InfuSystem (INFU) 10-Q 12 Nov 13 2013 Q3 Quarterly report Financial data

Document_and_Entity_Informatio

Document and Entity Information	9 Months Ended
	Sep. 30, 2013	Oct. 25, 2013
Document And Entity Information [Abstract]	'	'
Document Type	'10-Q	'
Amendment Flag	'false	'
Document Period End Date	30-Sep-13	'
Document Fiscal Year Focus	'2013	'
Document Fiscal Period Focus	'Q3	'
Entity Registrant Name	'InfuSystem Holdings, Inc	'
Entity Central Index Key	'0001337013	'
Current Fiscal Year End Date	'--12-31	'
Entity Filer Category	'Smaller Reporting Company	'
Entity Common Stock, Shares Outstanding	'	22,085,031

Condensed_Consolidated_Balance

Condensed Consolidated Balance Sheets (USD $)	Sep. 30, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Current Assets:	'	'
Cash and cash equivalents	$908	$2,326
Accounts receivable, less allowance for doubtful accounts of $4,178 and $3,136 at September 30, 2013 and December 31, 2012, respectively	9,291	8,511
Inventory	1,343	1,339
Other current assets	625	684
Deferred income taxes	1,986	1,971
Total Current Assets	14,153	14,831
Medical equipment held for sale or rental	2,995	2,626
Medical equipment in rental service, net of accumulated depreciation	14,941	13,071
Property & equipment, net of accumulated depreciation	813	867
Deferred debt issuance costs, net	1,972	2,362
Intangible assets, net	24,075	25,541
Deferred income taxes	17,259	17,806
Other assets	184	419
Total Assets	76,392	77,523
Current Liabilities:	'	'
Accounts payable	4,329	2,135
Accounts payable - related party	'	9
Current portion of long-term debt	3,239	3,953
Other current liabilities	2,824	4,098
Total Current Liabilities	10,392	10,195
Long-term debt, net of current portion	24,380	27,315
Total Liabilities	34,772	37,510
Stockholders' Equity:	'	'
Preferred stock, $.0001 par value; authorized 1,000,000 shares; none issued	'	'
Common stock, $.0001 par value; authorized 200,000,000 shares; issued and outstanding 22,088,731 and 22,085,031, respectively, as of September 30, 2013 and 21,990,000 and 21,802,515, respectively, as of December 31, 2012	2	2
Additional paid-in capital	89,544	88,742
Accumulated deficit	-47,926	-48,731
Total Stockholders' Equity	41,620	40,013
Total Liabilities and Stockholders' Equity	$76,392	$77,523

Condensed_Consolidated_Balance1

Condensed Consolidated Balance Sheets (Parenthetical) (USD $)	Sep. 30, 2013	Dec. 31, 2012
In Thousands, except Share data, unless otherwise specified
Statement Of Financial Position [Abstract]	'	'
Accounts receivable, allowance for doubtful accounts	$4,178	$3,136
Preferred stock, par value	$0.00	$0.00
Preferred stock, shares authorized	1,000,000	1,000,000
Preferred stock, shares issued	'	'
Common stock, par value	$0.00	$0.00
Common stock, shares authorized	200,000,000	200,000,000
Common stock, shares issued	22,088,731	21,990,000
Common stock, shares outstanding	22,085,031	21,802,515

Condensed_Consolidated_Stateme

Condensed Consolidated Statements of Operations and Statements of Comprehensive Income (Loss) (USD $)	3 Months Ended		9 Months Ended
In Thousands, except Share data, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
Net revenues:	'	'	'	'
Rentals	$14,493	$13,025	$41,556	$38,903
Product Sales	1,247	1,150	3,547	3,692
Net revenues	15,740	14,175	45,103	42,595
Cost of revenues:	'	'	'	'
Cost of revenues - Product, service and supply costs	2,750	2,377	8,174	6,760
Cost of revenues - Pump depreciation and disposals	1,650	1,601	4,836	4,928
Gross profit	11,340	10,197	32,093	30,907
Selling, general and administrative expenses:	'	'	'	'
Provision for doubtful accounts	1,795	979	4,782	3,119
Amortization of intangibles	648	670	1,972	2,028
Selling and marketing	2,391	2,349	7,281	7,635
General and administrative	4,583	5,278	14,622	17,688
Total sales, general and administrative	9,417	9,276	28,657	30,470
Operating income	1,923	921	3,436	437
Other (expense) income:	'	'	'	'
Interest expense	-838	-971	-2,636	-2,235
Loss on extinguishment of long term debt	'	'	'	-552
Other (expense) income	-7	-136	329	-134
Total other expense	-845	-1,107	-2,307	-2,921
Income (loss) before income taxes	1,078	-186	1,129	-2,484
Income tax (expense) benefit	-429	219	-324	774
Net income (loss)	649	33	805	-1,710
Net income (loss) per share:	'	'	'	'
Basic	$0.03	$0	$0.04	($0.08)
Diluted	$0.03	$0	$0.04	($0.08)
Weighted average shares outstanding:	'	'	'	'
Basic	21,891,041	21,601,529	21,851,798	21,311,116
Diluted	22,075,532	21,827,365	22,043,998	21,311,116
Comprehensive Income (Loss)	'	'	'	'
Net income (loss)	649	33	805	-1,710
Unrealized gain on interest rate swap, net of taxes	'	'	'	1
Reclassification of hedging losses, net of taxes	'	'	'	-111
Comprehensive income (loss)	$649	$33	$805	($1,820)

