InfuSystem (INFU) 10-K11 Mar 142013 FY Annual reportFinancial data

Company Profile

Document_and_Entity_Informatio

Document and Entity Information (USD $)	12 Months Ended
Document and Entity Information (USD $)	Dec. 31, 2013	Feb. 28, 2014	Jun. 30, 2013
Document And Entity Information [Abstract]	'	'	'
Document Type	'10-K	'	'
Amendment Flag	'false	'	'
Document Period End Date	31-Dec-13	'	'
Document Fiscal Year Focus	'2013	'	'
Document Fiscal Period Focus	'FY	'	'
Trading Symbol	'INFU	'	'
Entity Registrant Name	'InfuSystem Holdings, Inc	'	'
Entity Central Index Key	'0001337013	'	'
Current Fiscal Year End Date	'--12-31	'	'
Entity Well-known Seasoned Issuer	'No	'	'
Entity Current Reporting Status	'Yes	'	'
Entity Voluntary Filers	'No	'	'
Entity Filer Category	'Smaller Reporting Company	'	'
Entity Common Stock, Shares Outstanding	'	22,169,129	'
Entity Public Float	'	'	$28,400,850

Consolidated_Balance_Sheets

Consolidated Balance Sheets (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Current Assets:	'	'
Cash and cash equivalents	$1,138	$2,326
Accounts receivable, less allowance for doubtful accounts of $4,774 and $3,136 at December 31, 2013 and December 31, 2012, respectively	10,697	8,511
Inventories	1,234	1,339
Other current assets	518	684
Deferred income taxes	2,296	1,971
Total Current Assets	15,883	14,831
Medical equipment held for sale or rental	3,664	2,626
Medical equipment in rental service, net of accumulated depreciation	14,438	13,071
Property & equipment, net of accumulated depreciation	872	867
Deferred debt issuance costs, net	1,817	2,362
Intangible assets, net	24,182	25,541
Deferred income taxes	16,300	17,806
Other assets	217	419
Total Assets	77,373	77,523
Current Liabilities:	'	'
Accounts payable	4,736	2,135
Accounts payable - related party	'	9
Current portion of long-term debt	5,118	3,953
Other current liabilities	3,187	4,098
Total Current Liabilities	13,041	10,195
Long-term debt, net of current portion	21,609	27,315
Total Liabilities	34,650	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 22,158,041 and 21,960,351, as of December 31, 2013 and issued and outstanding 21,990,000 and 21,802,515, as of December 31, 2012, respectively.	2	2
Additional paid-in capital	89,783	88,742
Accumulated other comprehensive loss	'	'
Retained deficit	-47,062	-48,731
Total Stockholders' Equity	42,723	40,013
Total Liabilities and Stockholders' Equity	$77,373	$77,523

Consolidated_Balance_Sheets_Pa

Consolidated Balance Sheets (Parenthetical) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, except Share data, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Statement Of Financial Position [Abstract]	'	'
Accounts receivable, allowance for doubtful accounts	$4,774	$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	22,158,041	21,990,000
Common stock, shares outstanding	21,960,351	21,802,515

Consolidated_Statements_of_Ope

Consolidated Statements of Operations and Comprehensive Income (Loss) (USD $)	12 Months Ended
In Thousands, except Share data, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Net revenues:	'	'
Rentals	$55,962	$53,471
Product sales	6,318	5,357
Net revenues	62,280	58,828
Cost of revenues:	'	'
Cost of revenues - Product, service and supply costs	11,274	9,165
Cost of revenues - Pump depreciation and loss on disposal	7,327	6,752
Gross profit	43,679	42,911
Selling, general and administrative expenses:	'	'
Provision for doubtful accounts	6,534	5,251
Amortization of intangible assets	2,618	2,734
Selling and marketing	9,658	9,864
General and administrative	18,973	23,062
Total selling, general and administrative:	37,783	40,911
Operating income	5,896	2,000
Other income (loss):	'	'
Interest expense	-3,497	-3,340
Loss on extinguishment of long-term debt	'	-671
Other income (expense)	301	-141
Total other loss	-3,196	-4,152
Income (loss) before income taxes	2,700	-2,152
Income tax (expense) benefit	-1,031	663
Net income (loss)	1,669	-1,489
Net income (loss) per share:	'	'
Basic	$0.08	($0.07)
Diluted	$0.08	($0.07)
Weighted average shares outstanding:	'	'
Basic	21,868,379	21,430,012
Diluted	22,074,513	21,430,012
Comprehensive income (loss):	'	'
Net income (loss)	1,669	-1,489
Reclassification of hedging losses, net of taxes	'	136
Comprehensive income (loss)	$1,669	($1,353)

Consolidated_Statements_of_Sto

Consolidated Statements of Stockholders' Equity (USD $)	Total	Common Stock [Member]	Additional Paid in Capital [Member]	Retained Deficit [Member]	Accumulated Other Comprehensive Loss [Member]	Treasury Stock [Member]
In Thousands, except Share data	USD ($)	USD ($)	USD ($)	USD ($)	USD ($)	Treasury Stock [Member]
Beginning Balance at Dec. 31, 2011	$40,165	$2	$87,541	($47,242)	($136)	'
Beginning Balance, Share at Dec. 31, 2011	'	21,330	'	'	'	-198
Restricted shares issued upon vesting, Share	'	727	'	'	'	'
Stock-based compensation expense	1,328	'	1,328	'	'	'
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation	-127	'	-127	'	'	'
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation, Share	'	-67	'	'	'	'
Net income (loss)	-1,489	'	'	-1,489	'	'
Unrealized loss on interest rate swap	136	'	'	'	136	'
Ending Balance at Dec. 31, 2012	40,013	2	88,742	-48,731	'	'
Ending Balance, Share at Dec. 31, 2012	'	21,990	'	'	'	-198
Restricted shares issued upon vesting, Share	'	223	'	'	'	'
Stock-based compensation expense	1,120	'	1,120	'	'	'
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation	-79	'	-79	'	'	'
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation, Share	'	-55	'	'	'	'
Net income (loss)	1,669	'	'	1,669	'	'
Ending Balance at Dec. 31, 2013	$42,723	$2	$89,783	($47,062)	'	'
Ending Balance, Share at Dec. 31, 2013	'	22,158	'	'	'	-198

Consolidated_Statements_of_Cas

Consolidated Statements of Cash Flows (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013		Dec. 31, 2012
OPERATING ACTIVITIES	'		'
Net income (loss)	$1,669		($1,489)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:	'		'
Loss on extinguishment of long-term debt	'		671
Provision for doubtful accounts	6,534		5,251
Depreciation	5,415		5,668
(Gain)/Loss on disposal of medical equipment	-47		237
Gain on sale of medical equipment	-2,027		-1,964
Amortization of intangible assets	2,618		2,734
Amortization of deferred debt issuance costs	620		228
Stock-based compensation expense	1,120		964
Deferred income tax expense (benefit)	1,180		-906
Changes in Assets - (Increase)/Decrease:	'		'
Accounts receivable	-8,720		-6,490
Inventories	105		-30
Other current assets	166		249
Other assets	-92		664
Changes in Liabilities - Increase/(Decrease):	'		'
Accounts payable and other liabilities	-1,078		-335
NET CASH PROVIDED BY OPERATING ACTIVITIES	7,463		5,452
INVESTING ACTIVITIES	'		'
Purchases of medical equipment and property	-5,962		-6,542
Proceeds from sale of medical equipment and property	3,800		3,978
Other asset acquisitions	'		6
NET CASH USED IN INVESTING ACTIVITIES	-2,162		-2,558
FINANCING ACTIVITIES	'		'
Principal payments on term loans and capital lease obligations	-4,504		-9,631
Payoff of bank loan and revolver	'		-25,851
Cash proceeds from bank loans and revolving credit facility	36,166		37,101
Payments on revolving credit facility	-38,072		'
Payments for debt issuance costs	'		-2,842
Common stock repurchased to satisfy taxes on stock based compensation	-79		-144
NET CASH USED IN FINANCING ACTIVITIES	-6,489		-1,367
Net change in cash and cash equivalents	-1,188		1,527
Cash and cash equivalents, beginning of year	2,326		799
Cash and cash equivalents, end of year	1,138		2,326
SUPPLEMENTAL DISCLOSURES	'		'
Cash paid for interest	2,668		3,112
Cash paid for income taxes	549		79
NON-CASH TRANSACTIONS	'		'
Additions to medical equipment and property	266	[1]	121	[1]
Medical equipment acquired pursuant to a capital lease	$2,541		$522

[1]	Amounts consist of current liabilities for medical equipment that have not been included in investing activities. These amounts have not been paid for as of December 31, 2013 and 2012, respectively, but will be included as a cash outflow from investing activities for purchases of medical equipment and property when paid.

Basis_of_Presentation_and_Natu

Basis of Presentation and Nature of Operations	12 Months Ended
	Dec. 31, 2013
Text Block [Abstract]	'
Basis of Presentation and Nature of Operations	'
	1	Basis of Presentation and Nature of Operations
	The information in this Annual Report on Form 10-K includes the financial position as of December 31, 2013 and 2012 and results of operations, cash flows and stockholders’ equity for the years ended December 31, 2013 and 2012 of InfuSystem Holdings, Inc. and its consolidated subsidiaries (the “Company”). In the opinion of the Company, the consolidated statements for all periods presented include all adjustments necessary for a fair presentation of the financial statements.
	The Company is a leading provider of infusion pumps and related services in the United States. The Company services hospitals, oncology clinics and other alternate site health care 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, Texas and Ontario, Canada.
	The Company supplies electronic ambulatory infusion pumps and associated disposable supply kits to oncology clinics, infusion clinics and hospital outpatient chemotherapy clinics. These pumps and supplies are utilized primarily by colorectal cancer patients who receive a standard of care treatment that utilizes continuous chemotherapy infusions delivered via electronic ambulatory infusion pumps. The Company obtains an assignment of insurance benefits from the patient, bills the insurance company or patient accordingly, and collects payment. The Company provides pump management services for the pumps and associated disposable supply kits to approximately 1,800 oncology clinics in the United States. The Company retains title to the pumps during this process.
	In addition, the Company sells or rents new and pre-owned pole mounted and ambulatory infusion pumps to, and provides biomedical recertification, maintenance and repair services for oncology practices as well as other alternate site settings including home care and home infusion providers, skilled nursing facilities, pain centers and others. The Company also provides these products and services to customers in the small-hospital market.
	The Company purchases new and pre-owned pole mounted and ambulatory infusion pumps from a variety of sources on a non-exclusive basis. The Company repairs, refurbishes and provides biomedical certification for the devices as needed. The pumps are then available for sale, rental or to be used within the Company’s ambulatory infusion pump management service.
	The accompanying consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”).

Summary_of_Significant_Account

Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2013

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

Presentation in the Consolidated Statements

The Company both rents and sells medical equipment. Management believes that the predominant source of revenues and cash flows from this medical equipment is from rentals and most equipment purchased is likely to be rented prior to being sold. Accordingly, the Company has concluded that (i) the assets specifically supporting its two primary revenue streams should be separately disclosed on the balance sheet; (ii) the purchase and sale of medical equipment should be classified solely in investing cash flows based on their predominant source; and (iii) other activities ancillary to the rental process should be consistently classified.

Principles of Consolidation

The consolidated financial statements include the accounts of the Company and all wholly owned organizations. All intercompany transactions and account balances have been eliminated in consolidation.

Segments

The Company operates in one business segment based on management’s view of its business for purposes of evaluating performance and making operating decisions.

The Company utilizes shared services including but not limited to, human resources, payroll, finance, sales, pump repair and maintenance services, as well as certain shared assets and sales, general and administrative costs. The Company’s approach is to make operational decisions and assess performance based on delivering products and services that together provide solutions to our customer base, utilizing a functional management structure and shared services where possible. Based upon this business model, the chief operating decision maker only reviews consolidated financial information.

