# Integer Holdings Corp (ITGR) FY 2024 MD&A

Verbatim Item 7 Management's Discussion and Analysis from Integer Holdings Corp's 10-K for fiscal year 2024.

SEC filing source: https://www.sec.gov/Archives/edgar/data/1114483/000111448325000034/gb-20241231.htm
Accession: 0001114483-25-000034
Filing date: 2025-02-20
Report date: 2024-12-31
Extracted structurally from real Item 7 body heading to real Item 7A/8 boundary.
Confidence: high

Company profile: /company/ITGR/
All MD&A years: /company/ITGR/mda/
Previous year: /company/ITGR/mda/fy2023/ (FY 2023)
Next year: /company/ITGR/mda/fy2025/ (FY 2025)

ITEM 7.    MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF

OPERATIONS

The following discussion and analysis of our financial condition and results of operations should be read together with our consolidated financial statements and the related notes appearing in Item 8, “Financial Statements and Supplementary Data,” of this report. This discussion and analysis contains forward-looking statements that involve risks, uncertainties and assumptions. Our actual results may differ materially from those anticipated in these forward-looking statements as a result of many factors, including but not limited to those under the heading Item 1A, “Risk Factors,” of this report. Unless otherwise stated, all results and comparisons below represent results from continuing operations.

Our Business

•Our business

•Impact of global events

•Business acquisitions

•Divestiture and market exit

•Discontinued operations

Our Financial Results

•Fiscal 2024 compared with fiscal 2023

•Fiscal 2023 compared with fiscal 2022

•Liquidity and capital resources

•Cash and other commitments

•Impact of recently issued accounting standards

Critical Accounting Estimates

•Inventories

•Acquisition method of accounting

•Valuation of goodwill, indefinite-lived intangible assets and long-lived assets

Our Business

Integer Holdings Corporation is one of the largest medical device contract development and manufacturing organizations in the world, serving the cardiac rhythm management, neuromodulation, and cardio and vascular markets. As a strategic partner of choice to medical device companies and OEMs, we are committed to enhancing the lives of patients worldwide by providing innovative, high-quality products and solutions.

We operate our business in one segment and derive our revenues from three product lines: Cardio & Vascular, Cardiac Rhythm Management & Neuromodulation and Other Markets. Prior to the divestiture of Electrochem, we operated in two reportable segments: Medical and Non-Medical.

Impact of Global Events

Our future results of operations and liquidity could be materially adversely affected by uncertainty surrounding macroeconomic and geopolitical factors in the U.S. and globally characterized by the supply chain environment, inflationary pressure, elevated interest rates, disruptions in the commodities’ markets as a result of the conflict between Russia and Ukraine and conflicts in the Middle East, including Israel and Iran, and the introduction of or changes in tariffs or trade barriers. The impact of these issues on our business will vary by geographic market and product line, but specific impacts to our business include increased borrowing costs, labor shortages, disruptions in the supply chain, delayed or reduced customer orders and sales, delays in shipments to and from certain countries and potential increased expenses resulting from tariffs or other trade barriers. We monitor economic conditions closely. In response to reductions in revenue, we can take actions to align our cost structure with changes in demand and manage our working capital. However, there can be no assurance as to the effectiveness of our efforts to mitigate any impact of the current and future adverse economic conditions and other developments.

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MANAGEMENT’S DISCUSSION AND ANALYSIS

Business Acquisitions

We selectively evaluate acquisitions as a means to acquire additional technology or manufacturing capabilities to expand our product offering in our key existing growth markets. Consistent with our tuck-in acquisition strategy, since the beginning of 2022 we have completed the following acquisitions, including those that impact the comparability of our results between periods:

Subsequent to the end of the 2024, on January 7, 2025, we acquired substantially all of the assets and assumed certain liabilities of certain subsidiaries of Katahdin Industries, Inc., including its main operating subsidiary, Precision Coating LLC (collectively “Precision”). Prior to the acquisition, Precision was a privately-held manufacturer specializing in high value surface coating technology platforms, including fluoropolymer, anodic coatings, ion treatment solutions and laser processing. Based in Massachusetts, Precision has additional locations in the New England area and an additional facility in Costa Rica. The acquisition of Precision increased our service offerings to include differentiated and proprietary coatings capabilities that position us to better meet customers’ evolving needs. Given the January 7, 2025 closing date of the acquisition, Precision’s results are not included in this MD&A and the disclosures included herein. Refer to Note 21, “Subsequent Events,” of the Notes to Consolidated Financial Statements contained in Item 8, “Financial Statements and Supplementary Data,” of this report for additional information about the acquisition of Precision.

On January 5, 2024, we acquired Pulse, a privately-held technology, engineering and contract manufacturing company focused on complex micro machining of medical device components for high growth structural heart, heart pump, electrophysiology, leadless pacing, and neuromodulation markets. Pulse also provides proprietary advanced technologies, including hierarchical surface restructuring (HSRTM), scratch-free surface finishes, and titanium nitride coatings. The acquisition of Pulse further increased our end-to-end development capabilities and manufacturing footprint in targeted growth markets and provides customers with expanded capabilities, capacity and resources to accelerate the time to market for customer products.

On October 1, 2023, we acquired substantially all of the assets and assumed certain liabilities of InNeuroCo, a recognized leader in neurovascular catheter innovation with strong development and manufacturing capabilities. InNeuroCo’s expertise and highly differentiated neurovascular catheter innovation complements our existing capabilities and market focus. Consistent with our strategy, the addition of InNeuroCo further increased our ability to provide enhanced solutions to our customers in the neurovascular catheter space.

On April 6, 2022, we acquired Aran, a recognized leader in proprietary medical textiles, high precision biomaterial coverings and coatings as well as advanced metal and polymer braiding, Aran delivers development and manufacturing solutions for implantable medical devices. The acquisition of Aran further increased our ability to offer complete solutions for complex delivery and therapeutic devices in high growth cardiovascular markets such as structural heart, neurovascular, peripheral vascular, and endovascular as well as general surgery.

Refer to Note 2, “Business Acquisitions,” of the Notes to Consolidated Financial Statements contained in Item 8, “Financial Statements and Supplementary Data,” of this report for additional information about the acquisitions of Pulse, InNeuroCo and Aran.

Divestiture and Market Exit

On October 31, 2024, we completed the sale of our wholly-owned subsidiary Electrochem Solutions, Inc. (“Electrochem”) for a total purchase price of $50.0 million in cash, subject to customary working capital adjustments. Electrochem, which focused on nonmedical applications for the energy, military and environmental sectors, represented substantially all of the assets and operations in our previously reported Non-Medical reporting segment. Subsequently to the divestiture of Electrochem, we operate in one reportable segment.

During 2022, we announced plans to exit our portable medical market (the “Portable Medical Exit”) to enhance profitability and reallocate manufacturing capacity to support growth. Since that time, we have been working closely with impacted customers to support the transition of these products to other suppliers. Due to quality and regulatory requirements, we expected it would take three to four years to complete this transition. We currently expect Portable Medical sales to begin to wind down with the final sales and market exit occurring in 2025. Portable Medical sales are included in our Other Markets product line sales.

Discontinued Operations

As a result of the Electrochem divestiture, the results of operations of the Electrochem business have been classified as discontinued operations for all periods presented. Intersegment sales to Electrochem that were previously eliminated in consolidation have been treated as third-party sales and are included in sales from continuing operations as we will continue to supply the Electrochem business with certain specified products following its divestiture. Prior period amounts have been reclassified to conform to the continuing operations reporting presentation.

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MANAGEMENT’S DISCUSSION AND ANALYSIS

Income (loss) from discontinued operations, net of tax, was a loss of $1.2 million for 2024, which represented the results of operations of Electrochem for ten months prior to its divestiture on October 31, 2024 and a pre-tax gain on sale of discontinued operations of $0.8 million. During 2023, we recognized income from discontinued operations of $1.5 million, which represented the results of operations of Electrochem for the full year in 2023. During 2022, we recognized income from discontinued operations of $6.6 million, which included Electrochem results for the full year in 2022 and $1.0 million of income from a portion of our AS&O product line that we sold in 2018.

