InfuSystem (INFU) 10-K 22 Mar 17 2016 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2016	Mar. 08, 2017	Jun. 30, 2016
Document And Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2016
Document Fiscal Year Focus	2,016
Document Fiscal Period Focus	FY
Trading Symbol	INFU
Entity Registrant Name	InfuSystem Holdings, Inc
Entity Central Index Key	1,337,013
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		22,688,164
Entity Public Float			$ 50,821,129

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Current Assets:
Cash and cash equivalents	$ 3,398	$ 818
Accounts receivable, less allowance for doubtful accounts of $4,989 and $4,737 at December 31, 2016 and 2015, respectively	11,581	12,622
Inventories	2,166	1,916
Other current assets	949	861
Deferred income taxes	2,675	2,743
Total Current Assets	20,769	18,960
Medical equipment held for sale or rental	1,642	2,277
Medical equipment in rental service, net of accumulated depreciation	28,036	27,837
Property & equipment, net of accumulated depreciation	1,997	2,370
Intangible assets, net	31,239	31,534
Deferred income taxes	12,436	12,128
Other assets	225	251
Total Assets	96,344	95,357
Current Liabilities:
Accounts payable	5,315	6,586
Capital leases	2,938	3,187
Current portion of long-term debt	5,314	1,842
Other current liabilities	2,872	3,641
Total Current Liabilities	16,439	15,256
Long-term debt, net of current portion	26,577	26,548
Capital leases	2,573	3,233
Other long-term liabilities	66
Total Long-Term Liabilities	29,216	29,781
Total Liabilities	45,655	45,037
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 22,867,335 and 22,669,675, as of December 31, 2016 and issued and outstanding 22,739,550 and 22,541,890, as of December 31, 2015, respectively.	2	2
Additional paid-in capital	91,829	91,238
Retained deficit	(41,142)	(40,920)
Total Stockholders' Equity	50,689	50,320
Total Liabilities and Stockholders' Equity	$ 96,344	$ 95,357

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Statement of Financial Position [Abstract]
Accounts receivable, allowance for doubtful accounts	$ 4,989	$ 4,737
Preferred stock, par value	$ 0.0001	$ 0.0001
Preferred stock, shares authorized	1,000,000	1,000,000
Preferred stock, shares issued	0	0
Common stock, par value	$ 0.0001	$ 0.0001
Common stock, shares authorized	200,000,000	200,000,000
Common stock, shares issued	22,867,335	22,739,550
Common stock, shares outstanding	22,669,675	22,541,890

Consolidated Statements of Oper

Consolidated Statements of Operations - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Net revenues:
Rentals	$ 62,210	$ 62,952
Product sales	8,287	7,589
Net revenues	70,497	70,541
Cost of revenues:
Cost of revenues - Product, service and supply costs	16,206	13,802
Cost of revenues - Pump depreciation and loss on disposal	9,551	7,139
Gross profit	44,740	49,600
Selling, general and administrative expenses:
Provision for doubtful accounts	5,631	5,234
Amortization of intangible assets	3,849	2,884
Selling and marketing	9,657	10,424
General and administrative	24,629	23,778
Total selling, general and administrative	43,766	42,320
Operating income	974	7,280
Other income (expense):
Interest expense	(1,344)	(1,705)
Loss on extinguishment of long-term debt		(1,599)
Other income	6	13
Total other expense	(1,338)	(3,291)
Income before income taxes	(364)	3,989
Income tax benefit (expense)	142	(1,204)
Net (loss) income	$ (222)	$ 2,785
Net (loss) income per share:
Basic	$ (0.01)	$ 0.13
Diluted	$ (0.01)	$ 0.12
Weighted average shares outstanding:
Basic	22,617,901	22,414,587
Diluted	22,617,901	22,843,235

Consolidated Statements of Stoc

Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid in Capital [Member]	Retained Deficit [Member]	Treasury Stock [Member]
Beginning Balance at Dec. 31, 2014	$ 46,452	$ 2	$ 90,155	$ (43,705)
Beginning Balance, Share at Dec. 31, 2014		22,506,000			(198,000)
Stock based shares issued upon vesting - gross, Share		155,000
Stock-based compensation expense	996		996
Employee stock purchase plan	$ 268		268
Employee stock purchase plan, Share	98,070	98,000
Cash proceeds - other stock plans	$ 38		38
Cash proceeds - other stock plans, Share		25,000
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation	(219)		(219)
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation, Share		(44,000)
Net (loss) income	2,785			2,785
Ending Balance at Dec. 31, 2015	50,320	$ 2	91,238	(40,920)
Ending Balance, Share at Dec. 31, 2015		22,740,000			(198,000)
Stock based shares issued upon vesting - gross	0	$ 0	0	0	$ 0
Stock based shares issued upon vesting - gross, Share		56,000
Stock-based compensation expense	462		462
Employee stock purchase plan	$ 204		204
Employee stock purchase plan, Share	88,109	88,000
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation	$ (75)		(75)
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation, Share		(17,000)
Net (loss) income	(222)			(222)
Ending Balance at Dec. 31, 2016	$ 50,689	$ 2	$ 91,829	$ (41,142)
Ending Balance, Share at Dec. 31, 2016		22,867,000			(198,000)

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2016	Dec. 31, 2015
OPERATING ACTIVITIES
Net (loss) income		$ (222)	$ 2,785
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Loss on extinguishment of long-term debt			1,599
Provision for doubtful accounts		5,631	5,234
Depreciation		6,895	5,359
Loss/(gain) on disposal of medical equipment		641	591
Gain on sale of medical equipment		(1,231)	(2,441)
Amortization of intangible assets		3,849	2,884
Amortization of deferred debt issuance costs		31	127
Stock-based compensation expense		462	996
Deferred income tax expense		(240)	1,137
Changes in Assets - (Increase)/Decrease:
Accounts receivable		(4,589)	(7,556)
Inventories		(250)	(158)
Other current assets		(88)	(228)
Other assets		166	(497)
Changes in Liabilities - Increase/(Decrease):
Accounts payable and other liabilities		(3,146)	(2,778)
NET CASH PROVIDED BY OPERATING ACTIVITIES		7,909	7,054
INVESTING ACTIVITIES
Acquisitions		(370)	(6,156)
Purchases of medical equipment		(5,101)	(4,198)
Purchases of property		(168)	(314)
Purchases of intangible assets		(3,526)	(5,733)
Proceeds from sale of medical equipment		3,821	4,494
NET CASH USED IN INVESTING ACTIVITIES		(5,344)	(11,907)
FINANCING ACTIVITIES
Principal payments on term loans and capital lease obligations		(66,999)	(65,202)
Cash proceeds from bank loans and revolving credit facility		66,892	70,429
Debt Issuance Costs		(7)	(157)
Cash Proceeds - Stock Plans		204	265
Common stock repurchased to satisfy taxes on stock based compensation		(75)	(179)
NET CASH PROVIDED BY FINANCING ACTIVITIES		15	5,156
Net change in cash and cash equivalents		2,580	303
Cash and cash equivalents, beginning of year		818	515
Cash and cash equivalents, end of year		3,398	818
SUPPLEMENTAL DISCLOSURES
Cash paid for interest		1,234	1,508
Cash paid for income taxes		105	146
NON-CASH TRANSACTIONS
Additions to medical equipment and property (a)	[1]	429	1,415
Medical equipment acquired pursuant to a capital lease		$ 2,675	$ 4,233
[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, 2016 and 2015, 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 Natur