Use of Estimates

The preparation of financial statements in conformity with GAAP requires management to make estimates, assumptions and judgments that affect the amounts reported in the financial statements, including the notes thereto. The Company considers critical accounting policies to be those that require more significant judgments and estimates in the preparation of its consolidated financial statements, including the following: revenue recognition, which includes contractual adjustments, accounts receivable and allowance for doubtful accounts, sales return allowances, inventory reserves, long lived assets, intangible assets, income taxes and goodwill valuations. Management relies on historical experience and other assumptions believed to be reasonable in making its judgment and estimates. Actual results could differ materially from those estimates.

Cash and Cash Equivalents

The Company considers all highly liquid investments with original maturities of three months or less to be cash equivalents. The Company maintains its cash and cash equivalents primarily with two financial institutions and is insured with the Federal Deposit Insurance Corporation.

Accounts Receivable and Allowance for Doubtful Accounts

Accounts receivable are reported at the estimated net realizable amounts from patients, third-party payors and other direct pay customers for goods provided and services rendered. The Company performs periodic analyses to assess the accounts receivable balances. It records an allowance for doubtful accounts based on the estimated collectability of the accounts such that the recorded amounts reflect estimated net realizable value. Upon determination that an account is uncollectible, the account is written-off and charged to the allowance.

Accounts receivable are reduced by an allowance for amounts that could become uncollectible in the future. The Company’s estimate for its allowance for doubtful accounts is based upon management’s assessment of historical and expected net collections. Due to continuing changes in the health care industry and third-party reimbursement, it is possible that management’s estimates could change in the near term, which could have a material impact on its financial position, results of operations and cash flows.

Following is an analysis of the allowance for doubtful accounts for the Company for the years ended December 31 (in thousands):

Balance at

Charged

Deductions (1)

Balance

beginning

to costs and

at end of

of Year

expenses

Year

Allowance for doubtful accounts — 2013

3,136

6,534

(4,896

)

4,774

Allowance for doubtful accounts — 2012

1,773

5,251

(3,888

)

3,136

-1

Deductions represent the write-off of uncollectible account receivable balances.

Inventories

Our inventories consist of disposable products and related parts and supplies used in conjunction with medical equipment and are stated at the lower of cost or market. The Company periodically performs an analysis of slow moving inventory and records a reserve based on estimated obsolete inventory, which was $0.2 million as of both December 31, 2013 and 2012.

Medical Equipment

Medical Equipment (“ME”) consists of equipment that the Company purchases from third-parties and is 1) held for sale or rent, and 2) used in service to generate rental revenue. ME, once placed into service, is depreciated using the straight-line method over the estimated useful lives of the equipment which is typically five years. The Company does not depreciate ME held for sale or rent. When assets are sold, or otherwise disposed, the cost and related accumulated depreciation are removed from the accounts and a sale is recorded in the current period. The Company periodically performs an analysis of slow moving ME held for sale or rent and records a reserve based on estimated obsolescence, which was $0.1 million as of both December 31, 2013 and 2012.

Property and Equipment

Property and equipment is stated at acquired cost and depreciated using the straight-line method over the estimated useful lives of the related assets, ranging from three to seven years. Information Technology software and hardware are depreciated over three years. Leasehold improvements are amortized using the straight-line method over the life of the asset or the remaining term of the lease, whichever is shorter. Maintenance and minor repairs are charged to operations as incurred. When assets are sold (outside of pre-owned pump sales), or otherwise disposed of, the cost and related accumulated depreciation are removed from the accounts and any gain or loss is recorded in the current period.

Intangible Assets

Intangible assets consist of trade names, physician and customer relationships, non-compete agreements and software. The trade names, physician and customer relationships and non-compete agreements arose primarily from the acquisitions of InfuSystem and First Biomedical. The Company amortizes the value assigned to the physician and customer relationships on a straight-line basis over the period of expected benefit, which is fifteen years. The acquired physician and customer relationship base represents a valuable asset of the Company due to the expectation of future business opportunities to be leveraged from the existing relationship with each physician and customer. The Company has long-standing relationships with numerous oncology clinics, physicians, home care and home infusion providers, skilled nursing facilities, pain centers and others. These relationships are expected, on average, to have a fifteen year useful life, based on minimal attrition experienced to date by the Company and expectations of continued minimal attrition. Non-compete agreements are amortized on a straight-line basis over five years and software is amortized on a straight-line basis over three years.

Management tests trade names and other intangible assets for impairment annually or as often as deemed necessary. The Company performed its annual impairment analysis as of October 2013 and determined that the fair value of indefinite-lived assets was greater than the carrying value, resulting in no impairment of indefinite-lived assets.

Costs relating to the development of software for internal purposes are charged to expense until technological feasibility is established. Thereafter, the remaining software production costs up to the date placed into production are capitalized and included as Intangible Assets. Amortization of the capitalized amounts commences on the date the asset is ready for its intended use and is calculated using the straight-line method over the estimated useful life of the software, which is three years.

Impairment of Long-Lived Assets

Long-lived assets held for use, which includes property and equipment and amortizable intangible assets, are reviewed for impairment when events or changes in circumstances indicate that their carrying value may not be recoverable. If an impairment indicator exists, the Company assesses the asset or asset group for recoverability. Recoverability of these assets is determined based upon the expected undiscounted future net cash flows from the operations to which the assets relate, utilizing management’s best estimates, appropriate assumptions and projections at the time. If the carrying value is determined not to be recoverable from future operating cash flows, the asset is deemed impaired and an impairment loss would be recognized to the extent the carrying value exceeded the estimated fair market value of the asset or asset group.

Revenue Recognition

The Company recognizes revenue for selling, renting and servicing new and pre-owned infusion pumps and other medical equipment to oncology practices as well as other alternate site settings including home care and home infusion providers, skilled nursing facilities, pain centers and others, when persuasive evidence of an arrangement exists; services have been rendered; the price to the customer is fixed or determinable; and collectability is reasonably assured. Persuasive evidence of an arrangement is determined to exist, and collectability is reasonably assured, when the Company 1) receives a physician’s written order and assignment of benefits, signed by the physician and patient, respectively, and 2) has verified actual pump usage and insurance coverage. The Company recognizes rental revenue from electronic infusion pumps as earned, normally on a month-to-month basis. Pump rentals are billed at the Company’s established rates, which often differ from contractually allowable rates provided by third-party payors such as Medicare, Medicaid and commercial insurance carriers. All billings to third party payors are recorded net of provision for contractual adjustments to arrive at net revenues. The Company performs an analysis to estimate sales returns and records an allowance for returns when the related sale is recognized. This estimate is based on historical sales returns.

Due to the nature of the industry and the reimbursement environment in which the Company operates, certain estimates are required to record net revenues and accounts receivable at their net realizable values. Inherent in these estimates is the risk that the estimates will have to be revised or updated as additional information becomes available. Specifically, the complexity of many third-party billing arrangements and the uncertainty of reimbursement amounts for certain services from certain payors may result in adjustments to amounts originally recorded. Due to continuing changes in the health care industry and third-party reimbursement, it is possible that management’s estimates could change in the near term, which could have a material impact on our results of operations and cash flows.

The Company’s largest contracted payor is Medicare, which accounted for approximately 31% of its gross billings for ambulatory infusion pump services for both of the years ended December 31, 2013 and 2012. The contracts with the Company’s next largest contracted payor, in the aggregate, accounted for approximately 17% and 18% of its gross billings for ambulatory infusion pump services for the years ended December 31, 2013 and 2012, respectively. The Company also has contracts with various other third party payor organizations, commercial Medicare replacement plans, self-insured plans and numerous other insurance carriers. No individual payor, other than those listed above, accounts for greater than approximately 7% of the Company’s ambulatory infusion pump services gross billings.

Income Taxes

The Company recognizes deferred income tax liabilities and assets based on: (1) the differences between the financial statement carrying amounts and the tax basis of assets and liabilities using enacted tax rates in effect in the years the differences are expected to reverse and (2) the tax credit carry forwards. Deferred income tax (expense) benefit results from the change in net deferred tax assets or deferred tax liabilities. A valuation allowance is recorded when, in the opinion of management, it is more likely than not that some or all of any deferred tax assets will not be realized.

Provisions for federal, state and foreign taxes are calculated based on reported pre-tax earnings based on current tax law and include the cumulative effect of any changes in tax rates from those used previously in determining deferred tax assets and liabilities. Certain items of income and expense are recognized in different time periods for financial reporting than for income tax purposes; thus, such provisions differ from the amounts currently receivable or payable.

The Company follows a two-step approach for recognizing uncertain tax positions. First it evaluates the tax position for recognition by determining that the weight of available evidence indicates that it is more-likely-than-not to be sustained upon examination. Second, for positions that are determined to be more-likely-than-not to be sustained, it recognizes the tax benefits as the largest benefit that has a greater than 50% likelihood of being sustained. The Company establishes a reserve for unrecognized tax positions liability that is comprised of unrecognized tax benefits and related interest and penalties. The Company recognizes interest and penalties related to uncertain tax positions in the provision of income taxes.

Share Based Payments

Entities are required to recognize stock compensation expense in an amount equal to the fair value of share based payments made to employees, among other requirements. Under the fair value based method, compensation cost is measured at the grant date based on the fair value of the award and is recognized on a graded vesting basis over the award’s vesting period.

Cash Flow Hedge

The Company was exposed to risks associated with future cash flows related to the variability of the interest rate on its term loan with Bank of America. In order to manage the interest rate risk in 2010, the Company entered into a single interest rate swap and designated the swap as a cash flow hedge. During 2012, the Company’s single interest rate swap was terminated and the Company paid $0.2 million as a result of the Company’s new debt agreement. Amounts recorded in accumulated other comprehensive income based on the application of hedge accounting were reclassified to interest expense in 2012. The Company has no interest rate swaps or hedging activities as of December 31, 2013 or 2012.

Deferred Debt Issuance Costs

Capitalized debt issuance costs as of December 31, 2013 and 2012 relate to the Company’s current Credit Facility with Wells Fargo. The Company classified the costs related to these agreements as non-current assets and amortizes them using the interest method through the maturity date of the underlying debt.

Earnings (Loss) 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 additionally assumes the issuance of potentially dilutive shares of common stock during the periods. The following table reconciles the numerators and denominators of basic and diluted income (loss) per share computations for the years ended December 31:

2013

2012

Numerator:

Net income (loss) (in thousands)

1,669

(1,489

)

Denominator:

Weighted average common shares outstanding:

Basic

21,868,379

21,430,012

Dilutive effect of options and non-vested share awards

206,134

—

Diluted

22,074,513

21,430,012

Net income (loss) per share:

Basic

0.08

(0.07

)

Diluted

0.08

(0.07

)

For the year ended December 31, 2012, 0.2 million of unvested restricted shares were not included in the calculation because they would have an anti-dilutive effect. In addition, 1.4 million and 0.3 million, respectively, of vested stock options were not included in the calculation for the years ended December 31, 2013 and 2012, because they would have an anti-dilutive effect.

Going_Concern_and_Managements_

Going Concern and Management's Plan	12 Months Ended
	Dec. 31, 2013
Text Block [Abstract]	'
Going Concern and Management's Plan	'
	3	Going Concern and Management’s Plan
	The accompanying consolidated financial statements have been prepared on a going concern basis, which contemplates the realization of assets and the settlement of liabilities in the normal course of business and the continuation of the Company as a going concern.
	In February 2012, a concerned stockholder group (“Concerned Stockholder Group”) requested a special stockholders’ meeting (the “Special Meeting”). If the Special Meeting had resulted in a change in the majority of our Board of Directors (the “Board”) under the terms of the Company’s credit facility with Bank of America, N.A. and KeyBank National Association (the “Lenders”), such change would have constituted a change in control and an event of default, which would have allowed the Lenders to cause the debt to be immediately due and payable. This possibility of a change in the majority representation of the Board and consequent event of default under the credit facility, which would have allowed the Lenders to cause the debt of $24.0 million as of December 31, 2011 to become immediately due and payable, raised substantial doubt about the Company’s ability to continue as a going concern. The 2011 consolidated financial statements did not include any adjustments, if any, that would have resulted from the outcome of this uncertainty. As further described herein, although a change in the board composition took place during the second quarter of 2012, the Company negotiated an amendment to its credit agreement to exclude this change of board members from its definition of an event of default and the Special Meeting was cancelled.
	On April 24, 2012, the Company reached an agreement (the “Settlement Agreement”) with the Concerned Stockholder Group, resulting in a series of changes to the Board and senior leadership.
	Concurrent with and as a condition of the Settlement Agreement, on April 24, 2012, Mr. McDevitt entered into a consulting agreement with the Company under which he resigned as CEO of the Company and agreed to serve as a consultant until July 31, 2012. 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.
	Per the terms of the consulting agreement, Mr. McDevitt’s Share Award Agreement entered into on April 6, 2010 with the Company terminated, including the 2.0 million shares of common stock potentially issuable under such agreement. Approximately $6.0 million in unrecognized compensation expense associated with such shares will not be recognized by the Company in the future. As these shares were forfeited before the requisite service period for this award 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.
	On November 30, 2012, the Company entered into a new credit facility which replaced the prior facility and provided adequate funding for Company operations.