All results and information presented exclude discontinued operations unless otherwise noted. Refer to Note 3, “Discontinued Operations” of the Notes to Consolidated Financial Statements contained in Item 8, “Financial Statements and Supplementary Data,” of this report for additional information on the divestiture of Electrochem.

Our Financial Results

The following table presents selected financial information derived from our Consolidated Financial Statements, contained in Item 8, “Financial Statements and Supplementary Data,” of this report, for the periods presented (dollars in thousands, except per share amounts):

[[GREPCENT_TABLE]]
[["","","","Change","","Change"],["","","","","","","","2024 vs. 2023","","2023 vs. 2022"],["","2024","","2023","","2022","","$","","%","","$","","%"],["Cardio & Vascular","$","949,576","","","$","836,343","","","$","699,401","","","$","113,233","","","14","%","","$","136,942","","","20","%"],["Cardiac Rhythm Management & Neuromodulation","660,610","","","612,891","","","534,371","","","47,719","","","8","%","","78,520","","","15","%"],["Other Markets","106,410","","","106,422","","","97,505","","","(12)","","","\u2014","%","","8,917","","","9","%"],["Total sales","1,716,596","","","1,555,656","","","1,331,277","","","160,940","","","10","%","","224,379","","","17","%"],["Cost of sales","1,257,582","","","1,145,767","","","985,516","","","111,815","","","10","%","","160,251","","","16","%"],["Gross profit","459,014","","","409,889","","","345,761","","","49,125","","","12","%","","64,128","","","19","%"],["Gross profit as a % of sales","26.7","%","","26.3","%","","26.0","%"],["Operating expenses:"],["Selling, general and administrative","185,202","","","173,171","","","158,050","","","12,031","","","7","%","","15,121","","","10","%"],["Research, development and engineering","53,425","","","61,967","","","59,762","","","(8,542)","","","(14)","%","","2,205","","","4","%"],["Restructuring and other charges","12,149","","","11,428","","","15,271","","","721","","","6","%","","(3,843)","","","(25)","%"],["Total operating expenses","250,776","","","246,566","","","233,083","","","4,210","","","2","%","","13,483","","","6","%"],["Operating income","208,238","","","163,323","","","112,678","","","44,915","","","28","%","","50,645","","","45","%"],["Interest expense","56,374","","","51,275","","","37,265","","","5,099","","","10","%","","14,010","","","38","%"],["Loss on equity investments, net","780","","","5,691","","","7,636","","","(4,911)","","","(86)","%","","(1,945)","","","(25)","%"],["Other (income) loss, net","3,521","","","975","","","(899)","","","2,546","","","NM","","1,874","","","NM"],["Income from continuing operations before income taxes","147,563","","","105,382","","","68,676","","","42,181","","","40","%","","36,706","","","53","%"],["Provision for income taxes","26,510","","","16,239","","","8,929","","","10,271","","","63","%","","7,310","","","82","%"],["Effective tax rate","18.0","%","","15.4","%","","13.0","%"],["Income from continuing operations","$","121,053","","","$","89,143","","","$","59,747","","","$","31,910","","","36","%","","$","29,396","","","49","%"],["Diluted earnings per share from continuing operations","$","3.40","","","$","2.64","","","$","1.79","","","$","0.76","","","29","%","","$","0.85","","","47","%"]]
[[/GREPCENT_TABLE]]

NM - Calculated change not meaningful.

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MANAGEMENT’S DISCUSSION AND ANALYSIS

Fiscal 2024 Compared with Fiscal 2023

The following discussion is a comparison between results for the years ended December 31, 2024 and 2023.

Financial Overview

Income from continuing operations for 2024 was $121.1 million or $3.40 per diluted share compared to $89.1 million or $2.64 per diluted share for 2023. These variances are primarily the result of the following:

•Sales for 2024 increased 10% to $1.717 billion, driven by strong demand, new product ramps, growth from emerging customers with PMA (premarket approval) products and contributions from our recent acquisitions.

•Gross profit for 2024 increased $49.1 million, or 12%, primarily from higher sales volume leverage, efficiencies gained from the continued improvement in the supply chain and contributions from our recent acquisitions.

•Operating expenses for 2024 increased by $4.2 million compared to 2023, due to higher SG&A and Restructuring and other charges, partially offset by lower RD&E costs.

•Interest expense for 2024 increased by $5.1 million, primarily due to higher average debt outstanding, partially offset by a decrease in losses from extinguishment of debt.

•We recognized net losses on equity investments of $0.8 million and $5.7 million during 2024 and 2023, respectively. Gains and losses on equity investments are generally unpredictable in nature.

•Other (income) loss, net for 2024 and 2023 were losses of $3.5 million and $1.0 million, respectively, primarily due to fluctuations in foreign currency gains and losses in the respective periods.

•We recorded provisions for income taxes of $26.5 million and $16.2 million for 2024 and 2023, respectively. The changes in income tax were primarily due to relative changes in pre-tax income and the impact of discrete tax items.

Sales

During the fourth quarter of 2024, we began referring to our “Advanced Surgical, Orthopedics & Portable Medical” product line as the “Other Markets” product line, to better capture the evolving nature of our products and ongoing strategic focus. The name change has no impact on financial information previously reported.

Sales by product line for 2024 and 2023 were as follows (dollars in thousands):

[[GREPCENT_TABLE]]
[["","","","Change"],["","2024","","2023","","$","","%"],["Cardio & Vascular","$","949,576","","","$","836,343","","","$","113,233","","","13.5","%"],["Cardiac Rhythm Management & Neuromodulation","660,610","","","612,891","","","47,719","","","7.8","%"],["Other Markets","106,410","","","106,422","","","(12)","","","\u2014","%"],["Total sales","$","1,716,596","","","$","1,555,656","","","$","160,940","","","10.3","%"]]
[[/GREPCENT_TABLE]]

Cardio & Vascular (“C&V”) sales for 2024 increased $113.2 million, or 14%, in comparison to 2023. The increase in C&V sales for 2024 was driven by strong growth across targeted C&V markets, driven by electrophysiology, structural heart, and the InNeuroCo and Pulse acquisitions.

Cardiac Rhythm Management & Neuromodulation (“CRM&N”) sales for 2024 increased $47.7 million, or 8%, in comparison to 2023. CRM&N sales for 2024 were driven by double-digit neuromodulation growth from emerging customers with premarket approval products and normalized low single-digit cardiac rhythm management growth.

Other Markets sales for 2024 were flat in comparison to 2023, as the decline in Portable Medical from the multi-year exit announced in 2022 was offset by the Pulse acquisition.

Gross Profit

[[GREPCENT_TABLE]]
[["","2024","","2023"],["Gross profit (in thousands)","$","459,014","","","$","409,889"],["Gross margin","26.7","%","","26.3","%"]]
[[/GREPCENT_TABLE]]

Gross profit as a percent of sales (“Gross margin”) for 2024 increased 40 basis points compared to 2023. The improved year over year gross margin was primarily driven by higher sales volume leverage and efficiencies realized through our manufacturing excellence initiatives.

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MANAGEMENT’S DISCUSSION AND ANALYSIS

SG&A Expenses

SG&A expenses comprise the following for 2024 and 2023 (in thousands):

[[GREPCENT_TABLE]]
[["","2024","","2023","","Change"],["Compensation and benefits(a)","$","97,086","","","$","89,549","","","$","7,537"],["Depreciation and amortization expense(b)","42,837","","","41,516","","","1,321"],["Professional fees(c)","16,338","","","15,553","","","785"],["Contract services(d)","14,197","","","11,774","","","2,423"],["Bank fees and charges(e)","3,695","","","2,903","","","792"],["All other SG&A","11,049","","","11,876","","","(827)"],["Total SG&A expense","$","185,202","","","$","173,171","","","$","12,031"]]
[[/GREPCENT_TABLE]]

__________

(a)Compensation and benefits increased primarily due to annual merit increases and an increase in headcount related to the recent Pulse and InNeuroCo acquisitions.