Basis of Presentation and Nature of Operations	12 Months Ended
	Dec. 31, 2016
Accounting Policies [Abstract]
Basis of Presentation and Nature of Operations	1. Basis of Presentation and Nature of Operations InfuSystem Holdings, Inc. and its consolidated subsidiaries (the “Company”) are a leading provider of infusion pumps and related products and services for patients in the home, oncology clinics, ambulatory surgery centers, and other sites of care from five locations in the United States and Canada. The Company provides products and services to hospitals, oncology practices and facilities and other alternate site health care providers. Headquartered in Madison Heights, Michigan, the Company delivers local, field-based customer support, and also operate pump service and repair Centers of Excellence in Michigan, Kansas, California, Texas, Georgia and Ontario, Canada. InfuSystem Inc. (“ISI”), which is an operating subsidiary of the Company, is accredited by the Community Health Accreditation Program (“CHAP”) while First Biomedical, Inc. (“First Biomedical”), which is an operating subsidiary of the Company, is ISO certified. The Company’s core service is to supply electronic ambulatory infusion pumps and associated disposable supply kits to oncology clinics, infusion clinics and hospital outpatient chemotherapy clinics to be utilized in the treatment of a variety of cancers including colorectal cancer, pain management and other disease states. The majority of the Company’s pumps are electronic infusion pumps purchased from the following manufacturers, each of which supplies more than 10% of the ambulatory pumps purchased by the Company: Smiths Medical, Inc. and WalkMed Infusion, LLC. The Company has supply agreements in place with one of these suppliers. Certain “spot” purchases are made on the open market subject to individual negotiation. 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”) and the rules and regulations of the U.S. Securities and Exchange Commission (“SEC”).