Medical_Equipment

Medical Equipment	12 Months Ended
Medical Equipment	Dec. 31, 2013
Text Block [Abstract]	'
Medical Equipment	'
	4	Medical Equipment
	Medical equipment consisted of the following as of December 31 (in thousands):


			2013			2012
	Medical Equipment in rental service		$	37,252		$	34,193
	Medical Equipment in rental service — pump reserve			(87	)		(270	)
	Accumulated depreciation			(22,727	)		(20,852	)
	Medical Equipment held for sale or rental			3,664			2,626

	Total		$	18,102		$	15,697

	Included in medical equipment in rental service above are $3.4 million and $6.3 million, as of December 31, 2013 and 2012, respectively, of pumps obtained under various capital leases. Included in accumulated depreciation above are $0.6 million and $3.0 million, as of December 31, 2013 and 2012, respectively, associated with the same capital leases. Under the terms of all such capital leases, the Company does not presently hold title to these pumps and will not obtain title until such time as the capital lease obligations are settled in full.
	Depreciation expense for the years ended December 31, 2013 and 2012 was $5.1 million and $5.2 million, respectively, which were recorded in cost of revenues — pump depreciation and loss on disposal.
	As of December 31, 2013, medical equipment held for sale or rental contains approximately $1.0 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.

Property_and_Equipment

Property and Equipment	12 Months Ended
Property and Equipment	Dec. 31, 2013
Property Plant And Equipment [Abstract]	'
Property and Equipment	'
	5	Property and Equipment
	Property and equipment consisted of the following as of December 31 (in thousands):


			2013			2012
	Furniture, fixtures, and equipment		$	2,664		$	2,440
	Accumulated depreciation			(1,792	)		(1,573	)

	Total		$	872		$	867

	Depreciation expense for the years ended December 31, 2013 and 2012 was $0.3 million and $0.5 million, respectively, and was recorded in general and administrative expenses.

Intangible_Assets

Intangible Assets	12 Months Ended
Intangible Assets	Dec. 31, 2013
Goodwill And Intangible Assets Disclosure [Abstract]	'
Intangible Assets	'
	6	Intangible Assets
	The carrying amount and accumulated amortization of intangible assets as of December 31 are as follows (in thousands):


			2013
			Gross		Accumulated		Net
			Assets		Amortization		Net
	Nonamortizable intangible assets
	Trade names		$	2,000	$	—	$	2,000
	Amortizable intangible assets
	Physician and customer relationships			32,865		12,564		20,301
	Non-competition agreements			848		621		227
	Software			2,907		1,253		1,654

	Total nonamortizable and amortizable intangible assets		$	38,620	$	14,438	$	24,182



			2012
			Gross		Accumulated		Net
			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

	The weighted average remaining lives of Physician and customer relationships, Non-competition agreements and Software are nine years, one year, and one year, respectively, as of December 31, 2013.
	Amortization expense for intangible assets for the years ended December 31, 2013 and 2012 was $2.6 million and $2.7 million, respectively, which was recorded in operating expenses. Expected annual amortization expense for the next five years for intangible assets recorded as of December 31 are as follows (in thousands):


			2014		2015		2016		2017		2018		2019 and
			2014		2015		2016		2017		2018		thereafter
	Amortization expense		$	2,470	$	2,282	$	2,195	$	2,191	$	2,191	$	10,853

Debt

Debt	12 Months Ended
Debt	Dec. 31, 2013
Debt Disclosure [Abstract]	'
Debt	'
	7	Debt
	In conjunction with the acquisition of First Biomedical in 2010, the Company entered into a subordinated promissory note with the former majority shareholder of First Biomedical (the Seller) in the amount of $0.8 million. In accordance with the note, the Company paid the Seller in equal installments over 24 months, which included annual interest of 5%. As of December 31, 2012, the note was fully settled.
	On June 15, 2010, the Company entered into a credit facility with Bank of America, N.A. as Administrative Agent, and KeyBank National Association as Documentation Agent (the “Lenders”). The facility initially consisted of a $30.0 million term loan and a $5.0 million revolving credit facility, both of which were originally scheduled to mature in June 2014. Interest on the term loan was payable at the Company’s choice of LIBOR plus 4.5% or the Bank of America prime rate plus 3.5%. An amendment was executed on April 24, 2012 which accelerated the maturity of all borrowings to July 2012 and added a monthly fee equal to one (1) percent fee on outstanding amounts under that facility beginning in August 2012.
	On November 30, 2012, the Company entered into a credit facility with Wells Fargo Bank as Administrative Agent and PennantPark. The facility consists 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 loans and revolver 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 December 31, 2013, interest was payable at the Wells Fargo Prime rate of 3.25% plus 6.25% which equaled 9.50%.
	Proceeds from Term Loan A and Term Loan B were used for general corporate purposes as well as to repay the outstanding balance under the Company’s Bank of America credit agreement.
	Availability under the revolving credit facility is based upon the Company’s eligible accounts receivable and eligible inventories. As of December 31, 2013 and 2012, the Company had revolving loan gross availability of $5.9 million and $6.5 million, and outstanding amounts totaling $0.0 million and $1.8 million, respectively. This left approximately $5.9 million and $4.7 million available under the revolving credit facility at December 31, 2013 and 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 December 31, 2013 and 2012, 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 had 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 had 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, as defined in and in accordance with the credit agreement for the Credit Facility, that was $1.25 million for the month ended December 31, 2012 and $5.5 million for each year ending December 31, 2013 through 2016.
	In conjunction with the Credit Facility, the Company incurred debt issuance costs of $2.4 million. These costs are recognized in income using the effective interest method through the maturity date of November 30, 2016. Also, the Company incurred deferred debt issuance costs in 2010 in conjunction with the Bank of America loan agreement. The remaining unamortized debt costs, in respect to the previous loan agreement, were completely recognized when the Company executed the Fifth Amendment to that credit agreement on April 24, 2012. At that time, the Company also capitalized certain costs of $0.2 million incurred in the negotiation and execution of the Fifth Amendment which were to be amortized through the maturity date of July 30, 2013. The remaining unamortized debt costs, from the Fifth Amendment, were written off to loss on extinguishment of
	debt on the Company’s Statement of Operations when the Company executed the Wells Fargo loan agreement and repaid in full the Bank of America loan agreement on November 30, 2012. Amortization of all deferred debt issuance costs for the year ended December 31, 2012 was $0.2 million, including $0.1 million from the old credit facility, and was recorded in interest expense.
	The Company sometimes enters into capital leases to finance the purchase of ambulatory infusion pumps. The pumps are capitalized into property and equipment 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 December 31 as follows (in thousands):


			2014		2015		2016		Total
	Term Loans (a)		$	4,064	$	2,400	$	17,531	$	23,995
	Revolver			—		—		—		—
	Capital Leases			1,054		1,063		615		2,732

	Total		$	5,118	$	3,463	$	18,146	$	26,727


	(a)	2014 includes an additional payment of $1.7 million due in April 2014 as required under the Credit Facility due to excess cash flow.
	The following is a breakdown of the Company’s current and long-term debt as of December 31 (in thousands):


	2013								2012
			Current		Long-Term		Total				Current		Long-Term		Total
			Portion of		Debt						Portion of		Debt
			Long-Term								Long-Term
			Debt								Debt
	Term Loans		$	4,064	$	19,931	$	23,995	Term Loans		$	2,400	$	24,100	$	26,500
	Revolver			—		—		—	Revolver			—		1,800		1,800
	Capital Leases			1,054		1,678		2,732	Capital Leases			1,553		1,415		2,968

	Total		$	5,118	$	21,609	$	26,727	Total		$	3,953	$	27,315	$	31,268

Income_Taxes

Income Taxes	12 Months Ended
Income Taxes	Dec. 31, 2013
Income Tax Disclosure [Abstract]	'
Income Taxes	'
	8	Income Taxes
	The following table summarizes income (loss) before income taxes for the years ended December 31 (in thousands):



			2013				2012
	U.S income (loss)		$	2,281			$	(3,501	)
	Non-U.S. income			419				1,349

	Income (loss) before income taxes		$	2,700			$	(2,152	)


	The following table summarizes the components of the consolidated provision for income taxes for the years ended December 31 (in thousands):


			2013				2012
	U.S Federal income tax benefit (expense)
	Current		$	—			$	93
	Deferred			(1,107	)			717

	Total U.S. Federal income tax benefit (expense)			(1,107	)			810
	State and local income tax benefit (expense)
	Current			(3	)			18
	Deferred			(73	)			191

	Total state and local income tax benefit (expense)			(76	)			209

	Foreign income tax benefit (expense)
	Current			152				(356	)

	Total income tax benefit (expense)		$	(1,031	)		$	663

	The following table summarizes a reconciliation of the effective income tax rate to the U.S. federal statutory rate for the years ended December 31 as follows:


			2013				2012
	Income tax expense at the statutory rate			34	%			34	%
	State and local income tax expense			(0.35	%)			1.78	%
	Foreign income tax			(2.88	%)			(10.23	%)
	Permanent differences			2.85	%			(5.38	%)
	Resolution of uncertain tax positions			0	%			11.15	%
	Other adjustments			4.58	%			(0.48	%)

	Effective income tax rate			38.2	%			30.84	%


	The following table summarizes the temporary differences and carryforwards that give rise to deferred tax assets and liabilities as of December 31 (in thousands):


			2013				2012
	Deferred Federal income tax assets —
	Bad debt reserves		$	1,635			$	1,075
	Stock based compensation			736				635
	Net operating loss			4,728				5,564
	Accrued compensation			166				483
	Alternative minimum tax credit			47				47
	Inventories			77				70
	Accrued rent			27				18
	Goodwill and intangible assets			10,376				11,609
	Other			44				14

	Total deferred Federal income tax assets			17,836				19,515

Deferred Federal income tax liabilities —
Depreciation and asset basis differences			(1,199	)			(1,772	)

Total deferred Federal income tax liabilities			(1,199	)			(1,772	)

Net deferred Federal income tax asset			16,637				17,743
Net deferred state and local income tax asset			1,959				2,034

Net deferred income taxes		$	18,596			$	19,777

The classification of net deferred income taxes as of December 31, 2013 is summarized as follows (in thousands):


		Current				Long-term				Total
Deferred tax assets		$	2,296			$	19,011			$	21,307
Deferred tax liabilities			—				(2,711	)			(2,711	)

Net deferred income taxes		$	2,296			$	16,300			$	18,596

The classification of net deferred income taxes as of December 31, 2012 is summarized as follows (in thousands):


		Current				Long-term				Total
Deferred tax assets		$	1,971			$	21,751			$	23,722
Deferred tax liabilities			—				(3,945	)			(3,945	)

Net deferred income taxes		$	1,971			$	17,806			$	19,777

As of December 31, 2013 and 2012, the Company had federal and state net operating loss carryforward remaining of approximately $14.3 million and $16.4 million, respectively. The federal net operating losses can be used for a 20-year period, and if unused, will begin to expire in 2028. The state net operating losses have expiration periods which range from 5 to 20 years, vary by state, and will begin to expire in 2014. The Company expects to be able to utilize these net operating loss carryforwards and therefore has not recorded a valuation allowance which is discussed in more detail below.
The Company’s realization of its deferred tax assets is dependent upon many factors, including, but not limited to, the Company’s ability to generate sufficient taxable income. 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. After reviewing the historical losses for non-recurring items, including the 2011 goodwill impairment, 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. The Company is carrying on business in Canada as a branch; all the foreign earnings are repatriated to the U.S., concurrently subject to U.S. taxation and impact the effective tax rate.
The Company uses a recognition threshold and measurement attribute for the financial statement recognition of uncertain tax positions. The changes in unrecognized tax benefits were as follows for the years ended December 31:


		2013				2012
Beginning balance		$	—			$	240
Additions to prior year tax positions			—				—
Reductions to prior year tax positions			—				(109	)
Reductions for lapse in statute of limitations			—				(131	)

Ending balance		$	—			$	—

The federal income tax returns of the Company for the years 2010 through 2013 are subject to examination by the Internal Revenue Service. With respect to state jurisdictions, we are generally no longer subject to tax examinations on returns filed for the years prior to 2008. The state income tax returns and other state tax filings of the Company are subject to examination by the state taxing authorities, for various periods generally up to four years after they are filed. Canadian income tax returns of the Company for the years 2010 through 2013 are open to Canada Revenue Administration examination.

