InfuSystem (INFU) 10-Q1 Aug 142014 Q2 Quarterly reportFinancial data

Company Profile

Document_and_Entity_Informatio

Document and Entity Information	6 Months Ended
Document and Entity Information	Jun. 30, 2014	Jul. 28, 2014
Document And Entity Information [Abstract]	'	'
Document Type	'10-Q	'
Amendment Flag	'false	'
Document Period End Date	30-Jun-14	'
Document Fiscal Year Focus	'2014	'
Document Fiscal Period Focus	'Q2	'
Trading Symbol	'INFU	'
Entity Registrant Name	'InfuSystem Holdings, Inc	'
Entity Central Index Key	'0001337013	'
Current Fiscal Year End Date	'--12-31	'
Entity Filer Category	'Smaller Reporting Company	'
Entity Common Stock, Shares Outstanding	'	22,397,043

Condensed_Consolidated_Balance

Condensed Consolidated Balance Sheets (USD $)	Jun. 30, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified	Jun. 30, 2014	Dec. 31, 2013
Current Assets:	'	'
Cash and cash equivalents	$1,041	$1,138
Accounts receivable, less allowance for doubtful accounts of $5,574 and $4,774 at June 30, 2014 and December 31, 2013, respectively	10,768	10,697
Inventory	1,485	1,234
Other current assets	712	518
Deferred income taxes	2,296	2,296
Total Current Assets	16,302	15,883
Medical equipment held for sale or rental	2,255	3,664
Medical equipment in rental service, net of accumulated depreciation	16,185	14,438
Property & equipment, net of accumulated depreciation	1,577	872
Deferred debt issuance costs, net	1,505	1,817
Intangible assets, net	24,287	24,182
Deferred income taxes	15,376	16,300
Other assets	248	217
Total Assets	77,735	77,373
Current Liabilities:	'	'
Accounts payable	4,101	4,736
Current portion of long-term debt	3,871	5,118
Other current liabilities	2,573	3,187
Total Current Liabilities	10,545	13,041
Long-term debt, net of current portion	22,829	21,609
Total Liabilities	33,374	34,650
Stockholders' Equity:	'	'
Preferred stock, $.0001 par value: authorized 1,000,000 shares; none issued	0	0
Common stock, $.0001 par value: authorized 200,000,000 shares; issued and outstanding 22,400,743 and 22,203,053, respectively, as of June 30, 2014 and 22,158,041 and 21,960,351, respectively, as of December 31, 2013	2	2
Additional paid-in capital	89,951	89,783
Retained deficit	-45,592	-47,062
Total Stockholders' Equity	44,361	42,723
Total Liabilities and Stockholders' Equity	$77,735	$77,373

Condensed_Consolidated_Balance1

Condensed Consolidated Balance Sheets (Parenthetical) (USD $)	Jun. 30, 2014	Dec. 31, 2013
In Thousands, except Share data, unless otherwise specified	Jun. 30, 2014	Dec. 31, 2013
Statement Of Financial Position [Abstract]	'	'
Accounts receivable, allowance for doubtful accounts	$5,574	$4,774
Preferred stock, par value	$0.00	$0.00
Preferred stock, shares authorized	1,000,000	1,000,000
Preferred stock, shares issued	0	0
Common stock, par value	$0.00	$0.00
Common stock, shares authorized	200,000,000	200,000,000
Common stock, shares issued	22,400,743	22,158,041
Common stock, shares outstanding	22,203,053	21,960,351

Condensed_Consolidated_Stateme

Condensed Consolidated Statements of Operations and Statements of Comprehensive Income (USD $)	3 Months Ended		6 Months Ended
In Thousands, except Share data, unless otherwise specified	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013
Net revenues:	'	'	'	'
Rentals	$14,795	$13,618	$29,645	$27,061
Product Sales	1,577	1,044	3,969	2,302
Net revenues	16,372	14,662	33,614	29,363
Cost of revenues:	'	'	'	'
Cost of revenues - Product, service and supply costs	2,913	2,845	5,803	5,424
Cost of revenues - Pump depreciation and disposals	1,536	1,487	3,812	3,186
Gross profit	11,923	10,330	23,999	20,753
Selling, general and administrative expenses:	'	'	'	'
Provision for doubtful accounts	1,438	1,327	3,545	2,987
Amortization of intangibles	625	652	1,254	1,324
Selling and marketing	2,624	2,482	5,279	4,890
General and administrative	4,898	5,008	9,807	10,039
Total selling, general and administrative	9,585	9,469	19,885	19,240
Operating income	2,338	861	4,114	1,513
Other income (expense):	'	'	'	'
Interest expense	-776	-924	-1,603	-1,798
Other income	40	24	23	336
Total other expense	-736	-900	-1,580	-1,462
Income/(loss) before income taxes	1,602	-39	2,534	51
Income tax (expense)/benefit	-716	144	-1,065	105
Net income	886	105	1,469	156
Net income per share:	'	'	'	'
Basic	$0.04	$0	$0.07	$0.01
Diluted	$0.04	$0	$0.07	$0.01
Weighted average shares outstanding:	'	'	'	'
Basic	22,146,106	21,860,866	22,059,902	21,831,852
Diluted	22,399,434	22,015,499	22,321,143	22,052,151
Comprehensive Income	'	'	'	'
Net income	886	105	1,469	156
Comprehensive income	$886	$105	$1,469	$156