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2016
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Reclassifications Certain prior period reclassifications were made to conform with the current period presentation. These reclassifications had no effect on reported (loss) income, cash flows, total assets, or stockholders’ equity as previously reported. Presentation in the Consolidated Statements The Company 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 reportable 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 selling, 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 its 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 valuations and income tax 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. Business Combinations The Company accounts for all business combinations using the acquisition method of accounting, which allocates the fair value of the purchase consideration to the tangible and intangible assets acquired and liabilities assumed based on their estimated fair values. The excess of the purchase consideration over the fair values of these identifiable assets and liabilities is recorded as goodwill. When determining the fair values of assets acquired and liabilities assumed, management makes significant estimates and assumptions. The Company may utilize third-party valuation specialists to assist the Company in the allocation. Initial purchase price allocations are subject to revision within the measurement period, not to exceed one year from the date of acquisition. Acquisition-related expenses and transaction costs associated with business combinations are expensed as incurred. 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, Allowance for Doubtful Accounts and Contractual Allowances 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 value. 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. The Company records an allowance for doubtful accounts and contractual allowance (to reduce gross billed charges to a contractual or estimated net realizable value from third-party payors) based on management’s assessment of historical and expected 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 for doubtful accounts for patients or the contractual allowance for third-party payors. The Company’s allowance for doubtful accounts and contractual allowance are a reduction to accounts receivable on the Company’s consolidated financial position. Additions to the contractual allowance each period offset gross billed charges, which are not publicly reported in the Company’s filings, to arrive at net revenue, which is publicly reported in the Company’s consolidated results of operations. Additions to the allowance for doubtful accounts, however, impact the bad debt expense line item of the Company’s consolidated results of operations. 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 the Company’s consolidated business, 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 Allowance for doubtful accounts — 2016 $ 4,737 $ 5,631 $ (5,379 ) $ 4,989 Allowance for doubtful accounts — 2015 $ 4,739 $ 5,234 $ (5,236 ) $ 4,737 (1) Deductions represent the write-off of uncollectible account receivable balances. Inventories The Company’s inventories consist of disposable products and related parts and supplies used in conjunction with medical equipment and are stated at the lower of cost (first-in, first-out basis) 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 and $0.1 million, respectively, as of December 31, 2016 and 2015. 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 seven years. The Company does not depreciate ME held for sale or rent. When ME in Rental Service 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 $0.6 million and $0.2 million, respectively, as of December 31, 2016 and 2015. 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. Externally purchased 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, 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 physician and customer relationships and non-compete agreements arose primarily from the acquisitions of ISI and First Biomedical in 2010 and the acquisition of assets from Ciscura Holding Company, Inc. and its subsidiaries (“Ciscura”) in 2015. The Company amortizes the value assigned to the physician and customer relationships on a straight-line basis over the period of expected benefit, which ranges from fifteen to twenty 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. The useful lives of these relationships are 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 with the amortization periods ranging from two to five years and acquired software is amortized on a straight-line basis over three years. Trade names associated with the original acquisition of InfuSystem are not amortized while trade names from the Ciscura asset acquisition in 2015 are amortized over one year. Management tests trade names for impairment annually or as often as deemed necessary. The impairment test for intangible assets with indefinite lives consists of a comparison of the fair value of the intangible assets with their carrying amounts. If the carrying value of the intangible assets exceeds the fair value, an impairment loss is recognized in an amount equal to that excess. The Company determines the fair value of the reporting unit for goodwill impairment testing based on a discounted cash flow model. The Company determines the fair value of its intangibles assets with indefinite lives (trade names) through the royalty relief income valuation approach. The Company performed its annual impairment analysis as of October 2016 and determined that the fair value of the intangible assets with indefinite lives (trade names) was greater than their carrying value, resulting in no impairment. Software Capitalization and Depreciation We capitalize certain costs incurred in connection with obtaining or developing internal-use software, including payroll and payroll-related costs for employees who are directly associated with the internal-use software project, external direct costs of materials and services and interest costs while developing the software. Capitalized software costs are included in intangible assets, net and are amortized using the straight-line method over the estimated useful life of three to five years. Capitalization of such costs ceases when the project is substantially complete and ready for its intended purpose. Costs incurred during the preliminary project and post-implementation stages, as well as software maintenance and training costs, are expensed in the period in which they are incurred. The company capitalized $3.5 million and $5.7 million of internal-use software for the years ended December 31, 2016 and 2015, respectively. Amortization expense for capitalized software was $1.7 million in 2016 and $0.4 million in 2015. 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. The Company did not record any impairment related expenses for the years ended December 31, 2016 and 2015, respectively. Operating and Capital Leases Leases for all of our corporate and other operating locations are under operating leases and the Company recognizes rent expense on a straight-line basis over the lease terms. Rent holidays and rent escalation clauses, which provide for scheduled rent increases during the lease term, are taken into account in computing straight-line rent expense included in our consolidated statements of operations. The difference between the rent due under the stated periods of the leases compared to that of the straight-line basis is recorded as a component of other long-term liabilities in the consolidated balance sheets. Landlord funded lease incentives, including tenant improvement allowances provided for our benefit, are recorded as leasehold improvement assets and as deferred rent in the consolidated balance sheets and are amortized to depreciation expense and as rent expense credits, respectively. The Company periodically 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. Under the terms of all such capital leases, the Company does not hold title to these pumps and will not obtain title until such time as the capital lease obligations are settled in full. The weighted average interest rate under capital leases was 5.1% as of December 31, 2016. 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, and billing the oncology practice, or the third-party payor (“TPP”) or alternative site setting 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 (i) receives a physician’s written order and assignment of benefits, signed by the physician and patient, respectively, (ii) has verified actual pump usage via a patient treatment log (“PTL”) and insurance coverage and (iii) receives patient acknowledgement of assignment of benefits. 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 while billings made directly to an oncology practice and alternative site setting are recorded at a pre-determined amount with any uncollectible amount is recorded as bad debt expense in general and administrative expenses. 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 the Company’s results of operations and cash flows. For 2016 and 2015, the Company’s largest contracted payor was Medicare, which accounted for approximately 21% and 32% of our net revenue from our Oncology Business for the years ended December 31, 2016 and 2015, respectively. Medicare represented 5% and 23% of the Company’s consolidated accounts receivable, net for the years ended December 31, 2016 and 2015, respectively. For 2016 and 2015, the Company’s second largest contracted payor was a national association comprised of multiple members, which, in the aggregate, accounted for approximately 19% and 18% of our net revenue from our Oncology Business for the years ended December 31, 2016 and 2015, respectively. This same contracted payor represented 26% and 31% of the Company’s consolidated accounts receivable, net for the years ended December 31, 2016 and 2015, respectively. The Company also contracted 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, accounted for greater than approximately 10% of the Company’s Oncology Business net revenue for 2016 or 2015. 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 if 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 uncertain 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 The determination of the fair value of stock option awards on the date of grant using option-pricing models is affected by the Company’s stock price, as well as assumptions regarding a number of other inputs using the Black-Scholes pricing model. These variables include the Company’s expected stock price volatility over the expected term of the awards, actual and projected employee stock option exercise behaviors, risk-free interest rates and expected dividends. The expected volatility is based on the historical volatility. The Company uses historical data to estimate stock option exercise and forfeiture rates. The expected term represents the period over which the share-based awards are expected to be outstanding. The dividend yield is an estimate of the expected dividend yield on the Company’s stock. The risk-free rate is based on U.S. Treasury yields in effect at the time of the grant for the expected term of the stock options. All stock option awards are amortized based on their graded vesting over the requisite service period of the awards. Compensation costs are recognized over the requisite service period using the accelerated method and included in selling expenses and general and administrative expenses, based upon the department to which the associated employee or non-employee resides. Deferred Debt Issuance Costs Capitalized debt issuance costs as of December 31, 2016 and 2015 relate to the Chase Credit Facility. The Company classified the costs related to the agreement as non-current liabilities and amortizes them using the interest method through the maturity date of the underlying debt. Earnings Per Share The Company reports its earnings per share in accordance with the “Earnings Per Share” topic of the Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”), which requires the presentation of both basic and diluted earnings per share on the statements of operations. The diluted weighted average common shares include adjustments for the potential effects of outstanding stock options but only in the periods in which such effect is dilutive under the treasury stock method. Included in our basic and diluted weighted average common shares are those stock options and common stock shares due to participants granted from the 2014 stock incentive plan. Antidilutive stock awards are comprised of stock options and unvested share awards, which would have been antidilutive in the application of the treasury stock method in accordance with “Earnings Per Share” topic of FASB ASC. In accordance with this topic, the following table reconciles income and share amounts utilized to calculate basic and diluted net (loss) income per common share (in thousands, except shares): 2016 2015 Numerator: Net (loss) income (in thousands) $ (222 ) $ 2,785 Denominator: Weighted average common shares outstanding: Basic 22,617,901 22,414,587 Dilutive effect of restricted shares, options and non-vested share awards — 428,648 Diluted 22,617,901 22,843,235 Antidilutive awards: 90,715 43,215 Stock options of 0.1 million were not included in the calculation for both of the years ended December 31, 2016 and 2015, because they would have an anti-dilutive effect. Fair Value of Financial Instruments The carrying amounts reported in the consolidated balance sheets as of December 31, 2016 and 2015 for cash, accounts receivable, accounts payable and accrued expenses approximate fair value because of the short-term nature of these instruments (Level I). The carrying value of the Company’s long-term debt with variable interest rates approximates fair value based on instruments with similar terms (Level II). The Company has adopted ASC 820, Fair Value Measurements, which defines fair value, establishes a framework for assets and liabilities being measured and reported at fair value and appends disclosures about fair value measurements. For financial assets and liabilities measured at fair value on a recurring basis, fair value is the price the Company would receive to sell an asset or pay to transfer a liability in an orderly transaction with a market participant at the measurement date. A three-level fair value hierarchy prioritizes the inputs used to measure fair value as follows: Level I quoted prices in active markets for identical instruments; Level II quoted prices in active markets for similar instruments, quoted prices for identical instruments in markets that are not active, or other inputs that are observable or can be corroborated by observable data for substantially the full term of the instrument; and Level III significant inputs to the valuation model are unobservable. Recent Accounting Pronouncements and Developments In August 2016, the FASB issued Accounting Standards Update (“ASU”) No. 2016-15 Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments. The amendments in this ASU introduce clarifications to the presentation of certain cash receipts and cash payments in the statement of cash flows. The primary updates include additions and clarifications of the classification of cash flows related to certain debt repayment activities, contingent consideration payments related to business combinations, proceeds from insurance policies, distributions from equity method investees and cash flows related to securitized receivables. This update is effective for annual periods beginning after December 15, 2017, including interim periods within those fiscal years. Early adoption of this ASU is permitted, including in interim periods. The ASU requires retrospective application to all prior periods presented upon adoption. The Company is currently evaluating the impact, if any, that the adoption of this guidance will have on its cash flows and/or disclosures, however, the Company does not anticipate that the adoption of this new standard will have a material impact on the Company’s financial position, results of operations or statements of cash flow upon adoption. In June 2016, the FASB issued ASU No. 2016-13, “Financial Instruments (Topic 326) Credit Losses.” ASU 2016-13 changes the impairment model for most financial assets and certain other instruments. Under the new standard, entities holding financial assets and net investment in leases that are not accounted for at fair value through net income are to be presented at the net amount expected to be collected. An allowance for credit losses will be a valuation account that will be deducted from the amortized cost basis of the financial asset to present the net carrying value at the amount expected to be collected on the financial asset. ASU 2016-13 is effective as of January 1, 2020. Early adoption is permitted. The Company is currently evaluating the impact of ASU 2016-13. The adoption of this standard is not expected to have a material impact on the Company’s consolidated financial statements or footnote disclosures. In March 2016, the FASB issued ASU No. 2016-09, Compensation — Stock Compensation (Topic 718) (“ASU 2016-09”). The guidance changes how companies account for certain aspects of equity-based payments to employees. Entities will be required to recognize income tax effects of awards in the income statement when the awards vest or are settled. The guidance also allows an employer to repurchase more of an employee’s shares than it can under current guidance for tax withholding purposes providing for withholding at the employee’s maximum rate as opposed to the minimum rate without triggering liability accounting and to make a policy election to account for forfeitures as they occur. The updated guidance is effective for annual periods beginning after December 15, 2016. Early adoption is permitted. Under today’s guidance, the Company does not recognize the income tax effects of awards that have vested or are settled until they actually reduce taxes payable. This standard will require the Company to recognize these effects when they are vested or are settled. The adoption of this standard is not expected to have a material impact on the Company’s financial position, results of operations or statements of cash flows upon adoption. In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) (“ASU 2016-02”). Under ASU 2016-02, an entity will be required to recognize right-of-use assets and lease liabilities on its balance sheet and disclose key information about leasing arrangements. ASU 2016-02 offers specific accounting guidance for a lessee, a lessor and sale and leaseback transactions. Lessees and lessors are required to disclose qualitative and quantitative information about leasing arrangements to enable a user of the financial statements to assess the amount, timing and uncertainty of cash flows arising from leases. For public companies, ASU 2016-02 is effective for annual reporting periods beginning after December 15, 2018, including interim periods within that reporting period, and requires a modified retrospective adoption, with early adoption permitted. The Company is currently evaluating the impact that the adoption of this guidance will have on its financial position, results of operations, cash flows and/or disclosures. However, the Company expects that the adoption of the provisions of ASU 2016-02 will have a material impact on its consolidated balance sheet, as currently most of its real estate is leased via operating leases. In April 2015, the FASB issued ASU No. 2015-03, Interest — Imputation of Interest (Subtopic 835-30): Simplifying the Presentation of Debt Issuance Costs (“ASU 2015-03”), and, in August 2015, the FASB issued ASU No. 2015-15, Interest — Imputation of Interest (Subtopic 835-30): Presentation and Subsequent Measurement of Debt Issuance Costs Associated with Line-of-Credit Arrangements — Amendments to SEC Paragraphs Pursuant to Staff Announcement at June 18, 2015 EITF Meeting (“ASU 2015-15”). ASU 2015-03 requires that debt issuance costs related to a recognized debt liability be presented in the balance sheet as a direct deduction from the carrying amount of that debt liability, consistent with debt discounts. ASU 2015-15 then clarified that debt issuance costs related to a line-of-credit arrangement can be presented as an asset on the balance sheet, regardless of whether there are any outstanding borrowings on the line-of-credit arrangement. These ASUs are effective for fiscal years beginning after December 15, 2015, and for interim periods within those fiscal years. The Company adopted this guidance as of January 1, 2016, and as a result, has recast the December 31, 2015 consolidated balance sheet to conform to the current period presentation. The adoption of this standard reduced previously presented other assets and long-term debt by $0.1 million, based upon the balance of unamortized debt issuance costs relating to its credit facility as of December 31, 2015. On May 28, 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers (“ASU 2014-09”),