Condensed_Consolidated_Stateme1

Condensed Consolidated Statements of Cash Flows (USD $)	9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2012
Statement Of Cash Flows [Abstract]	'	'
NET CASH PROVIDED BY OPERATING ACTIVITIES	$4,765	$5,834
INVESTING ACTIVITIES	'	'
Purchase of medical equipment and property	-3,396	-4,312
Proceeds from sale of medical equipment and property	2,808	3,521
NET CASH USED IN INVESTING ACTIVITIES	-588	-791
FINANCING ACTIVITIES	'	'
Principal payments on bank loans, revolving credit facility and capital lease obligations	-27,912	-6,747
Cash proceeds from bank loans and revolving credit facility	22,395	2,500
Common stock repurchased to satisfy statutory withholding on stock based compensation	-78	-131
NET CASH USED IN FINANCING ACTIVITIES	-5,595	-4,378
Net change in cash and cash equivalents	-1,418	665
Cash and cash equivalents, beginning of period	2,326	799
Cash and cash equivalents, end of period	$908	$1,464

Basis_of_Presentation_Nature_o

Basis of Presentation, Nature of Operations and Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2013
Accounting Policies [Abstract]	'
Basis of Presentation, Nature of Operations and Summary of Significant Accounting Policies	'
	1	Basis of Presentation, Nature of Operations and Summary of Significant Accounting Policies
	InfuSystem Holdings, Inc. and Subsidiaries (the “Company”) is a leading provider of infusion pumps and related services. The Company services hospitals, oncology practices and other alternate site healthcare providers. Headquartered in Madison Heights, Michigan, the Company delivers local, field-based customer support, and also operates pump repair Centers of Excellence in Michigan, Kansas, California, and Ontario, Canada.
	The accompanying consolidated financial statements have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”) for interim financial information. Accordingly they do not include all of the information and notes required by U.S. GAAP for complete financial statements. The accompanying consolidated financial statements include all adjustments, composed of normal recurring adjustments, considered necessary by management to fairly state our results of operations, financial position and cash flows. The operating results for the interim periods are not necessarily indicative of results that may be expected for any other interim period or for the full year. These consolidated financial statements should be read in conjunction with the consolidated financial statements and notes thereto included in our Annual Report on Form 10-K and Form 10-K/A for the year ended December 31, 2012 (the “2012 Form 10-K”) as filed with the SEC.
	The consolidated financial statements are prepared in conformity with U.S. GAAP, which requires the use of estimates, judgments and assumptions that affect the amounts of assets and liabilities at the reporting date and the amounts of revenue and expenses in the periods presented. We believe that the accounting estimates employed are appropriate and the resulting balances are reasonable; however, due to the inherent uncertainties in making estimates, actual results could differ from the original estimates, requiring adjustments to these balances in future periods.
	Revised Presentation in the Consolidated Statements
	The Company both rents and sells medical equipment. In the first quarter of 2013, it came to management’s attention that based on promulgation through recent comments from the Staff of the Securities and Exchange Commission, greater clarity and consistent classification should be provided in an entity’s financial statements around such assets on the balance sheet and in the statement of cash flows. Specifically, the Staff believed that a company should clearly disclose (i) assets on the balance sheet; and (ii) cash flows when presenting cash flows in relation to, and in consideration of, its predominant source of revenues.
	Management believes that the predominant source of revenues and cash flows from this medical equipment is from rentals and that most equipment that the Company has purchased is likely to be rented prior to being sold. The Company first revised its presentation of revenue and cash flows in its Quarterly Report on Form 10-Q for the fiscal quarter ended March 31, 2013 and continues the revised presentation in this report.
	While management has concluded that the effect of correcting previous errors in the Company’s financial statements is not material, the Company reclassified certain amounts in its Condensed Consolidated Statements of Cash Flows for the nine months ended September 30, 2012 to allow for appropriate comparisons between periods presented.
	The effect of this reclassification to the Condensed Consolidated Statements of Cash Flows was to both reduce Net cash provided by operating activities and reduce Net cash used in investing activities by $2.4 million for the nine months ended September 30, 2012.
	The corrections and reclassifications described above did not affect the Company’s condensed consolidated statements of operations or total cash flows for the nine months ended September 30, 2012.

Medical_Equipment_and_Property

Medical Equipment and Property	9 Months Ended
	Sep. 30, 2013
Text Block [Abstract]	'
Medical Equipment and Property	'
	2	Medical Equipment and Property
	Medical equipment consisted of the following as of September 30, 2013 and December 31, 2012 (in thousands):
			September 30,			December 31,
			2013			2012
	Medical Equipment in rental service		$	37,040		$	34,193
	Medical Equipment in rental service - pump reserve			(103	)		(270	)
	Accumulated depreciation			(21,996	)		(20,852	)
	Medical Equipment in rental service, net of accumulated depreciation
				14,941			13,071
	Medical Equipment held for sale or rental			2,995			2,626
	Total		$	17,936		$	15,697
	Depreciation expense for medical equipment for the three and nine months ended September 30, 2013 was $1.3 million and $3.8 million, respectively, compared to $1.3 million and $4.0 million, respectively, for the same prior year periods. This was recorded in cost of revenues – pump depreciation and disposals.
	Depreciation expense for property and equipment for the three months and nine months ended September 30, 2013 was $0.1 million and $0.2 million, respectively, compared to $0.1 million and $0.4 million, respectively, for the same prior year periods. This expense was recorded in general and administrative expenses.
	Medical equipment held for sale or rental contains approximately $0.7 million of pre-owned equipment received from a financial institution with such equipment coming off lease. Under the Company’s arrangement with the financial institution, the Company does not pay for the equipment until it is sold. The liability for this equipment is shown in other current liabilities for a similar amount. The Company assumes risk of loss and accounts for the disposition of such equipment as a sale.