(b)Depreciation and amortization expense increased due to amortization of intangible assets from the Pulse and InNeuroCo customer list intangible assets.

(c)Professional fees increased primarily due to increased costs associated with third-party information technology services and higher legal expense related to general corporate matters.

(d)Contract services expense increased primarily due to higher software costs from information technology enhancements.

(e)The increase in bank fees and charges was driven by increased fees related to our factoring and supplier financing arrangements, primarily due to higher volume under both arrangements during 2024 compared to 2023.

RD&E

RD&E expenses for 2024 and 2023 were $53.4 million and $62.0 million, respectively. The decrease in RD&E expenses for 2024 compared to 2023 was primarily due to lower labor costs and the timing of program milestone achievements for customer funded programs. RD&E expenses are influenced by the number and timing of in-process projects and labor hours and other costs associated with these projects. Our research and development initiatives continue to emphasize new product development, product improvements, and the development of new technological platform innovations.

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MANAGEMENT’S DISCUSSION AND ANALYSIS

Restructuring and Other Charges

We continuously evaluate our business and identify opportunities to realign resources to better serve our customers and markets, improve operational efficiency and capabilities, and lower operating costs. To realize the benefits associated with these opportunities, we undertake restructuring-type activities to transform our business. We incur costs associated with these activities, which primarily include exit and disposal costs and other costs directly related to the restructuring initiative. Restructuring charges include exit and disposal costs from these activities. In addition, from time to time, we incur costs associated with acquiring and integrating businesses, and certain other general expenses, including asset impairments.

Restructuring and other charges comprise the following for 2024 and 2023 (in thousands):

[[GREPCENT_TABLE]]
[["","2024","","2023","","Change"],["Restructuring charges(a)","4,013","","","5,874","","","(1,861)"],["Acquisition and integration costs(b)","8,941","","","3,444","","","5,497"],["Other general expenses(c)","(805)","","","2,110","","","(2,915)"],["Total restructuring and other charges","$","12,149","","","$","11,428","","","$","721"]]
[[/GREPCENT_TABLE]]

__________

(a)Restructuring charges for 2024 and 2023 primarily consisted of costs associated with our strategic reorganization and alignment and manufacturing alignment to support growth initiatives. Included in restructuring charges for 2023 are $3.6 million in costs related to the relocation and closure of our R&D facility in Israel.

(b)Amount for 2024 primarily includes acquisition expenses of $5.5 million, primarily related to the Pulse and Precision Coating (completed in January 2025) acquisitions, and integration expenses of $3.4 million, primarily related to the InNeuroCo and Pulse acquisitions. Amount for 2023 primarily includes acquisition expenses of $0.7 million, primarily related to the InNeuroCo and Pulse acquisitions, and integration expenses of $2.8 million, primarily related to the Aran and Oscor acquisitions. The 2024 and 2023 acquisition amounts are net of benefits of $3.6 million and $0.7 million, respectively, related to adjustments to the fair value of acquisition-related contingent consideration liabilities. See Note 18, “Financial Instruments and Fair Value Measurements,” of the Notes to Consolidated Financial Statements contained in Item 8, “Financial Statements and Supplementary Data,” of this report for additional information related to the fair value measurement of the contingent consideration.

(c)Amounts include gains and losses in connection with the disposal of property, plant and equipment. In addition, during 2024 and 2023 we recorded $(1.2) million and $2.0 million, respectively, of property loss (recoveries) relating to property damage which occurred in the fourth quarter of 2023 at one of our manufacturing facilities.

Refer to Note 12, “Restructuring and Other Charges,” of the Notes to Consolidated Financial Statements contained in Item 8, “Financial Statements and Supplementary Data,” of this report for additional information regarding these initiatives.

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MANAGEMENT’S DISCUSSION AND ANALYSIS

Interest Expense

Information relating to our interest expense for 2024 and 2023 is as follows (dollars in thousands):

[[GREPCENT_TABLE]]
[["","2024","","2023","","Change"],["","Amount","","Rate","","Amount","","Rate","","Amount","","Rate (bp)"],["Contractual interest expense","$","51,520","","","4.83","%","","$","44,082","","","4.62","%","","$","7,438","","","21"],["Gain on interest rate swap","\u2014","","","\u2014","","","(1,262)","","","(0.12)","","","1,262","","","12"],["Amortization of deferred debt issuance costs and original issue discount","4,057","","","0.42","","","3,536","","","0.42","","","521","","","\u2014"],["Loss from extinguishment of debt","\u2014","","","\u2014","","","4,518","","","0.46","","","(4,518)","","","(46)"],["Interest expense on borrowings","55,577","","","5.25","%","","50,874","","","5.38","%","","4,703","","","(13)"],["Other interest expense","797","","","","","401","","","","","396"],["Total interest expense","$","56,374","","","","","$","51,275","","","","","$","5,099"]]
[[/GREPCENT_TABLE]]

Interest expense relates primarily to borrowings made under our Senior Secured Credit Facilities, which consist of a five-year $800 million revolving credit facility (the “Revolving Credit Facility”) and a five-year “term A” loan (the “TLA Facility”), and our 2028 Convertible Notes.

During 2024, contractual interest expense primarily increased due to higher average debt outstanding. The higher average debt balance outstanding is primarily the result of borrowings on our Revolving Credit Facility to fund the Pulse and InNeuroCo acquisitions.

Other components of interest expense on borrowings include gains on an interest rate swap contract and non-cash amortization and write-off (losses from extinguishment of debt) of deferred debt issuance costs and original issue discount. Gain on interest rate swap includes realized gains on an interest rate swap contract which matured as of June 30, 2023. Amortization of deferred debt issuance costs and original issue discount increased during 2024 compared to the same periods in 2023 as a result of higher unamortized balances related to new debt. The losses from extinguishment of debt during 2023 were related to prepayments of portions of the TLA Facility and full repayment of our Term Loan B facility in connection with issuance of the 2028 Convertible Notes.

See Note 9, “Debt,” of the Notes to the Consolidated Financial Statements contained in Item 8, “Financial Statements and Supplementary Data,” of this report for additional information pertaining to our debt.

As of December 31, 2024 and 2023, approximately 50% of our principal amount of debt were fixed rate borrowings.

Loss on Equity Investments, Net

During 2024 and 2023, we recognized net losses of $0.8 million and $5.7 million, respectively, on our equity investments. Gains and losses on equity investments are generally unpredictable in nature. During 2024 and 2023, we recognized impairment charges of $0.2 million and $5.2 million, respectively, related to investments in our non-marketable equity securities. The residual losses for 2024 and 2023 relate to our share of equity method investee gains/losses, including unrealized appreciation and depreciation of the underlying interests of the investee. As of December 31, 2024 and December 31, 2023, the carrying value of our equity investments was $7.4 million and $8.2 million, respectively. See Note 18, “Financial Instruments and Fair Value Measurements,” of the Notes to Consolidated Financial Statements contained in Item 8, “Financial Statements and Supplementary Data,” of this report for further details regarding these investments.

Other (Income) Loss, Net

Other (income) loss, net for 2024 and 2023 were net losses of $3.5 million and $1.0 million, respectively. Other (income) loss, net primarily includes gains/losses from the impact of exchange rates on transactions denominated in foreign currencies. Our foreign currency transaction gains/losses are based primarily on fluctuations of the U.S. dollar relative to the Euro, Mexican peso, Uruguayan peso, Malaysian ringgits or Dominican peso.

The impact of foreign currency exchange rates on transactions denominated in foreign currencies included in Other (income) loss, net for 2024 and 2023 were net losses of $3.2 million and $1.0 million, respectively. We continually monitor our foreign currency exposures and seek to take steps to mitigate these risks. However, fluctuations in foreign currency exchange rates could have a significant impact, positive or negative, on our financial results in the future.

