Natus Medical (NTUS) 10-Q 6 Nov 19 2019 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2019	Oct. 30, 2019
Cover page.
Entity Address, Address Line One	6701 Koll Center Parkway, Suite 120
Entity File Number	000-33001
Entity Incorporation, State or Country Code	DE
Document Transition Report	false
Document Quarterly Report	true
Title of 12(b) Security	Common Stock, $0.001 par value per share
Trading Symbol	NTUS
Security Exchange Name	NASDAQ
Entity Small Business	false
Entity Registrant Name	NATUS MEDICAL INC
Entity Central Index Key	0000878526
Document Type	10-Q
Document Period End Date	Sep. 30, 2019
Amendment Flag	false
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q3
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		34,090,315
Entity Emerging Growth Company	false
Entity Tax Identification Number	77-0154833
Entity Address, City or Town	Pleasanton
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	94566
City Area Code	925
Local Phone Number	223-6700
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Shell Company	false

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (unaudited) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Current assets:
Cash and cash equivalents	$ 63,062	$ 56,373
Accounts receivable, net of allowance for doubtful accounts of $9,047 in 2019 and $6,960 in 2018	108,964	127,041
Inventories	75,107	79,736
Prepaid expenses and other current assets	27,735	22,625
Total current assets	274,868	285,775
Property and equipment, net	25,095	22,913
Operating lease right-of-use assets	16,059	0
Intangible assets, net	119,008	139,453
Goodwill	146,144	147,644
Deferred income tax	21,955	22,639
Other assets	25,984	19,716
Total assets	629,113	638,140
Current liabilities:
Accounts payable	30,096	28,805
Current portion of long-term debt		35,000
Accrued liabilities	56,657	52,568
Deferred revenue	19,242	17,073
Current portion of operating lease liabilities	5,901	0
Total current liabilities	146,896	133,446
Long-term liabilities:
Other liabilities	20,200	19,845
Operating lease liabilities	13,112	0
Long-term debt, net	34,618	69,474
Deferred income tax	8,129	16,931
Total liabilities	222,955	239,696
Stockholders’ equity:
Common stock, $0.001 par value, 120,000,000 shares authorized; shares issued and outstanding 34,090,301 in 2019 and 33,804,379 in 2018	341,083	334,215
Preferred stock, $0.001 par value; 10,000,000 shares authorized; no shares issued and outstanding in 2019 and 2018	0	0
Retained earnings	86,241	102,261
Accumulated other comprehensive loss	(21,166)	(38,032)
Total stockholders’ equity	406,158	398,444
Total liabilities and stockholders’ equity	$ 629,113	$ 638,140

Consolidated Balance Sheets (un

Consolidated Balance Sheets (unaudited) (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Statement of Financial Position [Abstract]
Allowance for doubtful accounts	$ 9,047	$ 6,960
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)	34,090,301	33,804,379
Common Stock, shares outstanding (in shares)	34,090,301	33,804,379
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 Operations (unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Income Statement [Abstract]
Revenue	$ 123,463	$ 130,638	$ 363,759	$ 389,900
Cost of revenue	48,706	51,583	147,240	159,849
Intangibles amortization	1,736	1,930	5,237	6,235
Gross profit	73,021	77,125	211,282	223,816
Operating expenses:
Marketing and selling	30,848	33,200	96,813	102,474
Research and development	14,114	15,127	39,941	46,186
General and administrative	15,113	15,799	44,108	56,966
Intangibles amortization	3,751	4,477	11,300	13,434
Restructuring	1,106	11,432	41,147	14,182
Total operating expenses	64,932	80,035	233,309	233,242
Income (loss) from operations	8,089	(2,910)	(22,027)	(9,426)
Other expense, net	(1,609)	(726)	(4,921)	(4,944)
Income (loss) before provision for (benefit from) income tax	6,480	(3,636)	(26,948)	(14,370)
Provision for (benefit from) income tax	(1,981)	1,940	(9,596)	(3,069)
Net income (loss)	$ 8,461	$ (5,576)	$ (17,352)	$ (11,301)
Net income (loss) per share:
Basic (dollars per share)	$ 0.25	$ (0.17)	$ (0.52)	$ (0.34)
Diluted (dollars per share)	$ 0.25	$ (0.17)	$ (0.52)	$ (0.34)
Weighted average shares used in the calculation of net income (loss) per share:
Basic (in shares)	33,655	33,321	33,666	32,982
Diluted (in shares)	33,738	33,321	33,666	32,982

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Income (unaudited) Condensed Consolidated Statements of Comprehensive Income (unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Statement of Comprehensive Income [Abstract]
Net income (loss)	$ 8,461	$ (5,576)	$ (17,352)	$ (11,301)
Other comprehensive income (loss), net of tax:
Foreign currency translation adjustment	(6,181)	(2,411)	(6,411)	(12,046)
Interest rate swap designated as a cash flow hedge	(27)	99	(236)	98
Reclassification of stranded tax effects upon adoption of ASU 2018-02	0	0	(1,332)	0
Reclassification of deferred foreign currency related adjustments related to the sale of Medix (See Footnote 17 - Sale of Certain Subsidiary Assets)	0	0	24,845	0
Other comprehensive income (loss), net of tax	(6,208)	(2,312)	16,866	(11,948)
Comprehensive income (loss)	$ 2,253	$ (7,888)	$ (486)	$ (23,249)

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows (unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Statement of Cash Flows [Abstract]
Interest Paid, Excluding Capitalized Interest, Operating Activities	$ 3,727	$ 4,426
Operating activities:
Net loss	(17,352)	(11,301)
Adjustments to reconcile net loss to net cash provided by operating activities:
Provision for losses on accounts receivable	1,494	5,871
Depreciation and amortization	22,946	25,652
Loss on disposal of property and equipment	482	410
Warranty reserve	2,588	73
Share-based compensation	6,377	15,446
Impairment charge for sale of entity	24,571	0
Changes in operating assets and liabilities:
Accounts receivable	17,290	2,955
Inventories	(2,074)	(5,183)
Prepaid expenses and other assets	(10,643)	(14,398)
Accounts payable	1,607	(3,799)
Accrued liabilities	1,073	968
Deferred revenue	2,371	1,745
Deferred income tax	(2,817)	517
Net cash provided by operating activities	47,913	18,956
Investing activities:
Acquisition of businesses, net of cash acquired	0	151
Purchase of property and equipment	(3,872)	(5,127)
Purchase of intangible assets	(13)	(637)
Net cash used in investing activities	(3,885)	(5,613)
Financing activities:
Proceeds from stock option exercises and Employee Stock Purchase Program purchases	2,193	10,515
Repurchase of common stock	0	(5,629)
Taxes paid related to net share settlement of equity awards	(1,596)	(5,173)
Principal payments of financing lease liability	(404)	0
Payment of contingent consideration related to a business combination	0	(147)
Payments on borrowings	(35,000)	(40,000)
Net cash used in financing activities	(34,807)	(40,434)
Exchange rate changes effect on cash and cash equivalents	(2,532)	(7,419)
Net increase (decrease) in cash and cash equivalents	6,689	(34,510)
Cash and cash equivalents, beginning of period	56,373	88,950
Cash and cash equivalents, end of period	63,062	54,440
Supplemental disclosure of cash flow information:
Cash paid for income taxes	4,169	7,946
Non-cash investing activities:
Property and equipment included in accounts payable	15	82
Inventory transferred to property and equipment	$ 205	$ 754

Condensed Consolidated Statem_4

Condensed Consolidated Statement of Stockholders' Equity (unaudited) Condensed Consolidated Statement of Stockholders' Equity (unaudited) - USD ($) $ in Thousands	Total	Common Stock [Member]	Retained Earnings [Member]	AOCI Attributable to Parent [Member]
Beginning of period (shares) at Dec. 31, 2017		33,134,101
Beginning of period at Dec. 31, 2017	$ 422,097	$ 316,577	$ 129,115	$ (23,595)
Vesting Of Restricted Stock Units Shares		100
Stock Issued During Period, Shares, Restricted Stock Award, Net of Forfeitures		239,649
Shares Issued, Value, Share-based Payment Arrangement, after Forfeiture	2,361	$ 2,361
Stock Repurchased During Period, Shares		(147,893)
Stock Repurchased During Period, Value	(4,736)	$ (4,736)
Share-based Payment Arrangement, Shares Withheld for Tax Withholding Obligation		(600)
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	(19)	$ (19)
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period		46,173
Stock Issued During Period, Value, Stock Options Exercised	577	$ 577
Other Comprehensive Income (Loss), Net of Tax	3,617			3,617
Net loss	(3,148)		(3,148)
End of period (shares) at Mar. 31, 2018		33,271,530
End of period at Mar. 31, 2018	416,830	$ 314,760	122,048	(19,978)
Beginning of period (shares) at Dec. 31, 2017		33,134,101
Beginning of period at Dec. 31, 2017	422,097	$ 316,577	129,115	(23,595)
Other Comprehensive Income (Loss), Net of Tax	(11,948)
Net loss	(11,301)
End of period (shares) at Sep. 30, 2018		33,755,514
End of period at Sep. 30, 2018	409,959	$ 331,607	113,895	(35,543)
Beginning of period (shares) at Mar. 31, 2018		33,271,530
Beginning of period at Mar. 31, 2018	416,830	$ 314,760	122,048	(19,978)
Vesting Of Restricted Stock Units Shares		166
Stock Issued During Period, Shares, Restricted Stock Award, Net of Forfeitures		21,599
Stock Issued During Period, Shares, Employee Stock Purchase Plans		30,971
Stock Issued During Period, Value, Employee Stock Purchase Plan	870	$ 870
Shares Issued, Value, Share-based Payment Arrangement, after Forfeiture	3,219	$ 3,219
Stock Repurchased During Period, Shares		(25,652)
Stock Repurchased During Period, Value	(893)	$ (893)
Share-based Payment Arrangement, Shares Withheld for Tax Withholding Obligation		(8,627)
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	(306)	$ (306)
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period		300,350
Stock Issued During Period, Value, Stock Options Exercised	3,645	$ 3,645
Other Comprehensive Income (Loss), Net of Tax	(13,253)			(13,253)
Net loss	(2,577)		(2,577)
End of period (shares) at Jun. 30, 2018		33,590,337
End of period at Jun. 30, 2018	407,535	$ 321,295	119,471	(33,231)
Stock Issued During Period, Shares, Restricted Stock Award, Net of Forfeitures		2,595
Shares Issued, Value, Share-based Payment Arrangement, after Forfeiture	9,737	$ 9,737
Share-based Payment Arrangement, Shares Withheld for Tax Withholding Obligation		(151,163)
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	(4,848)	$ (4,848)
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period		313,745
Stock Issued During Period, Value, Stock Options Exercised	5,423	$ 5,423
Other Comprehensive Income (Loss), Net of Tax	(2,312)			(2,312)
Net loss	(5,576)		(5,576)
End of period (shares) at Sep. 30, 2018		33,755,514
End of period at Sep. 30, 2018	409,959	$ 331,607	113,895	(35,543)
Beginning of period (shares) at Dec. 31, 2018		33,804,379
Beginning of period at Dec. 31, 2018	398,444	$ 334,215	102,261	(38,032)
Vesting Of Restricted Stock Units Shares		42,130
Stock Issued During Period, Shares, Restricted Stock Award, Net of Forfeitures		139,718
Shares Issued, Value, Share-based Payment Arrangement, after Forfeiture	2,432	$ 2,432
Share-based Payment Arrangement, Shares Withheld for Tax Withholding Obligation		(47,767)
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	(1,567)	$ (1,567)
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period		16,617
Stock Issued During Period, Value, Stock Options Exercised	268	$ 268
Other Comprehensive Income (Loss), Net of Tax	(1,875)			(1,875)
Net loss	(30,001)		(30,001)
End of period (shares) at Mar. 31, 2019		33,955,077
End of period at Mar. 31, 2019	367,701	$ 335,348	73,592	(41,239)
Beginning of period (shares) at Dec. 31, 2018		33,804,379
Beginning of period at Dec. 31, 2018	398,444	$ 334,215	102,261	(38,032)
Other Comprehensive Income (Loss), Net of Tax	16,866
Net loss	(17,352)
End of period (shares) at Sep. 30, 2019		34,090,301
End of period at Sep. 30, 2019	406,158	$ 341,083	86,241	(21,166)
Beginning of period (shares) at Mar. 31, 2019		33,955,077
Beginning of period at Mar. 31, 2019	367,701	$ 335,348	73,592	(41,239)
Stock Issued During Period, Shares, Restricted Stock Award, Net of Forfeitures		5,762
Stock Issued During Period, Shares, Employee Stock Purchase Plans		31,879
Stock Issued During Period, Value, Employee Stock Purchase Plan	725	$ 725
Shares Issued, Value, Share-based Payment Arrangement, after Forfeiture	1,987	$ 1,987
Share-based Payment Arrangement, Shares Withheld for Tax Withholding Obligation		(274)
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	(7)	$ (7)
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period		47,786
Stock Issued During Period, Value, Stock Options Exercised	682	$ 682
Other Comprehensive Income (Loss), Net of Tax	26,281			26,281
Net loss	4,188		4,188
End of period (shares) at Jun. 30, 2019		34,040,230
End of period at Jun. 30, 2019	401,557	$ 338,735	77,780	(14,958)
Stock Issued During Period, Shares, Restricted Stock Award, Net of Forfeitures		27,025
Shares Issued, Value, Share-based Payment Arrangement, after Forfeiture	1,851	$ 1,851
Share-based Payment Arrangement, Shares Withheld for Tax Withholding Obligation		(754)
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	(22)	$ (22)
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period		23,800
Stock Issued During Period, Value, Stock Options Exercised	519	$ 519
Other Comprehensive Income (Loss), Net of Tax	(6,208)			(6,208)
Net loss	8,461		8,461
End of period (shares) at Sep. 30, 2019		34,090,301
End of period at Sep. 30, 2019	$ 406,158	$ 341,083	$ 86,241	$ (21,166)