Goodwill_and_Intangible_Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 30, 2013
Goodwill And Intangible Assets Disclosure [Abstract]	'
Goodwill and Intangible Assets	'
	3	Goodwill and Intangible Assets
	As of June 30, 2012, the goodwill balance was fully impaired with accumulated impairment charges of $64.1 million.
	Identifiable Intangible Assets
	The carrying amount and accumulated amortization of intangible assets as of September 30, 2013 and December 31, 2012 are as follows (in thousands):
			September 30, 2013
			Gross		Accumulated
			Assets		Amortization		Net
	Nonamortizable intangible assets
	Trade names		$	2,000	$	—	$	2,000
	Amortizable intangible assets
	Physician and customer relationships			32,866		12,016		20,850
	Non-competition agreements			848		576		272
	Software			2,153		1,200		953
	Total nonamortizable and amortizable intangible assets		$	37,867	$	13,792	$	24,075
			31-Dec-12
			Gross		Accumulated
			Assets		Amortization		Net
	Nonamortizable intangible assets
	Trade names		$	2,000	$	—	$	2,000
	Amortizable intangible assets
	Physician and customer relationships			32,866		10,373		22,493
	Non-competition agreements			848		441		407
	Software			1,647		1,006		641
	Total nonamortizable and amortizable intangible assets		$	37,361	$	11,820	$	25,541
	Amortization expense for the three and nine months ended September 30, 2013 was $0.6 million and $2.0 million, respectively, compared to $0.7 million and $2.0 million, respectively, for the same prior year periods. Expected annual amortization expense for intangible assets recorded as of September 30, 2013, is as follows (in thousands):
			10/1-										2018 and
			12/31/13		2014		2015		2016		2017		thereafter
	Amortization expense		$	646	$	2,468	$	2,279	$	2,191	$	2,191	$	11,537

Derivative_Financial_Instrumen

Derivative Financial Instruments	9 Months Ended
	Sep. 30, 2013
Derivative Instruments And Hedging Activities Disclosure [Abstract]	'
Derivative Financial Instruments	'
	4	Derivative Financial Instruments
	The Company used derivative instruments to manage interest rate risk and had previously designated an interest rate swap as a cash flow hedge of interest expense related to variable-rate long-term debt. To the extent this hedging relationship was effective; changes in the fair value of the interest rate swap were recorded in Accumulated Other Comprehensive Loss (“AOCL”). Amounts were reclassified from AOCL to interest expense in the period when the hedged forecasted transaction affected earnings. The Company terminated this interest rate swap in December 2012 and had no outstanding derivative contracts as of December 31, 2012 or September 30, 2013.
	As of September 30, 2012, the Company had a single interest rate swap liability outstanding with a fair market value of $0.2 million, classified in Derivative Liabilities. This swap had a notional value at September 30, 2012 of $13.4 million. The Company measured the fair value of its interest rate swap using Level 2 fair value measurement inputs which are observable in the market. There were no reclassifications among fair value measurement levels during the period ended September 30, 2012.
	During the three and nine month periods ended September 30, 2012, changes in the fair value of the derivative and reclassifications from AOCL to earnings were insignificant.