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MANAGEMENT’S DISCUSSION AND ANALYSIS

Provision for Income Taxes

During 2024 and 2023, our provision for income taxes was $26.5 million on worldwide pre-tax income of $147.6 million (effective tax rate of 18.0%) and $16.2 million on worldwide pre-tax income of $105.4 million (effective tax rate of 15.4%), respectively. The stand-alone U.S. component of the effective tax rate for 2024 reflected a $10.5 million provision on $55.6 million of pre-tax book income (effective tax rate of 19.0%) versus a $5.4 million provision on $29.1 million of pre-tax book income (effective tax rate of 18.5%) for 2023. The stand-alone International component of the effective tax rate for 2024 reflected a $16.0 million provision on $92.0 million of pre-tax book income (effective tax rate of 17.4%) versus a $10.8 million provision on $76.3 million of pre-tax book income (effective tax rate of 14.2%) for 2023.

The provision for income taxes for 2024 differs from the U.S. statutory rate due to the following (dollars in thousands):

[[GREPCENT_TABLE]]
[["","U.S.","","International","","Combined"],["","$","","%","","$","","%","","$","","%"],["Income before provision for income taxes","$","55,571","","","","","$","91,992","","","","","$","147,563"],["Provision at statutory rate","$","11,670","","","21.0","%","","$","19,318","","","21.0","%","","$","30,988","","","21.0","%"],["Federal tax credits (including R&D)","(13,628)","","","(24.5)","","","\u2014","","","\u2014","","","(13,628)","","","(9.2)"],["Foreign rate differential","1,881","","","3.4","","","(6,655)","","","(7.2)","","","(4,774)","","","(3.2)"],["Stock-based compensation","1,506","","","2.7","","","\u2014","","","\u2014","","","1,506","","","1.0"],["Uncertain tax positions","289","","","0.5","","","\u2014","","","\u2014","","","289","","","0.2"],["State taxes, net of federal benefit","1,413","","","2.5","","","\u2014","","","\u2014","","","1,413","","","1.0"],["U.S. tax on foreign earnings, net of \u00a7250 deduction","7,972","","","14.4","","","\u2014","","","\u2014","","","7,972","","","5.4"],["Valuation allowance","216","","","0.4","","","202","","","0.2","","","418","","","0.3"],["OECD Pillar II: Global Minimum Tax","\u2014","","","\u2014","","","2,189","","","2.4","","","2,189","","","1.5"],["Other","(792)","","","(1.4)","","","929","","","1.0","","","137","","","\u2014"],["Provision for income taxes","$","10,527","","","19.0","%","","$","15,983","","","17.4","%","","$","26,510","","","18.0","%"]]
[[/GREPCENT_TABLE]]

The provision for income taxes for 2023 differs from the U.S. statutory rate due to the following (dollars in thousands):

[[GREPCENT_TABLE]]
[["","U.S.","","International","","Combined"],["","$","","%","","$","","%","","$","","%"],["Income before provision for income taxes","$","29,089","","","","","$","76,293","","","","","$","105,382"],["Provision at statutory rate","$","6,109","","","21.0","%","","$","16,021","","","21.0","%","","$","22,130","","","21.0","%"],["Federal tax credits (including R&D)","(11,129)","","","(38.3)","","","\u2014","","","\u2014","","","(11,129)","","","(10.6)"],["Foreign rate differential","1,921","","","6.6","","","(7,434)","","","(9.7)","","","(5,513)","","","(5.2)"],["Stock-based compensation","1,847","","","6.3","","","\u2014","","","\u2014","","","1,847","","","1.7"],["Uncertain tax positions","(1,170)","","","(4.0)","","","\u2014","","","\u2014","","","(1,170)","","","(1.1)"],["State taxes, net of federal benefit","1,108","","","3.8","","","\u2014","","","\u2014","","","1,108","","","1.1"],["U.S. tax on foreign earnings, net of \u00a7250 deduction","6,194","","","21.3","","","\u2014","","","\u2014","","","6,194","","","5.9"],["Valuation allowance","411","","","1.4","","","1,326","","","1.7","","","1,737","","","1.6"],["Other","120","","","0.4","","","915","","","1.2","","","1,035","","","1.0"],["Provision for income taxes","$","5,411","","","18.5","%","","$","10,828","","","14.2","%","","$","16,239","","","15.4","%"]]
[[/GREPCENT_TABLE]]

Our effective tax rate of 18.0% for 2024 is higher than our effective tax rate of 15.4% for 2023, primarily due to the impact of the OECD Pillar II Global Minimum Tax enacted on January 1, 2024, the expiration of the Malaysia Tax Holiday described below, the increase in pre-tax book income and related statutory rate differential, and the impact of non-recurring discrete tax benefits recorded in 2023 for provision to return adjustments for the 2022 tax return filed in 2023, partially offset by favorable discrete tax benefits in 2024 including the release of uncertain tax benefits related to the expiration of the statute of the 2020 tax year.

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MANAGEMENT’S DISCUSSION AND ANALYSIS

Our effective tax rate for 2024 differs from the U.S. federal statutory tax rate of 21% due principally to the estimated impact of Federal Tax Credits (including R&D credits and Foreign tax credits), stock-based compensation and the impact of earnings realized in foreign jurisdictions with statutory rates that are different than the U.S. federal statutory rate. These benefits are partially offset by the impact of the OECD Pillar II Global Minimum Tax enacted on January 1, 2024, and the impact of U.S. taxes on foreign earnings, including the GILTI provision which requires us to include foreign subsidiary earnings in excess of a deemed return on a foreign subsidiary’s tangible assets in our U.S. income tax return. The U.S. tax on foreign earnings is reflected net of a statutory deduction of 50% of the GILTI inclusion (subject to limitations based on U.S. taxable income, if any) and net of FDII that provides a 37.5% deduction to domestic companies for certain foreign sales and services income. The primary foreign jurisdictions in which we operate and the statutory tax rate for each respective jurisdiction include Switzerland (22%), Mexico (30%), Uruguay (25%), Ireland (12.5%) and Malaysia (24%). We have previously operated in Malaysia under a tax holiday. We met the conditions of the Malaysian tax holiday and the holiday expired in accordance with its original terms on April 30, 2023. Our manufacturing operations in the Dominican Republic operate under a free trade zone agreement through March 2034.

There is a potential for volatility of our effective tax rate due to several factors, including changes in the mix of pre-tax income and the jurisdictions to which it relates, business acquisitions, settlements with taxing authorities, changes in tax rates, and foreign currency exchange rate fluctuations. In addition, we continue to explore tax planning opportunities that may have a material impact on our effective tax rate.

It is reasonably possible that a reduction of approximately $4.0 million of the balance of unrecognized tax benefits may occur within the next twelve months as a result of the lapse of the statute of limitations and/or audit settlements. As of December 31, 2024, approximately $6.1 million of unrecognized tax benefits would favorably impact the effective tax rate (net of federal impact on state issues), if recognized.

On December 15, 2022, the European Union (EU) Member States formally adopted the EU’s Pillar Two Directive, which generally provides for a minimum effective tax rate of 15%, as established by the OECD Pillar Two Framework. The effective dates are January 1, 2024, and January 1, 2025 for different aspects of the directive. Our 2024 provision for income taxes includes the impact of the Pillar Two 15% Global Minimum Tax, with an enactment date of January 1, 2024. A significant number of other countries are expected to also implement similar legislation with varying effective dates in the future. We are continuing to evaluate the potential impact on future periods of the Pillar Two Framework, pending legislative adoption by additional individual countries.

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MANAGEMENT’S DISCUSSION AND ANALYSIS

Fiscal 2023 Compared with Fiscal 2022

The following discussion is a comparison between results for the years ended December 31, 2023 and 2022.