Basis of Presentation

Basis of Presentation	9 Months Ended
	Sep. 30, 2019
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 (“we,” “us,” or “our”) have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”). Except where noted below within Note 1, the 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 our Annual Report on Form 10-K for the year ended December 31, 2018 . 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. We have made certain reclassifications to the prior period to conform to current period presentation. The consolidated balance sheet as of December 31, 2018 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 our Annual Report on Form 10-K for the year ended December 31, 2018 . Operating results for the three and nine months ended September 30, 2019 are not necessarily indicative of the results that may be expected for the year ending December 31, 2019 . The accompanying condensed consolidated financial statements include our accounts and our wholly owned subsidiaries. All intercompany accounts and transactions have been eliminated in consolidation. Recent Adopted Accounting Pronouncements In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842). This standard requires lease assets and lease liabilities arising from operating leases to be presented 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. In July 2018, FASB issued ASU 2018-10, Codification Improvements to Topic 842, Leases, which affects narrow aspects of the guidance issued in the amendments in Update 2016-02. In July 2018, the FASB also issued ASU 2018-11, Targeted Improvements. The amendments in ASU 2018-11 provide additional clarification and implementation guidance on certain aspects of the previously issued ASU 2016-02 and have the same effective and transition requirements as ASU 2016-02. The new standard provides a number of optional practical expedients in transition. We have elected the package of practical expedients, which permits an entity to not reassess prior conclusions about lease identification, lease classification and initial direct costs under the new standard. We have not elected the use-of-hindsight practical expedient or the practical expedient pertaining to land easements; the latter of which is not applicable to us. We made an accounting policy election to keep leases with an initial term of 12 months or less off the balance sheet. We will recognize those lease payments in the Consolidated Statements of Operations on a straight-line basis over the lease term. The new standard became effective for us on January 1, 2019. We adopted the new standard using the modified retrospective transition method with the effective date as the date of initial application. Upon adoption, we recognized additional new lease assets of approximately $19.5 million and additional lease liabilities of approximately $22.3 million as of January 1, 2019. The standard did not materially affect consolidated net earnings. By electing the effective date as the date of initial application, financial performance has not been adjusted and the disclosures required under the new standard have not been provided for periods prior to January 1, 2019. See Significant Accounting Policies and Note 14 for additional discussion and disclosure. The adoption of the new standard did not impact our liquidity or debt-covenant compliance under its current agreements. 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. Instead an entity should perform its annual, or interim, goodwill impairment test by comparing the fair value of a reporting unit with its carrying amount. An entity should recognize an impairment charge for the amount by which the carrying amount exceeds the reporting unit's fair value. ASU 2017-04 is effective for our annual and any interim goodwill impairment tests performed on or after January 1, 2020. We elected to early adopt. The adoption of ASU 2017-04 did not have an impact on our consolidated financial statements. 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 was effective for us as of January 1, 2019. Upon adoption, we reclassified its stranded tax effects resulting from the 2017 Act of $1.3 million , resulting in a decrease to AOCI and an increase to retained earnings as of January 1, 2019. Recent Issued Accounting Pronouncements In June 2016, the FASB issued ASU 2016-13, Credit Losses (Topic 326). This update requires financial assets measured at amortized cost, such as trade receivables and contract assets, to be presented net of expected credit losses, which may be estimated based on relevant information such as historical experience, current conditions, and future expectation for each pool of similar financial assets. The new guidance requires enhanced disclosures related to trade receivables and associated credit losses. In May 2019, the FASB issued ASU 2019-05 which provides targeted transition relief guidance intended to increase comparability of financial statement information. The guidance for both of these is effective beginning January 1, 2020. We are evaluating the impact, if any, that these pronouncements will have on our consolidated financial statements. In August 2018, the FASB issued ASU 2018-13 Fair Value Measurement (Topic 820), Disclosure Framework-Changes to the Disclosure Requirements for Fair Value Measurement. This update amends Topic 820 to add, remove, and clarify disclosure requirements related to fair value measurement disclosure. For calendar year-end entities, the update will be effective for annual periods beginning January 1, 2020, and interim periods within those fiscal years. Early adoption of the amendments is permitted, including adoption in any interim period. As the standard relates only to disclosures, we do not expect the adoption to have a material impact on our consolidated financial statements. Significant Accounting Policies Leases We determine if an arrangement is a lease at inception of the lease. Right-of-use (“ROU”) assets represent the right to use an underlying asset for the lease term, and lease liabilities represent an obligation to make lease payments arising from the lease. Operating lease ROU assets and liabilities are recognized at commencement date based on the present value of lease payments over the lease term. As most of our leases do not provide an implicit borrowing rate, generally we use an incremental borrowing rate based on the estimated rate of interest for collateralized borrowing over a similar term of the lease payments at the lease commencement date. We use the implicit rate when readily determinable. The operating lease ROU asset also includes any lease payments made and excludes lease incentives. Our lease terms may include options to exclude or terminate the lease when it is reasonably certain that they will exercise that option. Lease expense for lease payments are recognized on a straight-line basis over the lease term. Operating leases are included in operating lease ROU assets, accrued liabilities, and operating lease liabilities in our consolidated balance sheet. Finance leases are included in property and equipment, accrued liabilities, and other liabilities in the consolidated balance sheet. We have lease agreements with lease and non-lease components, which are generally accounted for based on the type of asset. For real estate and telecom leases, we account for these components separately. For equipment leases, such as office equipment and vehicles, we account for the lease and non-lease components as a single lease component. Assets and Liabilities Held for Sale We consider assets and liabilities to be held for sale when all of the following criteria are met: • Management approves and commits to a formal plan to sell the asset or disposal group; • The assets or disposal group is available for immediate sale in its present condition; • An active program to locate a buyer and other actions required to complete the sale have been initiated; • The sale of the asset or disposal group is expected to be completed within one year; • The asset or disposal group is being actively marketed for sale at a price that is reasonable in relation to the current fair value; and • It is unlikely that significant changes will be made to the plan.

Revenue (Notes)

Revenue (Notes)	9 Months Ended
	Sep. 30, 2019
Revenue from Contract with Customer [Abstract]
Revenue	Revenue Unbilled accounts receivable (“AR”) for the periods presented primarily represent the difference between revenue recognized based on the relative selling price of the related performance obligations and the contractual billing terms in the arrangements. Deferred revenue for the periods presented primarily relates to extended service contracts, installation, and training, for which the service fees are billed in advance. The associated deferred revenue is generally recognized ratably over the extended service period or when installation and training are complete. The following table summarizes the changes in the unbilled AR and deferred revenue balances for the nine months ended September 30, 2019 (in thousands): Unbilled AR, December 31, 2018 $ 3,012 Additions 235 Transferred to Trade Receivable (687 ) Unbilled AR, September 30, 2019 $ 2,560 Deferred Revenue, December 31, 2018 $ 21,410 Additions 16,589 Revenue Recognized (14,246 ) Deferred Revenue, September 30, 2019 $ 23,753 At September 30, 2019 , the short-term portion of deferred revenue of $19.2 million and the long-term portion of $4.5 million were included in deferred revenue and other long-term liabilities respectively, in the consolidated balance sheet. As of September 30, 2019 , we expect to recognize revenue associated with deferred revenue of approximately $7.2 million in 2019, $12.6 million in 2020, $1.9 million in 2021, $1.0 million in 2022, and $1.0 million

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 30, 2019
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 Nine Months Ended 2019 2018 2019 2018 Net income (loss) $ 8,461 $ (5,576 ) $ (17,352 ) $ (11,301 ) Weighted average common shares 33,655 33,321 33,666 32,982 Dilutive effect of stock based awards 83 — — — Diluted Shares 33,738 33,321 33,666 32,982 Basic income (loss) per share $ 0.25 $ (0.17 ) $ (0.52 ) $ (0.34 ) Diluted income (loss) per share $ 0.25 $ (0.17 ) $ (0.52 ) $ (0.34 ) Shares excluded from calculation of diluted EPS — 230 105 407

Inventories

Inventories	9 Months Ended
	Sep. 30, 2019
Inventory Disclosure [Abstract]
Inventories	Inventories Inventories consist of the following (in thousands): September 30, 2019 December 31, 2018 Raw materials and subassemblies $ 40,464 $ 31,459 Work in process 2,629 2,424 Finished goods 54,857 63,932 Total inventories 97,950 97,815 Less: Non-current inventories (22,843 ) (18,079 ) Inventories, current $ 75,107 $ 79,736 As of September 30, 2019 and December 31, 2018 , we have classified $22.8 million and $18.1 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 we no longer sell, inventory purchased for lifetime buys, and inventory that is turning over at a slow rate. We believe these inventories will be utilized for their intended purpose.