Debt

Debt	9 Months Ended
	Sep. 30, 2013
Debt Disclosure [Abstract]	'
Debt	'
	5	Debt
	On November 30, 2012, the Company entered into a credit facility with Wells Fargo as Administrative Agent and PennantPark as Lenders. The facility consisted of a $12.0 million Term Loan A (provided by Wells Fargo), a $14.5 million Term Loan B (provided by PennantPark) and a $10.0 million revolving credit facility, all of which mature on November 30, 2016, collectively (the “Credit Facility”). Interest on the term loan is payable at the Company’s choice of LIBOR plus 7.25% (with a LIBOR floor of 2.0%) or the Wells Fargo prime rate plus 6.25% (with a prime rate floor of 3.0%). As of September 30, 2013, interest was payable at the Wells Fargo prime rate plus 6.25%, which equaled 9.50%.
	The availability under the revolving Credit Facility is based upon the Company’s eligible accounts receivable and eligible inventory. The Company had revolving loan gross availability of $5.7 million and $6.5 million, respectively, outstanding amounts on the Revolver included $0.6 million and $1.8 million and a reserve amount of $0.1 million on a letter of credit at September 30, 2013, leaving approximately $5.0 million and $4.7 million available under the revolving Credit Facility as of September 30, 2013 and December 31, 2012, respectively.
	The Credit Facility is collateralized by substantially all of the Company’s assets and requires the Company to comply with covenants, including but not limited to, financial covenants relating to the satisfaction, on a quarterly and annual basis for the duration of the Credit Facility, of a total leverage ratio, a fixed charge coverage ratio and an annual limit on capital expenditures, including capital leases. As of September 30, 2013, the Company was in compliance with all such covenants and expects to be in compliance over the next 12 months.
	In connection with the Credit Facility, the Company has the following covenant obligations for the duration of the facility:
		a)	The fixed charge coverage ratio is calculated in accordance with the agreement governing the Credit Facility. This covenant was first required to be reported as of March 31, 2013 and has a minimum ratio at that time of 1.25:1. The required ratio varies quarterly for the remainder of the facility duration, from 1.25:1 to 2.00:1.
		b)	The leverage ratio is calculated in accordance with the agreement governing the Credit Facility. This covenant was first required to be reported as of March 31, 2013 and has a maximum ratio at that time of 2.50:1. The required ratio varies quarterly for the remainder of the facility duration, from 2.50:1 to 1.00:1.
		c)	The Credit Facility includes an annual limitation on capital expenditures in accordance with the agreement governing the Credit Facility that is $5.5 million for each year ending December 31, 2013 through 2016.
	The Company occasionally enters into capital leases to finance the purchase of ambulatory infusion pumps. The pumps are capitalized into medical equipment in rental service at their fair market value, which equals the value of the future minimum lease payments and are depreciated over the useful life of the pumps.
	The Company had approximate future maturities of loans and capital leases as of September 30, 2013 as follows (in thousands):
			2013		2014		2015		2016				Total
	Term Loans		$	600	$	2,400	$	2,400	$	19,300			$	24,700
	Revolver			—		—		—		629				629
	Capital Leases			203		852		828		407				2,290
	Total		$	803	$	3,252	$	3,228	$	20,336			$	27,619
	The following is a breakdown of the Company’s current and long-term debt as of September 30, 2013 and December 31, 2012 (in thousands):
			September 30, 2013						December 31, 2012
			Current								Current
			Portion of								Portion of
			Long-Term		Long-						Long-				Long-
			Debt		Term Debt		Total				Term Debt				Term Debt		Total
	Term Loans		$	2,400	$	22,300	$	24,700	Term Loans		$	2,400			$	24,100	$	26,500
	Revolver			—		629		629	Revolver			—				1,800		1,800
	Capital Leases			839		1,451		2,290	Capital Leases			1,553				1,415		2,968
	Total		$	3,239	$	24,380	$	27,619	Total		$	3,953			$	27,315	$	31,268

Income_Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2013
Income Tax Disclosure [Abstract]	'
Income Taxes	'
	6	Income Taxes
	Income tax expense was $0.4 million and $0.3 million for the three and nine months ended September 30, 2013 compared to $0.2 million and $0.8 million, respectively, of tax benefit for the same prior year periods. In computing its income tax provision, the Company estimates its effective income tax rate for the full year and applies that rate to income earned through the reporting period.
	Management assesses the available positive and negative evidence to estimate if sufficient future taxable income will be generated to use the existing deferred tax assets. A significant piece of objective negative evidence evaluated was the cumulative loss incurred over the three-year period ended September 30, 2013. After adjusting the historical losses for non-recurring items, including the goodwill impairment, legal costs pertaining to events related to the “Concerned Stockholder Group” (as described in our 2012 Form 10-K), severance agreements and sufficient earnings history exists to support the realization of the deferred tax assets. This evidenced ability to generate sufficient taxable income is the basis for the Company’s assessment that the deferred tax assets are more likely than not to be realized.

Related_Party_Transactions

Related Party Transactions	9 Months Ended
	Sep. 30, 2013
Related Party Transactions [Abstract]	'
Related Party Transactions	'
	7	Related Party Transactions
	During the three and nine months ended September 30, 2013 and 2012, the Company purchased pumps from Adepto Medical, a company that is controlled by a family member of Mr. Thomas Creal, an Executive Vice-President of the Company. Total purchases during each of the three and nine months ended September 30, 2013 and 2012 were less than $0.1 million, respectively. Outstanding payables associated with the purchases were insignificant as of September 30, 2013 and December 31, 2012. The Company also sold pumps to Adepto. Total sales during the three months and nine months ended September 30, 2013 and 2012 were less than $0.1 million. Outstanding receivables associated with the sales were less than $0.1 million as of September 30, 2013 and December 31, 2012.
	The Company also leases buildings from a company partially owned by Mr. Creal. Rent is paid monthly and totals approximately $0.1 million annually.

Commitments_and_Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2013
Commitments And Contingencies Disclosure [Abstract]	'
Commitments and Contingencies	'
	8	Commitments and Contingencies
	The Company is currently involved in legal proceedings arising out of the ordinary course and conduct of our business, the outcomes of which are not determinable at this time. In the normal course of business, the Company has insurance policies with independent insurance carriers to minimize our risk of potential losses. In the Company’s opinion, any liability that might be incurred by us upon the resolution of these claims and lawsuits will not, in the aggregate, have a material effect on the Company’s consolidated financial position, results of operations or cash flows.