Business Combinations

Business Combinations	12 Months Ended
	Dec. 31, 2016
Business Combinations [Abstract]
Business Combinations	3. Business Combinations Acquisitions Accounted for Using the Purchase Method On April 20, 2015 (the “Closing Date”), the Company acquired substantially all of the assets of Ciscura for $6.2 million in cash, based on the final number of pumps acquired and the associated treatments, which were generated during the 90-day period post-closing from the approximately 100 medical facility relationships Ciscura had prior to the acquisition. The Company acquired approximately 1,800 infusion pumps, its four-person field sales team, as well as its facilities management personnel, which have become the foundation of the Company’s new Southeast facility. Ciscura, based in Alpharetta, GA, was a privately-held Southeastern regional provider of ambulatory infusion pumps and services to medical facilities and will provide the Company with a new regional warehouse and service facility that will be in close proximity to a number of our largest existing customers, in addition to new customers previously serviced by Ciscura, enabling same day service for equipment and supplies to much of the Southeast region. The Company used available borrowings under our credit facility to finance the acquisition and associated expenses. As of December 31 2015, $6.2 million of the purchase price was paid in cash and approximately $0.7 million for integration, professional and other related expenses were expensed as incurred and are included in General and Administrative expenses in the Company’s consolidated statements of operations. The Company did not disclose the revenue and income of Ciscura for the period from the acquisition date through December 31, 2015 as it was not practical due to the fact that the operations were substantially integrated. See Note 7 – Debt of the Notes to the Consolidated Financial Statements included in this Form 10-K for additional information pertaining to this funding. Final Purchase Price Allocation Pursuant to ASC 805, “Business Combinations,” Amount Medical equipment in rental service $ 2,289 Trade names and Trademarks 23 Customer relationships 3,393 Furniture and fixtures 20 Leasehold improvements 185 Non-competition agreements 246 Total — final purchase price $ 6,156 Acquired property and equipment are being depreciated on a straight-line basis with estimated remaining lives ranging from 1 year to 7 years.

Medical Equipment

Medical Equipment	12 Months Ended
	Dec. 31, 2016
Text Block [Abstract]
Medical Equipment	4. Medical Equipment Medical equipment consisted of the following as of December 31 (in thousands): 2016 2015 Medical Equipment held for sale or rental $ 1,642 $ 2,277 Medical Equipment in rental service 59,034 53,681 Medical Equipment in rental service — pump reserve (551 ) (232 ) Accumulated depreciation (30,447 ) (25,612 ) Medical Equipment in rental service — net 28,036 27,837 Total $ 29,678 $ 30,114 Depreciation expense for the years ended December 31, 2016 and 2015 was $6.3 million and $4.8 million, respectively, which were recorded in cost of revenues — pump depreciation and loss on disposal.

Property and Equipment

Property and Equipment	12 Months Ended
	Dec. 31, 2016
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): 2016 Gross Accumulated Total Furniture, fixtures, and equipment $ 3,809 $ (3,071 ) $ 738 Automobiles 129 (83 ) 46 Leasehold improvements 2,177 (964 ) 1,213 Total $ 6,115 $ (4,118 ) $ 1,997 2015 Gross Accumulated Total Furniture, fixtures, and equipment $ 2,330 $ (1,382 ) $ 948 Automobiles 84 (76 ) 8 Leasehold improvements 2,240 (826 ) 1,414 Total $ 4,654 $ (2,284 ) $ 2,370 Depreciation expense for each of the years ended December 31, 2016 and 2015 was $0.6 million and was recorded in general and administrative expenses.

Intangible Assets

Intangible Assets	12 Months Ended
	Dec. 31, 2016
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): 2016 Gross Assets Accumulated Net Nonamortizable intangible assets Trade names $ 2,000 $ — $ 2,000 Amortizable intangible assets Trade names 23 23 — Physician and customer relationships 36,534 19,427 17,107 Non-compete agreements 1,136 1,064 72 Software 13,745 1,685 12,060 Total nonamortizable and amortizable intangible assets $ 53,438 $ 22,199 $ 31,239 2015 Gross Assets Accumulated Net Nonamortizable intangible assets Trade names $ 2,000 $ — $ 2,000 Amortizable intangible assets Trade names 23 15 8 Physician and customer relationships 36,258 17,049 19,209 Non-compete agreements 1,094 930 164 Software 11,942 1,789 10,153 Total nonamortizable and amortizable intangible assets $ 51,317 $ 19,783 $ 31,534 The weighted average remaining lives of physician and customer relationships, non-compete agreements and software are 8-years, 1-year and 3-years, respectively, as of December 31, 2016. Amortization expense for intangible assets for the years ended December 31, 2016 and 2015 was $3.8 million and $2.8 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, 2016 are as follows (in thousands): 2017 2018 2019 2020 2021 2022 and Amortization expense $ 5,649 $ 5,274 $ 4,841 $ 4,298 $ 3,943 $ 5,234