Intangible Assets

Intangible Assets	9 Months Ended
	Sep. 30, 2019
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): September 30, 2019 December 31, 2018 Gross Accumulated Accumulated Net Book Gross Accumulated Accumulated Net Book Intangible assets with definite lives: Technology $ 109,075 $ (6,619 ) $ (54,404 ) $ 48,052 $ 111,198 $ (6,768 ) $ (50,046 ) $ 54,384 Customer related 97,440 (50 ) (46,100 ) 51,290 99,440 (1,961 ) (38,574 ) 58,905 Trade names 46,605 (3,774 ) (24,035 ) 18,796 47,217 (4,397 ) (19,250 ) 23,570 Internally developed software 16,524 — (15,780 ) 744 16,264 — (14,164 ) 2,100 Patents 2,664 (133 ) (2,531 ) — 2,718 (133 ) (2,524 ) 61 Service Agreements 1,190 — (1,064 ) 126 1,190 — (757 ) 433 Definite-lived intangible assets $ 273,498 $ (10,576 ) $ (143,914 ) $ 119,008 $ 278,027 $ (13,259 ) $ (125,315 ) $ 139,453 Finite-lived intangible assets are amortized over their weighted average lives, which are 14 years for technology, 10 years for customer related intangibles, 7 years for trade names, 6 years for internally developed software, 13 years for patents, 2 years for service agreements and 11 years weighted average in total. Internally developed software consists of $14.3 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 Nine Months Ended 2019 2018 2019 2018 Technology $ 1,719 $ 2,028 $ 5,186 $ 6,405 Customer related 2,159 2,596 6,509 7,779 Trade names 1,487 1,553 4,476 4,635 Internally developed software 359 545 1,369 1,603 Patents 20 20 60 64 Service Agreements $ 102 $ 165 307 651 Total amortization $ 5,846 $ 6,907 $ 17,907 $ 21,137 The amortization expense amounts shown above include internally developed software not held for sale of $0.2 million and $1.2 million for the three and nine months ended September 30, 2019 , respectively which is recorded within our income statement as a general and administrative operating expense. Expected amortization expense related to definite-lived amortizable intangible assets is as follows (in thousands): Three months ending December 31, 2019 $ 5,378 2020 21,455 2021 20,568 2022 17,134 2023 16,164 2024 14,300 Thereafter 24,009 Total expected amortization expense $ 119,008

Goodwill

Goodwill	9 Months Ended
	Sep. 30, 2019
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, 2018 $ 147,644 Foreign currency translation (1,500 ) September 30, 2019 $ 146,144

Property and Equipment, net

Property and Equipment, net	9 Months Ended
	Sep. 30, 2019
Property, Plant and Equipment [Abstract]
Property and Equipment, net	Property and Equipment, net Property and equipment, net consist of the following (in thousands): September 30, 2019 December 31, 2018 Land $ 1,718 $ 1,828 Buildings 6,629 7,036 Leasehold improvements 8,479 4,649 Finance lease right-of-use assets 2,884 — Equipment and furniture 22,820 23,487 Computer software and hardware 12,315 12,803 Demonstration and loaned equipment 12,074 12,843 66,919 62,646 Accumulated depreciation (41,824 ) (39,733 ) Total $ 25,095 $ 22,913 Depreciation expense of property and equipment was approximately $1.6 million and $4.9 million for the three and nine months ended September 30, 2019 and approximately $2.0 million and $4.4 million for the three and nine months ended September 30, 2018

Reserve for Product Warranties

Reserve for Product Warranties	9 Months Ended
	Sep. 30, 2019
Product Warranties Disclosures [Abstract]
Reserve for Product Warranties	Reserve for Product Warranties We provide a warranty for products that is generally one year in length, but in some cases regulations may require us to provide repair or remediation beyond the typical warranty period. If any of the products contain defects, we may incur additional repair and remediation costs. Service for domestic customers is provided by our service centers that perform all service, repair, and calibration services. Service for international customers is provided by a combination of our 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. We consider 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 servicing is performed to honor existing warranty and regulatory obligations. As of September 30, 2019 , we have accrued $7.4 million for product related warranties, which includes $2.4 million of estimated costs to bring certain products into regulatory compliance. Our estimate of these costs is primarily based upon the number of units outstanding that may require repair and costs associated with shipping. The details of activity in the warranty reserve are as follows (in thousands): Three Months Ended Nine Months Ended 2019 2018 2019 2018 Balance, beginning of period $ 8,076 $ 10,913 $ 9,391 $ 10,995 Additions charged to expense 911 792 3,159 3,127 Utilizations (1,560 ) (945 ) (4,543 ) (2,003 ) Changes in estimate related to product remediation activities — (1,695 ) (571 ) (3,054 ) Divestiture adjustments — — (9 ) — Balance, end of period $ 7,427 $ 9,065 $ 7,427 $ 9,065 Our estimate of future product warranty costs may vary from actual product warranty costs, and any variance from estimates could impact our cost of sales, operating profits and results of operations.

Share-Based Compensation

Share-Based Compensation	9 Months Ended
	Sep. 30, 2019
Share-based Payment Arrangement [Abstract]
Share-Based Compensation	Share-Based Compensation As of September 30, 2019 , we have two active share-based compensation plans, the 2018 Equity Incentive Plan and the 2011 Employee Stock Purchase Plan. In January 2019, we granted market stock unit (“MSU”) awards to certain employees. These MSUs fully vest on December 31, 2021 and have separate market performance goals than the performance stock unit (“PSU”) awards we grant. Each MSU represents the right to one share of common stock. The actual number of MSUs which will be eligible to vest will be based on the performance of our stock price over the vesting period. The maximum number of MSUs which will be eligible to vest are 200% of the MSUs initially granted. A Monte Carlo simulation model was used to estimate the fair value of the MSUs as of their grant date. This model simulates our stock price movements using certain assumptions, including our stock price. The terms of all other awards granted during the nine months ended September 30, 2019 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, 2018 . Details of share-based compensation expense are as follows (in thousands): Three Months Ended Nine Months Ended 2019 2018 2019 2018 Cost of revenue $ 37 $ 42 $ 193 $ 181 Marketing and selling 161 207 600 603 Research and development 270 278 773 827 General and administrative 1,384 1,056 4,705 4,895 Restructuring — 8,231 — 8,940 Total $ 1,852 $ 9,814 $ 6,271 $ 15,446 As of September 30, 2019 , unrecognized compensation expense related to the unvested portion of stock options and other stock awards was approximately $12.3 million , which is expected to be recognized over a weighted average period of 2.1 years .

Other Income (Expense), net

Other Income (Expense), net	9 Months Ended
	Sep. 30, 2019
Other Income and Expenses [Abstract]
Other Income (Expense), net	Other Income (Expense), net Other income (expense), net consists of (in thousands): Three Months Ended Nine Months Ended 2019 2018 2019 2018 Interest income $ 93 $ 318 $ 239 $ 324 Interest expense (1,172 ) (1,649 ) (4,167 ) (5,250 ) Foreign currency gain (loss) (397 ) 572 (860 ) 337 Other expense (133 ) 33 (133 ) (355 ) Total other expense, net $ (1,609 ) $ (726 ) $ (4,921 ) $ (4,944 )

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2019
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes Ours tax provision for interim periods is determined using an estimated annual effective tax rate, adjusted for discrete events arising in each respective quarter. During each interim period, we update the estimated annual effective tax rate which is subject to significant volatility due to several factors, including our ability to accurately predict the income (loss) before provision for income taxes in multiple jurisdictions, the effects of acquisitions, the integration of those acquisitions, and changes in tax law. In circumstances where we are unable to predict income (loss) in multiple jurisdictions, the actual year to date effective tax rate may be the best estimate of the annual effective tax rate for purposes of determining the interim provision for income tax. We recorded a benefit from income tax of $2.0 million and $9.6 million for the three and nine months ended September 30, 2019 , respectively. The effective tax rate was (30.6)% and 35.6% for the three and nine months ended September 30, 2019 , respectively. Of the $9.6 million benefit from income tax recorded for the nine months ended September 30, 2019 , $8.2 million relates to the tax accounting effects of the sale of Medix. We recorded an expense for income tax of $1.9 million and a benefit from income tax of $3.1 million for the three and nine months ended September 30, 2018 , respectively. The effective tax rate was (53.4)% and 21.4% for the three and nine months ended September 30, 2018 , respectively. The increase in the effective tax rate for the three months ended September 30, 2019 compared with the three months ended September 30, 2018 is primarily attributable to changes in distribution of income among jurisdictions with varying tax rates. The increase in the effective tax rate for the nine months ended September 30, 2019 compared with the nine months ended September 30, 2018 is primarily attributable to the tax accounting effects of the sale of Medix. Our effective tax rate for the three months ended September 30, 2019 differed from the federal statutory rate of 21% primarily due to tax benefits from the reversal of uncertain tax positions and certain intra-entity transfers of assets. Our effective tax rate for the nine months ended September 30, 2019 differed from the federal statutory rate of 21% primarily due to the tax accounting effects of the sale of Medix and other tax benefits stated above. Other significant factors that impact the effective tax rate are Federal and California research and development credits, non-deductible executive compensation expenses, and inclusions related to global intangible low-taxed income. We recorded $0.6 million of net tax benefit related to unrecognized tax benefits for the nine months ended September 30, 2019 , primarily due to the lapse of the applicable statute of limitations. Within the next twelve months, it is possible that the uncertain tax benefit may change with a range of approximately zero to $0.4 million . Our tax returns remain open to examination as follows: U.S Federal, 2015 through 2018, U.S. states, 2015 through 2018, and significant foreign jurisdictions, generally 2014 through 2018.