Earnings_Per_Share

Earnings Per Share	9 Months Ended
	Sep. 30, 2013
Earnings Per Share [Abstract]	'
Earnings Per Share	'
	9	Earnings Per Share
	Basic income (loss) per share is computed by dividing net income (loss) by the weighted average number of common shares outstanding during the period. Diluted income (loss) per share assumes the issuance of potentially dilutive shares of common stock during the period. The following table reconciles the numerators and denominators of the basic and diluted income (loss) per share computations:
			Three Months Ended				Nine Months Ended
			September 30,				September 30,
			2013		2012		2013		2012
	Numerator:
	Net income (loss) (in thousands)		$	649	$	33	$	805	$	(1,710	)
	Denominator:
	Weighted average common shares outstanding:
	Basic			21,891,041		21,601,529		21,851,798		21,311,116
	Dilutive effect of non-vested awards			184,491		225,836		192,200		—
	Diluted			22,075,532		21,827,365		22,043,998		21,311,116
	Net income (loss) per share:
	Basic		$	0.03	$	0	$	0.04	$	(0.08	)
	Diluted		$	0.03	$	0	$	0.04	$	(0.08	)
	For the three and nine months ended September 30, 2013, vested stock options of 1.4 million and 1.3 million, respectively, were not included in the calculation because they would have an anti-dilutive effect. For the same prior year periods, 1.4 million in stock options and 0.7 million in unvested restricted shares, respectively, were not included in the calculation as they would have had an anti-dilutive effect.
	During the second quarter of 2012, per the terms of a consulting agreement with former CEO, Mr. Sean McDevitt, the Company terminated 2.0 million shares of common stock potentially issuable under such agreement. Under the consulting agreement, Mr. McDevitt received a consulting fee of $1.0 million, paid in shares of the Company’s common stock. Shares issued to Mr. McDevitt were issued from the Company’s 2007 Stock Incentive Plan, as amended (the “Plan”), valued at the average closing price of a share on the NYSE-MKT on the five trading days preceding the date of such issuance and totaled 0.5 million shares. In addition, the potentially issuable shares of 2.0 million were not part of Company’s 2007 Stock Plan. As these 2.0 million shares were forfeited before the requisite service period was rendered, previously recognized compensation expense of $1.3 million was reversed and recorded as a reduction of general and administrative expense during the three months ended June 30, 2012.

Subsequent_events

Subsequent events	9 Months Ended
	Sep. 30, 2013
Subsequent Events [Abstract]	'
Subsequent events	'
	10	Subsequent events
	On October 3, 2013, the Company issued a Current Report on Form 8-K that it had received offers to provide external infusion pumps and supplies in all nine of the Metropolitan Statistical Areas (“MSAs”) put out to bid by CMS as part of the announced timetable for Competitive Bidding Round 1 Recompete (“RD1RC”) from August 16, 2012. Since October 3, 2013, the Company has entered into contracts with CMS for these respective MSAs effective January 1, 2014. The impact of the reduced contract price from the current rates in these nine MSAs approximates $250,000 annually based on current volume in those respective MSAs.

Basis_of_Presentation_Nature_o1

Basis of Presentation, Nature of Operations and Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2013
Accounting Policies [Abstract]	'
Revised Presentation in the Consolidated Statements	'
	Revised Presentation in the Consolidated Statements
	The Company both rents and sells medical equipment. In the first quarter of 2013, it came to management’s attention that based on promulgation through recent comments from the Staff of the Securities and Exchange Commission, greater clarity and consistent classification should be provided in an entity’s financial statements around such assets on the balance sheet and in the statement of cash flows. Specifically, the Staff believed that a company should clearly disclose (i) assets on the balance sheet; and (ii) cash flows when presenting cash flows in relation to, and in consideration of, its predominant source of revenues.
	Management believes that the predominant source of revenues and cash flows from this medical equipment is from rentals and that most equipment that the Company has purchased is likely to be rented prior to being sold. The Company first revised its presentation of revenue and cash flows in its Quarterly Report on Form 10-Q for the fiscal quarter ended March 31, 2013 and continues the revised presentation in this report.
	While management has concluded that the effect of correcting previous errors in the Company’s financial statements is not material, the Company reclassified certain amounts in its Condensed Consolidated Statements of Cash Flows for the nine months ended September 30, 2012 to allow for appropriate comparisons between periods presented.
	The effect of this reclassification to the Condensed Consolidated Statements of Cash Flows was to both reduce Net cash provided by operating activities and reduce Net cash used in investing activities by $2.4 million for the nine months ended September 30, 2012.
	The corrections and reclassifications described above did not affect the Company’s condensed consolidated statements of operations or total cash flows for the nine months ended September 30, 2012.

Medical_Equipment_and_Property1

Medical Equipment and Property (Tables)	9 Months Ended
	Sep. 30, 2013
Text Block [Abstract]	'
Summary of Medical Equipment	'
	Medical equipment consisted of the following as of September 30, 2013 and December 31, 2012 (in thousands):
		September 30,			December 31,
		2013			2012
	Medical Equipment in rental service	$	37,040		$	34,193
	Medical Equipment in rental service - pump reserve		(103	)		(270	)
	Accumulated depreciation		(21,996	)		(20,852	)
	Medical Equipment in rental service, net of accumulated depreciation
			14,941			13,071
	Medical Equipment held for sale or rental		2,995			2,626
	Total	$	17,936		$	15,697

