Natus Medical (NTUS) 10-Q 6 May 20 2020 Q1 Quarterly report Financial data

Cover Page

Cover Page - shares	3 Months Ended
	Mar. 31, 2020	Apr. 29, 2020
Cover [Abstract]
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	Mar. 31, 2020
Amendment Flag	false
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q1
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		33,802,042
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

Fair Value Measurements

Fair Value Measurements	3 Months Ended
	Mar. 31, 2020
Fair Value Disclosures [Abstract]
Fair Value Measurements	Fair Value Measurements ASC 820 defines fair value, establishes a framework for measuring fair value and expands disclosures about fair value measurements. Fair value is defined under ASC 820 as the exit price associated with the sale of an asset or transfer of a liability in an orderly transaction between market participants at the measurement date. ASC 820 establishes the following three-tier fair value hierarchy, which prioritizes the inputs used in measuring fair value: Level 1 - Quoted prices (unadjusted) in active markets that are accessible at the measurement date for assets or liabilities. The fair value hierarchy gives the highest priority to Level 1 inputs. Level 2 - Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets and liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. Level 3 - Unobservable inputs that are used when little or no market data is available. The fair value hierarchy gives the lowest priority to Level 3 inputs. The derivative financial instruments described in Note 14 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 March 31, 2020, 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, 2019 Additions Payments Adjustments March 31, 2020 Liabilities: Interest rate swap $ 313 $ — $ — $ 232 $ 545 Total $ 313 $ — $ — $ 232 $ 545

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (unaudited) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 107,016	$ 63,297
Accounts receivable, net of allowance for doubtful accounts of $7,291 in 2020 and $7,384 in 2019	101,219	115,889
Inventories	74,808	71,368
Prepaid expenses and other current assets	19,671	19,195
Total current assets	302,714	269,749
Property and equipment, net	26,267	24,702
Operating lease right-of-use assets	14,198	15,046
Intangible assets, net	108,346	114,799
Goodwill	145,028	146,367
Deferred income tax	30,176	30,355
Other assets	20,741	21,509
Total assets	647,470	622,527
Current liabilities:
Accounts payable	33,284	27,253
Current portion of long-term debt	35,000	35,000
Accrued liabilities	45,255	54,451
Deferred revenue	22,823	20,246
Current portion of operating lease liabilities	5,727	5,871
Total current liabilities	142,089	142,821
Long-term liabilities:
Other liabilities	17,268	17,616
Operating lease liabilities	11,212	12,051
Long-term debt, net of current portion	64,713	19,665
Deferred income tax	14,035	14,251
Total liabilities	249,317	206,404
Stockholders’ equity:
Common stock, $0.001 par value, 120,000,000 shares authorized; shares issued and outstanding 33,802,133 in 2020 and 34,148,700 in 2019	334,296	344,476
Preferred stock, $0.001 par value; 10,000,000 shares authorized; no shares issued and outstanding in 2020 and 2019	0	0
Retained earnings	84,325	87,922
Accumulated other comprehensive loss	(20,468)	(16,275)
Total stockholders’ equity	398,153	416,123
Total liabilities and stockholders’ equity	$ 647,470	$ 622,527

Consolidated Balance Sheets (un

Consolidated Balance Sheets (unaudited) (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Statement of Financial Position [Abstract]
Allowance for doubtful accounts	$ 7,291	$ 7,384
Common Stock, par value (dollars per share)	$ 0.001	$ 0.001
Common Stock, shares authorized (in shares)	120,000,000	120,000,000
Common Stock, shares issued (in shares)	33,802,133	34,148,700
Common Stock, shares outstanding (in shares)	33,802,133	34,148,700
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
	Mar. 31, 2020	Mar. 31, 2019
Income Statement [Abstract]
Revenue	$ 109,383	$ 114,757
Cost of revenue	44,933	46,509
Intangibles amortization	1,668	1,756
Gross profit	62,782	66,492
Operating expenses:
Marketing and selling	30,730	33,729
Research and development	17,569	13,394
General and administrative	13,182	16,306
Intangibles amortization	3,661	3,786
Restructuring	871	37,372
Total operating expenses	66,013	104,587
Loss from operations	(3,231)	(38,095)
Other expense, net	(1,494)	(2,112)
Loss before provision for income tax benefit	(4,725)	(40,207)
Benefit from income taxes	(1,128)	(9,809)
Net loss	$ (3,597)	$ (30,398)
Net loss per share:
Basic (dollars per share)	$ (0.11)	$ (0.90)
Diluted (dollars per share)	$ (0.11)	$ (0.90)
Weighted average shares used in the calculation of net loss per share:
Basic (in shares)	33,800	33,590
Diluted (in shares)	33,800	33,590

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Income (unaudited) Condensed Consolidated Statements of Comprehensive Income (unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Statement of Comprehensive Income [Abstract]
Net income (loss)	$ (3,597)	$ (30,398)
Other comprehensive loss, net of tax:
Foreign currency translation adjustment	(4,018)	(1,797)
Interest rate swap designated as a cash flow hedge	(175)	(78)
Reclassification of stranded tax effects upon adoption of ASU 2018-02	0	(1,332)
Other comprehensive loss, net of tax	(4,193)	(3,207)
Comprehensive loss	$ (7,790)	$ (33,605)