Related_Party_Transactions

Related Party Transactions	12 Months Ended
	Dec. 31, 2013
Related Party Transactions [Abstract]	'
Related Party Transactions	'
	9	Related Party Transactions
	During the years ended December 31, 2013 and 2012, the Company purchased pumps from Adepto Medical, a company that is controlled by a family member of Mr. Thomas Creal, Executive Vice-President of First Biomedical. Total purchases during 2013 and 2012 amounted to $0.1 million each. Outstanding payables associated with the purchases as of December 31, 2013 and 2012 were negligible and have been shown separately as Accounts payable — related party in the Consolidated Balance Sheets. The Company also provided pumps to Adepto Medical during the years ended December 31, 2013 and 2012. Total revenue earned during the years ended December 31, 2013 and 2012 was also negligible as were outstanding accounts receivable at both dates. Effective March 2014, the Company no longer has related party transactions due to the retirement of Mr. Thomas Creal.
	As described in Note 7, in accordance with the terms of the Stock Purchase Agreement with First Biomedical, the Company entered into a subordinated promissory note (the “Note”) with Thomas Creal, the former majority shareholder of First Biomedical (the Seller) in the amount of $0.8 million. In accordance with the Note, the Company paid the Seller in equal installments over 24 months, which includes annual interest of 5%. The note was fully paid as of December 31, 2012. The Seller is a current employee of the Company and is subject to an employment agreement. Also, the Seller owns Jan-Mar LLC and is the principal owner of the CW Investment Group LLC with another company executive. In accordance with the Stock Purchase Agreement, the Company entered into operating lease agreements with Jan-Mar LLC and the CW Investment Group LLC, each of which owns one of the two office buildings utilized by First Biomedical in Olathe, Kansas. The terms of each lease was thirty-six months, commencing on July 1, 2010. The Company has extended those leases through the summer of 2014. Rent is paid monthly and totals less than $0.1 million annually to each property owner.

Commitments_and_Contingencies

Commitments and Contingencies	12 Months Ended
Commitments and Contingencies	Dec. 31, 2013
Commitments And Contingencies Disclosure [Abstract]	'
Commitments and Contingencies	'
	10	Commitments and Contingencies
	The Company is 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. We have insurance policies covering such potential losses where such coverage is cost effective. In the Company’s opinion, any liability that might be incurred by us upon the resolution of these claims and lawsuits, even prior to considering insurance coverage, will not, in the aggregate, have a material effect on the Company’s consolidated financial position, results of operations or cash flows.
	The Company had approximate minimum future operating lease commitments as of December 31 of (in thousands):


	2014		2015		2016		2017		2018		2019 and
	2014		2015		2016		2017		2018		thereafter
	$788		$	642	$	449	$	307	$	387	$	316
	Lease expense for the years ended December 31, 2013 and 2012 was $0.7 million and $0.6 million, respectively.

Sharebased_Compensation

Share-based Compensation	12 Months Ended
Share-based Compensation	Dec. 31, 2013
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]	'
Share-based Compensation	'
	11	Share-based Compensation
	Stock award compensation expense is recognized on a graded vesting basis over the requisite service period of the award, which is the vesting term. For stock awards which vest more quickly than a straight-line basis, additional expense is taken in the early year(s) to ensure the expense is commensurate with the vesting schedule.
	2007 Stock Incentive Plan
	In 2007, the Company adopted the 2007 Stock Incentive Plan (the “Plan”) providing for the issuance of a maximum of 2.0 million shares of common stock in connection with the grant of stock-based or stock-denominated awards. On May 27, 2011, the Company’s stockholders approved the reservation of an additional 3.0 million shares to be issued under the Plan.
	As of December 31, 2013, 0.2 million common shares remained available for future grant under the Plan.
	Restricted Shares
	During the years ended December 31, 2013 and 2012, the Company granted restricted shares and stock options under the Plan.
	During the years ended December 31, 2013 and 2012, the Company granted 0.2 million and 0.3 million restricted shares, of which 0.0 million and 0.1 million shares, respectively, vested immediately in each year with the remaining shares to be received at the end of a vesting period only if the participants remain employed by the Company through the vesting date and the number of shares earned will be based on the proportion of the length of service for a period of three or four years. In addition, for 2012, the Company issued 0.5 million shares to its former CEO as a condition of the Settlement Agreement under which he resigned from the Company and agreed to serve as a consultant until July 31, 2012. For additional information, see Note 3.
	During the year ended December 31, 2010, the Company granted 3.4 million restricted shares. Of the total shares granted, 1.4 million entitled a holder to receive, at the end of a vesting period, a specified number of shares of the Company’s common stock. The remaining 2.0 million shares granted entitled the holder to receive common stock when the shares vest based upon certain market conditions tied to the Company’s stock price, or certain performance conditions including a change in control. In 2012, these 2.0 million shares were forfeited as a condition of the Settlement Agreement under which the Company’s former CEO resigned.

	Restricted shares entitle the holder to receive, upon meeting certain vesting criteria, a specified number of shares of the Company’s common stock. Stock-based compensation cost of restricted shares is measured by the market value of the Company’s common stock on the date of grant. Compensation cost associated with certain restricted share grants also takes into account market conditions in its measurement. The following table summarizes restricted share activity for the years ended December 31:


							Weighted
			Number of				average
			shares				grant
			(In				date fair
			thousands)				value
	Unvested at December 31, 2011			2,636			$	1.88
	Granted			343				1.82
	Vested			(169	)			1.82
	Vested shares forgone to satisfy minimum statutory withholding			(70	)			1.81
	Forfeitures			(2,172	)			1.4

	Unvested at December 31, 2012			568			$	1.87
	Granted			212				1.73
	Vested			(168	)			2
	Vested shares forgone to satisfy minimum statutory withholding			(55	)			1.82
	Forfeitures			(103	)			1.65

	Unvested at December 31, 2013			454			$	1.82

	As of December 31, 2013 and 2012, there was $0.3 million and $0.5 million, respectively, of pre-tax total unrecognized compensation cost related to non-vested restricted shares, which will be adjusted for future forfeitures, if any. The Company expects to recognize such cost over the period ending in 2017. As of December 31, 2011, there was $6.6 million of pre-tax total unrecognized compensation cost related to non-vested restricted shares, of which approximately $6.0 million related to the former CEO’s restricted shares that were forfeited in April 2012 before the requisite service period for the awards were rendered and therefore previously recognized stock compensation expense totaling $1.3 million was reversed and recorded as a reduction of general and administrative expenses during the 2012 year. This represented a forfeiture of 2.0 million shares. For additional information, see Note 3.
	Stock Options
	The Company calculates the fair value of stock option awards using the Black-Scholes option pricing model, which incorporates various assumptions including volatility, expected term, risk-free interest rates and dividend yields. The expected volatility assumption is based on historical volatility of the Company’s common stock over the most recent period commensurate with the expected life of the stock option granted. The Company uses historical volatility because management believes such volatility is representative of prospective trends. The risk-free interest rate assumption is based upon observed interest rates appropriate for the expected life of the stock option awarded. Because the Company does not have an adequate history of granting options, the Company determines expected lives as the average of the vesting period and the contractual period. Dividend yields have not been a factor in determining fair value of stock options granted as the Company has never issued cash dividends and does not anticipate issuing cash dividends in the future.
	During the year ended December 31, 2013, the Company granted 0.2 million stock options, of which 0.1 million were issued to Board members, at exercise prices which were a preceding five-day average price on the date of grant. In addition, during 2013, the Company issued 0.8 million inducement stock options outside the 2007 Plan. During the year ended December 31, 2012, the Company granted 1.4 million stock options, of which 1.2 million were issued to Board members, at exercise prices which were the market price on the date of the grant. The following table details the various stock options and inducement stock options issued activity for the years ended December 31:


	2007 Plan (Options)		Number of				Weighted-			Weighted-			Aggregate
			Authorized				Average			Average			Intrinsic
			Shares				Exercise			Remaining			Value
							Price			Contractual
										Term(in Years)
	Outstanding at December 31, 2011			—			$	—
	Granted			1,375,000				2.21			3.62
	Exercised			—				—
	Forfeited			—				—

	Outstanding at December 31, 2012			1,375,000				2.21			3.62			—	(a)
	Granted			245,000				1.52			2.69
	Exercised			—				—
	Forfeited			(26,666	)			2.13

	Outstanding at December 31, 2013			1,598,334			$	2.11			3.09			53,083

	Exercisable at December 31, 2013			1,279,584			$	2.21


	(a)	Options were not in-the-money as of December 31, 2012.
	Aggregate Intrinsic Value Excess of market value at December 31st over the option exercise price of all in-the-money stock options outstanding at December 31st.

	Inducement Options		Number				Weighted-			Weighted-			Aggregate
			of Authorized				Average			Average			Intrinsic
Shares			Exercise				Remaining			Value
			Price				Contractual
							Term(in Years)
Outstanding at December 31, 2012				—			$	—			—		$	—
Granted				800,000				2.25			4.87
Exercised				—				—
Forfeited			—				—

Outstanding at December 31, 2013			800,000				2.25			4.87		$	156,000

Exercisable at December 31, 2013			—			$	—


The following table summarizes information about stock options outstanding at December 31, 2013.


2007 Plan (Options):		Options Outstanding										Options Exercisable
Range of Exercise Prices		Number of				Weighted-			Weighted-			Number of				Weighted-
		Shares				Average			Average			Shares				Average
		Outstanding				Remaining			Exercise			Exercisable				Exercise
						Contractual			Price							Price
						Life
$1.50 - $1.75			245,000				2.69		$	1.52			45,000			$	1.52
$1.76 - $2.00			110,000				4.01			1.93			33,750				1.93
$2.01 - $2.25			1,238,334				3.06			2.24			1,200,834				2.25

Outstanding at December 31, 2013			1,593,334				3.09		$	2.11			1,279,584			$	2.21


Inducement Options:		Options Outstanding										Options Exercisable
Range of Exercise Prices		Number of				Weighted-			Weighted-			Number of				Weighted-
		Shares				Average			Average			Shares				Average
		Outstanding				Remaining			Exercise			Exercisable				Exercise
						Contractual			Price							Price
						Life
$1.50 - $1.75			400,000				4.76		$	1.75			—			$	—
$2.26 - $2.75			400,000				5.01			2.75			—				—

Outstanding at December 31, 2013			800,000				4.87		$	2.25			—			$	—

The following is the average fair value per share estimated on the date of grant and the assumptions used for options granted during the year ended December 31:


Stock Options:		2013				2012
Expected volatility			29% to 57%				60%
Risk free interest rate			0.25% to 0.45%				0.25%
Expected lives at date of grant (in years)			2.89				3.42
Weighted average fair value of options granted			$1.52				$2.21


Inducement Stock Options:		2013
Expected volatility			56%
Risk free interest rate			0.25%
Expected lives at date of grant (in years)			5.34
Weighted average fair value of options granted		$	2.25
Stock-based compensation expense
The following table presents the total stock-based compensation expense, which is included in selling, general and administrative expenses for the years ended December 31 (in thousands):


		2013				2012
Restricted share expense		$	586			$	451	*
Stock option expense			534				513

Total stock-based compensation expense		$	1,120			$	964


*	Includes $0.4 million expense reversal for previously recognized tax gross-up liability; a change in estimate due to the $0.9 million forfeiture of 2.0 million restricted share grants; and $1.0 million of additional stock compensation expense due to the Settlement Agreement described in Note 3.