Sales

Sales by product line for 2023 and 2022 were as follows (dollars in thousands):

[[GREPCENT_TABLE]]
[["","","","Change"],["","2023","","2022","","$","","%"],["Cardio & Vascular","$","836,343","","","$","699,401","","","$","136,942","","","19.6","%"],["Cardiac Rhythm Management & Neuromodulation","612,891","","","534,371","","","78,520","","","14.7","%"],["Other Markets","106,422","","","97,505","","","8,917","","","9.1","%"],["Total sales","$","1,555,656","","","$","1,331,277","","","$","224,379","","","16.9","%"]]
[[/GREPCENT_TABLE]]

C&V sales for 2023 increased $136.9 million or 20% in comparison to 2022. The increase in C&V sales for 2023 was driven by strong demand, acquisition performance and supply chain improvements, with double-digit growth across all C&V markets. Foreign currency exchange rate fluctuations increased C&V sales for 2023 by $1.2 million.

CRM&N sales for 2023 increased $78.5 million or 15% in comparison to 2022. CRM&N sales for 2023 were driven by double-digit CRM growth from strong customer demand, double-digit Neuromodulation growth from emerging customers, and supply chain improvements.

Other Markets sales for 2023 increased by $8.9 million in comparison to 2022, driven by high double-digit growth in Portable Medical related to demand to support the multi-year Portable Medical exit.

Gross Profit

[[GREPCENT_TABLE]]
[["","2023","","2022"],["Gross profit (in thousands)","$","409,889","","","$","345,761"],["Gross margin","26.3","%","","26.0","%"]]
[[/GREPCENT_TABLE]]

Gross profit as a percent of sales (“Gross margin”) for 2023 increased 30 basis points compared to 2022. The improved year over year gross margin was primarily due to higher sales volume leverage and efficiencies gained from the continued improvement in the supply chain.

SG&A Expenses

SG&A expenses comprise the following for 2023 and 2022 (in thousands):

[[GREPCENT_TABLE]]
[["","2023","","2022","","Change"],["Compensation and benefits(a)","$","89,549","","","$","83,538","","","$","6,011"],["Depreciation and amortization expense(b)","41,516","","","37,682","","","3,834"],["Professional fees(c)","15,553","","","13,929","","","1,624"],["Contract services(d)","11,774","","","10,157","","","1,617"],["Bank fees and charges(e)","2,903","","","1,015","","","1,888"],["All other SG&A","11,876","","","11,729","","","147"],["Total SG&A expense","$","173,171","","","$","158,050","","","$","15,121"]]
[[/GREPCENT_TABLE]]

__________

(a)Compensation and benefits increased primarily due to annual merit increases and higher incentive compensation, partially offset by lower headcount.

(b)Depreciation and amortization expense increased due to amortization of customer list intangible assets from the acquisitions of Aran and Oscor, which was acquired in December 2021.

(c)Professional fees increased primarily due to increased costs associated with third-party information technology services.

(d)Contract services expense increased primarily due to higher software costs from information technology enhancements.

(e)The increase in bank fees and charges was driven by increased factoring and supplier financing fees primarily due to the launch of accounts receivable factoring arrangements during 2023.

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MANAGEMENT’S DISCUSSION AND ANALYSIS

RD&E

RD&E expenses for 2023 and 2022 were $62.0 million and $59.8 million, respectively. The increase in RD&E expenses for 2023 compared to 2022 was primarily due to higher labor costs attributed to annual merit increases and higher incentive compensation.

Restructuring and Other Charges

Restructuring and other charges comprise the following for 2023 and 2022 (in thousands):

[[GREPCENT_TABLE]]
[["","2023","","2022","","Change"],["Restructuring charges(a)","5,874","","","4,008","","","1,866"],["Acquisition and integration costs(b)","3,444","","","10,075","","","(6,631)"],["Other general expenses(c)","2,110","","","1,188","","","922"],["Total restructuring and other charges","$","11,428","","","$","15,271","","","$","(3,843)"]]
[[/GREPCENT_TABLE]]

__________

(a)Restructuring charges for 2023 and 2022 primarily consisted of costs associated with our strategic reorganization and alignment and manufacturing alignment to support growth initiatives. Included in restructuring charges for 2023 are $3.6 million in costs related to the relocation and closure of our R&D facility in Israel.

(b)Amount for 2023 primarily includes acquisition expenses related to the InNeuroCo and Pulse acquisitions, and integration expenses related to the Aran and Oscor acquisitions. Amount for 2022 primarily includes expenses related to the Aran and Oscor acquisitions. The 2023 and 2022 amounts also include a benefit of $0.7 million and expense of $3.1 million, respectively, related to adjustments to the fair value of acquisition-related contingent consideration liabilities.

(c)Amounts include gains and losses in connection with the disposal of property, plant and equipment. In addition, the 2023 amount includes $2.0 million of property loss and related expenses resulting from property damage which occurred in the fourth quarter of 2023 at one of our manufacturing facilities.

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MANAGEMENT’S DISCUSSION AND ANALYSIS

Interest Expense

Information relating to our interest expense for 2023 and 2022 is as follows (dollars in thousands):

[[GREPCENT_TABLE]]
[["","2023","","2022","","Change"],["","Amount","","Rate","","Amount","","Rate","","Amount","","Rate (bp)"],["Contractual interest expense","$","44,082","","","4.62","%","","$","33,915","","","3.80","%","","$","10,167","","","82"],["(Gain) loss on interest rate swap","(1,262)","","","(0.12)","","","918","","","0.10","","","(2,180)","","","(22)"],["Amortization of deferred debt issuance costs and original issue discount","3,536","","","0.42","","","1,922","","","0.23","","","1,614","","","19"],["Loss from extinguishment of debt","4,518","","","0.46","","","114","","","0.01","","","4,404","","","45"],["Interest expense on borrowings","50,874","","","5.38","%","","36,869","","","4.14","%","","14,005","","","124"],["Other interest expense","401","","","","","396","","","","","5"],["Total interest expense","$","51,275","","","","","$","37,265","","","","","$","14,010"]]
[[/GREPCENT_TABLE]]

During 2023, contractual interest expense increased due to higher average debt outstanding combined with increasing applicable interest rates. The higher average debt balance outstanding was the result of incremental borrowings related to the strategic change to replace some of our variable rate debt to fixed rate through issuance of the 2028 Convertible Notes. Interest rates climbed due to increases in overall market rates, partially offset by a 25 basis point decrease in the interest rate margin on our Senior Secured Credit Facilities. The decrease in the interest rate margin was effective during the second quarter of 2023 based on our secured net leverage ratio.

Our outstanding interest rate swap matured as of June 30, 2023. Amortization of deferred debt issuance costs and original issue discount increased during 2023 compared to 2022 as a result of higher unamortized balances related to new debt. The losses from extinguishment of debt during 2023 were related to prepayments of portions of the TLA Facility and full repayment of our Term Loan B facility in connection with issuance of the 2028 Convertible Notes.

Loss on Equity Investments, Net

During 2023 and 2022, we recognized net losses of $5.7 million and $7.6 million, respectively, on our equity investments. During 2023, we recognized impairment charges of $5.2 million related to investments in our non-marketable equity securities. The residual losses for 2023 and 2022 relate to our share of equity method investee gains/losses, including unrealized appreciation and depreciation of the underlying interests of the investee.

Other (Income) Loss, Net

Other (income) loss, net for 2023 were losses of $1.0 million compared to income of $0.9 million in 2022. Other (income) loss, net primarily includes gains/losses from the impact of exchange rates on transactions denominated in foreign currencies. The impact of foreign currency exchange rates on transactions denominated in foreign currencies included in Other (income) loss, net for 2023 were net losses of $1.0 million and net gains of $1.1 million for 2022.