Debt

Debt	12 Months Ended
	Dec. 31, 2016
Debt Disclosure [Abstract]
Debt	7. Debt On January 23, 2015, the Company entered into the third amendment (“Third Amendment”) to the credit agreement with Wells Fargo Bank, National Association (“Wells Fargo”), as Administrative Agent, and Wells Fargo and funds managed by PennantPark Investment Advisers, LLC (“PennantPark”) as Lenders (the “WF Credit Agreement”). The WF Credit Agreement consisted of a $12.0 million Term Loan A (provided by Wells Fargo), a $14.5 million Term Loan B (provided by PennantPark) and a $10.0 million revolving credit facility, all of which were scheduled to mature on November 30, 2016 (collectively the “WF Credit Facility”). This Third Amendment increased the maximum Leverage Covenant ratio for the period ending December 31, 2014 and all subsequent periods to 2.00:1.00. Prior to this amendment, the maximum Leverage Covenant ratio for the periods ending (a) December 31, 2014 through March 31, 2015 was 1.50:1.00, (b) June 30, 2015 through September 30, 2015 was 1.25:1.00, (c) December 31, 2015 through September 30, 2016 was 1.00:1.00. On March 23, 2015, the Company and its direct and indirect subsidiaries entered into a credit agreement (the “Chase Credit Agreement”) with JPMorgan Chase Bank, N.A., as lender (the “Lender”). The borrowers under the Chase Credit Agreement are the Company, InfuSystem Holdings USA, Inc. (“Holdings”), ISI, First Biomedical and IFC LLC (collectively, the “Borrowers”). The Chase Credit Agreement consists of a $27.0 million Term Loan A, up to $8.0 million Term Loan B and a $10.0 million revolving credit facility (the “Revolver”), all of which mature on March 23, 2020, (collectively, the “Chase Credit Facility”). On March 23, 2015, the Borrowers drew $27.0 million under the Term Loan A to repay and terminate the WF Credit Facility. Term Loan B was unfunded at closing and beginning on April 20, 2015, the Closing Date of the acquisition of the assets of Ciscura, the Borrowers drew on Term Loan B in several installments in accordance with the requirements of the asset purchase agreement governing the acquisition to fund the acquisition and associated expenses. As of December 31, 2015, a total of approximately $6.3 million had been drawn on Term Loan B, with an additional $1.7 million available to be drawn under certain conditions for acquisitions. The Company recorded a $1.6 million as loss on extinguishment of long-term debt in its consolidated statement of operations as of December 31, 2015 for the write-off of deferred financing costs associated with the WF Credit Facility. Under the terms of the Chase Credit Agreement, principal payments equal to $1.0 million are due on Term Loan A on the last business day of each quarter beginning with the last business day of September 2015 and are due until the maturity date of the Chase Credit Facility. Principal payments on Term Loan B are due on the last business day of each fiscal quarter beginning with the last business day of March 2016. The value of each principal payment due on Term Loan B shall be equal to 3.575% of the principal balance of Term Loan B as of the Term Loan B Draw Expiration Date for the first eight quarterly payments. Thereafter, the next eight principal payments shall be equal to 4.475% of the principal balance of Term Loan B as of the Term Loan B Draw Expiration Date. The entire outstanding balance of the revolver shall be due at the maturity of the Chase Credit Facility. During the year ended December 31, 2015, the Company made optional pre-payments of $4.8 million on our Term Loan A, which was applied against a future mandatory payment. Prepayments of $1.9 million were applied to the September 30, 2015 and December 31, 2015 Term Loan A required principal payments and prepayments of $2.9 million were applied to the March 31, 2016, June 30, 2016 and September 30, 2016 Term Loan A required principal payments. The restatement error and the Company’s decision to prepay debt, would have resulted in the Company being non-compliant with its fixed charge coverage ratio covenant under its credit facility as of March 31, 2016, however, as of June 30, 2016, the Company would have been in compliance with this ratio covenant. As a result of the Company’s restatement of prior consolidated financial statements described herein, the following Events of Default occurred under the Chase Credit Agreement: (i) an Event of Default resulting from our breach of the Fixed Charge Coverage covenant as of March 31, 2016 as required under Section 6.12(b); and (ii) an Event of Default resulting from the unintentional misrepresentations made prior to the date of the First Amendment in connection with the certification as to the accuracy of the financial statements and compliance certificate delivered pursuant to Section 5.01 as they relate solely to the source of the error that has necessitated the restatement discussed herein. The Company also experienced an Event of Default due to the delay in filing its Form 10-Q for the quarter ended September 30, 2016 because of its financial restatement. In order to cure these violations, the Company entered into the first amendment to credit agreement and waiver (“First Amendment”) on December 5, 2016. This First Amendment amends the Chase Credit Agreement in the following material respects: (i) a waiver of the Event of Default that resulted from the failure to timely deliver the unaudited financial statements for the fiscal quarter ended September 30, 2016 as required under Section 5.01(b) and (c); (ii) a waiver of the Event of Default that resulted from breach of the Fixed Charge Coverage covenant as of March 31, 2016 as required under Section 6.12(b); (iii) a waiver of the Event of Default that resulted from the unintentional misrepresentations made prior to the date of the First Amendment in connection with the certification as to the accuracy of the financial statements and compliance certificate delivered pursuant to Section 5.01 as they relate solely to the source of the error that has necessitated the restatement discussed herein; (iv) a restructuring of the credit facility that effectively consolidated Term Loan A and Term Loan B into a single Term Loan resulting in a new total drawn amount of $32 million under the Term Loan with the approximately $5 million excess over the current aggregate drawn amounts under Term Loan A and Term Loan B to be available to reduce the Company’s drawings under the revolving credit line; (v) set the maturity of the new Term Loan described in item (iv) and the revolving credit line to five years from the effective date of the First Amendment; (vi) set the quarterly mandatory principal payment due on the Term Loan to $1.3 million due on the last business day of each fiscal quarter with any remaining unpaid and outstanding amount due at maturity; (vii) amend the deadline for delivery of consolidated financial statements to allow for the delivery of such statements for the quarter ended September 30, 2016 by December 16, 2016; (viii) amend the deadline for delivery of the Company’s annual financial plan and forecast to 30 days after the end of each fiscal year; (ix) amend the Leverage Ratio covenant to provide for the following schedule of maximum permitted ratios: (i) 3.0 to 1.0 at any time on or after the effective date but prior to December 31, 2015, (ii) 2.75 to 1.0 at any time on or after December 31, 2015 but prior to March 31, 2017, (iii) 2.50 to 1.0 at any time on or after March 31, 2017 but prior to March 31, 2018 or (iv) 2.25 to 1.00 at any time on or after March 31, 2018; (x) amend the definition of EBITDA to provide for the exclusion of certain one-time expenses directly related to the financial restatement described herein; and (xi) amend Section 8.01(a) to replace references to “Jonathan Foster” with “Christopher Downs”. As of December 31, 2016, interest on the Chase Credit Facility was payable at the Borrower’s choice as a (i) Eurodollar Loan, which bears interest at a per annum rate equal to LIBOR, plus a margin ranging from 2.00% to 2.50% or (ii) CBFR Loan, which bears interest at a per annum rate equal to (a) the Lender’s prime rate or (b) LIBOR for a 30-day interest period, plus 2.50%, in each case plus a margin ranging from -0.75% to -0.25%. The actual rate at December 31, 2016 was 3.27% (LIBOR of 0.77% plus 2.50%). The availability under the Revolver is based upon the Borrower’s eligible accounts receivable and eligible inventory and is computed as of December 31 as follows (in thousands): 2016 2015 Gross availability $ 10,000 $ 10,000 Outstanding draws — — Letter of credit — (81 ) Landlord Reserves (45 ) (37 ) Availability on Revolver $ 9,955 $ 9,882 To secure repayment of the obligations of the Borrowers, each Borrower has granted to the Lender, for the benefit of various secured parties, a first priority security interest in substantially all of the personal property assets of each of the Borrowers. In addition, the Company has pledged the shares of Holdings and Holdings has pledged the shares of each of ISI and First Biomedical and the equity interests of IFC LLC to the Lender, for the benefit of the secured parties, to further secure the obligations under the Chase Credit Agreement. The Chase Credit Agreement contains certain affirmative and negative covenants typical for credit facilities of this type. These covenants (subject to certain agreed and customary exceptions set forth in the Chase Credit Agreement) restrict or limit subject to the Lender’s prior consent, and in some cases prohibit, the Borrowers from engaging in certain actions, including its ability to, among other things: (i) incur indebtedness; (ii) create liens; (iii) engage in mergers, consolidations, liquidations or dissolutions; (iv) engage in acquisitions; (v) dispose of assets; (vi) pay dividends and distributions or repurchase capital stock or make other restricted payments; (vii) make investments, loans, guarantees or advances; (viii) engage in certain transactions with affiliates; (ix) enter into sale and leaseback transactions; (x) enter into hedging agreements; (xi) enter into agreements that restrict distributions from subsidiaries; and (xii) change their fiscal year. In addition, the Chase Credit Agreement requires the Borrowers to maintain the following financial covenant obligations: (i) a minimum fixed charge coverage ratio of 1.25:1.00; (ii) a maximum total leverage ratio ranging from 3.00:1.00 to 2.25:1.00 during specified periods; and (iii) a minimum net worth of $37.5 million. As of December 31, 2016, the Company was in compliance with all such covenants. The Company had approximate future maturities of loans and capital leases as of December 31, 2016 as follows (in thousands): 2017 2018 2019 2020 2021 Total Term Loan A $ 5,336 $ 5,336 $ 5,336 $ 5,336 $ 10,656 $ 32,000 Unamortized value of the debt issuance costs (a) (22 ) (22 ) (22 ) (22 ) (21 ) (109 ) Total $ 5,314 $ 5,314 $ 5,314 $ 5,314 $ 10,635 $ 31,891 (a) Includes the reclassification of the debt issuance costs as a result of the Company adopting ASU 2015-03 (see Note 2) The following is a breakdown of the Company’s current and long-term debt (including capital leases) as of December 31, 2016 and December 31, 2015 (in thousands): December 31, 2016 December 31, 2015 Current Long-Term Long-Term Total Current Long-Term Long-Term Total Term Loans $ 5,336 $ 26,664 $ 32,000 Term Loans $ 1,873 $ 26,651 $ 28,524 Unamortized value of the debt issuance costs (a) (22 ) (87 ) (109 ) Unamortized value of (31 ) (103 ) (134 ) Total $ 5,314 $ 26,577 $ 31,891 Total $ 1,842 $ 26,548 $ 28,390 (a) Includes the reclassification of the debt issuance costs as a result of the Company adopting ASU 2015-03 (see Note 2)

