039 )

Debt and Credit Arrangements (T

Debt and Credit Arrangements (Tables)	3 Months Ended
	Mar. 31, 2018
Debt Disclosure [Abstract]
Schedule of Long-term debt	Long-term debt consists of (in thousands): March 31, 2018 December 31, 2017 Revolving credit facility $ 130,000 $ 155,000 Debt issuance costs (669 ) (717 ) Less: current portion of long-term debt — — Total long-term debt $ 129,331 $ 154,283

Segment, Customer and Geograp30

Segment, Customer and Geographic Information (Tables)	3 Months Ended
	Mar. 31, 2018
Segment Reporting [Abstract]
Revenue and Long-lived Asset Information by Geographic Region	Revenue and long-lived asset information are as follows (in thousands): Three Months Ended 2018 2017 Consolidated Revenue: United States $ 68,671 $ 64,710 Foreign countries 59,938 59,950 Totals $ 128,609 $ 124,660 Three Months Ended 2018 2017 Revenue by End Market: Neurology Products Devices and Systems $ 47,595 $ 38,190 Supplies 15,615 14,886 Services 2,737 3,193 Total Neurology Revenue 65,947 56,269 Newborn Care Products Devices and Systems 15,966 24,137 Supplies 9,522 11,446 Services 5,403 5,050 Total Newborn Care Revenue 30,891 40,633 Otometrics Products Devices and Systems 26,785 21,378 Supplies 4,986 6,380 Total Otometrics Revenue 31,771 27,758 Total Revenue $ 128,609 $ 124,660 March 31, 2018 December 31, 2017 Property and equipment, net: United States $ 10,678 $ 10,128 Canada 5,110 5,068 Argentina 1,495 1,591 Ireland 3,245 3,178 Denmark 1,190 1,158 Other foreign countries 900 948 Totals $ 22,618 $ 22,071

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	3 Months Ended
	Mar. 31, 2018
Fair Value Disclosures [Abstract]
Changes in fair value of contingent consideration	Contingent considerations are as follows (in thousands): December 31, 2017 Additions Payments Adjustments March 31, 2018 Liabilities: Contingent consideration $ 147 $ — $ (147 ) $ — $ — Total $ 147 $ — $ (147 ) $ — $ —

Basis of Presentation (Details)

Basis of Presentation (Details) - USD ($) $ in Millions	Jan. 01, 2018	Mar. 31, 2018
ASU 2016-16
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Tax effect of intra-entity transfer assets recorded to retained earnings	$ 3.9
Minimum
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Service period for separately-priced contracts		12 months
Maximum
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Service period for separately-priced contracts		36 months

Business Combinations - Narrati

Business Combinations - Narrative (Details) - USD ($) $ in Thousands	Oct. 06, 2017	Jan. 03, 2017	Mar. 31, 2017	Mar. 31, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Goodwill				$ 173,297	$ 172,998
Integra
Business Acquisition [Line Items]
Purchase price paid in cash to acquire entity	$ 46,400
Tangible assets	13,100
Intangible assets	$ 19,500
Weighted average life of intangible assets	9 years
Goodwill	$ 14,900
Net liabilities	$ 1,100
Pro forma revenue			$ 136,500
Otometric
Business Acquisition [Line Items]
Purchase price paid in cash to acquire entity		$ 149,200
Net working capital adjustment		$ 4,200

Earnings Per Share (Details)

Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Earnings Per Share [Abstract]
Net income (loss)	$ (3,148)	$ 348
Weighted average common shares (in shares)	32,760	32,485
Dilutive effect of stock based awards (in shares)	0	555
Diluted Shares (in shares)	32,760	33,040
Basic earnings per share (dollars per share)	$ (0.10)	$ 0.01
Diluted earnings per share (dollars per share)	$ (0.10)	$ 0.01
Diluted earnings per share (in shares)	390	0

Inventories (Details)

Inventories (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Summary of Inventories
Raw materials and subassemblies	$ 32,942	$ 44,699
Work in process	3,891	3,788
Finished goods	54,061	43,488
Total inventories	90,894	91,975
Less: Non-current inventories	(16,351)	(20,446)
Inventories, current	$ 74,543	$ 71,529