Provision for Income Taxes

During 2023 and 2022, our provision for income taxes was $16.2 million on worldwide pre-tax income of $105.4 million (effective tax rate of 15.4%) and $8.9 million on worldwide pre-tax income of $68.7 million (effective tax rate of 13.0%), respectively. The stand-alone U.S. component of the effective tax rate for 2023 reflected a $5.4 million provision on $29.1 million of pre-tax book income (effective tax rate of 18.5%) versus a $3.3 million provision on $7.2 million of pre-tax book income (effective tax rate of 45.6%) for 2022. The stand-alone International component of the effective tax rate for 2023 reflected a $10.8 million provision on $76.3 million of pre-tax book income (effective tax rate of 14.2%) versus a $5.7 million provision on $61.5 million of pre-tax book income (effective tax rate of 9.2%) for 2022.

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MANAGEMENT’S DISCUSSION AND ANALYSIS

The provision for income taxes for 2023 differs from the U.S. statutory rate due to the following (dollars in thousands):

[[GREPCENT_TABLE]]
[["","U.S.","","International","","Combined"],["","$","","%","","$","","%","","$","","%"],["Income before provision for income taxes","$","29,089","","","","","$","76,293","","","","","$","105,382"],["Provision at statutory rate","$","6,109","","","21.0","%","","$","16,021","","","21.0","%","","$","22,130","","","21.0","%"],["Federal tax credits (including R&D)","(11,129)","","","(38.3)","","","\u2014","","","\u2014","","","(11,129)","","","(10.6)"],["Foreign rate differential","1,921","","","6.6","","","(7,434)","","","(9.7)","","","(5,513)","","","(5.2)"],["Stock-based compensation","1,847","","","6.3","","","\u2014","","","\u2014","","","1,847","","","1.7"],["Uncertain tax positions","(1,170)","","","(4.0)","","","\u2014","","","\u2014","","","(1,170)","","","(1.1)"],["State taxes, net of federal benefit","1,108","","","3.8","","","\u2014","","","\u2014","","","1,108","","","1.1"],["U.S. tax on foreign earnings, net of \u00a7250 deduction","6,194","","","21.3","","","\u2014","","","\u2014","","","6,194","","","5.9"],["Valuation allowance","411","","","1.4","","","1,326","","","1.7","","","1,737","","","1.6"],["Other","120","","","0.4","","","915","","","1.2","","","1,035","","","1.0"],["Provision for income taxes","$","5,411","","","18.5","%","","$","10,828","","","14.2","%","","$","16,239","","","15.4","%"]]
[[/GREPCENT_TABLE]]

The provision for income taxes for 2022 differs from the U.S. statutory rate due to the following (dollars in thousands):

[[GREPCENT_TABLE]]
[["","U.S.","","International","","Combined"],["","$","","%","","$","","%","","$","","%"],["Income before provision for income taxes","$","7,164","","","","","$","61,512","","","","","$","68,676"],["Provision at statutory rate","$","1,505","","","21.0","%","","$","12,917","","","21.0","%","","$","14,422","","","21.0","%"],["Federal tax credits (including R&D)","(9,305)","","","(130.0)","","","\u2014","","","\u2014","","","(9,305)","","","(13.6)"],["Foreign rate differential","1,459","","","20.4","","","(9,152)","","","(14.9)","","","(7,693)","","","(11.2)"],["Stock-based compensation","1,983","","","27.7","","","\u2014","","","\u2014","","","1,983","","","2.9"],["Uncertain tax positions","2,469","","","34.5","","","\u2014","","","\u2014","","","2,469","","","3.6"],["State taxes, net of federal benefit","687","","","9.6","","","\u2014","","","\u2014","","","687","","","1.0"],["U.S. tax on foreign earnings, net of \u00a7250 deduction","5,323","","","74.3","","","\u2014","","","\u2014","","","5,323","","","7.8"],["Valuation allowance","(912)","","","(12.7)","","","694","","","1.1","","","(218)","","","(0.3)"],["Other","60","","","0.8","","","1,201","","","2.0","","","1,261","","","1.8"],["Provision for income taxes","$","3,269","","","45.6","%","","$","5,660","","","9.2","%","","$","8,929","","","13.0","%"]]
[[/GREPCENT_TABLE]]

Our effective tax rate of 15.4% for 2023 is higher than our effective tax rate of 13.0% for 2022, primarily due to the expiration of a tax holiday in Malaysia, the increase in pre-tax book income and related statutory rate differential, and the impact of non-recurring discrete tax benefits recorded in 2022 for provision to return adjustments for the 2021 tax return filed in 2022, partially offset by favorable discrete tax benefits in 2023 from the release of uncertain tax benefits related to the expiration of the statute of the 2019 tax year.

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MANAGEMENT’S DISCUSSION AND ANALYSIS

Liquidity and Capital Resources

Sources of Liquidity

[[GREPCENT_TABLE]]
[["(dollars in thousands)","December 31, 2024","","December 31, 2023"],["Cash and cash equivalents","$","46,543","","","$","23,674"],["Working capital from continuing operations(1)","$","443,946","","","$","382,497"],["Current ratio from continuing operations(1)","2.95","","","2.76"]]
[[/GREPCENT_TABLE]]

__________

(1) Excludes assets held for sale at December 31, 2023.

Cash and cash equivalents at December 31, 2024 increased by $22.9 million from December 31, 2023, primarily as a result of cash generated by operating activities, proceeds from the sale of Electrochem, and net borrowings on our Revolving Credit Facility, mostly offset by purchases of property, plant and equipment and cash paid to acquire Pulse.

Working capital increased by $61.4 million from December 31, 2023, or $38.6 million excluding the increase in cash and cash equivalents. The increase in working capital, exclusive of cash and cash equivalents, primarily relates to positive fluctuations in accounts receivable, inventory and contract assets. Inventory increased from higher sales volume and product demand which also contributed to the increase in contract assets and accounts receivable.

At December 31, 2024, $22.8 million of our cash and cash equivalents were held by foreign subsidiaries. We intend to limit our distributions from foreign subsidiaries to previously taxed income or current period earnings. If distributions are made utilizing current period earnings, we will record foreign withholding taxes in the period of the distribution.

As of December 31, 2024, our capital structure consisted of $990.2 million of debt, net of deferred debt issuance costs and unamortized discounts, outstanding under our Senior Secured Credit Facilities and the 2028 Convertible Notes, and 34 million shares of common stock outstanding. As of December 31, 2024, we have access to $668.7 million of borrowing capacity under our Revolving Credit Facility. We are authorized to issue up to 100 million shares of common stock, of which approximately 34 million shares were issued and outstanding at December 31, 2024, and 100 million shares of preferred stock, none of which were outstanding at December 31, 2024. As of December 31, 2024, our contractual debt service obligations for 2025, consisting of principal and interest on our outstanding debt and commitment fees on the unused portion of the Revolving Credit Facility are estimated to be approximately $52 million. Actual principal and interest payments may be higher if, for instance, the applicable interest rates on our Senior Secured Credit Facilities increase, we borrow additional amounts on our Revolving Credit Facility, or we pay principal amounts in excess of the required minimums reflected in the contractual debt service obligations above.

Our off-balance sheet commitments related to our outstanding letters of credit as of December 31, 2024 were $5.3 million.

Credit Facilities and 2028 Convertible Notes

As of December 31, 2024, we had Senior Secured Credit Facilities that consist of an $800 million Revolving Credit Facility, with an outstanding principal balance of $126 million, and a TLA Facility with an outstanding principal balance of $375 million. The Revolving Credit Facility and TLA Facility mature on February 15, 2028. The Senior Secured Credit Facilities include a mandatory prepayment provision customary for similar credit facilities.