Debt and Credit Arrangements

Debt and Credit Arrangements	9 Months Ended
	Sep. 30, 2019
Debt Disclosure [Abstract]
Debt and Credit Arrangements	Debt and Credit Arrangements We have a Credit Agreement with JP Morgan Chase Bank ("JP Morgan"), Citibank, NA (“Citibank”), and Wells Fargo Bank, National Association (“Wells Fargo”). The Credit Agreement provides for an aggregate $225.0 million of secured revolving credit facility. 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 our 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 the event has a material adverse effect. We have no other significant credit facilities. In addition to the customary restrictive covenants listed above, the Credit Agreement also contains financial covenants that require us 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 September 30, 2019 , we were in compliance with the Leverage Ratio and the Interest Coverage Ratio covenants as defined in the Credit Agreement. At September 30, 2019 , we had $70.0 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 nine months ended September 30, 2019 was 4.74% . The Credit Agreement matures on September 23, 2021, at which time all principal amounts outstanding under the Credit Agreement will be due and payable. As of September 30, 2019 , we have classified $35.0 million of the $70.0 million outstanding as short-term on our balance sheet due to our intent to repay this portion over the next twelve months. Long-term debt consists of (in thousands): September 30, 2019 December 31, 2018 Revolving credit facility $ 70,000 $ 105,000 Debt issuance costs (382 ) (526 ) Less: current portion of long-term debt 35,000 35,000 Total long-term debt $ 34,618 $ 69,474 Maturities of long-term debt as of September 30, 2019 are as follows (in thousands): September 30, 2019 December 31, 2018 2019 $ — $ — 2020 — — 2021 70,000 105,000 Thereafter — — Total $ 70,000 $ 105,000 As of September 30, 2019 , the carrying value of total debt approximated fair market value.

Financial Instruments and Deriv

Financial Instruments and Derivatives	9 Months Ended
	Sep. 30, 2019
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Financial Instruments and Derivatives	Financial Instruments and Derivatives We use interest rate swap derivative instruments to reduce earnings volatility and manage cash flow exposure resulting from changes in interest rates. These interest rate swaps apply a fixed interest rate on a portion of our expected LIBOR-indexed floating-rate borrowings. We held the following interest rate swaps as of September 30, 2019 (in thousands): Hedged Item Current Notional Amount Designation Date Effective Date Termination Date Fixed Interest Rate Floating Rate Estimated Fair Value 1-month USD LIBOR Loan $ 25,000 May 31, 2018 June 1, 2018 September 23, 2021 2.611% 1-month USD LIBOR $ 389 Total interest rate derivatives designated as cash flow hedge $ 25,000 $ 389 We have designated these derivative instruments as cash flow hedges. We assess the effectiveness of these derivative instruments and records the change in the fair value of a derivative instrument designated as a cash flow hedge as unrealized gains or losses in accumulated other comprehensive income (“AOCI”), net of tax. Once the hedged item affects earnings, the effective portion of any gain or loss will be reclassified to earnings. If the hedged cash flow does not occur, or if it becomes probable that it will not occur, we will reclassify the amount of any gain or loss on the related cash flow hedge to interest expense at that time. As of September 30, 2019 , we estimate that approximately $154.0

Leases (Notes)

Leases (Notes)	9 Months Ended
	Sep. 30, 2019
Leases [Abstract]
Leases	Leases We have operating and finance leases for offices, warehouses, and certain equipment. The leases have remaining lease terms of one to eight years , some of which include options to extend the leases for up to ten years . Our leases do not have any residual value guarantees or any restrictions or covenants imposed by leases. Components of lease cost were as follows (in thousands): Three Months Ended Nine Months Ended 2019 2019 Operating lease cost $ 1,719 $ 5,144 Finance lease cost: Amortization of right-of-use assets (principal payments) 115 380 Interest on lease liabilities 13 49 Short-term lease cost — 51 Variable lease cost 922 2,162 Sublease income (46 ) (135 ) Total lease cost $ 2,723 $ 7,651 Supplemental cash flow information related to leases was as follows (in thousands): Three Months Ended Nine Months Ended 2019 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 3,455 $ 10,212 Operating cash flows from finance leases 38 104 Financing cash flows from finance leases 138 404 Right-of-use assets obtained in exchange for lease obligations: Operating leases 774 2,494 Finance leases 123 228 Supplemental balance sheet information related to leases was as follows (in thousands): September 30, 2019 Operating Leases Operating lease right-of-use assets $ 16,059 Current portion of operating lease liabilities $ 5,901 Operating lease liabilities 13,112 Total operating lease liabilities $ 19,013 Finance Leases Property and equipment, gross $ 2,884 Accumulated amortization 1,706 Property and equipment, net $ 1,178 Accrued liabilities $ 445 Other liabilities 779 Total finance lease liabilities $ 1,224 Weighted Average Remaining Lease Term Operating leases 3.9 years Finance leases 3.1 years Weighted Average Discount Rate Operating leases 5.3 % Finance leases 5.1 % As of September 30, 2019 , future minimum lease payments included in the measurement of lease liabilities on the consolidated balance sheet, for the following five fiscal years and thereafter, were as follows (in thousands): Year ending December 31, Operating Leases Finance Leases 2019 $ 6,614 $ 394 2020 5,322 329 2021 3,929 221 2022 2,607 122 2023 1,645 7 Thereafter 1,057 — Total lease payments 21,174 1,073 Less imputed interest (2,161 ) 151 Total $ 19,013 $ 1,224 As we elected to apply the provisions of Topic 842 on a prospective basis, the following comparative period disclosure is being presented in accordance with Topic 840. The future minimum commitments under our leases as of December 31, 2018 were as follows (in thousands): Year ending December 31, Operating Leases 2019 $ 8,092 2020 6,951 2021 5,290 2022 3,423 2023 2,426 Thereafter 1,365 Total minimum lease payments $ 27,547
Leases	Leases We have operating and finance leases for offices, warehouses, and certain equipment. The leases have remaining lease terms of one to eight years , some of which include options to extend the leases for up to ten years . Our leases do not have any residual value guarantees or any restrictions or covenants imposed by leases. Components of lease cost were as follows (in thousands): Three Months Ended Nine Months Ended 2019 2019 Operating lease cost $ 1,719 $ 5,144 Finance lease cost: Amortization of right-of-use assets (principal payments) 115 380 Interest on lease liabilities 13 49 Short-term lease cost — 51 Variable lease cost 922 2,162 Sublease income (46 ) (135 ) Total lease cost $ 2,723 $ 7,651 Supplemental cash flow information related to leases was as follows (in thousands): Three Months Ended Nine Months Ended 2019 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 3,455 $ 10,212 Operating cash flows from finance leases 38 104 Financing cash flows from finance leases 138 404 Right-of-use assets obtained in exchange for lease obligations: Operating leases 774 2,494 Finance leases 123 228 Supplemental balance sheet information related to leases was as follows (in thousands): September 30, 2019 Operating Leases Operating lease right-of-use assets $ 16,059 Current portion of operating lease liabilities $ 5,901 Operating lease liabilities 13,112 Total operating lease liabilities $ 19,013 Finance Leases Property and equipment, gross $ 2,884 Accumulated amortization 1,706 Property and equipment, net $ 1,178 Accrued liabilities $ 445 Other liabilities 779 Total finance lease liabilities $ 1,224 Weighted Average Remaining Lease Term Operating leases 3.9 years Finance leases 3.1 years Weighted Average Discount Rate Operating leases 5.3 % Finance leases 5.1 % As of September 30, 2019 , future minimum lease payments included in the measurement of lease liabilities on the consolidated balance sheet, for the following five fiscal years and thereafter, were as follows (in thousands): Year ending December 31, Operating Leases Finance Leases 2019 $ 6,614 $ 394 2020 5,322 329 2021 3,929 221 2022 2,607 122 2023 1,645 7 Thereafter 1,057 — Total lease payments 21,174 1,073 Less imputed interest (2,161 ) 151 Total $ 19,013 $ 1,224 As we elected to apply the provisions of Topic 842 on a prospective basis, the following comparative period disclosure is being presented in accordance with Topic 840. The future minimum commitments under our leases as of December 31, 2018 were as follows (in thousands): Year ending December 31, Operating Leases 2019 $ 8,092 2020 6,951 2021 5,290 2022 3,423 2023 2,426 Thereafter 1,365 Total minimum lease payments $ 27,547

Segment, Customer and Geographi

Segment, Customer and Geographic Information	9 Months Ended
	Sep. 30, 2019
Segment Reporting [Abstract]
Segment, Customer and Geographic Information	Segment, Customer and Geographic Information We operate in one reportable segment in which we provide medical device solutions focused on the diagnosis and treatment of central nervous and sensory system disorders for patients of all ages. End-user customer base includes hospitals, clinics, laboratories, physicians, audiologists, and governmental agencies. Most of our 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 Nine Months Ended 2019 2018 2019 2018 Consolidated Revenue: United States $ 73,553 $ 77,980 $ 213,055 $ 222,135 International 49,910 52,658 150,704 167,765 Totals $ 123,463 $ 130,638 $ 363,759 $ 389,900 Three Months Ended Nine Months Ended 2019 2018 2019 2018 Revenue by End Market: Neurology Products Devices and Systems $ 55,460 $ 50,635 $ 155,726 $ 146,991 Supplies 16,732 16,405 49,582 50,108 Services — 2,722 871 9,025 Total Neurology Revenue 72,192 69,762 206,179 206,124 Newborn Care Products Devices and Systems 12,487 17,876 39,747 52,326 Supplies 9,864 11,289 28,844 30,436 Services 4,654 5,055 14,514 15,935 Total Newborn Care Revenue 27,005 34,220 83,105 98,697 Hearing & Balance Products Devices and Systems 23,092 25,352 70,795 79,824 Supplies 1,174 1,304 3,680 5,255 Total Hearing & Balance Revenue 24,266 26,656 74,475 85,079 Total Revenue $ 123,463 $ 130,638 $ 363,759 $ 389,900 September 30, 2019 December 31, 2018 Property and equipment, net: United States $ 12,365 $ 10,019 Ireland 5,603 5,083 Canada 4,256 4,504 Denmark 1,753 1,371 Argentina — 999 Other countries 1,118 937 Totals $ 25,095 $ 22,913 During the three and nine months ended September 30, 2019 and 2018 , no single customer or country outside the United States contributed more than 10% of our consolidated revenue.