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows (unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Statement of Cash Flows [Abstract]
Interest Paid, Excluding Capitalized Interest, Operating Activities	$ 637	$ 1,347
Operating activities:
Net loss	(3,597)	(30,398)
Adjustments to reconcile net loss to net cash provided by operating activities:
Provision for losses on accounts receivable	1,564	1,797
Loss on commencement of sales-type leases	(295)	0
Depreciation and amortization	6,994	7,711
Loss on disposal of property and equipment	42	179
Warranty reserve	704	354
Share-based compensation	2,291	2,554
Impairment charge for sale of entity	0	24,571
Changes in operating assets and liabilities:
Accounts receivable	14,570	14,358
Inventories	(3,443)	(4,476)
Prepaid expenses and other assets	(1,060)	(7,367)
Accounts payable	6,038	(3,436)
Accrued liabilities	(9,329)	(1,319)
Deferred revenue	2,190	1,982
Deferred income tax	103	(17)
Net cash provided by operating activities	17,362	6,493
Investing activities:
Purchase of property and equipment	(3,575)	(2,461)
Net cash used in investing activities	(3,575)	(2,461)
Financing activities:
Proceeds from stock option exercises and Employee Stock Purchase Program purchases	0	268
Repurchase of common stock	(10,495)	0
Taxes paid related to net share settlement of equity awards	(1,883)	(1,567)
Principal payments of financing lease liability	(133)	(165)
Proceeds from borrowings	60,000	0
Payments on borrowings	(15,000)	(5,000)
Net cash provided by (used in) financing activities	32,489	(6,464)
Exchange rate changes effect on cash and cash equivalents	(2,557)	(518)
Net increase (decrease) in cash and cash equivalents	43,719	(2,950)
Cash and cash equivalents, beginning of period	63,297	56,373
Cash and cash equivalents, end of period	107,016	53,423
Supplemental disclosure of cash flow information:
Cash paid for income taxes	3,492	1,224
Non-cash investing activities:
Property and equipment included in accounts payable	131	141
Inventory transferred to property and equipment	196	143
Transfer of leased assets to sales-type leases	$ 663	$ 0

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, 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
Stock Repurchased During Period, Shares		0
Stock Repurchased During Period, Value	0	$ 0
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	(3,207)
Other Comprehensive Income (Loss) Excluding Impact Of New Accounting Pronouncement	(1,875)			(1,875)
Net loss	(30,398)		(30,398)
End of period (shares) at Mar. 31, 2019		33,955,077
End of period at Mar. 31, 2019	367,304	$ 335,348	73,195	(41,239)
Beginning of period (shares) at Dec. 31, 2019		34,148,700
Beginning of period at Dec. 31, 2019	416,123	$ 344,476	87,922	(16,275)
Vesting Of Restricted Stock Units Shares		14,033
Stock Issued During Period, Shares, Restricted Stock Award, Net of Forfeitures		162,212
Shares Issued, Value, Share-based Payment Arrangement, after Forfeiture	2,198	$ 2,198
Stock Repurchased During Period, Shares		(465,117)
Stock Repurchased During Period, Value		$ (10,495)
Share-based Payment Arrangement, Shares Withheld for Tax Withholding Obligation		(57,695)
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	(1,883)	$ (1,883)
Other Comprehensive Income (Loss), Net of Tax	(4,193)			(4,193)
Net loss	(3,597)		(3,597)
End of period (shares) at Mar. 31, 2020		33,802,133
End of period at Mar. 31, 2020	$ 398,153	$ 334,296	$ 84,325	$ (20,468)

Basis of Presentation

Basis of Presentation	3 Months Ended
	Mar. 31, 2020
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, 2019. 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, 2019 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, 2019. Operating results for the three months ended March 31, 2020 are not necessarily indicative of the results that may be expected for the year ending December 31, 2020. The accompanying condensed consolidated financial statements include our accounts and our wholly owned subsidiaries. All intercompany accounts and transactions have been eliminated in consolidation. Impact of COVID-19 on Our Financial Statements The global spread and unprecedented impact of COVID-19 is complex and rapidly-evolving. On March 11, 2020, the World Health Organization declared COVID-19 a global pandemic and recommended extensive containment and mitigation measures worldwide. The outbreak has reached all of the regions in which we do business, and governmental authorities around the world have implemented numerous measures attempting to contain and mitigate the effects of the virus, including travel bans and restrictions, border closings, quarantines, shelter-in-place orders, shutdowns, limitations or closures of non-essential businesses, school closures, and social distancing requirements. The global spread of COVID-19 and actions taken in response to the virus have negatively affected workforces, customers, consumer confidence, financial markets, employment rates, consumer spending, credit markets and housing demand, caused significant economic and business disruption, volatility and financial uncertainty, and led to a significant economic downturn, including in the markets where we operate. We have assessed various accounting estimates and other matters, including those that require consideration of forecasted financial information, in context of the unknown future impacts of COVID-19 using information that is reasonably available to us at this time. The accounting estimates and other matters we assessed include, but were not limited to, our allowance for doubtful accounts, inventory and warranty reserves, stock-based compensation, goodwill and other long-lived assets, financial assets, valuation allowances for tax assets and revenue recognition. While based on our current assessment of these estimates there was not a material impact to our consolidated financial statements as of and for the quarter ended March 31, 2020, as additional information becomes available to us, our future assessment of these estimates, including our expectations at the time regarding the duration, scope and severity of the pandemic, as well as other factors, could materially and adversely impact our consolidated financial statements in future reporting periods. For further information, refer to Part II - Item 1A - "Risk Factors" of this 10-Q. Recently Adopted 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

Revenue (Notes)

Revenue (Notes)	3 Months Ended
	Mar. 31, 2020
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 three months ended March 31, 2020 (in thousands): Unbilled AR, December 31, 2019 $ 2,667 Additions 106 Transferred to trade receivable (153) Unbilled AR, March 31, 2020 $ 2,620 Deferred Revenue, December 31, 2019 $ 24,808 Additions 10,575 Revenue recognized (8,362) Deferred Revenue, March 31, 2020 $ 27,021

Earnings Per Share

Earnings Per Share	3 Months Ended
	Mar. 31, 2020
Earnings Per Share [Abstract]
Earnings Per Share	Earnings Per ShareThe components of basic and diluted EPS, and shares excluded from the calculation of diluted loss per share because the effect would have been anti-dilutive, are as follows (in thousands, except per share amounts): Three Months Ended March 31, 2020 2019 Net loss $ (3,597) $ (30,398) Weighted average common shares 33,800 33,590 Dilutive effect of stock based awards — — Diluted Shares 33,800 33,590 Basic loss per share $ (0.11) $ (0.90) Diluted loss per share $ (0.11) $ (0.90) Shares excluded from calculation of diluted EPS 85 119