Common Share Repurchase Program
Stock repurchases may be made through open market transactions, negotiated purchases or otherwise, at times and in such amounts as our management deems to be appropriate. The timing and actual number of shares repurchased will depend on a variety of factors, including price, financing and regulatory requirements, as well as other market conditions. The program does not require us to repurchase any specific number of shares or to complete the program within a specific period of time.
During the years ended December 31, 2013 and 2012, the Company did not repurchase any shares in the open market.

Employee_Benefit_Plans

Employee Benefit Plans	12 Months Ended
	Dec. 31, 2013
Compensation And Retirement Disclosure [Abstract]	'
Employee Benefit Plans	'
	12	Employee Benefit Plans
	The Company has defined contribution plans in which the Company makes matching contributions for a certain percentage of employee contributions. For the years ended December 31, 2013 and 2012, the Company’s matching contributions totaled $0.1 million each year. The Company does not provide other post-retirement or post-employment benefits to its employees.

Summary_of_Significant_Account1

Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2013

Accounting Policies [Abstract]

Presentation in the Consolidated Statements

Principles of Consolidation

The consolidated financial statements include the accounts of the Company and all wholly owned organizations. All intercompany transactions and account balances have been eliminated in consolidation.

Segments

The Company operates in one business segment based on management’s view of its business for purposes of evaluating performance and making operating decisions.

Use of Estimates

Cash and Cash Equivalents

Accounts Receivable and Allowance for Doubtful Accounts

Following is an analysis of the allowance for doubtful accounts for the Company for the years ended December 31 (in thousands):

Balance at

Charged

Deductions (1)

Balance

beginning

to costs and

at end of

of Year

expenses

Year

Allowance for doubtful accounts — 2013

3,136

6,534

(4,896

)

4,774

Allowance for doubtful accounts — 2012

1,773

5,251

(3,888

)

3,136

-1

Deductions represent the write-off of uncollectible account receivable balances.

Inventories

Medical Equipment

Property and Equipment

Intangible Assets

Impairment of Long-Lived Assets

Revenue Recognition

Income Taxes

Share Based Payments

Cash Flow Hedge

Deferred Debt Issuance Costs

Earnings (Loss) Per Share

2013

2012

Numerator:

Net income (loss) (in thousands)

1,669

(1,489

)

Denominator:

Weighted average common shares outstanding:

Basic

21,868,379

21,430,012

Dilutive effect of options and non-vested share awards

206,134

—

Diluted

22,074,513

21,430,012

Net income (loss) per share:

Basic

0.08

(0.07

)

Diluted

0.08

(0.07

)

Summary_of_Significant_Account2

Summary of Significant Accounting Policies (Tables)	12 Months Ended
Summary of Significant Accounting Policies (Tables)	Dec. 31, 2013
Accounting Policies [Abstract]	'
Analysis of Allowance for Doubtful Accounts	'
	Following is an analysis of the allowance for doubtful accounts for the Company for the years ended December 31 (in thousands):


			Balance at		Charged			Deductions (1)			Balance
			beginning		to costs and						at end of
			of Year		expenses						Year
	Allowance for doubtful accounts — 2013		$	3,136	$	6,534		$	(4,896	)	$	4,774
	Allowance for doubtful accounts — 2012		$	1,773	$	5,251		$	(3,888	)	$	3,136

	-1	Deductions represent the write-off of uncollectible account receivable balances.
Numerators and Denominators of Basic and Diluted Income (Loss) Per Share	'
	The following table reconciles the numerators and denominators of basic and diluted income (loss) per share computations for the years ended December 31:


			2013		2012
	Numerator:
	Net income (loss) (in thousands)		$	1,669	$	(1,489	)
	Denominator:
	Weighted average common shares outstanding:
	Basic			21,868,379		21,430,012
	Dilutive effect of options and non-vested share awards			206,134		—

	Diluted			22,074,513		21,430,012
	Net income (loss) per share:
	Basic		$	0.08	$	(0.07	)
	Diluted		$	0.08	$	(0.07	)

Medical_Equipment_Tables

Medical Equipment (Tables)	12 Months Ended
Medical Equipment (Tables)	Dec. 31, 2013
Text Block [Abstract]	'
Summary of Medical Equipment	'
	Medical equipment consisted of the following as of December 31 (in thousands):


		2013			2012
	Medical Equipment in rental service	$	37,252		$	34,193
	Medical Equipment in rental service — pump reserve		(87	)		(270	)
	Accumulated depreciation		(22,727	)		(20,852	)
	Medical Equipment held for sale or rental		3,664			2,626

	Total	$	18,102		$	15,697

Property_and_Equipment_Tables

Property and Equipment (Tables)	12 Months Ended
Property and Equipment (Tables)	Dec. 31, 2013
Property Plant And Equipment [Abstract]	'
Property and Equipment	'
	Property and equipment consisted of the following as of December 31 (in thousands):


		2013			2012
	Furniture, fixtures, and equipment	$	2,664		$	2,440
	Accumulated depreciation		(1,792	)		(1,573	)

	Total	$	872		$	867

Intangible_Assets_Tables

Intangible Assets (Tables)	12 Months Ended
Intangible Assets (Tables)	Dec. 31, 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 December 31 are as follows (in thousands):


		2013
		Gross		Accumulated		Net
		Assets		Amortization		Net
	Nonamortizable intangible assets
	Trade names	$	2,000	$	—	$	2,000
	Amortizable intangible assets
	Physician and customer relationships		32,865		12,564		20,301
	Non-competition agreements		848		621		227
	Software		2,907		1,253		1,654

	Total nonamortizable and amortizable intangible assets	$	38,620	$	14,438	$	24,182



		2012
		Gross		Accumulated		Net
		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 the next five years for intangible assets recorded as of December 31 are as follows (in thousands):


		2014		2015		2016		2017		2018		2019 and
		2014		2015		2016		2017		2018		thereafter
	Amortization expense	$	2,470	$	2,282	$	2,195	$	2,191	$	2,191	$	10,853

Debt_Tables

Debt (Tables)	12 Months Ended
Debt (Tables)	Dec. 31, 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 December 31 as follows (in thousands):


			2014		2015		2016		Total
	Term Loans (a)		$	4,064	$	2,400	$	17,531	$	23,995
	Revolver			—		—		—		—
	Capital Leases			1,054		1,063		615		2,732

	Total		$	5,118	$	3,463	$	18,146	$	26,727


	(a)	2014 includes an additional payment of $1.7 million due in April 2014 as required under the Credit Facility due to excess cash flow.
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 December 31 (in thousands):


	2013								2012
			Current		Long-Term		Total				Current		Long-Term		Total
			Portion of		Debt						Portion of		Debt
			Long-Term								Long-Term
			Debt								Debt
	Term Loans		$	4,064	$	19,931	$	23,995	Term Loans		$	2,400	$	24,100	$	26,500
	Revolver			—		—		—	Revolver			—		1,800		1,800
	Capital Leases			1,054		1,678		2,732	Capital Leases			1,553		1,415		2,968

	Total		$	5,118	$	21,609	$	26,727	Total		$	3,953	$	27,315	$	31,268

Income_Taxes_Tables

Income Taxes (Tables)	12 Months Ended
Income Taxes (Tables)	Dec. 31, 2013
Income Tax Disclosure [Abstract]	'
Summary of Income (Loss) Before Income Taxes	'
	The following table summarizes income (loss) before income taxes for the years ended December 31 (in thousands):



		2013			2012
	U.S income (loss)	$	2,281		$	(3,501	)
	Non-U.S. income		419			1,349

	Income (loss) before income taxes	$	2,700		$	(2,152	)

Summary of Components of Consolidated Provision for Income Taxes	'
	The following table summarizes the components of the consolidated provision for income taxes for the years ended December 31 (in thousands):


		2013			2012
	U.S Federal income tax benefit (expense)
	Current	$	—		$	93
	Deferred		(1,107	)		717

	Total U.S. Federal income tax benefit (expense)		(1,107	)		810
	State and local income tax benefit (expense)
	Current		(3	)		18
	Deferred		(73	)		191

	Total state and local income tax benefit (expense)		(76	)		209

	Foreign income tax benefit (expense)
	Current		152			(356	)

	Total income tax benefit (expense)	$	(1,031	)	$	663

Reconciliations of Effective Income Tax Rate to Federal Statutory Rate	'
	The following table summarizes a reconciliation of the effective income tax rate to the U.S. federal statutory rate for the years ended December 31 as follows:


		2013			2012
	Income tax expense at the statutory rate		34	%		34	%
	State and local income tax expense		(0.35	%)		1.78	%
	Foreign income tax		(2.88	%)		(10.23	%)
	Permanent differences		2.85	%		(5.38	%)
	Resolution of uncertain tax positions		0	%		11.15	%
	Other adjustments		4.58	%		(0.48	%)

	Effective income tax rate		38.2	%		30.84	%

Summary of Temporary Differences and Carryforwards that Gives Rise to Deferred Tax Assets and Liabilities	'
	The following table summarizes the temporary differences and carryforwards that give rise to deferred tax assets and liabilities as of December 31 (in thousands):


		2013			2012
	Deferred Federal income tax assets —
	Bad debt reserves	$	1,635		$	1,075
	Stock based compensation		736			635
	Net operating loss		4,728			5,564
	Accrued compensation		166			483
	Alternative minimum tax credit		47			47
	Inventories		77			70
	Accrued rent		27			18
	Goodwill and intangible assets		10,376			11,609
	Other		44			14

	Total deferred Federal income tax assets		17,836			19,515

	Deferred Federal income tax liabilities —
	Depreciation and asset basis differences		(1,199	)		(1,772	)

	Total deferred Federal income tax liabilities		(1,199	)		(1,772	)

	Net deferred Federal income tax asset		16,637			17,743
	Net deferred state and local income tax asset		1,959			2,034

	Net deferred income taxes	$	18,596		$	19,777

Classification of Net Deferred Income Taxes	'
	The classification of net deferred income taxes as of December 31, 2013 is summarized as follows (in thousands):


		Current			Long-term			Total
	Deferred tax assets	$	2,296		$	19,011		$	21,307
	Deferred tax liabilities		—			(2,711	)		(2,711	)

	Net deferred income taxes	$	2,296		$	16,300		$	18,596

	The classification of net deferred income taxes as of December 31, 2012 is summarized as follows (in thousands):


		Current			Long-term			Total
	Deferred tax assets	$	1,971		$	21,751		$	23,722
	Deferred tax liabilities		—			(3,945	)		(3,945	)

	Net deferred income taxes	$	1,971		$	17,806		$	19,777

Unrecognized Tax Benefits	'
	The Company uses a recognition threshold and measurement attribute for the financial statement recognition of uncertain tax positions. The changes in unrecognized tax benefits were as follows for the years ended December 31:


		2013			2012
	Beginning balance	$	—		$	240
	Additions to prior year tax positions		—			—
	Reductions to prior year tax positions		—			(109	)
	Reductions for lapse in statute of limitations		—			(131	)

	Ending balance	$	—		$	—

Commitments_and_Contingencies_

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2013
Commitments And Contingencies Disclosure [Abstract]	'
Minimum Future Operating Lease Commitments	'
	The Company had approximate minimum future operating lease commitments as of December 31 of (in thousands):