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2019
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. On April 1, 2019, as part of the sale of our Argentinian subsidiary, Medix, we provided a loan to Medix for $2.2 million . This asset was measured at fair value less costs to sell as of September 30, 2019 and is classified as Level 3 asset. The loan is classified within other assets on our condensed consolidated balance sheet. Subsequent changes in the fair value of the loan receivable are recorded within our income statement as an operating expense. December 31, 2018 Additions Receipts Adjustments September 30, 2019 Other assets: Loan receivable $ — $ 2,200 $ — $ (294 ) $ 1,906 Total $ — $ 2,200 $ — $ (294 ) $ 1,906 The derivative financial instruments described in Note 13 are measured at fair value on a recurring basis and are presented on the consolidated balance sheets at fair value. We estimate the fair value of the interest rate swaps by calculating the present value of the expected future cash flows of each swap. The calculation incorporates the contractual terms of the derivatives, observable market interest rates which are considered to be Level 2 inputs, and credit risk adjustments, if any, to reflect the counterpart's as well as our nonperformance risk. As of September 30, 2019 , there have been no events of default under the interest rate swap agreement. The table below presents the fair value of the derivative financial instruments as well as the classification on the consolidated balance sheet (in thousands): December 31, 2018 Additions Payments Adjustments September 30, 2019 Liabilities: Interest rate swap $ 77 $ — $ — $ 312 $ 389 Total $ 77 $ — $ — $ 312 $ 389 The following financial instruments are not measured at fair value on our consolidated balance sheet as of September 30, 2019 and December 31, 2018

Sale of Certain Subsidiary Asse

Sale of Certain Subsidiary Assets Sale of Certain Subsidiary Assets	9 Months Ended
	Sep. 30, 2019
Related Party Transactions [Abstract]
Sale of Certain Subsidiary Assets	Sale of Certain Subsidiary We divested our wholly owned subsidiary, Medix SA, on April 2, 2019 via a stock sale. In exchange for the stock, we received $2.5 thousand in cash and provided Medix with a $2.2 million limited-recourse loan. The loan is secured by a real estate asset of Medix and repayment is conditional upon the sale of the real estate asset. The held for sale criteria under GAAP was met in the first quarter of 2019. As such, we completed an asset impairment analysis which resulted in the full impairment of all assets held for sale. We recognized an impairment loss of $24.6 million which included an accrual for the anticipated realization of deferred foreign currency related translation adjustments in accumulated other comprehensive income of $24.8 million , net of tax, and an adjustment of $4.6 million for assets with a book value in excess of their fair market value. Included in the nine months ended September 30, 2019 is the sale of Medix, which was completed as of June 30, 2019, and the deferred foreign currency related translation adjustments previously in accumulated other comprehensive income have been released from the balance sheet along with the held for sale accrual.

Basis of Presentation (Policies

Basis of Presentation (Policies)	9 Months Ended
	Sep. 30, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation	The accompanying interim condensed consolidated financial statements of Natus Medical Incorporated (“we,” “us,” or “our”) have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”). Except where noted below within Note 1, the 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 our Annual Report on Form 10-K for the year ended December 31, 2018 . 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. We have made certain reclassifications to the prior period to conform to current period presentation. The consolidated balance sheet as of December 31, 2018 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 our Annual Report on Form 10-K for the year ended December 31, 2018 . Operating results for the three and nine months ended September 30, 2019 are not necessarily indicative of the results that may be expected for the year ending December 31, 2019 . The accompanying condensed consolidated financial statements include our accounts and our wholly owned subsidiaries. All intercompany accounts and transactions have been eliminated in consolidation.
Recent Accounting Pronouncements	Recent Adopted Accounting Pronouncements In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842). This standard requires lease assets and lease liabilities arising from operating leases to be presented 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. In July 2018, FASB issued ASU 2018-10, Codification Improvements to Topic 842, Leases, which affects narrow aspects of the guidance issued in the amendments in Update 2016-02. In July 2018, the FASB also issued ASU 2018-11, Targeted Improvements. The amendments in ASU 2018-11 provide additional clarification and implementation guidance on certain aspects of the previously issued ASU 2016-02 and have the same effective and transition requirements as ASU 2016-02. The new standard provides a number of optional practical expedients in transition. We have elected the package of practical expedients, which permits an entity to not reassess prior conclusions about lease identification, lease classification and initial direct costs under the new standard. We have not elected the use-of-hindsight practical expedient or the practical expedient pertaining to land easements; the latter of which is not applicable to us. We made an accounting policy election to keep leases with an initial term of 12 months or less off the balance sheet. We will recognize those lease payments in the Consolidated Statements of Operations on a straight-line basis over the lease term. The new standard became effective for us on January 1, 2019. We adopted the new standard using the modified retrospective transition method with the effective date as the date of initial application. Upon adoption, we recognized additional new lease assets of approximately $19.5 million and additional lease liabilities of approximately $22.3 million as of January 1, 2019. The standard did not materially affect consolidated net earnings. By electing the effective date as the date of initial application, financial performance has not been adjusted and the disclosures required under the new standard have not been provided for periods prior to January 1, 2019. See Significant Accounting Policies and Note 14 for additional discussion and disclosure. The adoption of the new standard did not impact our liquidity or debt-covenant compliance under its current agreements. 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. Instead an entity should perform its annual, or interim, goodwill impairment test by comparing the fair value of a reporting unit with its carrying amount. An entity should recognize an impairment charge for the amount by which the carrying amount exceeds the reporting unit's fair value. ASU 2017-04 is effective for our annual and any interim goodwill impairment tests performed on or after January 1, 2020. We elected to early adopt. The adoption of ASU 2017-04 did not have an impact on our consolidated financial statements. 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 was effective for us as of January 1, 2019. Upon adoption, we reclassified its stranded tax effects resulting from the 2017 Act of $1.3 million , resulting in a decrease to AOCI and an increase to retained earnings as of January 1, 2019. Recent Issued Accounting Pronouncements In June 2016, the FASB issued ASU 2016-13, Credit Losses (Topic 326). This update requires financial assets measured at amortized cost, such as trade receivables and contract assets, to be presented net of expected credit losses, which may be estimated based on relevant information such as historical experience, current conditions, and future expectation for each pool of similar financial assets. The new guidance requires enhanced disclosures related to trade receivables and associated credit losses. In May 2019, the FASB issued ASU 2019-05 which provides targeted transition relief guidance intended to increase comparability of financial statement information. The guidance for both of these is effective beginning January 1, 2020. We are evaluating the impact, if any, that these pronouncements will have on our consolidated financial statements.
Leases	We determine if an arrangement is a lease at inception of the lease. Right-of-use (“ROU”) assets represent the right to use an underlying asset for the lease term, and lease liabilities represent an obligation to make lease payments arising from the lease. Operating lease ROU assets and liabilities are recognized at commencement date based on the present value of lease payments over the lease term. As most of our leases do not provide an implicit borrowing rate, generally we use an incremental borrowing rate based on the estimated rate of interest for collateralized borrowing over a similar term of the lease payments at the lease commencement date. We use the implicit rate when readily determinable. The operating lease ROU asset also includes any lease payments made and excludes lease incentives. Our lease terms may include options to exclude or terminate the lease when it is reasonably certain that they will exercise that option. Lease expense for lease payments are recognized on a straight-line basis over the lease term. Operating leases are included in operating lease ROU assets, accrued liabilities, and operating lease liabilities in our consolidated balance sheet. Finance leases are included in property and equipment, accrued liabilities, and other liabilities in the consolidated balance sheet. We have lease agreements with lease and non-lease components, which are generally accounted for based on the type of asset. For real estate and telecom leases, we account for these components separately. For equipment leases, such as office equipment and vehicles, we account for the lease and non-lease components as a single lease component.

Revenue (Tables)

Revenue (Tables)	9 Months Ended
	Sep. 30, 2019
Revenue from Contract with Customer [Abstract]
Schedule of contract assets and liabilities	The following table summarizes the changes in the unbilled AR and deferred revenue balances for the nine months ended September 30, 2019 (in thousands): Unbilled AR, December 31, 2018 $ 3,012 Additions 235 Transferred to Trade Receivable (687 ) Unbilled AR, September 30, 2019 $ 2,560 Deferred Revenue, December 31, 2018 $ 21,410 Additions 16,589 Revenue Recognized (14,246 ) Deferred Revenue, September 30, 2019 $ 23,753

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2019
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 Nine Months Ended 2019 2018 2019 2018 Net income (loss) $ 8,461 $ (5,576 ) $ (17,352 ) $ (11,301 ) Weighted average common shares 33,655 33,321 33,666 32,982 Dilutive effect of stock based awards 83 — — — Diluted Shares 33,738 33,321 33,666 32,982 Basic income (loss) per share $ 0.25 $ (0.17 ) $ (0.52 ) $ (0.34 ) Diluted income (loss) per share $ 0.25 $ (0.17 ) $ (0.52 ) $ (0.34 ) Shares excluded from calculation of diluted EPS — 230 105 407

Inventories (Tables)

Inventories (Tables)	9 Months Ended
	Sep. 30, 2019
Inventory Disclosure [Abstract]
Summary of Inventories	Inventories consist of the following (in thousands): September 30, 2019 December 31, 2018 Raw materials and subassemblies $ 40,464 $ 31,459 Work in process 2,629 2,424 Finished goods 54,857 63,932 Total inventories 97,950 97,815 Less: Non-current inventories (22,843 ) (18,079 ) Inventories, current $ 75,107 $ 79,736

Intangible Assets (Tables)

Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2019
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): September 30, 2019 December 31, 2018 Gross Accumulated Accumulated Net Book Gross Accumulated Accumulated Net Book Intangible assets with definite lives: Technology $ 109,075 $ (6,619 ) $ (54,404 ) $ 48,052 $ 111,198 $ (6,768 ) $ (50,046 ) $ 54,384 Customer related 97,440 (50 ) (46,100 ) 51,290 99,440 (1,961 ) (38,574 ) 58,905 Trade names 46,605 (3,774 ) (24,035 ) 18,796 47,217 (4,397 ) (19,250 ) 23,570 Internally developed software 16,524 — (15,780 ) 744 16,264 — (14,164 ) 2,100 Patents 2,664 (133 ) (2,531 ) — 2,718 (133 ) (2,524 ) 61 Service Agreements 1,190 — (1,064 ) 126 1,190 — (757 ) 433 Definite-lived intangible assets $ 273,498 $ (10,576 ) $ (143,914 ) $ 119,008 $ 278,027 $ (13,259 ) $ (125,315 ) $ 139,453
Amortization expense	Amortization expense related to intangible assets with definite lives was as follows (in thousands): Three Months Ended Nine Months Ended 2019 2018 2019 2018 Technology $ 1,719 $ 2,028 $ 5,186 $ 6,405 Customer related 2,159 2,596 6,509 7,779 Trade names 1,487 1,553 4,476 4,635 Internally developed software 359 545 1,369 1,603 Patents 20 20 60 64 Service Agreements $ 102 $ 165 307 651 Total amortization $ 5,846 $ 6,907 $ 17,907 $ 21,137
Expected amortization expense related to amortizable intangible assets	Expected amortization expense related to definite-lived amortizable intangible assets is as follows (in thousands): Three months ending December 31, 2019 $ 5,378 2020 21,455 2021 20,568 2022 17,134 2023 16,164 2024 14,300 Thereafter 24,009 Total expected amortization expense $ 119,008