Allowance for Doubtful Accounts

Allowance for Doubtful Accounts	3 Months Ended
	Mar. 31, 2020
Credit Loss [Abstract]
Allowance for Doubtful Accounts	Allowance for Doubtful Accounts We estimate the lifetime allowance for doubtful, potentially uncollectible, accounts receivable upon their inception based on historical collection experience within the markets in which we operate, customer-specific information such as bankruptcy filings or customer liquidity problems, current conditions, and reasonable and supportable forecasts about the future. Our allowance for doubtful accounts is presented as a reduction to accounts receivable on our consolidated balance sheet. When all internal efforts have been exhausted to collect the receivable, it is written off and relieved from the reserve. The details of activity in allowance for doubtful accounts are as follows for the three months ended March 31, 2020 (in thousands): Three Months Ended March 31, 2020 2019 Balance, beginning of period $ 7,384 $ 6,960 Additions charged to expense 1,564 1,797 Write-offs charged against allowance (557) (726) Recoveries of amounts previously written off (1,100) (580) Balance, end of period $ 7,291 $ 7,451

Inventories

Inventories	3 Months Ended
	Mar. 31, 2020
Inventory Disclosure [Abstract]
Inventories	Inventories Inventories consist of the following (in thousands): March 31, 2020 December 31, 2019 Raw materials and subassemblies $ 35,516 $ 37,259 Work in process 2,270 1,780 Finished goods 54,186 50,521 Total inventories 91,972 89,560 Less: Non-current inventories (17,164) (18,192) Inventories, current $ 74,808 $ 71,368 As of March 31, 2020 and December 31, 2019, we have classified $17.2 million and $18.2 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	3 Months Ended
	Mar. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Intangible Assets	Intangible Assets The following table summarizes the components of gross and net intangible asset balances (in thousands): March 31, 2020 December 31, 2019 Gross Accumulated Accumulated Net Book Gross Accumulated Accumulated Net Book Intangible assets with definite lives: Technology $ 107,716 $ (6,029) $ (56,827) $ 44,860 $ 108,400 $ (6,035) $ (55,408) $ 46,957 Customer related 89,191 (50) (42,071) 47,070 90,351 (50) (40,527) 49,774 Trade names 45,644 (3,214) (26,722) 15,708 45,874 (3,237) (25,355) 17,282 Internally developed software 13,281 — (12,674) 607 13,281 — (12,606) 675 Patents 2,675 (133) (2,542) — 2,692 (133) (2,559) — Service agreements 1,190 — (1,089) 101 1,190 — (1,079) 111 Definite-lived intangible assets $ 259,697 $ (9,426) $ (141,925) $ 108,346 $ 261,788 $ (9,455) $ (137,534) $ 114,799 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 $11.1 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 March 31, 2020 2019 Technology $ 1,712 $ 1,738 Customer related 2,140 2,183 Trade names 1,466 1,498 Internally developed software 69 504 Patents — 20 Service agreements $ 10 $ 102 Total amortization $ 5,397 $ 6,045 The amortization expense amounts shown above include internally developed software not held for sale of $24.0 thousand and $459.0 thousand for the three months ended March 31, 2020 and March 31, 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): Nine months ending December 31, 2020 $ 16,062 2021 20,540 2022 17,153 2023 16,199 2024 14,333 2025 13,676 Thereafter 10,383 Total expected amortization expense $ 108,346

Goodwill

Goodwill	3 Months Ended
	Mar. 31, 2020
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, 2019 $ 146,367 Foreign currency translation (1,339) March 31, 2020 $ 145,028

Property and Equipment, net

Property and Equipment, net	3 Months Ended
	Mar. 31, 2020
Property, Plant and Equipment [Abstract]
Property and Equipment, net	Property and Equipment, net Property and equipment, net consist of the following (in thousands): March 31, 2020 December 31, 2019 Land $ 1,719 $ 1,719 Buildings 6,878 6,943 Leasehold improvements 8,697 8,664 Finance lease right-of-use assets 2,548 2,377 Equipment and furniture 23,496 22,819 Computer software and hardware 13,750 12,610 Demonstration and loaned equipment 11,871 11,621 68,959 66,753 Accumulated depreciation (42,692) (42,051) Total $ 26,267 $ 24,702

Reserve for Product Warranties

Reserve for Product Warranties	3 Months Ended
	Mar. 31, 2020
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. 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, repair and calibration services are provided by a combination of our owned facilities and vendors on a contract basis. We accrue estimated product warranty costs at the time of sale based on historical experience. 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 costs are incurred to honor existing warranty and regulatory obligations. As of March 31, 2020, we have accrued $5.8 million for product related warranties. 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 March 31, 2020 2019 Balance, beginning of period $ 6,404 $ 9,391 Additions charged to expense 704 609 Utilizations (1,271) (1,511) Changes in estimate related to product remediation activities — (255) Divestiture adjustments — (9) Balance, end of period $ 5,837 $ 8,225 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	3 Months Ended
	Mar. 31, 2020
Share-based Payment Arrangement [Abstract]
Share-Based Compensation	Share-Based Compensation As of March 31, 2020, we have two active share-based compensation plans, the 2018 Equity Incentive Plan and the 2011 Employee Stock Purchase Plan. In January 2020, we granted performance stock unit (“PSU”) awards to our CEO and CFO. These PSUs fully vest on December 31, 2022 and have separate performance goals than the previously granted market stock units. We estimate fair value of performance stock unit awards based on the share price and other pertinent factors on the grant date. Compensation expense for performance stock unit awards are recognized on a straight-line basis over the requisite service period of the award based on expected achievement of the performance condition. Provided that the requisite service is rendered, the shares will become vested and payout will occur based on the outcome of the performance condition. Any unrecognized compensation cost shall be recognized when the award becomes vested. The terms of all other awards granted during the three months ended March 31, 2020 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, 2019. Details of share-based compensation expense are as follows (in thousands): Three Months Ended March 31, 2020 2019 Cost of revenue $ 75 $ 67 Marketing and selling 469 245 Research and development 254 230 General and administrative 1,400 1,890 Total $ 2,198 $ 2,432 As of March 31, 2020, unrecognized compensation expense related to the unvested portion of stock options and other stock awards was approximately $16.4 million, which is expected to be recognized over a weighted average period of 2.4 years.