Condensed_Consolidated_Stateme1

Condensed Consolidated Statements of Cash Flows (USD $)	6 Months Ended
In Thousands, unless otherwise specified	Jun. 30, 2014	Jun. 30, 2013
Statement Of Cash Flows [Abstract]	'	'
NET CASH PROVIDED BY OPERATING ACTIVITIES	$1,806	$2,233
INVESTING ACTIVITIES	'	'
Purchase of medical equipment and property	-4,524	-2,564
Proceeds from sale of medical equipment and property	4,005	1,726
NET CASH USED IN INVESTING ACTIVITIES	-519	-838
FINANCING ACTIVITIES	'	'
Principal payments on revolving credit facility, term loans, and capital lease obligations	-33,479	-16,918
Cash proceeds from revolving credit facility	32,198	13,340
Common stock repurchased to satisfy statutory withholding on employee stock based compensation plans	-103	-41
NET CASH USED IN FINANCING ACTIVITIES	-1,384	-3,619
Net change in cash and cash equivalents	-97	-2,224
Cash and cash equivalents, beginning of period	1,138	2,326
Cash and cash equivalents, end of period	$1,041	$102

Basis_of_Presentation_Nature_o

Basis of Presentation, Nature of Operations and Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2014
Accounting Policies [Abstract]	'
Basis of Presentation, Nature of Operations and Summary of Significant Accounting Policies	'
	1	Basis of Presentation, Nature of Operations and Summary of Significant Accounting Policies
	InfuSystem Holdings, Inc. (the “Company”) is a leading provider of infusion pumps and related services. The Company services hospitals, oncology practices and other alternate site healthcare providers. Headquartered in Madison Heights, Michigan, the Company delivers local, field-based customer support, and also operates pump repair Centers of Excellence in Michigan, Kansas, California, Texas, and Ontario, Canada.
	The accompanying consolidated financial statements have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”) for interim financial information. Accordingly they do not include all of the information and notes required by U.S. Generally Accepted Accounting Principles (“GAAP”) for complete financial statements. The accompanying consolidated financial statements include all adjustments, composed of normal recurring adjustments, considered necessary by management to fairly state our results of operations, financial position and cash flows. The operating results for the interim periods are not necessarily indicative of results that may be expected for any other interim period or for the full year. These consolidated financial statements should be read in conjunction with the consolidated financial statements and notes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2013 (“2013 Form 10-K”) as filed with the SEC.
	The consolidated financial statements are prepared in conformity with GAAP, which requires the use of estimates, judgments and assumptions that affect the amounts of assets and liabilities at the reporting date and the amounts of revenue and expenses in the periods presented. We believe that the accounting estimates employed are appropriate and the resulting balances are reasonable; however, due to the inherent uncertainties in making estimates, actual results could differ from the original estimates, requiring adjustments to these balances in future periods.

Medical_Equipment_and_Property

Medical Equipment and Property	6 Months Ended
Medical Equipment and Property	Jun. 30, 2014
Text Block [Abstract]	'
Medical Equipment and Property	'
	2	Medical Equipment and Property
	Medical equipment consisted of the following as of June 30, 2014 and December 31, 2013 (in thousands):


			June 30,			December 31,
			2014			2013
	Medical Equipment in rental service		$	39,460		$	37,252
	Medical Equipment in rental service - pump reserve			(119	)		(87	)
	Accumulated depreciation			(23,156	)		(22,727	)
	Medical Equipment held for sale or rental			2,255			3,664

	Total		$	18,440		$	18,102

	Depreciation expense for medical equipment for the three and six months ended June 30, 2014 was $0.8 million and $1.5 million, respectively compared to $1.3 million and $2.4 million for the same prior year periods, which was recorded in cost of revenues – pump depreciation and disposals, respectively.
	During the first quarter of 2014, the Company reassessed the estimated useful life of certain of its property and equipment. As a result, the estimated useful life of the Company’s medical equipment was changed from five to seven years due to the determination that the Company was using these assets longer than originally anticipated. A major factor in this change was the servicing of such equipment by the Company’s Kansas facility, which was acquired in 2010. As a result, disposal of such equipment has decreased significantly since that acquisition.
	The change in the estimated useful lives of the Company’s pump equipment was accounted for as a change in accounting estimate, on a prospective basis, effective January 1, 2014. The change in estimated useful lives resulted in $0.5 million and $1.0 million in less depreciation expense for the three and six months ended June 30, 2014, respectively, than otherwise would have been recorded. After-tax impact to net income would have been lower by $0.3 million and $0.6 million for the three months and six months ended June 30, 2014 if this change in estimate had not been made. There was no impact to the basic or diluted income per share due to this change in estimate.