Goodwill (Tables)

Goodwill (Tables)	9 Months Ended
	Sep. 30, 2019
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, 2018 $ 147,644 Foreign currency translation (1,500 ) September 30, 2019 $ 146,144

Property and Equipment, net (Ta

Property and Equipment, net (Tables)	9 Months Ended
	Sep. 30, 2019
Property, Plant and Equipment [Abstract]
Property and Equipment net	Property and equipment, net consist of the following (in thousands): September 30, 2019 December 31, 2018 Land $ 1,718 $ 1,828 Buildings 6,629 7,036 Leasehold improvements 8,479 4,649 Finance lease right-of-use assets 2,884 — Equipment and furniture 22,820 23,487 Computer software and hardware 12,315 12,803 Demonstration and loaned equipment 12,074 12,843 66,919 62,646 Accumulated depreciation (41,824 ) (39,733 ) Total $ 25,095 $ 22,913

Reserve for Product Warranties

Reserve for Product Warranties (Tables)	9 Months Ended
	Sep. 30, 2019
Product Warranties Disclosures [Abstract]
Reserve for Product Warranties	The details of activity in the warranty reserve are as follows (in thousands): Three Months Ended Nine Months Ended 2019 2018 2019 2018 Balance, beginning of period $ 8,076 $ 10,913 $ 9,391 $ 10,995 Additions charged to expense 911 792 3,159 3,127 Utilizations (1,560 ) (945 ) (4,543 ) (2,003 ) Changes in estimate related to product remediation activities — (1,695 ) (571 ) (3,054 ) Divestiture adjustments — — (9 ) — Balance, end of period $ 7,427 $ 9,065 $ 7,427 $ 9,065

Share-Based Compensation (Table

Share-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2019
Share-based Payment Arrangement [Abstract]
Share-Based Compensation Expense	Details of share-based compensation expense are as follows (in thousands): Three Months Ended Nine Months Ended 2019 2018 2019 2018 Cost of revenue $ 37 $ 42 $ 193 $ 181 Marketing and selling 161 207 600 603 Research and development 270 278 773 827 General and administrative 1,384 1,056 4,705 4,895 Restructuring — 8,231 — 8,940 Total $ 1,852 $ 9,814 $ 6,271 $ 15,446

Other Income (Expense), net (Ta

Other Income (Expense), net (Tables)	9 Months Ended
	Sep. 30, 2019
Other Income and Expenses [Abstract]
Other Income (Expense), net	Other income (expense), net consists of (in thousands): Three Months Ended Nine Months Ended 2019 2018 2019 2018 Interest income $ 93 $ 318 $ 239 $ 324 Interest expense (1,172 ) (1,649 ) (4,167 ) (5,250 ) Foreign currency gain (loss) (397 ) 572 (860 ) 337 Other expense (133 ) 33 (133 ) (355 ) Total other expense, net $ (1,609 ) $ (726 ) $ (4,921 ) $ (4,944 )

Debt and Credit Arrangements (T

Debt and Credit Arrangements (Tables)	9 Months Ended
	Sep. 30, 2019
Debt Disclosure [Abstract]
Schedule of Long-term debt	Long-term debt consists of (in thousands): September 30, 2019 December 31, 2018 Revolving credit facility $ 70,000 $ 105,000 Debt issuance costs (382 ) (526 ) Less: current portion of long-term debt 35,000 35,000 Total long-term debt $ 34,618 $ 69,474

Financial Instruments and Der_2

Financial Instruments and Derivatives (Tables)	9 Months Ended
	Sep. 30, 2019
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of interest rate swaps	held the following interest rate swaps as of September 30, 2019 (in thousands): Hedged Item Current Notional Amount Designation Date Effective Date Termination Date Fixed Interest Rate Floating Rate Estimated Fair Value 1-month USD LIBOR Loan $ 25,000 May 31, 2018 June 1, 2018 September 23, 2021 2.611% 1-month USD LIBOR $ 389 Total interest rate derivatives designated as cash flow hedge $ 25,000 $ 389

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 2019
Leases [Abstract]
Lease, Cost [Table Text Block]	Components of lease cost were as follows (in thousands): Three Months Ended Nine Months Ended 2019 2019 Operating lease cost $ 1,719 $ 5,144 Finance lease cost: Amortization of right-of-use assets (principal payments) 115 380 Interest on lease liabilities 13 49 Short-term lease cost — 51 Variable lease cost 922 2,162 Sublease income (46 ) (135 ) Total lease cost $ 2,723 $ 7,651 Supplemental cash flow information related to leases was as follows (in thousands): Three Months Ended Nine Months Ended 2019 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 3,455 $ 10,212 Operating cash flows from finance leases 38 104 Financing cash flows from finance leases 138 404 Right-of-use assets obtained in exchange for lease obligations: Operating leases 774 2,494 Finance leases 123 228
Assets and Liabilities, Lessee [Table Text Block]	Supplemental balance sheet information related to leases was as follows (in thousands): September 30, 2019 Operating Leases Operating lease right-of-use assets $ 16,059 Current portion of operating lease liabilities $ 5,901 Operating lease liabilities 13,112 Total operating lease liabilities $ 19,013 Finance Leases Property and equipment, gross $ 2,884 Accumulated amortization 1,706 Property and equipment, net $ 1,178 Accrued liabilities $ 445 Other liabilities 779 Total finance lease liabilities $ 1,224 Weighted Average Remaining Lease Term Operating leases 3.9 years Finance leases 3.1 years Weighted Average Discount Rate Operating leases 5.3 % Finance leases 5.1 %
Finance Lease, Liability, Maturity [Table Text Block]	As of September 30, 2019 , future minimum lease payments included in the measurement of lease liabilities on the consolidated balance sheet, for the following five fiscal years and thereafter, were as follows (in thousands): Year ending December 31, Operating Leases Finance Leases 2019 $ 6,614 $ 394 2020 5,322 329 2021 3,929 221 2022 2,607 122 2023 1,645 7 Thereafter 1,057 — Total lease payments 21,174 1,073 Less imputed interest (2,161 ) 151 Total $ 19,013 $ 1,224
Lessee, Operating Lease, Liability, Maturity [Table Text Block]	As of September 30, 2019 , future minimum lease payments included in the measurement of lease liabilities on the consolidated balance sheet, for the following five fiscal years and thereafter, were as follows (in thousands): Year ending December 31, Operating Leases Finance Leases 2019 $ 6,614 $ 394 2020 5,322 329 2021 3,929 221 2022 2,607 122 2023 1,645 7 Thereafter 1,057 — Total lease payments 21,174 1,073 Less imputed interest (2,161 ) 151 Total $ 19,013 $ 1,224
Schedule of Future Minimum Rental Payments for Operating Leases [Table Text Block]	The future minimum commitments under our leases as of December 31, 2018 were as follows (in thousands): Year ending December 31, Operating Leases 2019 $ 8,092 2020 6,951 2021 5,290 2022 3,423 2023 2,426 Thereafter 1,365 Total minimum lease payments $ 27,547

Segment, Customer and Geograp_2

Segment, Customer and Geographic Information (Tables)	9 Months Ended
	Sep. 30, 2019
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 Nine Months Ended 2019 2018 2019 2018 Consolidated Revenue: United States $ 73,553 $ 77,980 $ 213,055 $ 222,135 International 49,910 52,658 150,704 167,765 Totals $ 123,463 $ 130,638 $ 363,759 $ 389,900 Three Months Ended Nine Months Ended 2019 2018 2019 2018 Revenue by End Market: Neurology Products Devices and Systems $ 55,460 $ 50,635 $ 155,726 $ 146,991 Supplies 16,732 16,405 49,582 50,108 Services — 2,722 871 9,025 Total Neurology Revenue 72,192 69,762 206,179 206,124 Newborn Care Products Devices and Systems 12,487 17,876 39,747 52,326 Supplies 9,864 11,289 28,844 30,436 Services 4,654 5,055 14,514 15,935 Total Newborn Care Revenue 27,005 34,220 83,105 98,697 Hearing & Balance Products Devices and Systems 23,092 25,352 70,795 79,824 Supplies 1,174 1,304 3,680 5,255 Total Hearing & Balance Revenue 24,266 26,656 74,475 85,079 Total Revenue $ 123,463 $ 130,638 $ 363,759 $ 389,900 September 30, 2019 December 31, 2018 Property and equipment, net: United States $ 12,365 $ 10,019 Ireland 5,603 5,083 Canada 4,256 4,504 Denmark 1,753 1,371 Argentina — 999 Other countries 1,118 937 Totals $ 25,095 $ 22,913

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2019
Fair Value Disclosures [Abstract]
Fair value of the derivative financial instrument	December 31, 2018 Additions Receipts Adjustments September 30, 2019 Other assets: Loan receivable $ — $ 2,200 $ — $ (294 ) $ 1,906 Total $ — $ 2,200 $ — $ (294 ) $ 1,906 December 31, 2018 Additions Payments Adjustments September 30, 2019 Liabilities: Interest rate swap $ 77 $ — $ — $ 312 $ 389 Total $ 77 $ — $ — $ 312 $ 389

Basis of Presentation (Details)

Basis of Presentation (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Jan. 01, 2019	Dec. 31, 2018
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Operating Lease, Right-of-Use Asset	$ 16,059		$ 0
Operating Lease, Liability	$ 19,013
ASU 2016-02
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Operating Lease, Right-of-Use Asset		$ 19,500
Operating Lease, Liability		22,300
ASU 2018-02
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Cumulative effect adjustment		0
Retained Earnings [Member] | ASU 2018-02
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Cumulative effect adjustment		$ 1,332

Revenue - Narrative (Details)

Revenue - Narrative (Details) $ in Millions	Sep. 30, 2019USD ($)
Revenue from Contract with Customer [Abstract]
Short-term contract liability	$ 19.2
Long-term contract liability	$ 4.5
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2018-07-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Expected timing of satisfaction for remaining performance obligation	3 months
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2019-01-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Remaining performance obligation	$ 7.2
Expected timing of satisfaction for remaining performance obligation	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2020-01-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Remaining performance obligation	$ 12.6
Expected timing of satisfaction for remaining performance obligation	2 years
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2021-01-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Remaining performance obligation	$ 1.9
Expected timing of satisfaction for remaining performance obligation	3 years
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2022-01-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Remaining performance obligation	$ 1
Expected timing of satisfaction for remaining performance obligation	4 years
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2023-01-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Remaining performance obligation	$ 1
Expected timing of satisfaction for remaining performance obligation