Goodwill_and_Intangible_Assets1

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2013
Goodwill And Intangible Assets Disclosure [Abstract]	'
Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets	'
	The carrying amount and accumulated amortization of intangible assets as of September 30, 2013 and December 31, 2012 are as follows (in thousands):
		September 30, 2013
		Gross		Accumulated
		Assets		Amortization		Net
	Nonamortizable intangible assets
	Trade names	$	2,000	$	—	$	2,000
	Amortizable intangible assets
	Physician and customer relationships		32,866		12,016		20,850
	Non-competition agreements		848		576		272
	Software		2,153		1,200		953
	Total nonamortizable and amortizable intangible assets	$	37,867	$	13,792	$	24,075
		31-Dec-12
		Gross		Accumulated
		Assets		Amortization		Net
	Nonamortizable intangible assets
	Trade names	$	2,000	$	—	$	2,000
	Amortizable intangible assets
	Physician and customer relationships		32,866		10,373		22,493
	Non-competition agreements		848		441		407
	Software		1,647		1,006		641
	Total nonamortizable and amortizable intangible assets	$	37,361	$	11,820	$	25,541
Schedule of Expected Annual Amortization Expense for Intangible Assets	'
	Expected annual amortization expense for intangible assets recorded as of September 30, 2013, is as follows (in thousands):
		10/1-										2018 and
		12/31/13		2014		2015		2016		2017		thereafter
	Amortization expense	$	646	$	2,468	$	2,279	$	2,191	$	2,191	$	11,537

Debt_Tables

Debt (Tables)	9 Months Ended
	Sep. 30, 2013
Debt Disclosure [Abstract]	'
Summary of Future Maturities of Loans and Capital Leases	'
	The Company had approximate future maturities of loans and capital leases as of September 30, 2013 as follows (in thousands):
		2013		2014		2015		2016				Total
	Term Loans	$	600	$	2,400	$	2,400	$	19,300			$	24,700
	Revolver		—		—		—		629				629
	Capital Leases		203		852		828		407				2,290
	Total	$	803	$	3,252	$	3,228	$	20,336			$	27,619
Summary of Company's Current and Long-Term Debt	'
	The following is a breakdown of the Company’s current and long-term debt as of September 30, 2013 and December 31, 2012 (in thousands):
		September 30, 2013						December 31, 2012
		Current								Current
		Portion of								Portion of
		Long-Term		Long-						Long-				Long-
		Debt		Term Debt		Total				Term Debt				Term Debt		Total
	Term Loans	$	2,400	$	22,300	$	24,700	Term Loans		$	2,400			$	24,100	$	26,500
	Revolver		—		629		629	Revolver			—				1,800		1,800
	Capital Leases		839		1,451		2,290	Capital Leases			1,553				1,415		2,968
	Total	$	3,239	$	24,380	$	27,619	Total		$	3,953			$	27,315	$	31,268

Earnings_Per_Share_Tables

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2013
Earnings Per Share [Abstract]	'
Numerators and Denominators of Basic and Diluted Income (Loss) Per Share	'
	The following table reconciles the numerators and denominators of the basic and diluted income (loss) per share computations:
		Three Months Ended				Nine Months Ended
		September 30,				September 30,
		2013		2012		2013		2012
	Numerator:
	Net income (loss) (in thousands)	$	649	$	33	$	805	$	(1,710	)
	Denominator:
	Weighted average common shares outstanding:
	Basic		21,891,041		21,601,529		21,851,798		21,311,116
	Dilutive effect of non-vested awards		184,491		225,836		192,200		—
	Diluted		22,075,532		21,827,365		22,043,998		21,311,116
	Net income (loss) per share:
	Basic	$	0.03	$	0	$	0.04	$	(0.08	)
	Diluted	$	0.03	$	0	$	0.04	$	(0.08	)

Basis_of_Presentation_Nature_o2

Basis of Presentation, Nature of Operations and Summary of Significant Accounting Policies - Additional Information (Detail) (USD $)	9 Months Ended
In Millions, unless otherwise specified	Sep. 30, 2012
Organization Consolidation And Presentation Of Financial Statements [Abstract]	'
Reduction of Net cash provided by operating and investing activity	$2.40

Medical_Equipment_and_Property2

Medical Equipment and Property - Summary of Medical Equipment (Detail) (USD $)	Sep. 30, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Medical Equipment And Property [Abstract]	'	'
Medical Equipment in rental service	$37,040	$34,193
Medical Equipment in rental service - pump reserve	-103	-270
Accumulated depreciation	-21,996	-20,852
Medical Equipment in rental service, net of accumulated depreciation	14,941	13,071
Medical equipment held for sale or rental	2,995	2,626
Total	$17,936	$15,697

Medical_Equipment_and_Property3

Medical Equipment and Property - Additional Information (Detail) (USD $)	3 Months Ended		9 Months Ended
In Millions, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
Property, Plant and Equipment [Line Items]	'	'	'	'
Depreciation expense for medical equipment recorded in cost of revenues - pump depreciation and disposals	$1.30	$1.30	$3.80	$4
Depreciation expense for property and equipment recorded in general and administrative expenses	0.1	0.1	0.2	0.4
Pre-Owned Equipment [Member]	'	'	'	'
Property, Plant and Equipment [Line Items]	'	'	'	'
Medical equipment held for sale or rental - financial institution	$0.70	'	$0.70	'

Goodwill_and_Intangible_Assets2

Goodwill and Intangible Assets - Additional Information (Detail) (USD $)	3 Months Ended		9 Months Ended
	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012	Jun. 30, 2012
Goodwill And Intangible Assets Disclosure [Abstract]	'	'	'	'	'
Goodwill accumulated impairment charges	'	'	'	'	$64,100,000
Amortization of intangible assets	$648,000	$670,000	$1,972,000	$2,028,000	'