	Depreciation expense for property and equipment for the three and six months ended June 30, 2014 was $0.1 million and $0.2 million, respectively, consistent with the same prior year periods. This expense was recorded in general and administrative expenses.
	At December 31, 2013, Medical equipment held for sale or rental included approximately $0.8 million of pre-owned equipment received from a financial institution when such equipment came off lease. Under the Company’s former arrangement with the financial institution, the Company did not pay for the equipment until it was sold. The liability for this equipment was included in other current liabilities for a similar amount. The Company assumed risk of loss and accounted for the disposition of such equipment as a sale. In June 2014, the Company bought out the remaining equipment from the financial institution for $0.5 million and payment was made in July 2014. As such, the Company no longer has any liabilities pertaining to this transaction.

Intangible_Assets

Intangible Assets	6 Months Ended
Intangible Assets	Jun. 30, 2014
Goodwill And Intangible Assets Disclosure [Abstract]	'
Intangible Assets	'
	3	Intangible Assets
	The carrying amount and accumulated amortization of intangible assets as of June 30, 2014 and December 31, 2013, are as follows (in thousands):


			June 30, 2014
			Gross			Accumulated			Net
			Assets			Amortization			Net
	Nonamortizable intangible assets
	Trade names		$	2,000		$	—		$	2,000
	Amortizable intangible assets
	Physician and customer relationships			32,865			13,659			19,206
	Non-competition agreements			848			703			145
	Software			4,269			1,333			2,936

	Total nonamortizable and amortizable intangible assets		$	39,982		$	15,695		$	24,287


			31-Dec-13
			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


	Amortization expense for the three and six months ended June 30, 2014 was $0.6 million and $1.3 million, respectively, compared to $0.7 million and $1.3 million for the same prior year periods. Expected annual amortization expense for intangible assets recorded as of June 30, 2014, is as follows (in thousands):


	7/1-		2015		2016	2017		2018	2019 and
	12/31/14		2015		2016	2017		2018	thereafter
	$1,243		$2,321		$2,235	$2,201		$2,191	$12,096

Debt

Debt	6 Months Ended
Debt	Jun. 30, 2014
Debt Disclosure [Abstract]	'
Debt	'
	4	Debt
	On November 30, 2012, the Company entered into a credit agreement with Wells Fargo as Administrative Agent and Wells Fargo and PennantPark as Lenders. The credit agreement 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 (the “Revolver”), all of which mature on November 30, 2016, collectively (the “Credit Facility”). Interest on the Credit Facility 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%).
	On May 19, 2014, the Company entered into the Second Amendment to the Credit Agreement with Wells Fargo Capital Finance and funds managed by PennantPark Investment Advisers, LLC. This amendment lowers both the effective floating rate and the effective fixed rate by 150 basis points each. As of June 30, 2014, the effective floating interest rate under this Amendment was 7.75%.
	The availability under the Revolver is based upon the Company’s eligible accounts receivable and eligible inventory and is broken down as follows (in thousands):.


			June 30,			December 31,
			2014			2013
	Revolver:
	Gross Availability		$	6,500		$	5,900
	Outstanding Draws			(2,021	)		—
	Letter of Credit			(81	)		—

	Availability on Revolver		$	4,398		$	5,900

	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 June 30, 2014, the Company was in compliance with all such covenants and expects to be in compliance over the next 12 months.
	In connection with the Credit Facility, the Company has the following covenant obligations for the duration of the facility:

		a)	The fixed charge coverage ratio is calculated in accordance with the agreement governing the Credit Facility. This covenant was first required to be reported as of March 31, 2013 and has a minimum ratio at that time of 1.25:1. The required ratio varies quarterly for the remainder of the facility duration, from 1.25:1 to 2.00:1. The required ratio as of June 30, 2014 was 1.50:1.

		b)	The leverage ratio is calculated in accordance with the agreement governing the Credit Facility. This covenant was first required to be reported as of March 31, 2013 and has a maximum ratio at that time of 2.50:1. The required ratio varies quarterly for the remainder of the facility duration, from 2.50:1 to 1.00:1. The required ratio as of June 30, 2014 was 1.75:1.