Revenue - Unbilled AR and Defer

Revenue - Unbilled AR and Deferred Revenue (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Movement in Deferred Revenue [Roll Forward]
Deferred Revenue, December 31, 2018	$ 21,410
Additions		$ 16,589
Revenue Recognized		$ (14,246)
Deferred Revenue, March 31, 2019	23,753
Unbilled AR
Movement in Unbilled AR [Roll Forward]
Unbilled AR, December 31, 2018	3,012
Additions	235
Transferred to Trade Receivable	(687)
Unbilled AR, March 31, 2019	$ 2,560

Earnings Per Share (Details)

Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2019	Sep. 30, 2018
Earnings Per Share [Abstract]
Net loss	$ 8,461	$ 4,188	$ (30,001)	$ (5,576)	$ (2,577)	$ (3,148)	$ (17,352)	$ (11,301)
Weighted average common shares (in shares)	33,655			33,321			33,666	32,982
Dilutive effect of stock based awards (in shares)	83			0			0	0
Diluted Shares (in shares)	33,738			33,321			33,666	32,982
Basic earnings per share (dollars per share)	$ 0.25			$ (0.17)			$ (0.52)	$ (0.34)
Diluted earnings per share (dollars per share)	$ 0.25			$ (0.17)			$ (0.52)	$ (0.34)
Diluted earnings per share (in shares)	0			230			105	407

Inventories (Details)

Inventories (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Summary of Inventories
Raw materials and subassemblies	$ 40,464	$ 31,459
Work in process	2,629	2,424
Finished goods	54,857	63,932
Total inventories	97,950	97,815
Less: Non-current inventories	(22,843)	(18,079)
Inventories, current	$ 75,107	$ 79,736

Intangible Assets - Components

Intangible Assets - Components of Gross and Net Intangible Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 273,498	$ 278,027
Accumulated Impairment	(10,576)	(13,259)
Accumulated Amortization	(143,914)	(125,315)
Net Book Value	119,008	139,453
Technology
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	109,075	111,198
Accumulated Impairment	(6,619)	(6,768)
Accumulated Amortization	(54,404)	(50,046)
Net Book Value	48,052	54,384
Customer related
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	97,440	99,440
Accumulated Impairment	(50)	(1,961)
Accumulated Amortization	(46,100)	(38,574)
Net Book Value	51,290	58,905
Trade names
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	46,605	47,217
Accumulated Impairment	(3,774)	(4,397)
Accumulated Amortization	(24,035)	(19,250)
Net Book Value	18,796	23,570
Internally developed software
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	16,524	16,264
Accumulated Impairment	0	0
Accumulated Amortization	(15,780)	(14,164)
Net Book Value	744	2,100
Patents
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	2,664	2,718
Accumulated Impairment	(133)	(133)
Accumulated Amortization	(2,531)	(2,524)
Net Book Value	0	61
Service Agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	1,190	1,190
Accumulated Impairment	0	0
Accumulated Amortization	(1,064)	(757)
Net Book Value	$ 126	$ 433

Intangible Assets - Narrative (

Intangible Assets - Narrative (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Acquired Finite-Lived Intangible Assets [Line Items]
Total amortization	$ 5,846,000	$ 6,907,000	$ 17,907,000	$ 21,137,000
Useful life (in years)			11 years
Technology
Acquired Finite-Lived Intangible Assets [Line Items]
Total amortization	1,719,000	2,028,000	$ 5,186,000	6,405,000
Useful life (in years)			14 years
Customer related
Acquired Finite-Lived Intangible Assets [Line Items]
Total amortization	2,159,000	2,596,000	$ 6,509,000	7,779,000
Useful life (in years)			10 years
Trade names
Acquired Finite-Lived Intangible Assets [Line Items]
Total amortization	1,487,000	1,553,000	$ 4,476,000	4,635,000
Useful life (in years)			7 years
Internally developed software
Acquired Finite-Lived Intangible Assets [Line Items]
Total amortization	359,000	545,000	$ 1,369,000	1,603,000
Useful life (in years)			6 years
Costs incurred for development of internal use computer software	14,300,000		$ 14,300,000
Costs incurred for development of software to be sold	2,200,000		2,200,000
Patents
Acquired Finite-Lived Intangible Assets [Line Items]
Total amortization	20,000	20,000	$ 60,000	64,000
Useful life (in years)			13 years
Service Agreements
Acquired Finite-Lived Intangible Assets [Line Items]
Total amortization	102,000	$ 165,000	$ 307,000	$ 651,000
Useful life (in years)			2 years
General and administrative | Internally developed software
Acquired Finite-Lived Intangible Assets [Line Items]
Total amortization	$ 200,000		$ 1,200,000

Intangible Assets - Schedule of

Intangible Assets - Schedule of Amortization Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Finite-Lived Intangible Assets [Line Items]
Total amortization	$ 5,846	$ 6,907	$ 17,907	$ 21,137
Technology
Finite-Lived Intangible Assets [Line Items]
Total amortization	1,719	2,028	5,186	6,405
Customer related
Finite-Lived Intangible Assets [Line Items]
Total amortization	2,159	2,596	6,509	7,779
Trade names
Finite-Lived Intangible Assets [Line Items]
Total amortization	1,487	1,553	4,476	4,635
Internally developed software
Finite-Lived Intangible Assets [Line Items]
Total amortization	359	545	1,369	1,603
Patents
Finite-Lived Intangible Assets [Line Items]
Total amortization	20	20	60	64
Service Agreements
Finite-Lived Intangible Assets [Line Items]
Total amortization	$ 102	$ 165	$ 307	$ 651

Intangible Assets - Schedule _2

Intangible Assets - Schedule of Expected Amortization Expense (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Expected annual amortization expense related to amortizable intangible assets
Three months ending December 31, 2019	$ 5,378
2019	21,455
2020	20,568
2021	17,134
2022	16,164
2023	14,300
Thereafter	24,009
Net Book Value	$ 119,008	$ 139,453

Goodwill (Details)

Goodwill (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2019USD ($)
Carrying amount of goodwill
December 31, 2018	$ 147,644
Foreign currency translation	(1,500)
September 30, 2019	$ 146,144

Property and Equipment, net (De

Property and Equipment, net (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 66,919		$ 66,919		$ 62,646
Finance Lease, Right-of-Use Asset	2,884		2,884		0
Accumulated depreciation	(41,824)		(41,824)		(39,733)
Total	25,095		25,095		22,913
Depreciation	1,600	$ 2,000	4,900	$ 4,400
Land
Property, Plant and Equipment [Line Items]
Property and equipment, gross	1,718		1,718		1,828
Buildings
Property, Plant and Equipment [Line Items]
Property and equipment, gross	6,629		6,629		7,036
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	8,479		8,479		4,649
Equipment and furniture
Property, Plant and Equipment [Line Items]
Property and equipment, gross	22,820		22,820		23,487
Computer software and hardware
Property, Plant and Equipment [Line Items]
Property and equipment, gross	12,315		12,315		12,803
Demonstration and loaned equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 12,074		$ 12,074		$ 12,843

Reserve for Product Warrantie_2

Reserve for Product Warranties - Narrative (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Jun. 30, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Dec. 31, 2017
Product Warranties Disclosures [Abstract]
Product warranty period (in years)	1 year
Product Liability Contingency [Line Items]
Accrual of estimated costs	$ 7,427	$ 8,076	$ 9,391	$ 9,065	$ 10,913	$ 10,995
Certain products
Product Liability Contingency [Line Items]
Accrual of estimated costs	$ 2,400

Reserve for Product Warrantie_3

Reserve for Product Warranties - Schedule of Warranty Reserve (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Reserve for Product Warranties
Balance, beginning of period	$ 8,076	$ 10,913	$ 9,391	$ 10,995
Additions charged to expense	911	792	3,159	3,127
Utilizations	(1,560)	(945)	(4,543)	(2,003)
Changes in estimate related to product remediation activities	0	(1,695)	(571)	(3,054)
Standard and Extended Product Warranty Accrual, Decrease for Divestiture	0	0	(9)	0
Balance, end of period	$ 7,427	$ 9,065	$ 7,427	$ 9,065

Share-Based Compensation - Narr

Share-Based Compensation - Narrative (Details) $ in Millions	9 Months Ended
	Sep. 30, 2019USD ($)	Jun. 30, 2019plan
Share-based Payment Arrangement [Abstract]
Number of active share based compensation plans | plan		2
Unrecognized compensation expense related to unvested portion of stock options | $	$ 12.3
Weighted average period of recognition of unrecognized compensation expense	2 years 1 month 6 days

Share-Based Compensation - Sche

Share-Based Compensation - Schedule of Share-based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	$ 1,852	$ 9,814	$ 6,271	$ 15,446
Cost of revenue
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	37	42	193	181
Marketing and selling
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	161	207	600	603
Research and development
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	270	278	773	827
General and administrative
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	1,384	1,056	4,705	4,895
Restructuring
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	$ 0	$ 8,231	$ 0	$ 8,940

Other Income (Expense), net (De

Other Income (Expense), net (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Other expense, net
Interest income	$ 93	$ 318	$ 239	$ 324
Interest expense	(1,172)	(1,649)	(4,167)	(5,250)
Foreign currency gain (loss)	(397)	572	(860)	337
Other expense	(133)	33	(133)	(355)
Total other expense, net	$ (1,609)	$ (726)	$ (4,921)	$ (4,944)

Income Taxes (Details)

Income Taxes (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Significant Change in Unrecognized Tax Benefits is Reasonably Possible [Line Items]
Provision for income tax benefit	$ (1,981,000)	$ 1,940,000	$ (9,596,000)	$ (3,069,000)
Effective income tax rate	(30.60%)	(53.40%)	35.60%	21.40%
tax benefit related to unrecognized tax benefits due to the lapse of applicable statute of limitations			$ 600,000
Minimum
Significant Change in Unrecognized Tax Benefits is Reasonably Possible [Line Items]
Possible of uncertain tax benefit within the next twelve months	$ 0		0
Maximum
Significant Change in Unrecognized Tax Benefits is Reasonably Possible [Line Items]
Possible of uncertain tax benefit within the next twelve months	$ 400,000		400,000
Medix Medical Devices, SRL [Member]
Significant Change in Unrecognized Tax Benefits is Reasonably Possible [Line Items]
Tax related to divestiture			$ 8,200,000

Debt and Credit Arrangements -

Debt and Credit Arrangements - Narrative (Details)	9 Months Ended
	Sep. 30, 2019USD ($)	Dec. 31, 2018USD ($)
Line of Credit Facility [Line Items]
Revolving credit facility	$ 70,000,000	$ 105,000,000
Current portion of long-term debt		$ 35,000,000
Revolving credit facility | Line of Credit
Line of Credit Facility [Line Items]
Revolving credit facility	70,000,000
Credit Agreement | Citibank, National Association
Line of Credit Facility [Line Items]
Aggregate secured revolving credit facility	$ 225,000,000
All-in rate	4.74%
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 _2