Other Income (Expense), net

Other Income (Expense), net	3 Months Ended
	Mar. 31, 2020
Other Income and Expenses [Abstract]
Other Income (Expense), net	Other Income (Expense), net Other income (expense), net consists of (in thousands): Three Months Ended March 31, 2020 2019 Interest income $ 24 $ 20 Interest expense (717) (1,527) Foreign currency loss (801) (598) Other expense — (7) Total other expense, net $ (1,494) $ (2,112)

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2020
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes Our 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. For the three months ended March 31, 2020, we have included our best estimate of the impact of the COVID-19 pandemic to the estimated annual effective tax rate. Our estimated annual effective tax rate could be impacted by any changes in facts and circumstances or new information related to the COVID-19 pandemic. We recorded a benefits from income tax of $1.1 million and $9.8 million for the three months ended March 31, 2020 and March 31, 2019, respectively. The effective tax rate was 23.9% and 24.4% for the three months ended March 31, 2020 and March 31, 2019 respectively. Of the $9.8 million benefit from income tax recorded for the three months ended March 31, 2019, $8.2 million relates to the tax accounting effects of the sale of Medix. The decrease in the effective tax rate for the three months ended March 31, 2020 compared with the three months ended March 31, 2019 is primarily attributable to changes in distribution of income among jurisdictions with varying tax rates. 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 no changes related to unrecognized tax benefits for the three months ended March 31, 2020. Within the next twelve months, it is possible that the uncertain tax benefit may change with a range of approximately zero to $2.4 million. Our tax returns remain open to examination as follows: U.S Federal, 2016 through 2019, U.S. states, 2015 through 2019, and significant foreign jurisdictions, generally 2015 through 2019.

Debt and Credit Arrangements

Debt and Credit Arrangements	3 Months Ended
	Mar. 31, 2020
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 March 31, 2020, we were in compliance with the Leverage Ratio and the Interest Coverage Ratio covenants as defined in the Credit Agreement. During the first quarter of 2020 we drew an additional $60.0 million on our credit line as a precaution to ensure we have the necessary capital to continue to reliably serve our customers during an extended period of uncertainty. At March 31, 2020, we had $100.0 million outstanding under the Credit Agreement. Pursuant to the terms of the Credit Agreement, the outstanding principal balance will bear interest at either (a) a fluctuating rate per annum equal to the Applicable Rate, as defined in the Credit Agreement, depending on our leverage ratio plus the higher of (i) the federal funds rate plus one-half of one percent per annum; (ii) the prime rate in effect on such a day; and (iii) the LIBOR rate plus one percent, or (b) a fluctuating rate per annum of LIBOR Rate plus the Applicable Rate, which ranges between 1.75% to 2.75%. The effective interest rate during the three months ended March 31, 2020 was 3.64%. 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 March 31, 2020, we have classified $35.0 million of the $100.0 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): March 31, 2020 December 31, 2019 Revolving credit facility $ 100,000 $ 55,000 Debt issuance costs (287) (335) Less: current portion of long-term debt 35,000 35,000 Total long-term debt $ 64,713 $ 19,665 Maturities of long-term debt as of March 31, 2020 are as follows (in thousands): March 31, 2020 December 31, 2019 2020 $ — $ — 2021 100,000 55,000 2022 — — Thereafter — — Total $ 100,000 $ 55,000 As of March 31, 2020, the carrying value of total debt approximated fair market value.

Financial Instruments and Deriv

Financial Instruments and Derivatives	3 Months Ended
	Mar. 31, 2020
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 March 31, 2020 (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 $ 545 Total interest rate derivatives designated as cash flow hedge $ 25,000 $ 545 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.

Segment, Customer and Geographi

Segment, Customer and Geographic Information	3 Months Ended
	Mar. 31, 2020
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. The following tables present revenue and long-lived asset information by end market and geographic region. Revenue is based on the destination of the shipments and long-lived assets are based on the physical location of the assets (in thousands): Three Months Ended March 31, 2020 2019 Consolidated Revenue: United States $ 68,338 $ 66,067 International 41,045 48,690 Totals $ 109,383 $ 114,757 Three Months Ended March 31, 2020 2019 Revenue by End Market: Neuro Products Devices and Systems $ 49,397 $ 45,692 Supplies 15,924 15,898 Services — 800 Total Neuro Revenue 65,321 62,390 Newborn Care Products Devices and Systems 11,690 14,644 Supplies 9,794 10,047 Services 2,748 4,845 Total Newborn Care Revenue 24,232 29,536 Hearing & Balance Products Devices and Systems 18,589 21,525 Supplies 1,241 1,306 Total Hearing & Balance Revenue 19,830 22,831 Total Revenue $ 109,383 $ 114,757 March 31, 2020 December 31, 2019 Property and equipment, net: United States $ 13,728 $ 11,868 Ireland 5,623 5,732 Canada 4,073 4,140 Denmark 1,761 1,799 Other countries 1,082 1,163 Totals $ 26,267 $ 24,702 During the three months ended March 31, 2020 and 2019, no single customer or country outside the United States contributed more than 10% of our consolidated revenue.