		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, which was $1.25 million for the month ended December 31, 2012 and $5.5 million for each year ending December 31, 2013 through 2016.
	The Company occasionally enters into capital leases to finance the purchase of ambulatory infusion pumps. The pumps are capitalized into medical equipment in rental service at their fair market value, which equals the value of the future minimum lease payments and are depreciated over the useful life of the pumps.
	The Company had approximate future maturities of loans and capital leases as of June 30, 2014 as follows (in thousands):


			Remainder			2015		2016		2017				Total
			of 2014			2015		2016		2017				Total
	Term Loans		$	1,200		$	2,400	$	17,688	$	—			$	21,288
	Revolver			—			—		2,021		—				2,021
	Capital Leases			712			1,474		1,056		149				3,391

	Total		$	1,912		$	3,874	$	20,765	$	149			$	26,700

	The following is a breakdown of the Company’s current and long-term debt (including capital leases) as of June 30, 2014 and December 31, 2013 (in thousands):


	June 30, 2014									December 31, 2013
			Current			Long-Term		Total				Current				Long-Term		Total
			Portion of			Debt						Portion of				Debt
			Long-Term									Long-Term
			Debt									Debt
	Term Loans		$	2,400		$	18,888	$	21,288	Term Loans		$	4,064			$	19,931	$	23,995
	Revolver			—			2,021		2,021	Revolver			—				—		—
	Capital Leases			1,471			1,920		3,391	Capital Leases			1,054				1,678		2,732

	Total		$	3,871		$	22,829	$	26,700	Total		$	5,118			$	21,609	$	26,727

	On April 11, 2014, the Company repaid $1.6 million on its Credit Facility for its annual Excess Cash Flow sweep as required and defined by the Company’s Credit Agreement.

Income_Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2014
Income Tax Disclosure [Abstract]	'
Income Taxes	'
	5	Income Taxes
	During the three and six months ended June 30, 2014, the Company recorded income tax expense of $0.7 million and $1.1 million, respectively. The company recorded income tax benefits of $0.1 million, respectively, for the same prior year periods. The increase is tax expense was primarily due to profitability during the quarter ended June 30, 2014. In computing its income tax provision, the Company estimates its effective tax rate for the full year and applies that rate to income earned though the reporting period. The effective income tax rate was 41.3% and 38.2% for the quarters ended June 30, 2014 and 2013, respectively. For the six months ended June 30, 2014 the effective tax rate was 42.1%.

Commitments_and_Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2014
Commitments And Contingencies Disclosure [Abstract]	'
Commitments and Contingencies	'
	6	Commitments and Contingencies
	The Company is currently involved in legal proceedings arising out of the ordinary course and conduct of our business, the outcomes of which are not determinable at this time. We have insurance policies covering 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 will not, in the aggregate, have a material effect on the Company’s consolidated financial condition, results of operations or cash flows.

Earnings_Per_Share

Earnings Per Share	6 Months Ended
Earnings Per Share	Jun. 30, 2014
Earnings Per Share [Abstract]	'
Earnings Per Share	'
	7	Earnings Per Share
	Basic income per share is computed by dividing net income by the weighted average number of common shares outstanding during the period. Diluted income per share assumes the issuance of potentially dilutive shares of common stock during the period. The following table reconciles the numerators and denominators of the basic and diluted income per share computations:


			Three Months Ended				Six Months Ended
			June 30				June 30
			2014		2013		2014		2013
	Numerator:
	Net income (in thousands)		$	886	$	105	$	1,469	$	156
	Denominator:
	Weighted average common shares outstanding:
	Basic			22,146,106		21,860,866		22,059,902		21,831,852
	Dilutive effect of non-vested awards			253,328		154,633		261,241		220,299

	Diluted			22,399,434		22,015,499		22,321,143		22,052,151
	Net income per share:
	Basic		$	0.04	$	—	$	0.07	$	0.01
	Diluted		$	0.04	$	—	$	0.07	$	0.01

	For the three and six months ended June 30, 2014, vested stock options of 0.1 million were not included in the calculation because they were not in-the-money.

Subsequent_Event

Subsequent Event	6 Months Ended
	Jun. 30, 2014
Subsequent Events [Abstract]	'
Subsequent Event	'
	8	Subsequent Event
	On July 2, 2014, the Compensation Committee of InfuSystem Holdings, Inc. (the “Company”) authorized a grant of the option to purchase 100,000 shares of the Company’s common stock, par value $0.0001 per share, at an exercise price of $2.674 per share, to Jonathan P. Foster, Chief Financial Officer of the Company. The option vests in equal monthly installments over a three-year period, expires after five (5) years and is otherwise exercisable in accordance with the InfuSystem Holdings, Inc. Equity Plan.