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Income Taxes	8. Income Taxes The following table summarizes (loss) income before income taxes for the years ended December 31 (in thousands): 2016 2015 U.S (loss) income $ (600 ) $ 3,752 Non-U.S. income 236 237 (Loss) income before income taxes $ (364 ) $ 3,989 The following table summarizes the components of the consolidated provision for income taxes for the years ended December 31 (in thousands): 2016 2015 U.S Federal income tax benefit (expense) Current $ — $ — Deferred 157 (970 ) Total U.S. Federal income tax benefit (expense) 157 (970 ) State and local income tax (expense) benefit Current (58 ) (101 ) Deferred 83 (168 ) Total state and local income tax benefit (expense) 25 (269 ) Foreign income tax (expense) benefit Current (40 ) 35 Total income tax benefit (expense) $ 142 $ (1,204 ) 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: 2016 2015 Income tax expense at the statutory rate 34.00 % 34.00 % State and local income tax expense 9.16 % 5.81 % Foreign income tax (3.79 %) (0.33 %) Permanent differences (38.40 %) 1.05 % Research & Development Credits 37.81 % (10.47 %) Other adjustments 0.31 % 0.14 % Effective income tax rate 39.09 % 30.20 % The following table summarizes the temporary differences and carryforwards that give rise to deferred tax assets and liabilities as of December 31 (in thousands): 2016 2015 Deferred Federal tax assets — Bad debt reserves $ 1,710 $ 1,612 Stock based compensation 668 636 Net operating loss 8,184 5,649 Accrued compensation 280 624 Alternative minimum tax credit 73 73 Inventories 69 52 Accrued rent 46 51 Goodwill and intangible assets 6,675 7,919 Research & Development Credits 534 418 Other Credits 5 3 Other 189 79 Total deferred Federal tax assets 18,433 17,116 Deferred Federal tax liabilities — Depreciation and asset basis differences (4,725 ) (3,358 ) Other (157 ) (364 ) Total deferred Federal tax liabilities (4,882 ) (3,722 ) Net deferred Federal tax assets 13,551 13,394 Net deferred state and local tax assets 1,560 1,477 Net deferred tax assets $ 15,111 $ 14,871 The classification of net deferred income taxes as of December 31, 2016 is summarized (in thousands): Current Long-term Total Deferred tax assets $ 2,675 $ 19,067 $ 21,742 Deferred tax liabilities — (6,631 ) (6,631 ) Net deferred tax assets $ 2,675 $ 12,436 $ 15,111 The classification of net deferred tax assets as of December 31, 2015 is summarized (in thousands): Current Long-term Total Deferred tax assets $ 2,743 $ 17,278 $ 20,021 Deferred tax liabilities — (5,150 ) (5,150 ) Net deferred income taxes $ 2,743 $ 12,128 $ 14,871 As of December 31, 2016 the Company recognized a benefit of $0.6 million for research and development credits pertaining to the Company’s development of software that enables third parties to interact, initiate functions or review data on the Company’s system. As of December 31, 2016 and 2015, the Company had federal net operating loss carryforwards remaining of approximately $24.1 million and $15.5 million, respectively. The Company’s deferred tax asset related to net operating losses (“NOLs”) is less than the actual NOLs available for tax return filings. The U.S. Federal NOL carryforwards include $0.6 million relating to deductions taken with respect to stock option exercises in excess of amounts recognized for financial reporting purposes for which a benefit would be recorded in APIC when realized. This portion of the NOL carryforwards is not included as a component of the Company’s deferred tax asset. Therefore, the Company did not recognize the benefit of tax deductions allowed for stock option exercises in excess of compensation expense recognized for financial reporting purposes, because the Company has NOL carryforwards available and it did not reduce income tax payable. The Company’s federal net operating loss carryforwards of approximately $24.1 million will begin to expire in various years beginning in 2028. The state net operating losses of approximately $0.8 million can be used for a period of 5 to 20 years and vary by state, and if unused, begin to expire in 2017, though a substantial portion expires beyond 2017. Tax benefits of operating loss and tax credit carryforwards are evaluated on an ongoing basis, including a review of historical and projected future operating results, the eligible carryforward period, and other circumstances. The Company expects to be able to utilize these net operating loss carryforwards and therefore has not recorded a valuation allowance which is described 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. Based on historical performance, sufficient earnings history exists to support the realization of the deferred tax assets. In addition, the Company has significant future reversals of taxable temporary differences such as depreciation and amortization that will provide a source of taxable income. The evidenced ability to generate sufficient taxable income such as cumulative earnings in recent years and significant future reversals of taxable temporary differences is the basis for the Company’s assessment that the deferred tax assets are more likely than not to be realized. The Company had no uncertain tax positions for the years ended December 31, 2016 and 2015. The Company is subject to taxation for Federal and various state jurisdictions in the United States and Canada. The Federal income tax returns of the Company for the years 2013 through 2016 are subject to examination by the Internal Revenue Service. 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 2012 through 2016 are subject to examination by the Canada Revenue Agency. The Company completed an update to its analysis of past ownership (as defined under Section 382 of the Code), and as a result, the Company believes that, consistent with previously completed analyses, it has not experienced an ownership change since December 31, 2010. The Company has undertaken a definitive analysis necessary to quantify the effect of ownership change as of December 31, 2010 on the net operating loss carryforwards generated prior to December 31, 2010. Based on the analysis, the Company is subject to an annual limitation of $1.8 million on its use of remaining pre-ownership change net operating loss carryforwards of $4.7 million (and certain other pre-change tax attributes).