Basis of Presentation (Policies

Basis of Presentation (Policies)	3 Months Ended
	Mar. 31, 2020
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, 2019. 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, 2019 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, 2019. Operating results for the three months ended March 31, 2020 are not necessarily indicative of the results that may be expected for the year ending December 31, 2020. The accompanying condensed consolidated financial statements include our accounts and our wholly owned subsidiaries. All intercompany accounts and transactions have been eliminated in consolidation. Impact of COVID-19 on Our Financial Statements The global spread and unprecedented impact of COVID-19 is complex and rapidly-evolving. On March 11, 2020, the World Health Organization declared COVID-19 a global pandemic and recommended extensive containment and mitigation measures worldwide. The outbreak has reached all of the regions in which we do business, and governmental authorities around the world have implemented numerous measures attempting to contain and mitigate the effects of the virus, including travel bans and restrictions, border closings, quarantines, shelter-in-place orders, shutdowns, limitations or closures of non-essential businesses, school closures, and social distancing requirements. The global spread of COVID-19 and actions taken in response to the virus have negatively affected workforces, customers, consumer confidence, financial markets, employment rates, consumer spending, credit markets and housing demand, caused significant economic and business disruption, volatility and financial uncertainty, and led to a significant economic downturn, including in the markets where we operate. We have assessed various accounting estimates and other matters, including those that require consideration of forecasted financial information, in context of the unknown future impacts of COVID-19 using information that is reasonably available to us at this time. The accounting estimates and other matters we assessed include, but were not limited to, our allowance for doubtful accounts, inventory and warranty reserves, stock-based compensation, goodwill and other long-lived assets, financial assets, valuation allowances for tax assets and revenue recognition. While based on our current assessment of these estimates there was not a material impact to our consolidated financial statements as of and for the quarter ended March 31, 2020, as additional information becomes available to us, our future assessment of these estimates, including our expectations at the time regarding the duration, scope and severity of the pandemic, as well as other factors, could materially and adversely impact our consolidated financial statements in future reporting periods. For further information, refer to Part II - Item 1A - "Risk Factors" of this 10-Q.
Recent Accounting Pronouncements	Recently Adopted 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

Revenue (Tables)

Revenue (Tables)	3 Months Ended
	Mar. 31, 2020
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 three months ended March 31, 2020 (in thousands): Unbilled AR, December 31, 2019 $ 2,667 Additions 106 Transferred to trade receivable (153) Unbilled AR, March 31, 2020 $ 2,620 Deferred Revenue, December 31, 2019 $ 24,808 Additions 10,575 Revenue recognized (8,362) Deferred Revenue, March 31, 2020 $ 27,021

Earnings Per Share (Tables)

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2020
Earnings Per Share [Abstract]
Earnings Per Share	The components of basic and diluted EPS, and shares excluded from the calculation of diluted loss per share because the effect would have been anti-dilutive, are as follows (in thousands, except per share amounts): Three Months Ended March 31, 2020 2019 Net loss $ (3,597) $ (30,398) Weighted average common shares 33,800 33,590 Dilutive effect of stock based awards — — Diluted Shares 33,800 33,590 Basic loss per share $ (0.11) $ (0.90) Diluted loss per share $ (0.11) $ (0.90) Shares excluded from calculation of diluted EPS 85 119

Allowance for Doubtful Accoun_2

Allowance for Doubtful Accounts (Tables)	3 Months Ended
	Mar. 31, 2020
Credit Loss [Abstract]
Schedule of Allowance for Credit Losses	The details of activity in allowance for doubtful accounts are as follows for the three months ended March 31, 2020 (in thousands): Three Months Ended March 31, 2020 2019 Balance, beginning of period $ 7,384 $ 6,960 Additions charged to expense 1,564 1,797 Write-offs charged against allowance (557) (726) Recoveries of amounts previously written off (1,100) (580) Balance, end of period $ 7,291 $ 7,451

Inventories (Tables)

Inventories (Tables)	3 Months Ended
	Mar. 31, 2020
Inventory Disclosure [Abstract]
Summary of Inventories	Inventories consist of the following (in thousands): March 31, 2020 December 31, 2019 Raw materials and subassemblies $ 35,516 $ 37,259 Work in process 2,270 1,780 Finished goods 54,186 50,521 Total inventories 91,972 89,560 Less: Non-current inventories (17,164) (18,192) Inventories, current $ 74,808 $ 71,368

Intangible Assets (Tables)

Intangible Assets (Tables)	3 Months Ended
	Mar. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense related to intangible assets with definite lives	The following table summarizes the components of gross and net intangible asset balances (in thousands): March 31, 2020 December 31, 2019 Gross Accumulated Accumulated Net Book Gross Accumulated Accumulated Net Book Intangible assets with definite lives: Technology $ 107,716 $ (6,029) $ (56,827) $ 44,860 $ 108,400 $ (6,035) $ (55,408) $ 46,957 Customer related 89,191 (50) (42,071) 47,070 90,351 (50) (40,527) 49,774 Trade names 45,644 (3,214) (26,722) 15,708 45,874 (3,237) (25,355) 17,282 Internally developed software 13,281 — (12,674) 607 13,281 — (12,606) 675 Patents 2,675 (133) (2,542) — 2,692 (133) (2,559) — Service agreements 1,190 — (1,089) 101 1,190 — (1,079) 111 Definite-lived intangible assets $ 259,697 $ (9,426) $ (141,925) $ 108,346 $ 261,788 $ (9,455) $ (137,534) $ 114,799
Amortization expense	Amortization expense related to intangible assets with definite lives was as follows (in thousands): Three Months Ended March 31, 2020 2019 Technology $ 1,712 $ 1,738 Customer related 2,140 2,183 Trade names 1,466 1,498 Internally developed software 69 504 Patents — 20 Service agreements $ 10 $ 102 Total amortization $ 5,397 $ 6,045
Expected amortization expense related to amortizable intangible assets	Expected amortization expense related to definite-lived amortizable intangible assets is as follows (in thousands): Nine months ending December 31, 2020 $ 16,062 2021 20,540 2022 17,153 2023 16,199 2024 14,333 2025 13,676 Thereafter 10,383 Total expected amortization expense $ 108,346

Goodwill (Tables)

Goodwill (Tables)	3 Months Ended
	Mar. 31, 2020
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, 2019 $ 146,367 Foreign currency translation (1,339) March 31, 2020 $ 145,028