Goodwill_and_Intangible_Assets3

Goodwill and Intangible Assets - Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets (Detail) (USD $)	Sep. 30, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Indefinite Lived And Finite Lived Intangible Assets [Line Items]	'	'
Total nonamortizable and amortizable intangible assets, Gross Assets	$37,867	$37,361
Total nonamortizable and amortizable intangible assets, Accumulated Amortization	13,792	11,820
Total nonamortizable and amortizable intangible assets, Net	24,075	25,541
Physician and Customer Relationships [Member]	'	'
Indefinite Lived And Finite Lived Intangible Assets [Line Items]	'	'
Amortizable intangible assets, Gross Assets	32,866	32,866
Amortizable intangible assets, Accumulated Amortization	12,016	10,373
Amortizable intangible assets, Net	20,850	22,493
Non-Competition Agreements [Member]	'	'
Indefinite Lived And Finite Lived Intangible Assets [Line Items]	'	'
Amortizable intangible assets, Gross Assets	848	848
Amortizable intangible assets, Accumulated Amortization	576	441
Amortizable intangible assets, Net	272	407
Software [Member]	'	'
Indefinite Lived And Finite Lived Intangible Assets [Line Items]	'	'
Amortizable intangible assets, Gross Assets	2,153	1,647
Amortizable intangible assets, Accumulated Amortization	1,200	1,006
Amortizable intangible assets, Net	953	641
Trade Names [Member]	'	'
Indefinite Lived And Finite Lived Intangible Assets [Line Items]	'	'
Nonamortizable intangible assets	$2,000	$2,000

Goodwill_and_Intangible_Assets4

Goodwill and Intangible Assets - Schedule of Expected Annual Amortization Expense for Intangible Assets (Detail) (USD $)	Sep. 30, 2013
In Thousands, unless otherwise specified
Finite Lived Intangible Assets Future Amortization Expense [Abstract]	'
Amortization expense for remaining fiscal year, 2013	$646
Amortization expense, 2014	2,468
Amortization expense, 2015	2,279
Amortization expense, 2016	2,191
Amortization expense, 2017	2,191
Amortization expense, 2018 and thereafter	$11,537

Derivative_Financial_Instrumen1

Derivative Financial Instruments - Additional Information (Detail) (USD $)	Sep. 30, 2013	Dec. 31, 2012	Sep. 30, 2013	Sep. 30, 2012
			Interest Rate Swap [Member]	Interest Rate Swap [Member]
Derivative Instruments, Gain (Loss) [Line Items]	'	'	'	'
Derivative termination period	'	'	'2012-12	'
Outstanding derivative contracts	$0	$0	'	'
Interest rate swap liability outstanding	'	'	'	200,000
Interest rate swap agreement, notional value	'	'	'	$13,400,000

Debt_Additional_Information_De

Debt - Additional Information (Detail) (USD $)

1 Months Ended

1 Months Ended

3 Months Ended

In Millions, unless otherwise specified

Nov. 30, 2012

Sep. 30, 2013

Nov. 30, 2012

Nov. 30, 2012

Mar. 31, 2013

Mar. 31, 2013

Mar. 31, 2013

Nov. 30, 2012

Nov. 30, 2012

Sep. 30, 2013

Dec. 31, 2012

Nov. 30, 2012

LIBOR [Member]

Prime Rate [Member]

Credit Facility [Member]

Credit Facility [Member]

Credit Facility [Member]

Term Loan A [Member]

Term Loan B [Member]

Revolving Credit Facility [Member]

Revolving Credit Facility [Member]

Revolving Credit Facility [Member]

Minimum [Member]

Maximum [Member]

Line of Credit Facility [Line Items]

'

'

'

'

'

'

'

'

'

'

'

'

Line of credit facility

'

'

'

'

'

'

'

$12

$14.50

$5.70

$6.50

$10

Credit facility, maturity date

30-Nov-16

'

'

'

'

'

'

'

'

'

'

'

Interest on the term loans, description

'LIBOR plus 7.25% (with a LIBOR floor of 2.0%) or the Wells Fargo prime rate plus 6.25% (with a prime rate floor of 3.0%)

'

'

'

'

'

'

'

'

'

'

'

Interest rate on term loan

'

'

7.25%

6.25%

'

'

'

'

'

'

'

'

Debt instrument floor rate

'

'

2.00%

3.00%

'

'

'

'

'

'

'

'

Interest rate

'

9.50%

'

'

'

'

'

'

'

'

'

'

Revolving loan amounts outstanding

'

'

'

'

'

'

'

'

'

0.6

1.8

'

Revolving credit facility available

'

'

'

'

'

'

'

'

'

5

4.7

'

Reserve amount on letter of credit

'

'

'

'

'

'

'

'

'

0.1

'

'

Minimum fixed charge coverage ratio

'

'

'

'

1.25

'

'

'

'

'

'

'

Fixed charge coverage ratio for the remainder period

'

'

'

'

'

1.25

2

'

'

'

'

'

Maximum leverage ratio

'

'

'

'

2.5

'

'

'

'

'

'

'

Leverage ratio for remainder period

'

'

'

'

'