During 2023, we issued $500 million aggregate principal amount of notes. The 2028 Convertible Notes mature on February 15, 2028 and bear interest at a fixed rate of 2.125% per annum. The conditions allowing holders of the 2028 Convertible Notes to convert the 2028 Convertible Notes were met as of June 30, 2024 and, thereafter, continued to be met as of December 31, 2024, in each instance due to the trading price of our common stock exceeding 130% of the 2028 Convertible Notes conversion price on at least 20 out of the 30 consecutive trading days prior to such date. Therefore, the 2028 Convertible Notes became eligible for conversion at the option of the holders beginning on July 1, 2024 and will continue to be eligible for conversion through March 31, 2025. Any determination regarding the convertibility of the 2028 Convertible Notes during future periods will be made in accordance with the terms of the indenture governing the 2028 Convertible Notes. If a conversion request occurs, we have the intent and ability to refinance the amounts that may become due with respect to the 2028 Convertible Notes using available borrowing capacity under the Revolving Credit Facility. As such, the obligations associated with the 2028 Convertible Notes continue to be classified as a long-term liability on the Consolidated Balance Sheets as of December 31, 2024.

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MANAGEMENT’S DISCUSSION AND ANALYSIS

The Revolving Credit Facility and TLA Facility contain covenants requiring that we maintain (i) a Total Net Leverage Ratio not to exceed 5.00:1.00, subject to increase in certain circumstances following certain qualified acquisitions and (ii) an interest coverage ratio of at least 2.50:1.00. As of December 31, 2024, we were in compliance with these financial covenants. As of December 31, 2024, our Total Net Leverage Ratio, calculated in accordance with our Senior Secured Credit Facilities agreement, was approximately 2.3:1.0. For the year ended December 31, 2024, our interest coverage ratio, calculated in accordance with our Senior Secured Credit Facilities agreement, was approximately 8.1:1.0.

Failure to comply with these financial covenants would result in an event of default as defined under the Revolving Credit Facility and TLA Facility unless waived by the lenders. An event of default may result in the acceleration of our indebtedness. As a result, management believes that compliance with these covenants is material to us.

See Note 9, “Debt,” of the Notes to the Consolidated Financial Statements contained in Item 8, “Financial Statements and Supplementary Data,” of this report for a further information of our outstanding debt.

Factoring Arrangements

We may utilize accounts receivable factoring arrangements with financial institutions to accelerate the timing of cash receipts and enhance our cash position. These arrangements, in all cases, do not contain recourse provisions which would obligate us in the event of our customers’ failure to pay. During 2024 and 2023, we sold, without recourse, $231.0 million and $144.4 million, respectively, of accounts receivable. See Note 1, “Summary of Significant Accounting Policies,” of the Notes to the Consolidated Financial Statements contained in Item 8, “Financial Statements and Supplementary Data,” of this report for a further information regarding the factoring arrangements.

Summary of Cash Flow

The following cash flow summary information includes cash flows related to discontinued operations (in thousands):

[[GREPCENT_TABLE]]
[["","2024","","2023"],["Cash provided by (used in):"],["Operating activities","$","205,205","","","$","180,213"],["Investing activities","(195,414)","","","(163,367)"],["Financing activities","13,321","","","(18,014)"],["Effect of foreign currency exchange rates on cash and cash equivalents","(243)","","","570"],["Net change in cash and cash equivalents","$","22,869","","","$","(598)"]]
[[/GREPCENT_TABLE]]

Operating Activities - During 2024, we generated cash from operations of $205.2 million, compared to $180.2 million in 2023. The increase of $25.0 million was the result of a $27.3 million increase in net income adjusted for non-cash items such as depreciation and amortization, partially offset by a $2.3 million decrease in cash flow provided by changes in operating assets and liabilities. The increase in net income adjusted for non-cash items such as depreciation and amortization was primarily from higher sales volume and margin partially offset by higher acquisition costs due to the Pulse and Precision acquisitions.

Investing Activities – The $32.0 million increase in net cash used in investing activities was primarily attributable to an increase in net cash paid for acquisitions, partially offset by decreased purchases of property, plant and equipment and net cash proceeds from the sale of Electrochem. Investing activities for 2024 included net cash paid of $138.5 million for the Pulse acquisition. For 2023, investing activities included $43.6 million for the InNeuroCo acquisition.

Financing Activities – Net cash provided by financing activities during 2024 was $13.3 million compared to net cash used in financing activities of $18.0 million in 2023. Cash provided by financing activities during 2024 was primarily due to net borrowings on our Revolving Credit Facility of $27.0 million. The cash used in financing activities during 2023 was primarily related to the $335.6 million full repayment of our Term Loan B facility, $80.3 million in repayments of our TLA Facility, $41.7 million of net payments on our Revolving Credit Facility, $35.0 million of capped call purchases related to the issuance of our 2028 Convertible Notes, and $7.7 million paid to settle certain contingent consideration liabilities related to acquisitions, which was partially offset by the issuance of our 2028 Convertible Notes of $486.3 million.

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MANAGEMENT’S DISCUSSION AND ANALYSIS

Cash and Other Commitments

We have material cash requirements to pay third parties under various contractual obligations discussed below. Presented below is a summary of contractual obligations and other minimum commitments as of December 31, 2024. Refer to Note 14, “Commitments and Contingencies,” of the Notes to Consolidated Financial Statements contained in Item 8, “Financial Statements and Supplementary Data,” of this report for additional information regarding self-insurance liabilities, which are not reflected in the table below.

[[GREPCENT_TABLE]]
[["","Payments due by period"],["","Total","","Less than 1 year","","1-3 years","","3-5 years","","More than 5 years"],["Principal amount of debt outstanding(a)","$","1,001,000","","","$","10,000","","","$","57,500","","","$","933,500","","","$","\u2014"],["Interest on debt(a)","124,992","","","41,652","","","78,774","","","4,566","","","\u2014"],["Operating lease obligations(b)","115,782","","","12,501","","","24,804","","","23,671","","","54,806"],["Finance lease obligations(b)","35,484","","","5,952","","","10,789","","","6,053","","","12,690"]]
[[/GREPCENT_TABLE]]

__________

(a)Interest payments in the table above reflect the contractual interest payments on our outstanding debt and commitment fees on the unused portion of the Revolving Credit Facility based upon the balance outstanding and applicable interest rates at December 31, 2024, and exclude the impact of the debt discount and deferred issuance costs. Refer to Note 9, “Debt,” of the Notes to Consolidated Financial Statements contained in Item 8, “Financial Statements and Supplementary Data,” of this report for additional information regarding long-term debt.

(b)Refer to Note 15, “Leases,” of the Notes to Consolidated Financial Statements contained in Item 8, “Financial Statements and Supplementary Data,” of this report for additional information about our operating and finance lease obligations.

Capital expenditures, which are net of proceeds from the sale of property, plant and equipment, for 2024 totaled $105.3 million, compared to $119.8 million and $74.1 million in 2023 and 2022, respectively. Capital expenditures in 2024 related primarily to upgrades of manufacturing facilities, manufacturing equipment and information technology systems. We expect 2025 capital expenditures to approximate $110 million to $120 million, with a significant portion related to additional upgrades of manufacturing facilities, as well as for manufacturing equipment to support productivity initiatives and information technology systems.

We have recorded liabilities for unrecognized tax benefits that, because of their nature, have a high degree of uncertainty regarding the timing of future cash payment and other events that extinguish these liabilities. Refer to Note 13, “Income Taxes,” of the Notes to Consolidated Financial Statements in Item 8, “Financial Statements and Supplementary Data,” of this report for additional information about these unrecognized tax benefits.

Based on current expectations, we believe that our projected cash flows provided by operations, available cash and cash equivalents and borrowings under our Revolving Credit Facility are sufficient to meet our working capital, debt service and capital expenditure requirements for the next twelve months. However, such cash flows are dependent upon our future operating performance which, in turn, is subject to prevailing economic conditions, and to financial, business and other factors, including the conditions of our markets, some of which are beyond our control. If our future financing needs increase, we may need to arrange additional debt or equity financing. We continually evaluate and consider various financing alternatives to enhance or supplement our existing financial resources. However, we cannot be assured that we will be able to enter into any such arrangements on acceptable terms or at all.