Recent_Accounting_Pronouncemen

Recent Accounting Pronouncements and Developments	6 Months Ended
	Jun. 30, 2014
Accounting Changes And Error Corrections [Abstract]	'
Recent Accounting Pronouncements and Developments	'
	9	Recent Accounting Pronouncements and Developments
	In May 2014, the Financial Accounting Standards Board issued a comprehensive new standard, which amends revenue recognition principles and provides a single set of criteria for revenue recognition among all industries. The new standard provides a five step framework whereby revenue is recognized when promised goods or services are transferred to a customer at an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. The standard also requires enhanced disclosure pertaining to revenue recognition in both the interim and annual periods. The standard is effective for interim and annual periods beginning after December 15, 2016 and allows for adoption using a full retrospective method, or a modified retrospective method. We are currently assessing the method of adoption and the expected impact the new standard has on our financial position and results of operations.

	Cautionary Statement about Forward-Looking Statements
	This quarterly report on Form 10-Q contains “forward-looking statements” within the meaning of the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995, Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934. Forward-looking statements can be identified by words such as: “anticipate,” “continue,” “intend,” “plan,” “goal,” “seek,” “believe,” “project,” “estimate,” “expect,” “strategy,” “future,” “likely,” “may,” “should,” “will” and similar references to future periods. Forward-looking statements are neither historical facts nor assurances of future performance. Instead, they are based only on the Company’s current beliefs, expectations and assumptions regarding the future of its business, future plans and strategies, projections, anticipated events and trends, the economy and other future conditions. Because forward-looking statements relate to the future, they are subject to inherent uncertainties, risks and changes in circumstances that are difficult to predict and many of which are outside of the Company’s control. Actual results and financial condition may differ materially from those indicated in the forward-looking statements. Therefore, you should not rely on any of these forward-looking statements. Important factors that could cause the Company’s actual results and financial condition to differ materially from those indicated in the forward-looking statements include, among others, the Company’s expectations regarding financial condition or results of operations in future periods; the Company’s expectations regarding potential legislative and regulatory changes impacting, among other things, the level of reimbursement received from the Medicare and state Medicaid programs including CMS competitive bidding; the Company’s expectations regarding the size and growth of the market for its products and services; the Company’s ability to execute its business strategies to grow its business, including its ability to introduce new products and services; the Company’s ability to hire and retain key employees; the Company’s ability to remain in compliance with its credit facility; the Company’s dependence on its Medicare Supplier Number; changes in third-party reimbursement processes and rates; availability of chemotherapy drugs used in the Company’s infusion pump systems; physicians’ acceptance of infusion pump therapy over alternative therapies; the Company’s dependence on a limited number of third party payors; the Company’s ability to maintain relationships with health care professionals and organizations; the adequacy of the Company’s allowance for doubtful accounts; the Company’s ability to comply with changing health care regulations; sequestration; natural disasters affecting the Company, its customers or its suppliers; industry competition; the Company’s ability to implement information technology improvements and to respond to technological changes; dependence upon the Company’s suppliers; and such other factors as discussed in Part I, Item 1A. Risk Factors of the Company’s annual report on Form 10-K for the year ended December 31, 2013, this quarterly report on Form 10-Q for the quarter ended June 30, 2013 and other public filings made by the Company from time to time with the SEC.

Recent_Accounting_Pronouncemen1

Recent Accounting Pronouncements and Developments (Policies)	6 Months Ended
	Jun. 30, 2014
Accounting Changes And Error Corrections [Abstract]	'
Recent Accounting Pronouncements and Developments	'
Recent Accounting Pronouncements and Developments	In May 2014, the Financial Accounting Standards Board issued a comprehensive new standard, which amends revenue recognition principles and provides a single set of criteria for revenue recognition among all industries. The new standard provides a five step framework whereby revenue is recognized when promised goods or services are transferred to a customer at an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. The standard also requires enhanced disclosure pertaining to revenue recognition in both the interim and annual periods. The standard is effective for interim and annual periods beginning after December 15, 2016 and allows for adoption using a full retrospective method, or a modified retrospective method. We are currently assessing the method of adoption and the expected impact the new standard has on our financial position and results of operations.