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2016
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	9. Commitments and Contingencies From time to time in the ordinary course of its business, the Company may be involved in legal proceedings, the outcomes of which may not be determinable. The results of litigation are inherently unpredictable. Any claims against the Company, whether meritorious or not, could be time consuming, result in costly litigation, require significant amounts of management time and result in diversion of significant resources. The Company is not able to estimate an aggregate amount or range of reasonably possible losses for those legal matters for which losses are not probable and estimable, primarily for the following reasons: (i) many of the relevant legal proceedings are in preliminary stages, and until such proceedings develop further, there is often uncertainty regarding the relevant facts and circumstances at issue and potential liability; and (ii) many of these proceedings involve matters of which the outcomes are inherently difficult to predict. The Company has insurance policies covering potential losses where such coverage is cost effective. As a result of the restatement of the Company’s financial statements as of December 31, 2015 and the first and second quarter of 2016, the Company is currently involved in a class-action lawsuit filed by shareholders. On November 8, 2016, a purported shareholder of the Company filed a putative class action in the U.S. District Court for the Central District of California (the “Court”) (Case No. 2:16-cv-08295-ODW) against the Company and two individual defendants: Eric Steen, the Company’s current Chief Executive Officer, President and director; and Jonathan Foster, the Company’s former Chief Financial Officer. The complaint alleges that the defendants issued materially false and misleading statements in and/or omitted material facts from documents filed with the SEC between May 12, 2015 and November 7, 2016. The complaint asserts claims against all defendants under the antifraud provisions of the federal securities laws and against Messrs. Steen and Foster as control persons. The complaint seeks compensatory damages for the putative class, prejudgment and post-judgment interest, attorneys’ fees and other costs. Two other shareholders subsequently filed motions for appointment as lead plaintiff and for appointment of their attorneys as lead counsel for the putative class. On February 17, 2017, the Court appointed a lead plaintiff for the putative class. The parties have entered into a stipulation, adopted by the Court, pursuant to which it is expected that the lead plaintiff will file a consolidated amended complaint that will be the operative complaint going forward. The Company has not determined that losses related to the foregoing matters are probable. Because the allegations of the operative complaint are not yet known, together with the inherent difficulty of predicting the outcome of litigation generally, the Company does not have sufficient information to determine the amount or range of reasonably possible loss with respect to these matters. The Company’s assessments are based on estimates and assumptions that have been deemed reasonable by management, but that may prove to be incomplete or inaccurate, and unanticipated events and circumstances may occur that might cause the Company to change those estimates and assumptions. The Company and the individual defendants intend to vigorously defend the claims asserted against them in these matters, but there can be no assurances as to the outcome for such matters. The Company is not at this time involved in any additional legal proceedings that the Company believes could have a material effect on the Company’s financial condition, results of operations or cash flows.

Leases

Leases	12 Months Ended
	Dec. 31, 2016
Leases [Abstract]
Leases	10. Leases The Company leases office space, service facility centers and equipment under non-cancelable capital and operating lease arrangements. The Company periodically enter 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 weighted average interest rate under capital leases was 5.1% as of December 31, 2016. The leases for office space and service facility centers used in the Company’s logistics operations are operating leases. In most cases, we expect our facility leases will be renewed or replaced by other leases in the ordinary course of business. Future minimum rental payments pursuant to leases that have an initial or remaining non-cancelable lease term in excess of one year as of December 31, 2016 are as follows (in thousands): Capital Operating Total 2017 $ 3,114 $ 990 $ 4,104 2018 1,826 831 2,657 2019 571 562 1,133 2020 274 178 452 2021 — 181 181 Thereafter — 938 938 Total require payments $ 5,785 $ 3,680 $ 9,465 Less amounts representing interest (3.1% to 10.5%) (274 ) Present value of minimum lease payments 5,511 Less current maturities (2,938 ) Long-term capital lease liability $ 2,573 At December 31, 2016 and 2015, pump assets obtained under capital leases, had a cost of approximately $13.9 million and $11.2 million, respectively, and accumulated depreciation of $3.9 million and $2.4 million, respectively. Included in depreciation expense for the years ended December 31, 2016 and 2015 was $6.3 million and $4.8 million, respectively, which were recorded in cost of revenues – pump depreciation and loss on disposal. The Company had minimum future operating lease commitments, mainly related to its leased facilities. Related rental expense for facilities and other equipment from third parties under operating leases approximated $1.0 million.