Property and Equipment, net (Ta

Property and Equipment, net (Tables)	3 Months Ended
	Mar. 31, 2020
Property, Plant and Equipment [Abstract]
Property and Equipment net	Property and equipment, net consist of the following (in thousands): March 31, 2020 December 31, 2019 Land $ 1,719 $ 1,719 Buildings 6,878 6,943 Leasehold improvements 8,697 8,664 Finance lease right-of-use assets 2,548 2,377 Equipment and furniture 23,496 22,819 Computer software and hardware 13,750 12,610 Demonstration and loaned equipment 11,871 11,621 68,959 66,753 Accumulated depreciation (42,692) (42,051) Total $ 26,267 $ 24,702

Reserve for Product Warranties

Reserve for Product Warranties (Tables)	3 Months Ended
	Mar. 31, 2020
Product Warranties Disclosures [Abstract]
Reserve for Product Warranties	The details of activity in the warranty reserve are as follows (in thousands): Three Months Ended March 31, 2020 2019 Balance, beginning of period $ 6,404 $ 9,391 Additions charged to expense 704 609 Utilizations (1,271) (1,511) Changes in estimate related to product remediation activities — (255) Divestiture adjustments — (9) Balance, end of period $ 5,837 $ 8,225

Share-Based Compensation (Table

Share-Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2020
Share-based Payment Arrangement [Abstract]
Share-Based Compensation Expense	Details of share-based compensation expense are as follows (in thousands): Three Months Ended March 31, 2020 2019 Cost of revenue $ 75 $ 67 Marketing and selling 469 245 Research and development 254 230 General and administrative 1,400 1,890 Total $ 2,198 $ 2,432

Other Income (Expense), net (Ta

Other Income (Expense), net (Tables)	3 Months Ended
	Mar. 31, 2020
Other Income and Expenses [Abstract]
Other Income (Expense), net	Other income (expense), net consists of (in thousands): Three Months Ended March 31, 2020 2019 Interest income $ 24 $ 20 Interest expense (717) (1,527) Foreign currency loss (801) (598) Other expense — (7) Total other expense, net $ (1,494) $ (2,112)

Debt and Credit Arrangements (T

Debt and Credit Arrangements (Tables)	3 Months Ended
	Mar. 31, 2020
Debt Disclosure [Abstract]
Schedule of Long-term debt	Long-term debt consists of (in thousands): March 31, 2020 December 31, 2019 Revolving credit facility $ 100,000 $ 55,000 Debt issuance costs (287) (335) Less: current portion of long-term debt 35,000 35,000 Total long-term debt $ 64,713 $ 19,665

Financial Instruments and Der_2

Financial Instruments and Derivatives (Tables)	3 Months Ended
	Mar. 31, 2020
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of interest rate swaps	held the following interest rate swaps as of March 31, 2020 (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 $ 545 Total interest rate derivatives designated as cash flow hedge $ 25,000 $ 545

Segment, Customer and Geograp_2

Segment, Customer and Geographic Information (Tables)	3 Months Ended
	Mar. 31, 2020
Segment Reporting [Abstract]
Revenue and Long-lived Asset Information by Geographic Region	Revenue is based on the destination of the shipments and long-lived assets are based on the physical location of the assets (in thousands): Three Months Ended March 31, 2020 2019 Consolidated Revenue: United States $ 68,338 $ 66,067 International 41,045 48,690 Totals $ 109,383 $ 114,757 Three Months Ended March 31, 2020 2019 Revenue by End Market: Neuro Products Devices and Systems $ 49,397 $ 45,692 Supplies 15,924 15,898 Services — 800 Total Neuro Revenue 65,321 62,390 Newborn Care Products Devices and Systems 11,690 14,644 Supplies 9,794 10,047 Services 2,748 4,845 Total Newborn Care Revenue 24,232 29,536 Hearing & Balance Products Devices and Systems 18,589 21,525 Supplies 1,241 1,306 Total Hearing & Balance Revenue 19,830 22,831 Total Revenue $ 109,383 $ 114,757 March 31, 2020 December 31, 2019 Property and equipment, net: United States $ 13,728 $ 11,868 Ireland 5,623 5,732 Canada 4,073 4,140 Denmark 1,761 1,799 Other countries 1,082 1,163 Totals $ 26,267 $ 24,702

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	3 Months Ended
	Mar. 31, 2020
Fair Value Disclosures [Abstract]
Fair value of the derivative financial instrument	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, 2019 Additions Payments Adjustments March 31, 2020 Liabilities: Interest rate swap $ 313 $ — $ — $ 232 $ 545 Total $ 313 $ — $ — $ 232 $ 545

Revenue - Narrative (Details)

Revenue - Narrative (Details) $ in Millions	Mar. 31, 2020USD ($)
Revenue from Contract with Customer [Abstract]
Short-term contract liability	$ 22.8
Long-term contract liability	4.2
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	$ 19.3
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	$ 5.3
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	$ 1.3
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	$ 0.8
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	$ 0.3
Expected timing of satisfaction for remaining performance obligation

Revenue - Unbilled AR and Defer

Revenue - Unbilled AR and Deferred Revenue (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2020USD ($)
Movement in Deferred Revenue [Roll Forward]
Deferred Revenue, December 31, 2018	$ 24,808
Additions	10,575
Revenue Recognized	(8,362)
Deferred Revenue, March 31, 2019	27,021
Unbilled AR
Movement in Unbilled AR [Roll Forward]
Unbilled AR, December 31, 2018	2,667
Additions	106
Transferred to trade receivable	(153)
Unbilled AR, March 31, 2019	$ 2,620

Earnings Per Share (Details)

Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Earnings Per Share [Abstract]
Net loss	$ (3,597)	$ (30,398)
Weighted average common shares (in shares)	33,800	33,590
Dilutive effect of stock based awards (in shares)	0	0
Diluted Shares (in shares)	33,800	33,590
Basic earnings per share (dollars per share)	$ (0.11)	$ (0.90)
Diluted earnings per share (dollars per share)	$ (0.11)	$ (0.90)
Diluted earnings per share (in shares)	85	119

Allowance for Doubtful Accoun_3

Allowance for Doubtful Accounts (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Accounts Receivable, Allowance for Credit Loss [Roll Forward]
Balance, beginning of period	$ 7,384	$ 6,960
Additions charged to expense	1,564	1,797
Write-offs charged against allowance	(557)	(726)
Recoveries of amounts previously written off	(1,100)	(580)
Balance, end of period	$ 7,291	$ 7,451