1

2.5

'

'

'

'

'

Credit facility subject to limitation on capital expenditures in year one

'

5.5

'

'

'

'

'

'

'

'

'

'

Credit facility subject to limitation on capital expenditures in year two

'

5.5

'

'

'

'

'

'

'

'

'

'

Credit facility subject to limitation on capital expenditures in year three

'

5.5

'

'

'

'

'

'

'

'

'

'

Credit facility subject to limitation on capital expenditures in year four

'

$5.50

'

'

'

'

'

'

'

'

'

'

Debt_Summary_of_Future_Maturit

Debt - Summary of Future Maturities of Loans and Capital Leases (Detail) (USD $)	Sep. 30, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Line of Credit Facility [Line Items]	'	'
Remainder of 2013	$803	'
2014	3,252	'
2015	3,228	'
2016	20,336	'
Total	27,619	31,268
Term Loans [Member]	'	'
Line of Credit Facility [Line Items]	'	'
Remainder of 2013	600	'
2014	2,400	'
2015	2,400	'
2016	19,300	'
Total	24,700	26,500
Revolver [Member]	'	'
Line of Credit Facility [Line Items]	'	'
Remainder of 2013	'	'
2014	'	'
2015	'	'
2016	629	'
Total	629	1,800
Capital Leases [Member]	'	'
Line of Credit Facility [Line Items]	'	'
Remainder of 2013	203	'
2014	852	'
2015	828	'
2016	407	'
Total	$2,290	$2,968

Debt_Summary_of_Companys_Curre

Debt - Summary of Company's Current and Long-Term Debt (Detail) (USD $)	Sep. 30, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Line of Credit Facility [Line Items]	'	'
Current portion of long-term debt	$3,239	$3,953
Long-Term Debt	24,380	27,315
Total	27,619	31,268
Term Loans [Member]	'	'
Line of Credit Facility [Line Items]	'	'
Current portion of long-term debt	2,400	2,400
Long-Term Debt	22,300	24,100
Total	24,700	26,500
Revolver [Member]	'	'
Line of Credit Facility [Line Items]	'	'
Current portion of long-term debt	'	'
Long-Term Debt	629	1,800
Total	629	1,800
Capital Leases [Member]	'	'
Line of Credit Facility [Line Items]	'	'
Current portion of long-term debt	839	1,553
Long-Term Debt	1,451	1,415
Total	$2,290	$2,968

Income_Taxes_Additional_Inform

Income Taxes - Additional Information (Detail) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
Income Tax Disclosure [Abstract]	'	'	'	'
Income tax (expense) income	($429)	$219	($324)	$774
Period at which cumulative loss incurred	'	'	'3 years	'

Related_Party_Transactions_Add

Related Party Transactions - Additional Information (Detail) (USD $)	3 Months Ended		9 Months Ended
In Millions, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012	Dec. 31, 2012
Related Party Transactions [Abstract]	'	'	'	'	'
Total purchases	$0.10	$0.10	$0.10	$0.10	'
Total sales	0.1	0.1	0.1	0.1	'
Outstanding receivables	0.1	'	0.1	'	0.1
Rent paid	'	'	$0.10	'	'

Earnings_Per_Share_Numerators_

Earnings Per Share - Numerators and Denominators of Basic and Diluted Income (Loss) Per Share (Detail) (USD $)	3 Months Ended		9 Months Ended
In Thousands, except Share data, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
Numerator:	'	'	'	'
Net income (loss)	$649	$33	$805	($1,710)
Weighted average common shares outstanding:	'	'	'	'
Basic	21,891,041	21,601,529	21,851,798	21,311,116
Dilutive effect of non-vested awards	184,491	225,836	192,200	'
Diluted	22,075,532	21,827,365	22,043,998	21,311,116
Net income (loss) per share:	'	'	'	'
Basic	$0.03	$0	$0.04	($0.08)
Diluted	$0.03	$0	$0.04	($0.08)

Earnings_Per_Share_Additional_

Earnings Per Share - Additional Information (Detail) (USD $)	3 Months Ended		9 Months Ended	3 Months Ended	9 Months Ended	3 Months Ended	9 Months Ended
In Millions, unless otherwise specified	Jun. 30, 2012	Sep. 30, 2013	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2012	Sep. 30, 2012	Sep. 30, 2012
		Vested Stock Options [Member]	Vested Stock Options [Member]	Stock Options [Member]	Stock Options [Member]	Unvested Restricted Shares [Member]	Unvested Restricted Shares [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]	'	'	'	'	'	'	'
Shares with anti-dilutive effect	'	1.4	1.3	1.4	1.4	0.7	0.7
Forfeiture of potentially issuable common stock	2	'	'	'	'	'	'
Common stock issued in lieu of consulting fee, value	$1	'	'	'	'	'	'
Common stock issued in lieu of consulting fee, shares	0.5	'	'	'	'	'	'
Reversal of compensation expense	$1.30	'	'	'	'	'	'

Subsequent_Events_Additional_I

Subsequent Events - Additional Information (Detail) (USD $)	1 Months Ended	0 Months Ended
	Oct. 31, 2013	Oct. 03, 2013
		Subsequent Event [Member]
		Areas
Subsequent Event [Line Items]	'	'
Number of Metropolitan Statistical Areas	'	9
Reduction of contract price from current rates in MSAs	$250,000	'