Medical_Equipment_and_Property1

Medical Equipment and Property (Tables)	6 Months Ended
Medical Equipment and Property (Tables)	Jun. 30, 2014
Text Block [Abstract]	'
Summary of Medical Equipment	'
	Medical equipment consisted of the following as of June 30, 2014 and December 31, 2013 (in thousands):


		June 30,			December 31,
		2014			2013
	Medical Equipment in rental service	$	39,460		$	37,252
	Medical Equipment in rental service - pump reserve		(119	)		(87	)
	Accumulated depreciation		(23,156	)		(22,727	)
	Medical Equipment held for sale or rental		2,255			3,664

	Total	$	18,440		$	18,102

Intangible_Assets_Tables

Intangible Assets (Tables)	6 Months Ended
Intangible Assets (Tables)	Jun. 30, 2014
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 June 30, 2014 and December 31, 2013, are as follows (in thousands):


		June 30, 2014
		Gross			Accumulated			Net
		Assets			Amortization			Net
	Nonamortizable intangible assets
	Trade names	$	2,000		$	—		$	2,000
	Amortizable intangible assets
	Physician and customer relationships		32,865			13,659			19,206
	Non-competition agreements		848			703			145
	Software		4,269			1,333			2,936

	Total nonamortizable and amortizable intangible assets	$	39,982		$	15,695		$	24,287


		31-Dec-13
		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

Schedule of Expected Annual Amortization Expense for Intangible Assets	'
	Expected annual amortization expense for intangible assets recorded as of June 30, 2014, is as follows (in thousands):


	7/1-	2015		2016	2017		2018	2019 and
	12/31/14	2015		2016	2017		2018	thereafter
	$1,243	$2,321		$2,235	$2,201		$2,191	$12,096

Debt_Tables

Debt (Tables)	6 Months Ended
Debt (Tables)	Jun. 30, 2014
Debt Disclosure [Abstract]	'
Summary of Revolver Based upon Company's Eligible Accounts Receivable and Inventory	'
	The availability under the Revolver is based upon the Company’s eligible accounts receivable and eligible inventory and is broken down as follows (in thousands):.


		June 30,			December 31,
		2014			2013
	Revolver:
	Gross Availability	$	6,500		$	5,900
	Outstanding Draws		(2,021	)		—
	Letter of Credit		(81	)		—

	Availability on Revolver	$	4,398		$	5,900

Summary of Future Maturities of Loans and Capital Leases	'
	The Company had approximate future maturities of loans and capital leases as of June 30, 2014 as follows (in thousands):


		Remainder			2015		2016		2017				Total
		of 2014			2015		2016		2017				Total
	Term Loans	$	1,200		$	2,400	$	17,688	$	—			$	21,288
	Revolver		—			—		2,021		—				2,021
	Capital Leases		712			1,474		1,056		149				3,391

	Total	$	1,912		$	3,874	$	20,765	$	149			$	26,700

Summary of Company's Current and Long-Term Debt (Including Capital Leases)	'
	The following is a breakdown of the Company’s current and long-term debt (including capital leases) as of June 30, 2014 and December 31, 2013 (in thousands):


	June 30, 2014								December 31, 2013
		Current			Long-Term		Total				Current				Long-Term		Total
		Portion of			Debt						Portion of				Debt
		Long-Term									Long-Term
		Debt									Debt
	Term Loans	$	2,400		$	18,888	$	21,288	Term Loans		$	4,064			$	19,931	$	23,995
	Revolver		—			2,021		2,021	Revolver			—				—		—
	Capital Leases		1,471			1,920		3,391	Capital Leases			1,054				1,678		2,732

	Total	$	3,871		$	22,829	$	26,700	Total		$	5,118			$	21,609	$	26,727

Earnings_Per_Share_Tables

Earnings Per Share (Tables)	6 Months Ended
Earnings Per Share (Tables)	Jun. 30, 2014
Earnings Per Share [Abstract]	'
Numerators and Denominators of Basic and Diluted Income (Loss) Per Share	'
	The following table reconciles the numerators and denominators of the basic and diluted income per share computations:


		Three Months Ended				Six Months Ended
		June 30				June 30
		2014		2013		2014		2013
	Numerator:
	Net income (in thousands)	$	886	$	105	$	1,469	$	156
	Denominator:
	Weighted average common shares outstanding:
	Basic		22,146,106		21,860,866		22,059,902		21,831,852
	Dilutive effect of non-vested awards		253,328		154,633		261,241		220,299

	Diluted		22,399,434		22,015,499		22,321,143		22,052,151
	Net income per share:
	Basic	$	0.04	$	—	$	0.07	$	0.01
	Diluted	$	0.04	$	—	$	0.07	$	0.01

Medical_Equipment_and_Property2

Medical Equipment and Property - Summary of Medical Equipment (Detail) (USD $)	Jun. 30, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified	Jun. 30, 2014	Dec. 31, 2013
Medical Equipment And Property [Abstract]	'	'
Medical Equipment in rental service	$39,460	$37,252
Medical Equipment in rental service - pump reserve	-119	-87
Accumulated depreciation	-23,156	-22,727
Medical equipment held for sale or rental	2,255	3,664
Total	$18,440	$18,102