	2014	2015		2016		2017		2018		2019 and
										thereafter
	$788	$	642	$	449	$	307	$	387	$	316

Sharebased_Compensation_Tables

Share-based Compensation (Tables)	12 Months Ended
Share-based Compensation (Tables)	Dec. 31, 2013
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]	'
Summary of Restricted Share Activity	'
	The following table summarizes restricted share activity for the years ended December 31:


						Weighted
			Number of			average
			shares			grant
			(In			date fair
			thousands)			value
	Unvested at December 31, 2011			2,636		$	1.88
	Granted			343			1.82
	Vested			(169	)		1.82
	Vested shares forgone to satisfy minimum statutory withholding			(70	)		1.81
	Forfeitures			(2,172	)		1.4

	Unvested at December 31, 2012			568		$	1.87
	Granted			212			1.73
	Vested			(168	)		2
	Vested shares forgone to satisfy minimum statutory withholding			(55	)		1.82
	Forfeitures			(103	)		1.65

	Unvested at December 31, 2013			454		$	1.82

Summary of Stock Options and Inducement Stock Options Activity	'
	The following table details the various stock options and inducement stock options issued activity for the years ended December 31:


	2007 Plan (Options)		Number of			Weighted-			Weighted-		Aggregate
			Authorized			Average			Average		Intrinsic
			Shares			Exercise			Remaining		Value
						Price			Contractual
									Term(in Years)
	Outstanding at December 31, 2011			—		$	—
	Granted			1,375,000			2.21			3.62
	Exercised			—			—
	Forfeited			—			—

	Outstanding at December 31, 2012			1,375,000			2.21			3.62		—	(a)
	Granted			245,000			1.52			2.69
	Exercised			—			—
	Forfeited			(26,666	)		2.13

	Outstanding at December 31, 2013			1,598,334		$	2.11			3.09		53,083

	Exercisable at December 31, 2013			1,279,584		$	2.21


	(a)	Options were not in-the-money as of December 31, 2012.
	Aggregate Intrinsic Value Excess of market value at December 31st over the option exercise price of all in-the-money stock options outstanding at December 31st.


	Inducement Options		Number			Weighted-			Weighted-		Aggregate
			of Authorized			Average			Average		Intrinsic
			Shares			Exercise			Remaining		Value
						Price			Contractual
									Term(in Years)
	Outstanding at December 31, 2012			—		$	—			—	$	—
	Granted			800,000			2.25			4.87
	Exercised			—			—
	Forfeited			—			—

	Outstanding at December 31, 2013			800,000			2.25			4.87	$	156,000

	Exercisable at December 31, 2013			—		$	—



Schedule of Stock Options Outstanding	'
	The following table summarizes information about stock options outstanding at December 31, 2013.


	2007 Plan (Options):		Options Outstanding								Options Exercisable
	Range of Exercise Prices		Number of			Weighted-			Weighted-		Number of			Weighted-
			Shares			Average			Average		Shares			Average
			Outstanding			Remaining			Exercise		Exercisable			Exercise
						Contractual			Price					Price
						Life
	$1.50 - $1.75			245,000			2.69		$	1.52		45,000		$	1.52
	$1.76 - $2.00			110,000			4.01			1.93		33,750			1.93
	$2.01 - $2.25			1,238,334			3.06			2.24		1,200,834			2.25

	Outstanding at December 31, 2013			1,593,334			3.09		$	2.11		1,279,584		$	2.21


	Inducement Options:		Options Outstanding								Options Exercisable
	Range of Exercise Prices		Number of			Weighted-			Weighted-		Number of			Weighted-
			Shares			Average			Average		Shares			Average
			Outstanding			Remaining			Exercise		Exercisable			Exercise
						Contractual			Price					Price
						Life
	$1.50 - $1.75			400,000			4.76		$	1.75		—		$	—
	$2.26 - $2.75			400,000			5.01			2.75		—			—

	Outstanding at December 31, 2013			800,000			4.87		$	2.25		—		$	—



Schedule of Share-based Compensation Expense Based on Fair Value of Options	'
	The following is the average fair value per share estimated on the date of grant and the assumptions used for options granted during the year ended December 31:


	Stock Options:		2013			2012
	Expected volatility			29% to 57%			60%
	Risk free interest rate			0.25% to 0.45%			0.25%
	Expected lives at date of grant (in years)			2.89			3.42
	Weighted average fair value of options granted			$1.52			$2.21


	Inducement Stock Options:		2013
	Expected volatility			56%
	Risk free interest rate			0.25%
	Expected lives at date of grant (in years)			5.34
	Weighted average fair value of options granted		$	2.25
Stock Based Compensation	'
	The following table presents the total stock-based compensation expense, which is included in selling, general and administrative expenses for the years ended December 31 (in thousands):


			2013			2012
	Restricted share expense		$	586		$	451	*
	Stock option expense			534			513

	Total stock-based compensation expense		$	1,120		$	964


	*	Includes $0.4 million expense reversal for previously recognized tax gross-up liability; a change in estimate due to the $0.9 million forfeiture of 2.0 million restricted share grants; and $1.0 million of additional stock compensation expense due to the Settlement Agreement described in Note 3.

Basis_of_Presentation_and_Natu1

Basis of Presentation and Nature of Operations - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2013
	Clinic
Organization Consolidation And Presentation Of Financial Statements [Abstract]	'
Number of oncology clinics	1,800

Summary_of_Significant_Account3

Summary of Significant Accounting Policies - Additional Information (Detail) (USD $)	1 Months Ended	12 Months Ended
In Millions, unless otherwise specified	Oct. 31, 2013	Dec. 31, 2013	Dec. 31, 2012
		Payor
		Segment
		Financial_Institutions
Summary Of Significant Accounting Policies [Line Items]	'	'	'
Number of operating business segments	'	1	'
Liquid Investments with original maturities period	'	'Three months or less	'
Maintenance of cash and cash equivalents with number of financial institutions	'	2	'
Estimated obsolete inventory	'	$0.20	$0.20
Medical equipment in rental services useful life	'	'5 years	'
Medical equipment held for sale or rental reserves	'	0.1	0.1
Impairment of indefinite-lived assets	0	'	'
Number of payors having greater than 7% of the Company's revenue	'	0	'
Maximum Percentage of revenue of specified payors	'	7.00%	'
Percentage of tax benefits greater than likelihood	'	50.00%	'
Unvested restricted shares with anti-dilutive effect	'	1.4	0.3
Restricted Stock [Member]	'	'	'
Summary Of Significant Accounting Policies [Line Items]	'	'	'
Unvested restricted shares with anti-dilutive effect	'	'	0.2
Interest Rate Swap [Member]	'	'	'
Summary Of Significant Accounting Policies [Line Items]	'	'	'
Company's new debt agreement	'	'	0.2
Interest rate swaps	'	$0	$0
Medicare [Member]	'	'	'
Summary Of Significant Accounting Policies [Line Items]	'	'	'
Gross billings for ambulatory infusion pump services	'	31.00%	31.00%
Blue Cross/Blue Shield affiliates [Member]	'	'	'
Summary Of Significant Accounting Policies [Line Items]	'	'	'
Gross billings for ambulatory infusion pump services	'	17.00%	18.00%
Physician and Customer Relationships [Member]	'	'	'
Summary Of Significant Accounting Policies [Line Items]	'	'	'
Estimated useful life Period	'	'15 years	'
Noncompete Agreements [Member]	'	'	'
Summary Of Significant Accounting Policies [Line Items]	'	'	'
Estimated useful life Period	'	'5 years	'
Software [Member]	'	'	'
Summary Of Significant Accounting Policies [Line Items]	'	'	'
Estimated useful life Period	'	'3 years	'
Computers Equipment and Software [Member]	'	'	'
Summary Of Significant Accounting Policies [Line Items]	'	'	'
Estimated useful lives	'	'3 years	'
Minimum [Member]	'	'	'
Summary Of Significant Accounting Policies [Line Items]	'	'	'
Estimated useful lives	'	'3 years	'
Maximum [Member]	'	'	'
Summary Of Significant Accounting Policies [Line Items]	'	'	'
Estimated useful lives	'	'7 years	'

Summary_of_Significant_Account4

Summary of Significant Accounting Policies - Analysis of Allowance for Doubtful Accounts (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Accounting Policies [Abstract]	'	'
Balance at beginning of Year	$3,136	$1,773
Charged to costs and expenses	6,534	5,251
Deductions	-4,896	-3,888
Balance at end of Year	$4,774	$3,136

Summary_of_Significant_Account5

Summary of Significant Accounting Policies - Numerators and Denominators of Basic and Diluted Income (Loss) Per Share (Detail) (USD $)	12 Months Ended
In Thousands, except Share data, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Numerator:	'	'
Net income (loss)	$1,669	($1,489)
Weighted average common shares outstanding:	'	'
Basic	21,868,379	21,430,012
Dilutive effect of options and non-vested share awards	206,134	'
Diluted	22,074,513	21,430,012
Net income (loss) per share:	'	'
Basic	$0.08	($0.07)
Diluted	$0.08	($0.07)

Going_Concern_and_Managements_1

Going Concern and Management's Plan - Additional Information (Detail) (USD $)	0 Months Ended	1 Months Ended	3 Months Ended		12 Months Ended
In Millions, unless otherwise specified	Apr. 06, 2010	Apr. 30, 2012	Jul. 31, 2012	Jun. 30, 2012	Dec. 31, 2013	Dec. 31, 2011
Line of Credit Facility [Line Items]	'	'	'	'	'	'
Consulting fees paid	'	'	$1	'	'	'
Number of trading days	'	'	'	'	'5 days	'
Number of shares issued to Mr. McDevitt for services	'	0.5	'	'	'	'
Number of shares of common stock potentially issuable	2	'	'	'	'	'
Unrecognized compensation expense	6	'	'	'	'	6
Recognized compensation expense	'	'	'	1.3	'	'
Line of Credit [Member]	'	'	'	'	'	'
Line of Credit Facility [Line Items]	'	'	'	'	'	'
Amount of debt to be allowed to the lenders	'	'	'	'	'	$24

Medical_Equipment_Summary_of_M

Medical Equipment - Summary of Medical Equipment (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Medical Equipment And Property [Abstract]	'	'
Medical Equipment in rental service	$37,252	$34,193
Medical Equipment in rental service - pump reserve	-87	-270
Accumulated depreciation	-22,727	-20,852
Medical equipment held for sale or rental	3,664	2,626
Total	$18,102	$15,697

Medical_Equipment_Additional_I

Medical Equipment - Additional Information (Detail) (USD $)	12 Months Ended
In Millions, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Property, Plant and Equipment [Line Items]	'	'
Pump equipment	$3.40	$6.30
Accumulated depreciation related to leased assets	0.6	3
Depreciation expense related to medical equipment	5.1	5.2
Pre-Owned Equipment [Member]	'	'
Property, Plant and Equipment [Line Items]	'	'
Medical consignment equipment	$1	'

Property_and_Equipment_Propert

Property and Equipment - Property and Equipment (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Property Plant And Equipment [Abstract]	'	'
Furniture, fixtures, and equipment	$2,664	$2,440
Accumulated depreciation	-1,792	-1,573
Total	$872	$867

Property_and_Equipment_Additio

Property and Equipment - Additional Information (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Property Plant And Equipment [Abstract]	'	'
Total depreciation expense recorded	$5,415	$5,668

Intangible_Assets_Summary_of_C

Intangible Assets - Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Indefinite Lived And Finite Lived Intangible Assets [Line Items]	'	'
Total nonamortizable and amortizable intangible assets, Gross Assets	$38,620	$37,361
Total nonamortizable and amortizable intangible assets, Accumulated Amortization	14,438	11,820
Total nonamortizable and amortizable intangible assets, Net	24,182	25,541
Physician and Customer Relationships [Member]	'	'
Indefinite Lived And Finite Lived Intangible Assets [Line Items]	'	'
Amortizable intangible assets, Gross Assets	32,865	32,866
Amortizable intangible assets, Accumulated Amortization	12,564	10,373
Amortizable intangible assets, Net	20,301	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	621	441
Amortizable intangible assets, Net	227	407
Software [Member]	'	'
Indefinite Lived And Finite Lived Intangible Assets [Line Items]	'	'
Amortizable intangible assets, Gross Assets	2,907	1,647
Amortizable intangible assets, Accumulated Amortization	1,253	1,006
Amortizable intangible assets, Net	1,654	641
Trade Names [Member]	'	'
Indefinite Lived And Finite Lived Intangible Assets [Line Items]	'	'
Nonamortizable intangible assets	$2,000	$2,000