Debt and Credit Arrangements - Schedule of Long-term debt (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
2019	$ 0	$ 0
2020	0	0
2021	70,000	105,000
Thereafter	0	0
Revolving credit facility	70,000	105,000
Debt issuance costs	(382)	(526)
Less: current portion of long-term debt	35,000	35,000
Total long-term debt	34,618	$ 69,474
Revolving credit facility | Line of Credit
Debt Instrument [Line Items]
Revolving credit facility	$ 70,000

Financial Instruments and Der_3

Financial Instruments and Derivatives (Details)	Sep. 30, 2019USD ($)
Derivative [Line Items]
Losses associated with cash flow hedge expected to be reclassified within the next 12 months	$ 154,000
Designated as Hedging Instrument | Cash Flow Hedging | Interest Rate Swap
Derivative [Line Items]
Current Notional Amount	$ 25,000,000
Fixed Interest Rate	2.611%
Estimated Fair Value	$ 389,000

Leases - Narrative (Details)

Leases - Narrative (Details)	Sep. 30, 2019
Operating Leased Assets [Line Items]
Operating Lease, Weighted Average Remaining Lease Term	3 years 10 months 24 days
Lessee, Operating Lease, Renewal Term	10 years
Minimum
Operating Leased Assets [Line Items]
Operating Lease, Weighted Average Remaining Lease Term	1 year
Maximum
Operating Leased Assets [Line Items]
Operating Lease, Weighted Average Remaining Lease Term	8 years

Leases - Lease Cost (Details)

Leases - Lease Cost (Details) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2019
Leases [Abstract]
Operating Lease, Cost	$ 1,719	$ 5,144
Finance Lease, Right-of-Use Asset, Amortization	115	380
Finance Lease, Interest Expense	13	49
Short-term Lease, Cost	0	51
Variable Lease, Cost	922	2,162
Sublease Income	(46)	(135)
Lease, Cost	$ 2,723	$ 7,651

Leases - Supplemental Cash Flow

Leases - Supplemental Cash Flow (Details) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2019	Sep. 30, 2018
Leases [Abstract]
Operating Lease, Payments	$ 3,455	$ 10,212
Finance Lease, Interest Payment on Liability	38	104
Finance Lease, Principal Payments	138	404	$ 0
Right-of-Use Asset Obtained in Exchange for Operating Lease Liability	774	2,494
Right-of-Use Asset Obtained in Exchange for Finance Lease Liability	$ 123	$ 228

Leases - Supplemental Balance S

Leases - Supplemental Balance Sheet (Details) - USD ($)	Sep. 30, 2019	Dec. 31, 2018
Leases [Abstract]
Operating lease right-of-use assets	$ 16,059,000	$ 0
Current portion of operating lease liabilities	5,901,000	0
Operating lease liabilities	13,112,000	$ 0
Operating Lease, Liability	19,013,000
Finance Lease, Right-Of-Use Asset, Gross	2,884,000
Finance Lease, Right-Of-Use Asset, Accumulated Depreciation	1,706,000
Finance Lease, Right-of-Use Asset	1,178,000
Finance Lease, Liability, Current	445,000
Finance Lease, Liability, Noncurrent	779,000
Finance Lease, Liability	$ 1,224,000
Operating Lease, Weighted Average Remaining Lease Term	3 years 10 months 24 days
Finance Lease, Weighted Average Remaining Lease Term	3 years 1 month 6 days
Operating Lease, Weighted Average Discount Rate, Percent	5.30%
Finance Lease, Weighted Average Discount Rate, Percent	5.10%

Leases - Lease Maturities (Deta

Leases - Lease Maturities (Details)	Sep. 30, 2019USD ($)
Operating Leases
Lessee, Operating Lease, Liability, Payments, Remainder of Fiscal Year	$ 6,614,000
Lessee, Operating Lease, Liability, Payments, Due Year Two	5,322,000
Lessee, Operating Lease, Liability, Payments, Due Year Three	3,929,000
Lessee, Operating Lease, Liability, Payments, Due Year Four	2,607,000
Lessee, Operating Lease, Liability, Payments, Due Year Five	1,645,000
Lessee, Operating Lease, Liability, Payments, Due after Year Five	1,057,000
Lessee, Operating Lease, Liability, Payments, Due	21,174,000
Lessee, Operating Lease, Liability, Undiscounted Excess Amount	(2,161,000)
Operating Lease, Liability	19,013,000
Finance Leases
Finance Lease, Liability, Payments, Remainder of Fiscal Year	394,000
Finance Lease, Liability, Payments, Due Year Two	329,000
Finance Lease, Liability, Payments, Due Year Three	221,000
Finance Lease, Liability, Payments, Due Year Four	122,000
Finance Lease, Liability, Payments, Due Year Five	7,000
Finance Lease, Liability, Payments, Due after Year Five	0
Finance Lease, Liability, Payment, Due	1,073,000
Finance Lease, Liability, Undiscounted Excess Amount	151,000
Finance Lease, Liability	$ 1,224,000

Leases - Future Minimum Payment

Leases - Future Minimum Payments (Details)	Dec. 31, 2018USD ($)
Leases [Abstract]
Operating Leases, Future Minimum Payments Due, Next Twelve Months	$ 8,092,000
Operating Leases, Future Minimum Payments, Due in Two Years	6,951,000
Operating Leases, Future Minimum Payments, Due in Three Years	5,290,000
Operating Leases, Future Minimum Payments, Due in Four Years	3,423,000
Operating Leases, Future Minimum Payments, Due in Five Years	2,426,000
Operating Leases, Future Minimum Payments, Due Thereafter	1,365,000
Operating Leases, Future Minimum Payments Due	$ 27,547,000

Segment, Customer and Geograp_3

Segment, Customer and Geographic Information - Narrative (Details)	9 Months Ended
	Sep. 30, 2019segment
Segment Reporting [Abstract]
Number of reportable segments (segments)	1

Segment, Customer and Geograp_4

Segment, Customer and Geographic Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Consolidated Revenue:
Revenue	$ 123,463	$ 130,638	$ 363,759	$ 389,900
Revenue by End Market:
Total Revenue	123,463	130,638	363,759	389,900
Property and equipment, net:
Property and equipment, net	25,095		25,095		$ 22,913
Neurology Products
Revenue by End Market:
Total Revenue	72,192	69,762	206,179	206,124
Neurology Products | Devices and Systems
Revenue by End Market:
Total Revenue	55,460	50,635	155,726	146,991
Neurology Products | Supplies
Revenue by End Market:
Total Revenue	16,732	16,405	49,582	50,108
Neurology Products | Services
Revenue by End Market:
Total Revenue	0	2,722	871	9,025
Newborn Care Products
Revenue by End Market:
Total Revenue	27,005	34,220	83,105	98,697
Newborn Care Products | Devices and Systems
Revenue by End Market:
Total Revenue	12,487	17,876	39,747	52,326
Newborn Care Products | Supplies
Revenue by End Market:
Total Revenue	9,864	11,289	28,844	30,436
Newborn Care Products | Services
Revenue by End Market:
Total Revenue	4,654	5,055	14,514	15,935
Hearing & Balance Products
Revenue by End Market:
Total Revenue	24,266	26,656	74,475	85,079
Hearing & Balance Products | Devices and Systems
Revenue by End Market:
Total Revenue	23,092	25,352	70,795	79,824
Hearing & Balance Products | Supplies
Revenue by End Market:
Total Revenue	1,174	1,304	3,680	5,255
United States
Consolidated Revenue:
Revenue	73,553	77,980	213,055	222,135
Property and equipment, net:
Property and equipment, net	12,365		12,365		10,019
International
Consolidated Revenue:
Revenue	49,910	$ 52,658	150,704	$ 167,765
Property and equipment, net:
Property and equipment, net	1,118		1,118		937
Canada
Property and equipment, net:
Property and equipment, net	4,256		4,256		4,504
Denmark
Property and equipment, net:
Property and equipment, net	1,753		1,753		1,371
Long-Lived Assets	5,603		5,603		5,083
Argentina
Property and equipment, net:
Property and equipment, net	$ 0		$ 0		$ 999

Fair Value Measurements - Relat

Fair Value Measurements - Related Party Loan Receivable (Details) - Medix Medical Devices, SRL [Member] - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Aug. 02, 2019	Apr. 01, 2019
Long Lived Assets Held-for-sale [Line Items]
Loan receivable		$ 2,200
Level III
Long Lived Assets Held-for-sale [Line Items]
Loan receivable	$ 0		$ 2,200
Loans and Leases Receivable, Related Parties [Roll Forward]
December 31, 2018	0
Additions	2,200
Receipts	0
Adjustments	(294)
September 30, 2019	$ 1,906

Fair Value Measurements - Sched

Fair Value Measurements - Schedule of Derivative Financial Instruments at Fair Value (Details) - Level II - Recurring $ in Thousands	9 Months Ended
	Sep. 30, 2019USD ($)
Derivative Liability [Roll Forward]
December 31, 2018	$ 77
Additions	0
Payments	0
Adjustments	312
September 30, 2019	$ 389

Sale of Certain Subsidiary As_2

Sale of Certain Subsidiary Assets (Details) - USD ($)	Apr. 02, 2019	Sep. 30, 2019	Aug. 02, 2019	Dec. 31, 2018
Related Party Transaction [Line Items]
Accumulated Other Comprehensive Income (Loss), Net of Tax		$ (21,166,000)		$ (38,032,000)
Medix Medical Devices, SRL [Member]
Related Party Transaction [Line Items]
Related Party Transaction, Amounts of Transaction	$ 2,500
Loan receivable			$ 2,200,000
Gain (Loss) on Sale of Assets and Asset Impairment Charges	24,600,000
Accumulated Other Comprehensive Income (Loss), Net of Tax			$ 24,800,000
Assets, Fair Value Adjustment	$ 4,600,000

Uncategorized Items - ntus93019

Label	Element	Value
Accounting Standards Update 2016-16 [Member]
Cumulative Effect of New Accounting Principle in Period of Adoption	us-gaap_CumulativeEffectOfNewAccountingPrincipleInPeriodOfAdoption	$ (3,919,000)
Accounting Standards Update 2016-16 [Member] | Retained Earnings [Member]
Cumulative Effect of New Accounting Principle in Period of Adoption	us-gaap_CumulativeEffectOfNewAccountingPrincipleInPeriodOfAdoption	(3,919,000)
Accounting Standards Update 2018-02 [Member] | AOCI Attributable to Parent [Member]
Cumulative Effect of New Accounting Principle in Period of Adoption	us-gaap_CumulativeEffectOfNewAccountingPrincipleInPeriodOfAdoption	$ (1,332,000)