Intangible Assets - Components

Intangible Assets - Components of Gross and Net Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 279,136	$ 276,820
Accumulated Impairment	(5,209)	(5,157)
Accumulated Amortization	(106,438)	(99,081)
Net Book Value	167,489	172,582
Technology
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	102,114	101,045
Accumulated Impairment	(1,070)	(1,058)
Accumulated Amortization	(44,108)	(42,048)
Net Book Value	56,936	57,939
Customer related
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	109,025	108,074
Accumulated Impairment	(50)	(50)
Accumulated Amortization	(32,019)	(28,972)
Net Book Value	76,956	79,052
Trade names
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	49,579	49,313
Accumulated Impairment	(3,957)	(3,916)
Accumulated Amortization	(14,943)	(13,273)
Net Book Value	30,679	32,124
Internally developed software
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	15,606	15,610
Accumulated Impairment	0	0
Accumulated Amortization	(12,820)	(12,293)
Net Book Value	2,786	3,317
Patents
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	2,812	2,778
Accumulated Impairment	(132)	(133)
Accumulated Amortization	(2,548)	(2,495)
Net Book Value	$ 132	$ 150

Intangible Assets - Narrative (

Intangible Assets - Narrative (Details) $ in Millions	3 Months Ended
	Mar. 31, 2018USD ($)
Acquired Finite-Lived Intangible Assets [Line Items]
Useful life (in years)	11 years
Developed Technology Rights [Member]
Acquired Finite-Lived Intangible Assets [Line Items]
Useful life (in years)	14 years
Customer related
Acquired Finite-Lived Intangible Assets [Line Items]
Useful life (in years)	10 years
Internally developed software
Acquired Finite-Lived Intangible Assets [Line Items]
Useful life (in years)	6 years
Costs incurred for development of internal use computer software	$ 13.4
Costs incurred for development of software to be sold	$ 2.2
Trade names
Acquired Finite-Lived Intangible Assets [Line Items]
Useful life (in years)	10 years
Patents
Acquired Finite-Lived Intangible Assets [Line Items]
Useful life (in years)	13 years

Intangible Assets - Schedule of

Intangible Assets - Schedule of Amortization Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Finite-Lived Intangible Assets [Line Items]
Total amortization	$ 6,878	$ 5,652
Technology
Finite-Lived Intangible Assets [Line Items]
Total amortization	1,819	1,326
Customer related
Finite-Lived Intangible Assets [Line Items]
Total amortization	2,881	2,208
Trade names
Finite-Lived Intangible Assets [Line Items]
Total amortization	1,626	1,587
Internally developed software
Finite-Lived Intangible Assets [Line Items]
Total amortization	530	504
Patents
Finite-Lived Intangible Assets [Line Items]
Total amortization	$ 22	$ 27

Intangible Assets - Schedule 39

Intangible Assets - Schedule of Expected Amortization Expense (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Expected annual amortization expense related to amortizable intangible assets
Nine months ending December 31, 2018	$ 20,367
2,019	26,061
2,020	23,857
2,021	22,436
2,022	18,785
2,023	17,785
Thereafter	38,198
Net Book Value	$ 167,489	$ 172,582

Goodwill (Details)

Goodwill (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2018USD ($)
Carrying amount of goodwill
December 31, 2017	$ 172,998
Purchase accounting adjustments	(595)
Foreign currency translation	894
March 31, 2018	$ 173,297

Property and Equipment, net (De

Property and Equipment, net (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Dec. 31, 2017
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 60,136		$ 58,510
Accumulated depreciation	(37,518)		(36,439)
Total	22,618		22,071
Depreciation	1,000	$ 1,100
Land
Property, Plant and Equipment [Line Items]
Property and equipment, gross	2,797		2,815
Buildings
Property, Plant and Equipment [Line Items]
Property and equipment, gross	5,021		5,096
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	3,362		3,295
Equipment and furniture
Property, Plant and Equipment [Line Items]
Property and equipment, gross	26,978		25,612
Computer software and hardware
Property, Plant and Equipment [Line Items]
Property and equipment, gross	9,792		9,760
Demonstration and loaned equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 12,186		$ 11,932