Intangible_Assets_Additional_I

Intangible Assets - Additional Information (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Finite-Lived Intangible Assets [Line Items]	'	'
Amortization of intangible assets	$2,618	$2,734
Physician and Customer Relationships [Member]	'	'
Finite-Lived Intangible Assets [Line Items]	'	'
Weighted average remaining lives	'9 years	'
Non-Competition Agreements [Member]	'	'
Finite-Lived Intangible Assets [Line Items]	'	'
Weighted average remaining lives	'1 year	'
Software [Member]	'	'
Finite-Lived Intangible Assets [Line Items]	'	'
Weighted average remaining lives	'1 year	'

Intangible_Assets_Schedule_of_

Intangible Assets - Schedule of Expected Annual Amortization Expense for Intangible Assets (Detail) (USD $)	Dec. 31, 2013
In Thousands, unless otherwise specified	Dec. 31, 2013
Finite Lived Intangible Assets Future Amortization Expense [Abstract]	'
Amortization expense, 2014	$2,470
Amortization expense, 2015	2,282
Amortization expense, 2016	2,195
Amortization expense, 2017	2,191
Amortization expense, 2018	2,191
Amortization expense, 2019 and thereafter	$10,853

Debt_Additional_Information_De

Debt - Additional Information (Detail) (USD $)

1 Months Ended

12 Months Ended

0 Months Ended

1 Months Ended

0 Months Ended

1 Months Ended

12 Months Ended

Nov. 30, 2012

Apr. 30, 2012

Dec. 31, 2013

Dec. 31, 2012

Jun. 15, 2010

Nov. 30, 2012

Jun. 15, 2010

Nov. 30, 2012

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Dec. 31, 2013

Nov. 30, 2012

Dec. 31, 2013

Dec. 31, 2012

Nov. 30, 2012

Jun. 15, 2010

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2013

Dec. 31, 2012

Jun. 15, 2010

LIBOR [Member]

Prime Rate [Member]

Subordinated Promissory Note [Member]

Term Loan A [Member]

Term Loan B [Member]

Revolving Credit Facility [Member]

Credit Facility [Member]

Old Credit Facility [Member]

Term Loan [Member]

Minimum [Member]

Maximum [Member]

Line of Credit Facility [Line Items]

Subordinated promissory note, face amount

$800,000

Period on with installments paid to seller

'24 months

Annual interest on note

5.00%

Line of credit facility

12,000,000

14,500,000

5,900,000

6,500,000

10,000,000

5,000,000

30,000,000

Credit facility, maturity date

30-Nov-16

30-Jun-14

Interest on the term loan, 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%)

'LIBOR plus 4.5%

'Bank of America prime rate plus 3.5%

Interest rate on term loan

4.50%

7.25%

3.50%

6.25%

Debt instrument floor rate

2.00%

3.00%

3.25%

Interest rate

9.50%

Revolving loan amounts outstanding

1,800,000

Revolving credit facility available

5,900,000

4,700,000

Minimum fixed charge coverage ratio

1.25

Fixed charge coverage ratio for the remainder period

1.25

Maximum leverage ratio

2.5

Leverage ratio for remainder period

2.5

Credit facility subject to limitation on capital expenditures

1,250,000

Credit facility subject to limitation on capital expenditures in year one

5,500,000

Credit facility subject to limitation on capital expenditures in year two

5,500,000

Credit facility subject to limitation on capital expenditures in year three

5,500,000

Credit facility subject to limitation on capital expenditures in year four

5,500,000

Deferred debt issuance costs

2,400,000

Finance cost maturity date

30-Nov-16

Company capitalized certain costs incurred in the negotiation

200,000

Fifth Amendment which were to be amortized

30-Jul-13

Total deferred debt amortization expense

200,000

Amortization of deferred debt issuance costs

$620,000

$228,000

$100,000

Debt_Summary_of_Future_Maturit

Debt - Summary of Future Maturities of Loans and Capital Leases (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Line of Credit Facility [Line Items]	'	'
2014	$5,118	'
2015	3,463	'
2016	18,146	'
Total	26,727	31,268
Term Loans [Member]	'	'
Line of Credit Facility [Line Items]	'	'
2014	4,064	'
2015	2,400	'
2016	17,531	'
Total	23,995	26,500
Revolving Credit Facility [Member]	'	'
Line of Credit Facility [Line Items]	'	'
2014	'	'
2015	'	'
2016	'	'
Total	'	1,800
Capital Lease Obligations [Member]	'	'
Line of Credit Facility [Line Items]	'	'
2014	1,054	'
2015	1,063	'
2016	615	'
Total	$2,732	$2,968

Debt_Summary_of_Future_Maturit1

Debt - Summary of Future Maturities of Loans and Capital Leases (Parenthetical) (Detail) (Term Loans [Member], USD $)	Dec. 31, 2013
In Millions, unless otherwise specified	Dec. 31, 2013
Term Loans [Member]	'
Line of Credit Facility [Line Items]	'
Additional payment included in term loan for 2014	$1.70

Debt_Summary_of_Companys_Curre

Debt - Summary of Company's Current and Long-Term Debt (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Line of Credit Facility [Line Items]	'	'
Current portion of long-term debt	$5,118	$3,953
Long-Term Debt	21,609	27,315
Total	26,727	31,268
Term Loans [Member]	'	'
Line of Credit Facility [Line Items]	'	'
Current portion of long-term debt	4,064	2,400
Long-Term Debt	19,931	24,100
Total	23,995	26,500
Revolving Credit Facility [Member]	'	'
Line of Credit Facility [Line Items]	'	'
Current portion of long-term debt	'	'
Long-Term Debt	'	1,800
Total	'	1,800
Capital Lease Obligations [Member]	'	'
Line of Credit Facility [Line Items]	'	'
Current portion of long-term debt	1,054	1,553
Long-Term Debt	1,678	1,415
Total	$2,732	$2,968

Income_Taxes_Summary_of_Income

Income Taxes - Summary of Income (Loss) Before Income Taxes (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Income Tax Disclosure [Abstract]	'	'
U.S income (loss)	$2,281	($3,501)
Non-U.S. income	419	1,349
Income (loss) before income taxes	$2,700	($2,152)

Income_Taxes_Summary_of_Compon

Income Taxes - Summary of Components of Consolidated Provision for Income Taxes (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
U.S Federal income tax benefit (expense)	'	'
U.S Federal income tax benefit (expense) Current	'	$93
U.S Federal income tax benefit (expense) Deferred	-1,107	717
Total U.S. Federal income tax benefit (expense)	-1,107	810
State and local income tax benefit (expense)	'	'
State and local income tax benefit (expense) Current	-3	18
State and local income tax benefit (expense) Deferred	-73	191
Total state and local income tax benefit (expense)	-76	209
Foreign income tax benefit (expense)	'	'
Foreign income tax benefit (expense) Current	152	-356
Total income tax benefit (expense)	($1,031)	$663

Income_Taxes_Reconciliations_o

Income Taxes - Reconciliations of Effective Income Tax Rate to Federal Statutory Rate (Detail)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012
Income Tax Disclosure [Abstract]	'	'
Income tax expense at the statutory rate	34.00%	34.00%
State and local income tax expense	-0.35%	1.78%
Foreign income tax	-2.88%	-10.23%
Permanent differences	2.85%	-5.38%
Resolution of uncertain tax positions	0.00%	11.15%
Other adjustments	4.58%	-0.48%
Effective income tax rate	38.20%	30.84%

Income_Taxes_Summary_of_Tempor

Income Taxes - Summary of Temporary Differences and Carryforwards that Gives Rise to Deferred Tax Assets and Liabilities (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Deferred Federal income tax assets -	'	'
Total deferred Federal income tax assets	$21,307	$23,722
Deferred Federal income tax liabilities -	'	'
Total deferred Federal income tax liabilities	-2,711	-3,945
Net deferred income taxes	18,596	19,777
Deferred Federal Income Tax [Member]	'	'
Deferred Federal income tax assets -	'	'
Bad debt reserves	1,635	1,075
Stock based compensation	736	635
Net operating loss	4,728	5,564
Accrued compensation	166	483
Alternative minimum tax credit	47	47
Inventories	77	70
Accrued rent	27	18
Goodwill and intangible assets	10,376	11,609
Other	44	14
Total deferred Federal income tax assets	17,836	19,515
Deferred Federal income tax liabilities -	'	'
Depreciation and asset basis differences	-1,199	-1,772
Total deferred Federal income tax liabilities	-1,199	-1,772
Net deferred income taxes	16,637	17,743
Deferred State and Local Income Tax [Member]	'	'
Deferred Federal income tax liabilities -	'	'
Net deferred income taxes	$1,959	$2,034

Income_Taxes_Classification_of

Income Taxes - Classification of Net Deferred Income Taxes (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Income Tax Disclosure [Abstract]	'	'
Deferred tax assets, Current	$2,296	$1,971
Deferred tax liabilities, Current	'	'
Net deferred income taxes, Current	2,296	1,971
Deferred tax asset, Long-term	19,011	21,751
Deferred tax liabilities, Long-term	-2,711	-3,945
Net deferred income taxes, Long-term	16,300	17,806
Total deferred Federal income tax assets	21,307	23,722
Total deferred Federal income tax liabilities	-2,711	-3,945
Net deferred income taxes	$18,596	$19,777

Income_Taxes_Additional_Inform

Income Taxes - Additional Information (Detail) (USD $)	12 Months Ended
In Millions, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Operating Loss Carryforwards [Line Items]	'	'
Federal net operating losses expiry time period	'20 years	'
Federal net operating losses used, expired	31-Dec-28	'
Deferred Federal Income Tax [Member]	'	'
Operating Loss Carryforwards [Line Items]	'	'
Federal and state operating loss carryforwards	$14.30	'
Deferred State and Local Income Tax [Member]	'	'
Operating Loss Carryforwards [Line Items]	'	'
Federal and state operating loss carryforwards	'	$16.40
Open period for income tax returns examination	'4 years	'
Minimum [Member]	'	'
Operating Loss Carryforwards [Line Items]	'	'
Operating loss carryforwards expiration period	'5 years	'
Maximum [Member]	'	'
Operating Loss Carryforwards [Line Items]	'	'
Operating loss carryforwards expiration period	'20 years	'

Income_Taxes_Unrecognized_Tax_

Income Taxes - Unrecognized Tax Benefits (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Income Tax Disclosure [Abstract]	'	'
Beginning balance	'	$240
Additions to prior year tax positions	'	'
Reductions to prior year tax positions	'	-109
Reductions for lapse in statute of limitations	'	-131
Ending balance	'	'

Related_Party_Transactions_Add

Related Party Transactions - Additional Information (Detail) (USD $)	12 Months Ended					12 Months Ended
In Millions, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2013
			Subordinated Promissory Note [Member]	Subordinated Promissory Note [Member]	Subordinated Promissory Note [Member]	Jan-Mar LLC [Member]	CW Investment Group LLC [Member]
						Buildings
Related Party Transaction Due From To Related Party [Line Items]	'	'	'	'	'	'	'
Total purchases	$0.10	$0.10	'	'	'	'	'
Subordinated promissory note, face amount	'	'	0.8	'	0.8	'	'
Annual interest on note	'	'	5.00%	'	5.00%	'	'
Period on with installments paid to seller	'	'	'24 months	'24 months	'	'	'
Number of office buildings utilized by the company	'	'	'	'	'	2	'
Term of operating lease agreements	'36 months	'	'	'	'	'	'
Rent paid	$0.70	$0.60	'	'	'	'	$0.10