Inventories (Details)

Inventories (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Summary of Inventories
Raw materials and subassemblies	$ 35,516	$ 37,259
Work in process	2,270	1,780
Finished goods	54,186	50,521
Total inventories	91,972	89,560
Less: Non-current inventories	(17,164)	(18,192)
Inventories, current	$ 74,808	$ 71,368

Intangible Assets - Components

Intangible Assets - Components of Gross and Net Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 259,697	$ 261,788
Accumulated Impairment	(9,426)	(9,455)
Accumulated Amortization	(141,925)	(137,534)
Net Book Value	108,346	114,799
Technology
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	107,716	108,400
Accumulated Impairment	(6,029)	(6,035)
Accumulated Amortization	(56,827)	(55,408)
Net Book Value	44,860	46,957
Customer related
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	89,191	90,351
Accumulated Impairment	(50)	(50)
Accumulated Amortization	(42,071)	(40,527)
Net Book Value	47,070	49,774
Trade names
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	45,644	45,874
Accumulated Impairment	(3,214)	(3,237)
Accumulated Amortization	(26,722)	(25,355)
Net Book Value	15,708	17,282
Internally developed software
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	13,281	13,281
Accumulated Impairment	0	0
Accumulated Amortization	(12,674)	(12,606)
Net Book Value	607	675
Patents
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	2,675	2,692
Accumulated Impairment	(133)	(133)
Accumulated Amortization	(2,542)	(2,559)
Net Book Value	0	0
Service agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	1,190	1,190
Accumulated Impairment	0	0
Accumulated Amortization	(1,089)	(1,079)
Net Book Value	$ 101	$ 111

Intangible Assets - Narrative (

Intangible Assets - Narrative (Details) - USD ($)	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Acquired Finite-Lived Intangible Assets [Line Items]
Total amortization	$ 5,397,000	$ 6,045,000
Useful life (in years)	11 years
Technology
Acquired Finite-Lived Intangible Assets [Line Items]
Total amortization	$ 1,712,000	1,738,000
Useful life (in years)	14 years
Customer related
Acquired Finite-Lived Intangible Assets [Line Items]
Total amortization	$ 2,140,000	2,183,000
Useful life (in years)	10 years
Trade names
Acquired Finite-Lived Intangible Assets [Line Items]
Total amortization	$ 1,466,000	1,498,000
Useful life (in years)	7 years
Internally developed software
Acquired Finite-Lived Intangible Assets [Line Items]
Total amortization	$ 69,000	504,000
Useful life (in years)	6 years
Costs incurred for development of internal use computer software	$ 11,100,000
Costs incurred for development of software to be sold	2,200,000
Patents
Acquired Finite-Lived Intangible Assets [Line Items]
Total amortization	$ 0	20,000
Useful life (in years)	13 years
Service agreements
Acquired Finite-Lived Intangible Assets [Line Items]
Total amortization	$ 10,000	102,000
Useful life (in years)	2 years
General and administrative | Internally developed software
Acquired Finite-Lived Intangible Assets [Line Items]
Total amortization	$ 24,000	$ 459,000

Intangible Assets - Schedule of

Intangible Assets - Schedule of Amortization Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Finite-Lived Intangible Assets [Line Items]
Total amortization	$ 5,397	$ 6,045
Technology
Finite-Lived Intangible Assets [Line Items]
Total amortization	1,712	1,738
Customer related
Finite-Lived Intangible Assets [Line Items]
Total amortization	2,140	2,183
Trade names
Finite-Lived Intangible Assets [Line Items]
Total amortization	1,466	1,498
Internally developed software
Finite-Lived Intangible Assets [Line Items]
Total amortization	69	504
Patents
Finite-Lived Intangible Assets [Line Items]
Total amortization	0	20
Service agreements
Finite-Lived Intangible Assets [Line Items]
Total amortization	$ 10	$ 102

Intangible Assets - Schedule _2

Intangible Assets - Schedule of Expected Amortization Expense (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Expected annual amortization expense related to amortizable intangible assets
Nine months ending December 31, 2020	$ 16,062
2019	20,540
2020	17,153
2021	16,199
2022	14,333
2023	13,676
Thereafter	10,383
Net Book Value	$ 108,346	$ 114,799

Goodwill (Details)

Goodwill (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2020USD ($)
Carrying amount of goodwill
43830	$ 146,367
Foreign currency translation	(1,339)
43921	$ 145,028

Property and Equipment, net (De

Property and Equipment, net (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 68,959		$ 66,753
Finance Lease, Right-of-Use Asset	2,548		2,377
Accumulated depreciation	(42,692)		(42,051)
Total	26,267		24,702
Depreciation	1,700	$ 1,500
Land
Property, Plant and Equipment [Line Items]
Property and equipment, gross	1,719		1,719
Buildings
Property, Plant and Equipment [Line Items]
Property and equipment, gross	6,878		6,943
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	8,697		8,664
Equipment and furniture
Property, Plant and Equipment [Line Items]
Property and equipment, gross	23,496		22,819
Computer software and hardware
Property, Plant and Equipment [Line Items]
Property and equipment, gross	13,750		12,610
Demonstration and loaned equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 11,871		$ 11,621

Reserve for Product Warrantie_2

Reserve for Product Warranties - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Dec. 31, 2019	Mar. 31, 2019	Dec. 31, 2018
Product Warranties Disclosures [Abstract]
Product warranty period (in years)	1 year
Product Liability Contingency [Line Items]
Accrual of estimated costs	$ 5,837	$ 6,404	$ 8,225	$ 9,391

Reserve for Product Warrantie_3

Reserve for Product Warranties - Schedule of Warranty Reserve (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Reserve for Product Warranties
Balance, beginning of period	$ 6,404	$ 9,391
Additions charged to expense	704	609
Utilizations	(1,271)	(1,511)
Changes in estimate related to product remediation activities	0	(255)
Standard and Extended Product Warranty Accrual, Decrease for Divestiture	0	(9)
Balance, end of period	$ 5,837	$ 8,225