Property and Equipment, Net (42

Property and Equipment, Net (Details Textual) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Property, Plant and Equipment [Abstract]
Depreciation expense of property and equipment	$ 1	$ 1.1

Reserve for Product Warrantie43

Reserve for Product Warranties - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Dec. 31, 2017	Mar. 31, 2017	Dec. 31, 2016
Product Warranties Disclosures [Abstract]
Product warranty period (in years)	1 year
Product Liability Contingency [Line Items]
Accrual of estimated costs	$ 9,068	$ 10,995	$ 12,721	$ 10,670
Certain NeoBLUE Phototherapy Products
Product Liability Contingency [Line Items]
Accrual of estimated costs	$ 3,900

Reserve for Product Warrantie44

Reserve for Product Warranties - Schedule of Warranty Reserve (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Reserve for Product Warranties
Balance, beginning of period	$ 10,995	$ 10,670
Assumed through acquisitions	0	1,176
Additions (decreases) charged to expense	(1,125)	2,806
Reductions	(802)	(1,931)
Balance, end of period	$ 9,068	$ 12,721

Share-Based Compensation - Narr

Share-Based Compensation - Narrative (Details) $ in Millions	3 Months Ended
	Mar. 31, 2018USD ($)plan
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Number of active share based compensation plans | plan	2
Unrecognized compensation expense related to unvested portion of stock options | $	$ 19.8
Weighted average period of recognition of unrecognized compensation expense	2 years 7 months

Share-Based Compensation - Sche

Share-Based Compensation - Schedule of Share-based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	$ 2,362	$ 2,756
Cost of revenue
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	68	81
Marketing and selling
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	198	69
Research and development
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	276	467
General and administrative
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	$ 1,820	$ 2,139

Other Income (Expense), net (De

Other Income (Expense), net (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Other expense, net
Interest income	$ 10	$ 332
Interest expense	(1,960)	(980)
Foreign currency gain (loss)	604	(428)
Other income	(475)	37
Total other income (expense), net	$ (1,821)	$ (1,039)

Income Taxes (Details)

Income Taxes (Details) - USD ($)	3 Months Ended
	Mar. 31, 2018	Dec. 31, 2017	Mar. 31, 2017
Significant Change in Unrecognized Tax Benefits is Reasonably Possible [Line Items]
Provision for income tax expense (benefit)	$ (1,401,000)		$ 16,000
Effective income tax rate	30.80%		4.40%
Statutory tax rate	21.00%		35.00%
Income tax provision related to one-time transition tax on mandatory deemed repatriation of foreign earnings		$ 16,600,000
tax benefit related to unrecognized tax benefits due to the lapse of applicable statute of limitations	$ 12,000
Minimum
Significant Change in Unrecognized Tax Benefits is Reasonably Possible [Line Items]
Possible of uncertain tax benefit within the next twelve months	0
Maximum
Significant Change in Unrecognized Tax Benefits is Reasonably Possible [Line Items]
Possible of uncertain tax benefit within the next twelve months	$ 1,000,000

Debt and Credit Arrangements -

Debt and Credit Arrangements - Narrative (Details)	3 Months Ended		9 Months Ended
	Mar. 31, 2018USD ($)	Sep. 30, 2017USD ($)	Sep. 30, 2017USD ($)	Dec. 31, 2017USD ($)	Jun. 30, 2017USD ($)
Line of Credit Facility [Line Items]
Revolving credit facility	$ 129,331,000			$ 154,283,000
Revolving credit facility | Line of Credit
Line of Credit Facility [Line Items]
Revolving credit facility	$ 130,000,000			$ 155,000,000
Credit Agreement | Citibank, National Association
Line of Credit Facility [Line Items]
Aggregate secured revolving credit facility		$ 225,000,000	$ 225,000,000		$ 150,000,000
Increase in credit facility		$ 75,000,000
Leverage Ratio	2.24
Interest Coverage Ratio	6.58
All-in rate	4.10%
Credit Agreement | Citibank, National Association | Federal Funds Rate
Line of Credit Facility [Line Items]
Interest rate	0.50%
Credit Agreement | Citibank, National Association | LIBOR rate
Line of Credit Facility [Line Items]
Interest rate	1.00%
Credit Agreement | Citibank, National Association | Maximum
Line of Credit Facility [Line Items]
Leverage Ratio	2.75
Credit Agreement | Citibank, National Association | Maximum | LIBOR rate
Line of Credit Facility [Line Items]
Interest rate	275.00%
Credit Agreement | Citibank, National Association | Minimum
Line of Credit Facility [Line Items]
Interest Coverage Ratio	1.75
Credit Agreement | Citibank, National Association | Minimum | LIBOR rate
Line of Credit Facility [Line Items]
Interest rate			175.00%