Medical_Equipment_and_Property3

Medical Equipment and Property - Additional Information (Detail) (USD $)	1 Months Ended	3 Months Ended			6 Months Ended		12 Months Ended
In Millions, except Per Share data, unless otherwise specified	Jun. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013	Dec. 31, 2013
Property, Plant and Equipment [Line Items]	'	'	'	'	'	'	'
Depreciation expense for medical equipment	'	$0.80	'	$1.30	$1.50	$2.40	'
Estimated useful life of medical equipment	'	'	'7 years	'	'	'	'5 years
Change in estimated useful lives, decrease in depreciation	'	0.5	'	'	1	'	'
Change in estimated useful lives, decrease in net income after tax	'	0.3	'	'	0.6	'	'
Change in estimated useful lives, basic and diluted income per share	'	'	'	'	$0	'	'
Depreciation expense for property and equipment (other than medial equipment) recorded in general and administrative expenses	'	0.1	'	0.1	0.2	0.2	'
Payment for remaining equipment	0.5	'	'	'	'	'	'
Pre-Owned Equipment [Member]	'	'	'	'	'	'	'
Property, Plant and Equipment [Line Items]	'	'	'	'	'	'	'
Medical equipment held for sale or rental - financial institution	'	'	'	'	'	'	0.8

Intangible_Assets_Summary_of_C

Intangible Assets - Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets (Detail) (USD $)	Jun. 30, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified	Jun. 30, 2014	Dec. 31, 2013
Indefinite Lived And Finite Lived Intangible Assets [Line Items]	'	'
Total nonamortizable and amortizable intangible assets, Gross Assets	$39,982	$38,620
Total nonamortizable and amortizable intangible assets, Accumulated Amortization	15,695	14,438
Total nonamortizable and amortizable intangible assets, Net	24,287	24,182
Physician and Customer Relationships [Member]	'	'
Indefinite Lived And Finite Lived Intangible Assets [Line Items]	'	'
Amortizable intangible assets, Gross Assets	32,865	32,865
Amortizable intangible assets, Accumulated Amortization	13,659	12,564
Amortizable intangible assets, Net	19,206	20,301
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	703	621
Amortizable intangible assets, Net	145	227
Software [Member]	'	'
Indefinite Lived And Finite Lived Intangible Assets [Line Items]	'	'
Amortizable intangible assets, Gross Assets	4,269	2,907
Amortizable intangible assets, Accumulated Amortization	1,333	1,253
Amortizable intangible assets, Net	2,936	1,654
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 $)	3 Months Ended		6 Months Ended
In Thousands, unless otherwise specified	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013
Goodwill And Intangible Assets Disclosure [Abstract]	'	'	'	'
Amortization of intangible assets	$625	$652	$1,254	$1,324

Intangible_Assets_Schedule_of_

Intangible Assets - Schedule of Expected Annual Amortization Expense for Intangible Assets (Detail) (USD $)	Jun. 30, 2014
In Thousands, unless otherwise specified	Jun. 30, 2014
Goodwill And Intangible Assets Disclosure [Abstract]	'
Amortization expense for remaining fiscal year, 2014	$1,243
Amortization expense, 2015	2,321
Amortization expense, 2016	2,235
Amortization expense, 2017	2,201
Amortization expense, 2018	2,191
Amortization expense, 2019 and thereafter	$12,096

Debt_Additional_Information_De

Debt - Additional Information (Detail) (USD $)

0 Months Ended

6 Months Ended

0 Months Ended

6 Months Ended

Jun. 30, 2014

19-May-14

Apr. 11, 2014

Jun. 30, 2014

Nov. 30, 2012

Jun. 30, 2014

Dec. 31, 2013

Nov. 30, 2012

Jun. 30, 2014

Dec. 31, 2012

Jun. 30, 2014

LIBOR [Member]

Prime Rate [Member]

Term Loan A [Member]

Term Loan B [Member]

Revolving Credit Facility [Member]

Credit Facility [Member]

Minimum [Member]

Maximum [Member]

Line of Credit Facility [Line Items]

Line of credit facility

$12,000,000

$14,500,000

$10,000,000

Credit facility, maturity date

30-Nov-16

Interest on the credit facility, 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%).