Commitments_and_Contingencies_1

Commitments and Contingencies - Minimum Future Operating Lease Commitments (Detail) (USD $)	Dec. 31, 2013
In Thousands, unless otherwise specified	Dec. 31, 2013
Operating Leases Future Minimum Payments Due [Abstract]	'
2014	$788
2015	642
2016	449
2017	307
2018	387
2019 and thereafter	$316

Commitments_and_Contingencies_2

Commitments and Contingencies - Additional Information (Detail) (USD $)	12 Months Ended
In Millions, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Commitments And Contingencies Disclosure [Abstract]	'	'
Lease expenses	$0.70	$0.60

Sharebased_Compensation_Additi

Share-based Compensation - Additional Information (Detail) (USD $)

12 Months Ended

In Millions, except Share data, unless otherwise specified

Dec. 31, 2012

Dec. 31, 2011

Apr. 06, 2010

Dec. 31, 2012

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2010

Dec. 31, 2011

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2013

27-May-11

Dec. 31, 2007

Chief Executive Officer [Member]

Restricted Stock [Member]

Stock Options [Member]

Inducement Stock Options [Member]

Minimum [Member]

Maximum [Member]

2007 Stock Incentive Plan [Member]

Chief Executive Officer [Member]

Restricted Stock [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Issuance of shares of common stock

2,000,000

Additional share issued under stock incentive plan

3,000,000

Availability of common shares

200,000

Number of shares, Granted

212,000

343,000

3,400,000

Shares vested immediately

100,000

1,400,000

Vesting period

'3 years

'4 years

Number of common shares for vest immediately as condition of settlement agreement

500,000

Remaining number of common shares for vest

2,000,000

Pre-tax total unrecognized compensation cost related to non-vested restricted shares

$0.30

$0.50

$6.60

Period of recognize the cost

'2017

Unrecognized compensation expense

Previously recognized stock compensation expense

$1.30

Shares forfeited as a condition of settlement

2,000,000

103,000

2,172,000

Stock options granted

245,000

1,375,000

100,000

1,200,000

800,000

Sharebased_Compensation_Summar

Share-based Compensation - Summary of Restricted Share Activity (Detail) (Restricted Stock [Member], USD $)	12 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2010
Restricted Stock [Member]	'	'	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'	'
Unvested Number of shares, Beginning Balance	568	2,636	'
Number of shares, Granted	212	343	3,400
Number of shares, Vested	-168	-169	'
Vested shares forgone to satisfy minimum statutory withholding	-55	-70	'
Number of shares, Forfeitures	-103	-2,172	'
Unvested Number of shares, Ending Balance	454	568	'
Unvested Weighted average grant date fair value, Beginning Balance	$1.87	$1.88	'
Weighted average grant date fair value, Granted	$1.73	$1.82	'
Weighted average grant date fair value, Vested	$2	$1.82	'
Weighted average grant date fair value, Vested shares forgone to satisfy minimum statutory withholding	$1.82	$1.81	'
Weighted average grant date fair value, Forfeitures	$1.65	$1.40	'
Unvested Weighted average grant date fair value, Ending Balance	$1.82	$1.87	'

Sharebased_Compensation_Summar1

Share-based Compensation - Summary of Stock Options and Inducement Stock Options Activity (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012
2007 Plan (Options) [Member]	'	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'
Number of Authorized Shares, Options outstanding, beginning balance	1,375,000	'
Number of Authorized Shares, Granted	245,000	1,375,000
Number of Authorized Shares, Exercised	'	'
Number of Authorized Shares, Forfeited	-26,666	'
Number of Authorized Shares, Options outstanding, ending balance	1,598,334	1,375,000
Number of Authorized Shares, Exercisable at December 31, 2013	1,279,584	'
Weighted-Average Exercise Price, Outstanding, beginning balance	$2.21	'
Weighted-Average Exercise Price, Granted	$1.52	$2.21
Weighted-Average Exercise Price, Exercised	'	'
Weighted-Average Exercise Price, Forfeited	$2.13	'
Weighted-Average Exercise Price, Outstanding, ending balance	$2.11	$2.21
Exercisable at December 31, 2013	$2.21	'
Aggregate Intrinsic value, Outstanding, beginning balance	'	'
Weighted-Average Remaining Contractual Term (in Years), Granted	'2 years 8 months 9 days	'3 years 7 months 13 days
Aggregate Intrinsic value, Outstanding, ending balance	53,083	'
Weighted-Average Remaining Contractual Term (in Years)	'3 years 1 month 2 days	'3 years 7 months 13 days
Inducement Stock Options [Member]	'	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'
Number of Authorized Shares, Options outstanding, beginning balance	'	'
Number of Authorized Shares, Granted	800,000	'
Number of Authorized Shares, Exercised	'	'
Number of Authorized Shares, Forfeited	'	'
Number of Authorized Shares, Options outstanding, ending balance	800,000	'
Number of Authorized Shares, Exercisable at December 31, 2013	'	'
Weighted-Average Exercise Price, Outstanding, beginning balance	'	'
Weighted-Average Exercise Price, Granted	$2.25	'
Weighted-Average Exercise Price, Exercised	'	'
Weighted-Average Exercise Price, Forfeited	'	'
Weighted-Average Exercise Price, Outstanding, ending balance	$2.25	'
Exercisable at December 31, 2013	'	'
Aggregate Intrinsic value, Outstanding, beginning balance	'	'
Weighted-Average Remaining Contractual Term (in Years), Granted	'4 years 10 months 13 days	'
Aggregate Intrinsic value, Outstanding, ending balance	$156,000	'
Weighted-Average Remaining Contractual Term (in Years)	'4 years 10 months 13 days	'

Sharebased_Compensation_Schedu

Share-based Compensation - Schedule of Stock Options Outstanding (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
2007 Plan (Options) [Member]	'	'	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'	'
Options Outstanding, Number of shares outstanding	1,593,334	'	'
Options Outstanding, Weighted-Average Remaining Contractual Life	'3 years 1 month 2 days	'	'
Options Outstanding, Weighted-Average Exercise Price	$2.11	$2.21	'
Options Exercisable, Number of Shares Exercisable	1,279,584	'	'
Options Exercisable, Weighted-Average Exercise Price	$2.21	'	'
Inducement Stock Options [Member]	'	'	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'	'
Options Outstanding, Number of shares outstanding	800,000	'	'
Options Outstanding, Weighted-Average Remaining Contractual Life	'4 years 10 months 13 days	'	'
Options Outstanding, Weighted-Average Exercise Price	$2.25	'	'
Options Exercisable, Number of Shares Exercisable	'	'	'
Options Exercisable, Weighted-Average Exercise Price	'	'	'
$1.50 - $1.75 [Member] \| 2007 Plan (Options) [Member]	'	'	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'	'
Options Outstanding, Number of shares outstanding	245,000	'	'
Options Outstanding, Weighted-Average Remaining Contractual Life	'2 years 8 months 9 days	'	'
Options Outstanding, Weighted-Average Exercise Price	$1.52	'	'
Options Exercisable, Number of Shares Exercisable	45,000	'	'
Options Exercisable, Weighted-Average Exercise Price	$1.52	'	'
$1.50 - $1.75 [Member] \| Inducement Stock Options [Member]	'	'	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'	'
Options Outstanding, Number of shares outstanding	400,000	'	'
Options Outstanding, Weighted-Average Remaining Contractual Life	'4 years 9 months 4 days	'	'
Options Outstanding, Weighted-Average Exercise Price	$1.75	'	'
Options Exercisable, Number of Shares Exercisable	'	'	'
Options Exercisable, Weighted-Average Exercise Price	'	'	'
$1.76 - $2.00 [Member] \| 2007 Plan (Options) [Member]	'	'	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'	'
Options Outstanding, Number of shares outstanding	110,000	'	'
Options Outstanding, Weighted-Average Remaining Contractual Life	'4 years 4 days	'	'
Options Outstanding, Weighted-Average Exercise Price	$1.93	'	'
Options Exercisable, Number of Shares Exercisable	33,750	'	'
Options Exercisable, Weighted-Average Exercise Price	$1.93	'	'
$2.01 - 2.25 [Member] \| 2007 Plan (Options) [Member]	'	'	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'	'
Options Outstanding, Number of shares outstanding	1,238,334	'	'
Options Outstanding, Weighted-Average Remaining Contractual Life	'3 years 22 days	'	'
Options Outstanding, Weighted-Average Exercise Price	$2.24	'	'
Options Exercisable, Number of Shares Exercisable	1,200,834	'	'
Options Exercisable, Weighted-Average Exercise Price	$2.25	'	'
$2.26 - $2.75 [Member] \| Inducement Stock Options [Member]	'	'	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'	'
Options Outstanding, Number of shares outstanding	400,000	'	'
Options Outstanding, Weighted-Average Remaining Contractual Life	'5 years 4 days	'	'
Options Outstanding, Weighted-Average Exercise Price	$2.75	'	'
Options Exercisable, Number of Shares Exercisable	'	'	'
Options Exercisable, Weighted-Average Exercise Price	'	'	'

Sharebased_Compensation_Schedu1

Share-based Compensation - Schedule of Stock Options Outstanding (Parenthetical) (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013
$1.50 - $1.75 [Member] \| 2007 Plan (Options) [Member]	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'
Range of Exercise Prices, minimum	$1.50
Range of Exercise Prices, maximum	$1.75
$1.50 - $1.75 [Member] \| Inducement Stock Options [Member]	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'
Range of Exercise Prices, minimum	$1.50
Range of Exercise Prices, maximum	$1.75
$1.76 - $2.00 [Member] \| 2007 Plan (Options) [Member]	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'
Range of Exercise Prices, minimum	$1.76
Range of Exercise Prices, maximum	$2
$2.01 - 2.25 [Member] \| 2007 Plan (Options) [Member]	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'
Range of Exercise Prices, minimum	$2.01
Range of Exercise Prices, maximum	$2.25
$2.26 - $2.75 [Member] \| Inducement Stock Options [Member]	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'
Range of Exercise Prices, minimum	$2.26
Range of Exercise Prices, maximum	$2.75

Sharebased_Compensation_Schedu2

Share-based Compensation - Schedule of Share Based Compensation Expense Based on Fair Value of Options (Detail) (USD $)	12 Months Ended
	Dec. 13, 2013	Dec. 31, 2012	Dec. 13, 2013	Dec. 13, 2013	Dec. 31, 2013
	Stock Options [Member]	Stock Options [Member]	Stock Options [Member]	Stock Options [Member]	Inducement Stock Options [Member]
			Minimum [Member]	Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'	'	'	'
Expected volatility	'	60.00%	29.00%	57.00%	56.00%
Risk free interest rate	'	0.25%	0.25%	0.45%	0.25%
Expected lives at date of grant (in years)	'2 years 10 months 21 days	'3 years 5 months 1 day	'	'	'5 years 4 months 2 days
Weighted average fair value of options granted	$1.52	$2.21	'	'	$2.25

Sharebased_Compensation_Stock_

Share-based Compensation - Stock Based Compensation (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Share Based Compensation [Abstract]	'	'
Restricted share expense	$586	$451
Stock option expense	534	513
Total stock-based compensation expense	$1,120	$964

Sharebased_Compensation_Stock_1

Share-based Compensation - Stock Based Compensation (Parenthetical) (Detail) (USD $)	12 Months Ended
Share data in Thousands, unless otherwise specified	Dec. 31, 2013
Share Based Compensation Expense [Line Items]	'
Reversal for previously recognized tax gross up liability expenses	$400,000
Share based compensation related to settlement agreement	1,000,000
Certain Restricted Shares [Member]	'
Share Based Compensation Expense [Line Items]	'
Stock-based compensation	$900
Share forfeited as a condition of settlement	2,000

Employee_Benefit_Plans_Additio

Employee Benefit Plans - Additional Information (Detail) (USD $)	12 Months Ended
In Millions, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Compensation And Retirement Disclosure [Abstract]	'	'
Employer contributions	$0.10	$0.10