Debt and Credit Arrangements 50

Debt and Credit Arrangements - Schedule of Long-term debt (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Revolving credit facility	$ 129,331	$ 154,283
Debt issuance costs	(669)	(717)
Less: current portion of long-term debt	0	0
Total long-term debt	129,331	154,283
Revolving credit facility | Line of Credit
Debt Instrument [Line Items]
Revolving credit facility	$ 130,000	$ 155,000

Segment, Customer and Geograp51

Segment, Customer and Geographic Information - Narrative (Details)	3 Months Ended
	Mar. 31, 2018segment
Segment Reporting [Abstract]
Number of reportable segments (segments)	1

Segment, Customer and Geograp52

Segment, Customer and Geographic Information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Dec. 31, 2017
Consolidated Revenue:
Revenue	$ 128,609	$ 124,660
Revenue by End Market:
Total Revenue	128,609	124,660
Property and equipment, net:
Property and equipment, net	22,618		$ 22,071
Neurology Products
Revenue by End Market:
Total Revenue	65,947	56,269
Neurology Products | Devices and Systems
Revenue by End Market:
Total Revenue	47,595	38,190
Neurology Products | Supplies
Revenue by End Market:
Total Revenue	15,615	14,886
Neurology Products | Services
Revenue by End Market:
Total Revenue	2,737	3,193
Newborn Care Products
Revenue by End Market:
Total Revenue	30,891	40,633
Newborn Care Products | Devices and Systems
Revenue by End Market:
Total Revenue	15,966	24,137
Newborn Care Products | Supplies
Revenue by End Market:
Total Revenue	9,522	11,446
Newborn Care Products | Services
Revenue by End Market:
Total Revenue	5,403	5,050
Otometrics Products
Revenue by End Market:
Total Revenue	31,771	27,758
Otometrics Products | Devices and Systems
Revenue by End Market:
Total Revenue	26,785	21,378
Otometrics Products | Supplies
Revenue by End Market:
Total Revenue	4,986	6,380
United States
Consolidated Revenue:
Revenue	68,671	64,710
Property and equipment, net:
Property and equipment, net	10,678		10,128
Foreign countries
Consolidated Revenue:
Revenue	59,938	$ 59,950
Property and equipment, net:
Property and equipment, net	900		948
Canada
Property and equipment, net:
Property and equipment, net	5,110		5,068
Argentina
Property and equipment, net:
Property and equipment, net	1,495		1,591
Ireland
Property and equipment, net:
Property and equipment, net	3,245		3,178
Denmark
Property and equipment, net:
Property and equipment, net	$ 1,190		$ 1,158

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Sep. 30, 2014	Jun. 30, 2014
Long Lived Assets Held-for-sale [Line Items]
Loss on disposal of property and equipment	$ 52	$ 5
Mundelein Facility | Level II
Long Lived Assets Held-for-sale [Line Items]
Asset held-for-sale book value				$ 3,600
Loss on disposal of property and equipment			$ 2,200
Asset held-for-sale at fair value	$ 1,400

Fair Value Measurements - Sched

Fair Value Measurements - Schedule of Contingent Consideration Liabilities (Details) - Level III $ in Thousands	3 Months Ended
	Mar. 31, 2018USD ($)
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Contingent consideration, beginning balance	$ 147
Additions	0
Payments	(147)
Adjustments	0
Contingent consideration, ending balance	0
Contingent consideration
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Contingent consideration, beginning balance	147
Additions	0
Payments	(147)
Adjustments	0
Contingent consideration, ending balance	$ 0