Impact of Recently Issued Accounting Standards

In the normal course of business, we evaluate all new accounting pronouncements issued by the Financial Accounting Standards Board (“FASB”), SEC, or other authoritative accounting bodies to determine the potential impact they may have on our Consolidated Financial Statements. Refer to Note 1, “Summary of Significant Accounting Policies,” of the Notes to Consolidated Financial Statements contained in Item 8, “Financial Statements and Supplementary Data,” of this report for additional information about these recently issued accounting standards and their potential impact on our financial condition or results of operations.

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MANAGEMENT’S DISCUSSION AND ANALYSIS

CRITICAL ACCOUNTING ESTIMATES

Management’s discussion and analysis of financial condition and results of operations are based upon our consolidated financial statements, which have been prepared in accordance with GAAP. We make estimates and assumptions in the preparation of our consolidated financial statements that affect the reported amounts of assets and liabilities, revenue and expenses and related disclosures of contingent assets and liabilities. We base our estimates and judgments upon historical experience and other factors that are believed to be reasonable under the circumstances. Changes in estimates or assumptions could result in a material adjustment to the consolidated financial statements.

We have identified several critical accounting estimates. An accounting estimate is considered critical if both: (a) the nature of the estimates or assumptions is material due to the levels of subjectivity and judgment involved, and (b) the impact of changes in the estimates and assumptions have had or are reasonably likely to have a material effect on the consolidated financial statements. This listing is not a comprehensive list of all of our accounting policies. For further information regarding the application of these and other accounting policies, see Note 1, “Summary of Significant Accounting Policies,” of the Notes to Consolidated Financial Statements contained in Item 8, “Financial Statements and Supplementary Data,” of this report.

Inventories

Inventories are measured on a first-in, first-out basis at the lower of cost or net realizable value. Net realizable value is the estimated selling prices in the ordinary course of business, less reasonably predictable costs of completion, disposal, and transportation. The valuation of inventory requires us to estimate obsolete or excess inventory, as well as inventory that is not of saleable quality.

Historically, our inventory adjustment has been adequate to cover our losses. However, variations in methods or assumptions could have a material impact on our results. If our demand forecast for specific products is greater than actual demand and we fail to reduce manufacturing output accordingly, we could be required to record additional inventory write-down or expense a greater amount of overhead costs, which would negatively impact our net income.

Acquisition Method of Accounting

We account for business combinations using the acquisition method of accounting. We recognize the identifiable assets acquired, the liabilities assumed and any noncontrolling interest in the acquiree at their estimated fair values on the date of acquisition. Any excess purchase price over the fair value of net assets acquired is recorded to goodwill. Determining the fair value of these items requires management’s judgment and more often than not the utilization of independent valuation specialists. The judgments made in the determination of the estimated fair values assigned to the assets acquired, the liabilities assumed and any noncontrolling interest in the investee, as well as the estimated useful life of each asset and the duration of each liability, can materially impact the financial statements in periods after acquisition, such as through depreciation and amortization expense. For more information on our acquisitions and application of the acquisition method, see Note 2, “Business Acquisitions,” of the Notes to Consolidated Financial Statements contained in Item 8, “Financial Statements and Supplementary Data,” of this report.

Valuation of Goodwill, Indefinite-Lived Intangible Assets and Long-Lived Assets

We make assumptions in establishing the carrying value, fair value and, if applicable, the estimated lives of our intangible and other long-lived assets. Goodwill and intangible assets determined to have an indefinite useful life are not amortized. Instead, these assets are evaluated for impairment on an annual basis on the last day of our fiscal year and whenever events or business conditions change that could indicate that the asset is impaired. Long-lived assets are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset (asset group) may not be recoverable.

Evaluation of goodwill for impairment

We test our reporting unit’s goodwill for impairment on the last day of our fiscal year and between annual tests if an event occurs or circumstances change that would more-likely-than-not reduce the fair value of the reporting unit below its carrying value. In conducting this annual impairment testing, we may first perform a qualitative assessment of whether it is more-likely-than-not that the reporting unit’s fair value is less than its carrying value. If not, no further goodwill impairment testing is required. If it is more-likely-than-not that the reporting unit’s fair value is less than its carrying value, or if we elect not to perform a qualitative assessment of the reporting unit, a quantitative analysis is performed, in which the fair value of the reporting unit is compared to its carrying value. If the carrying value of the reporting unit exceeds its fair value, an impairment loss is recognized equal to the excess, limited to the amount of goodwill allocated to the reporting unit.

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MANAGEMENT’S DISCUSSION AND ANALYSIS

We performed a qualitative assessment of our single reporting unit as of December 31, 2024. As part of this analysis, we evaluated factors including, but not limited to, our market capitalization and stock price performance, macro-economic conditions, market and industry conditions, cost factors, the competitive environment, and the operational stability and overall financial performance of the reporting unit. The assessment indicated that it was more likely than not that the fair value of the reporting unit exceeded its carrying value.

Due to the divestiture of our Non-Medical segment, which also historically represented the Non-Medical reporting unit, we considered the goodwill attributable to our Non-Medical reporting unit for impairment at the time the assets and liabilities were reclassified as held-for-sale and concluded there was no indication of impairment as the cash consideration received exceeded the carrying value of the net assets.

Evaluation of indefinite-lived intangible assets for impairment

Our indefinite-lived intangible assets include the Greatbatch Medical and Lake Region Medical tradenames. Similar to goodwill, we perform an annual impairment review of our indefinite-lived intangible assets on the last day of our fiscal year, unless events occur that trigger the need for an interim impairment review. We have the option to first assess qualitative factors in determining whether it is more-likely-than-not that an indefinite-lived intangible asset is impaired. If we elect not to use this option, or we determine that it is more-likely-than-not that the asset is impaired, we perform a quantitative assessment that requires us to estimate the fair value of each indefinite-lived intangible asset and compare that amount to its carrying value. Fair value is estimated using the relief-from-royalty method. Significant assumptions inherent in this methodology include estimates of royalty rates and discount rates. The discount rate applied is based on the risk inherent in the respective intangible assets and royalty rates are based on the rates at which comparable tradenames are being licensed in the marketplace. Impairment, if any, is based on the excess of the carrying value over the fair value of these assets.

We performed a quantitative assessment to test our indefinite-lived intangible assets for impairment as of December 31, 2024. For the Greatbatch Medical tradename, the excess of the estimated fair value over carrying value (expressed as a percentage of carrying value) was in excess of its carrying value of $20 million by approximately 354% as of December 31, 2024. The Lake Region Medical tradename had an excess of the estimated fair value over carrying value of approximately 88% and a carrying value of $70 million at December 31, 2024. We do not believe that our indefinite-lived intangible assets are at risk for impairment. However, a significant increase in the discount rate, decrease in the terminal growth rate, increase in tax rates, decrease in the royalty rate or substantial reductions in our end-markets and volume assumptions could have a negative impact on the estimated fair values of either of our tradenames and require us to recognize impairments of these indefinite-lived intangible assets in a future period.

Evaluation of long-lived assets for impairment

When impairment indicators exist, we determine if the carrying value of the long-lived asset(s) or definite-lived intangible asset(s) including, but not limited to, PP&E and right-of-use lease assets, exceeds the related undiscounted future cash flows. In cases where the carrying value exceeds the undiscounted future cash flows, the carrying value is written down to fair value. Fair value is generally determined using a discounted cash flow analysis. When it is determined that the useful life of an asset (asset group) is shorter than the originally estimated life, and there are sufficient cash flows to support the carrying value of the asset (asset group), we accelerate the rate of depreciation/amortization in order to fully depreciate/amortize the asset over its shorter useful life.

Estimation of the cash flows and useful lives of long-lived assets and definite-lived intangible assets requires significant management judgment. Events could occur that would materially affect our estimates and assumptions. Unforeseen changes, such as the loss of one or more significant customers, technology obsolescence, or significant manufacturing disruption, among other factors, could substantially alter the assumptions regarding the ability to realize the return of our investment in long-lived assets, definite-lived intangible assets or their estimated useful lives.

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