Share-Based Compensation - Narr

Share-Based Compensation - Narrative (Details) $ in Millions	3 Months Ended
	Mar. 31, 2020USD ($)plan
Share-based Payment Arrangement [Abstract]
Number of active share based compensation plans | plan	2
Unrecognized compensation expense related to unvested portion of stock options | $	$ 16.4
Weighted average period of recognition of unrecognized compensation expense	2 years 4 months 24 days

Share-Based Compensation - Sche

Share-Based Compensation - Schedule of Share-based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	$ 2,198	$ 2,432
Cost of revenue
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	75	67
Marketing and selling
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	469	245
Research and development
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	254	230
General and administrative
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	$ 1,400	$ 1,890

Other Income (Expense), net (De

Other Income (Expense), net (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Other expense, net
Interest income	$ 24	$ 20
Interest expense	(717)	(1,527)
Foreign currency loss	(801)	(598)
Other expense	0	(7)
Total other expense, net	$ (1,494)	$ (2,112)

Income Taxes (Details)

Income Taxes (Details) - USD ($)	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Significant Change in Unrecognized Tax Benefits is Reasonably Possible [Line Items]
Provision for income tax benefit	$ (1,128,000)	$ (9,809,000)
Effective income tax rate	23.90%	24.40%
Minimum
Significant Change in Unrecognized Tax Benefits is Reasonably Possible [Line Items]
Possible of uncertain tax benefit within the next twelve months	$ 0
Maximum
Significant Change in Unrecognized Tax Benefits is Reasonably Possible [Line Items]
Possible of uncertain tax benefit within the next twelve months	$ 2,400,000
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)	3 Months Ended
	Mar. 31, 2020USD ($)	Dec. 31, 2019USD ($)
Line of Credit Facility [Line Items]
Revolving credit facility	$ 100,000,000	$ 55,000,000
Current portion of long-term debt	35,000,000	$ 35,000,000
Revolving credit facility | Line of Credit
Line of Credit Facility [Line Items]
Revolving credit facility	100,000,000
Credit Agreement | Citibank, National Association
Line of Credit Facility [Line Items]
Aggregate secured revolving credit facility	$ 225,000,000
All-in rate	3.64%
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	Mar. 31, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
2019	$ 0	$ 0
2020	100,000	55,000
2021	0	0
Thereafter	0	0
Revolving credit facility	100,000	55,000
Debt issuance costs	(287)	(335)
Less: current portion of long-term debt	35,000	35,000
Total long-term debt	64,713	$ 19,665
Revolving credit facility | Line of Credit
Debt Instrument [Line Items]
Revolving credit facility	$ 100,000

Financial Instruments and Der_3

Financial Instruments and Derivatives (Details)	Mar. 31, 2020USD ($)
Derivative [Line Items]
Losses associated with cash flow hedge expected to be reclassified within the next 12 months	$ 281,000
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	$ 545,000

Segment, Customer and Geograp_3

Segment, Customer and Geographic Information - Narrative (Details)	3 Months Ended
	Mar. 31, 2020segment
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
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Consolidated Revenue:
Revenue	$ 109,383	$ 114,757
Revenue by End Market:
Total Revenue	109,383	114,757
Property and equipment, net:
Property and equipment, net	26,267		$ 24,702
Neuro Products
Revenue by End Market:
Total Revenue	65,321	62,390
Neuro Products | Devices and Systems
Revenue by End Market:
Total Revenue	49,397	45,692
Neuro Products | Supplies
Revenue by End Market:
Total Revenue	15,924	15,898
Neuro Products | Services
Revenue by End Market:
Total Revenue	0	800
Newborn Care Products
Revenue by End Market:
Total Revenue	24,232	29,536
Newborn Care Products | Devices and Systems
Revenue by End Market:
Total Revenue	11,690	14,644
Newborn Care Products | Supplies
Revenue by End Market:
Total Revenue	9,794	10,047
Newborn Care Products | Services
Revenue by End Market:
Total Revenue	2,748	4,845
Hearing & Balance Products
Revenue by End Market:
Total Revenue	19,830	22,831
Hearing & Balance Products | Devices and Systems
Revenue by End Market:
Total Revenue	18,589	21,525
Hearing & Balance Products | Supplies
Revenue by End Market:
Total Revenue	1,241	1,306
United States
Consolidated Revenue:
Revenue	68,338	66,067
Property and equipment, net:
Property and equipment, net	13,728		11,868
International
Consolidated Revenue:
Revenue	41,045	$ 48,690
Property and equipment, net:
Property and equipment, net	1,082		1,163
Canada
Property and equipment, net:
Property and equipment, net	4,073		4,140
Denmark
Property and equipment, net:
Property and equipment, net	1,761		1,799
Long-Lived Assets	$ 5,623		$ 5,732

Fair Value Measurements - Sched

Fair Value Measurements - Schedule of Derivative Financial Instruments at Fair Value (Details) - Level II - Recurring $ in Thousands	3 Months Ended
	Mar. 31, 2020USD ($)
Derivative Liability [Roll Forward]
Beginning of period	$ 313
Additions	0
Payments	0
Adjustments	232
End of period	$ 545

Uncategorized Items - ntus-2020

Label	Element	Value
Accounting Standards Update 2016-16 [Member]
Cumulative Effect of New Accounting Principle in Period of Adoption	us-gaap_CumulativeEffectOfNewAccountingPrincipleInPeriodOfAdoption	$ 0
Accounting Standards Update 2016-16 [Member] | Retained Earnings [Member]
Cumulative Effect of New Accounting Principle in Period of Adoption	us-gaap_CumulativeEffectOfNewAccountingPrincipleInPeriodOfAdoption	1,332,000
Accounting Standards Update 2016-16 [Member] | AOCI Attributable to Parent [Member]
Cumulative Effect of New Accounting Principle in Period of Adoption	us-gaap_CumulativeEffectOfNewAccountingPrincipleInPeriodOfAdoption	$ (1,332,000)