Effective floating interest rate

7.75%

7.25%

6.25%

Debt instrument floor rate

2.00%

3.00%

Decrease in effective floating and fixed interest rate

-1.50%

Minimum fixed charge coverage ratio

1.25

Fixed charge coverage ratio for the remainder period

1.5

1.25

Maximum leverage ratio

2.5

Leverage ratio for remainder period

1.75

2.5

Credit Facility subject to limitation on Capital Expenditures

6,500,000

5,900,000

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

Repayment of credit facility

$1,600,000

Debt_Summary_of_Revolver_Based

Debt - Summary of Revolver Based upon Company's Eligible Accounts Receivable and Inventory (Detail) (Revolving Credit Facility [Member], USD $)	Jun. 30, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified	Jun. 30, 2014	Dec. 31, 2013
Revolving Credit Facility [Member]	'	'
Line of Credit Facility [Line Items]	'	'
Gross Availability	$6,500	$5,900
Outstanding Draws	-2,021	'
Letter of Credit	-81	'
Availability on Revolver	$4,398	$5,900

Debt_Summary_of_Future_Maturit

Debt - Summary of Future Maturities of Loans and Capital Leases (Detail) (USD $)	Jun. 30, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified	Jun. 30, 2014	Dec. 31, 2013
Line of Credit Facility [Line Items]	'	'
Remainder of 2014	$1,912	'
2015	3,874	'
2016	20,765	'
2017	149	'
Total	26,700	26,727
Term Loans [Member]	'	'
Line of Credit Facility [Line Items]	'	'
Remainder of 2014	1,200	'
2015	2,400	'
2016	17,688	'
2017	0	'
Total	21,288	23,995
Revolving Credit Facility [Member]	'	'
Line of Credit Facility [Line Items]	'	'
Remainder of 2014	0	'
2015	0	'
2016	2,021	'
2017	0	'
Total	2,021	0
Capital Lease Obligations [Member]	'	'
Line of Credit Facility [Line Items]	'	'
Remainder of 2014	712	'
2015	1,474	'
2016	1,056	'
2017	149	'
Total	$3,391	$2,732

Debt_Summary_of_Companys_Curre

Debt - Summary of Company's Current and Long-Term Debt (Including Capital Leases) (Detail) (USD $)	Jun. 30, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified	Jun. 30, 2014	Dec. 31, 2013
Line of Credit Facility [Line Items]	'	'
Current portion of long-term debt	$3,871	$5,118
Long-Term Debt	22,829	21,609
Total	26,700	26,727
Term Loans [Member]	'	'
Line of Credit Facility [Line Items]	'	'
Current portion of long-term debt	2,400	4,064
Long-Term Debt	18,888	19,931
Total	21,288	23,995
Revolving Credit Facility [Member]	'	'
Line of Credit Facility [Line Items]	'	'
Current portion of long-term debt	0	0
Long-Term Debt	2,021	0
Total	2,021	0
Capital Lease Obligations [Member]	'	'
Line of Credit Facility [Line Items]	'	'
Current portion of long-term debt	1,471	1,054
Long-Term Debt	1,920	1,678
Total	$3,391	$2,732

Income_Taxes_Additional_Inform

Income Taxes - Additional Information (Detail) (USD $)	3 Months Ended		6 Months Ended
In Thousands, unless otherwise specified	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013
Income Tax Disclosure [Abstract]	'	'	'	'
Income tax expense (benefit)	($716)	$144	($1,065)	$105
Effective income tax rate	41.30%	38.20%	42.10%	'

Earnings_Per_Share_Numerators_

Earnings Per Share - Numerators and Denominators of Basic and Diluted Income (Loss) Per Share (Detail) (USD $)	3 Months Ended		6 Months Ended
In Thousands, except Share data, unless otherwise specified	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013
Numerator:	'	'	'	'
Net income	$886	$105	$1,469	$156
Weighted average common shares outstanding:	'	'	'	'
Basic	22,146,106	21,860,866	22,059,902	21,831,852
Dilutive effect of non-vested awards	253,328	154,633	261,241	220,299
Diluted	22,399,434	22,015,499	22,321,143	22,052,151
Net income per share:	'	'	'	'
Basic	$0.04	$0	$0.07	$0.01
Diluted	$0.04	$0	$0.07	$0.01

Earnings_Per_Share_Additional_

Earnings Per Share - Additional Information (Detail) (Vested Stock Options [Member])	3 Months Ended	6 Months Ended
In Millions, unless otherwise specified	Jun. 30, 2014	Jun. 30, 2014
Vested Stock Options [Member]	'	'
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]	'	'
Shares with anti-dilutive effect	0.1	0.1

Subsequent_Event_Additional_In

Subsequent Event - Additional Information (Detail) (USD $)	Jun. 30, 2014	Dec. 31, 2013	Jul. 02, 2014	Jul. 02, 2014
Subsequent Event - Additional Information (Detail) (USD $)	Jun. 30, 2014	Dec. 31, 2013	Subsequent Event [Member]	Subsequent Event [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'	'	'
Common stock, shares authorized	'	'	'	100,000
Common stock, par value	$0.00	$0.00	'	$0.00
Option Vesting period	'	'	'3 years	'
Expiration of option vesting period	'	'	'5 years	'
Exercise price of common stock	'	'	$2.67	'