Share-based Compensation

Share-based Compensation	12 Months Ended
	Dec. 31, 2016
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Share-based Compensation	11. Share-based Compensation All stock option awards are amortized based on their graded vesting over the requisite service period of the awards. Compensation costs are recognized over the requisite service period using the accelerated method and included in selling expenses and general and administrative expenses, based upon the department to which the associated employee or non-employee resides. Stock Incentive Plan The Company has various stock option and stock-based incentive plans and agreements whereby stock options and restricted stock awards were made available to certain employees, directors and others approved by the Company’s Board of Directors (the “Board) or Compensation Committee. Stock options are granted at, or above, fair market value and generally expire in three to ten years from the grant date. Restricted stock awards are granted at the fair market value on the date of grant and generally become exercisable over a period of up to four years. Awards typically vest and are issued only if the participants remain employed by the Company through the vesting date. Stock options and restricted stock awards are issued from shares under one of the Company’s plans described below. Grants may be made in the form of stock options, restricted stock units or unrestricted common stock. On April 23, 2014, the Company’s Board adopted the 2014 Amended and Restated Stock Incentive Plan (the “2014 Plan”). The 2014 Plan was approved by the Company’s shareholders at the 2014 Annual Meeting and became effective as of the date it was adopted by the Board of Directors. The 2014 Plan provides 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. As of December 31, 2016, a total of 0.7 million common shares remained available for future grant under the 2014 Plan. The 2014 Plan replaced our 2007 Stock Incentive Plan (the “Plan”) and provided 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. The Plan is no longer in effect other than for stock options that were previously granted and remain outstanding. Options representing approximately 0.5 million and rights representing less than 0.1 million remain outstanding under this plan. Restricted stock awards currently outstanding under the Plan will remain outstanding in accordance with the terms of that plan. The Company granted restricted shares and stock options under the Plan and 2014 Plan during the year ended December 31, 2015 and stock options under the 2014 Plan during the year ended December 31, 2016. Shares Forgone to Satisfy Minimum Statutory Withholdings During the years ended December 31, 2016 and 2015, shares of common stock were issued to employees and directors as their restricted stock awards vested or stock options were exercised. Under the terms of the Company’s stock plans, at the election of each employee, the Company can authorize a net settlement of distributable shares to employees after satisfaction of an individual employees’ tax withholding obligations. For the years ended December 31, 2016 and 2015, respectively, the Company received 0.1 million shares from employees for tax withholding obligations. Restricted Shares During the year ended December 31, 2016, the Company did not grant any restricted shares. During the year ended December 31, 2015, the Company granted 0.1 million restricted shares, which vest over a three- or four-year period only if the participants remain employed by the Company through the vesting date. 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, excluding the Company’s employee stock purchase plan, for the years ended December 31: Number of Weighted Aggregate Unvested at December 31, 2014 256,003 $ 1.78 Granted 61,663 2.60 Vested (83,029 ) 1.53 $ 244,319 Vested shares forgone to satisfy minimum statutory withholding (24,031 ) 2.96 $ 71,445 Forfeitures (39,774 ) 1.79 Unvested at December 31, 2015 170,832 2.09 Granted — — Vested (64,182 ) 1.74 $ 236,161 Vested shares forgone to satisfy minimum statutory withholding (16,484 ) 2.81 $ 49,592 Forfeitures (32,833 ) 2.18 Unvested at December 31, 2016 57,333 $ 2.21 As of December 31, 2016, there was less than $0.1 million 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 2019. Employee Stock Purchase Plan In May 2014, the Company received approval from stockholders to adopt an employee stock purchase plan (“ESPP”) effective October 2014 (collectively the “Original ESPP”). Under the Original ESPP, 200,000 shares of common stock are authorized for purchase by eligible employees at a 15% discount through payroll deductions during the six month offering periods. Shares were purchased in whole numbers and generally would be the last day of the offering period. On September 7, 2016, the Company received approval from shareholders for an additional 350,000 shares. No employee may purchase more than $25,000 worth of fair market value shares in any calendar year. As allowed under the ESPP, a participant may elect to withdraw from the plan, effective for the purchase period in progress at the time of the election with all accumulated payroll deductions returned to the participant at the time of withdrawal. As of December 31, 2016, there were 363,821 shares remaining available for future issuance. The following table summarizes the activity relating to the Company’s ESPP program for the years ended December 31: 2016 2015 Compensation expense $ 113,531 $ 40,233 Shares of stock sold to employees 88,109 98,070 Weighted average fair value per ESPP award $ 2.73 $ 2.73 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. 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, 2016, the Company granted 0.6 million stock options, none of which were issued to Board members. During the year ended December 31, 2015, the Company granted 0.5 million stock options, of which 0.2 million were issued to Board members, at exercise prices which were a preceding five-day average price on the date of grant and a vesting period of 12-months. The following table details the various stock option and inducement stock option activity for the years ended December 31: 2007 Plan (Options) Number of Weighted- Weighted- Aggregate Outstanding at December 31, 2014 595,000 $ 2.19 1.51 $ 571,717 Granted — — — Exercised (52,030 ) 1.64 140,368 Exercised shares forgone to satisfy minimum statutory withholding (7,688 ) 1.76 Cashless exercise (41,950 ) 1.70 Forfeited (5,000 ) 1.93 Outstanding at December 31, 2015 488,332 $ 2.31 0.41 $ 348,415 Granted — — — Exercised — — — Exercised shares forgone to satisfy minimum statutory withholding — — Cashless exercise — — Forfeited — — Outstanding at December 31, 2016 488,332 $ 2.31 0.25 $ 118,899 Exercisable at December 31, 2016 483,332 $ 2.29 Aggregate Intrinsic Value = Excess of market value over the option exercise price of all in-the-money stock options. 2014 Plan (Options) Number Weighted- Weighted- Aggregate Outstanding at December 31, 2014 530,000 $ 2.69 5.00 $ 243,800 Granted 470,000 $ 2.90 3.25 $ — Exercised — Exercised shares forgone to satisfy minimum statutory withholding — Forfeited (30,000 ) 2.69 Outstanding at December 31, 2015 970,000 $ 2.79 3.58 $ 222,200 Exercisable at December 31, 2015 410,903 $ 2.85 Granted 600,000 2.76 4.60 Exercised (1,866 ) 2.69 Exercised shares forgone to satisfy minimum statutory withholding (798 ) 2.69 Cashless exercise (12,614 ) 2.69 Forfeited (304,723 ) 2.70 Outstanding at December 31, 2016 1,249,999 $ 2.80 4.26 $ — Exercisable at December 31, 2016 616,597 $ 2.87 Aggregate Intrinsic Value = Excess of market value over the option exercise price of all in-the-money stock options. Inducement Options Number of Weighted- Weighted- Aggregate Outstanding at December 31, 2014 800,000 $ 2.25 3.89 $ 720,000 Granted — — — — Exercised — — — — Forfeited — — — — Outstanding at December 31, 2015 800,000 $ 2.25 2.90 $ 616,000 Granted — — — — Exercised — — — — Forfeited — — — — Outstanding at December 31, 2016 800,000 $ 2.25 2.26 $ 240,000 Exercisable at December 31, 2016 756,250 $ 2.25 Aggregate Intrinsic Value = Excess of market value over the option exercise price of all in-the-money stock options. The following table summarizes information about stock options outstanding at December 31, 2016: 2007 Plan (Options): Options Outstanding Options Exercisable Range of Exercise Prices Number of Weighted- Weighted- Number of Weighted- $1.50 - $1.75 110,000 — $ 1.51 110,000 $ 1.51 $1.76 - $2.00 91,666 — 1.93 91,666 1.70 $2.01 - $3.00 286,666 0.25 2.71 281,666 2.71 Outstanding at December 31, 2016 488,332 0.25 $ 2.31 483,332 $ 2.29 2014 Plan (Options): Options Outstanding Options Exercisable Range of Exercise Prices Number of Weighted- Weighted- Number of Weighted- $2.01 - $3.00 1,249,999 4.26 $ 2.80 616,597 $ 2.87 Outstanding at December 31, 2016 1,249,999 4.26 $ 2.80 616,597 $ 2.87 Inducement Options: Options Outstanding Options Exercisable Range of Exercise Prices Number of Weighted- Weighted- Number of Weighted- $1.50 - $1.75 400,000 2.26 $ 1.75 381,250 $ 1.75 $2.26 - $2.75 400,000 2.26 2.75 375,000 2.75 Outstanding at December 31, 2016 800,000 2.26 $ 2.25 756,250 $ 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 years ended December 31: Stock Options: 2016 2015 Expected volatility 35% 50% to 54% Risk free interest rate 0.69% 0.25% to 0.66% Expected lives at date of grant (in years) 5.01 4.43 Weighted average fair value of options granted $ 2.76 $ 2.90 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): 2016 2015 Restricted share expense $ 151 $ 107 Stock option expense 311 889 Total stock-based compensation expense $ 462 $ 996 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, 2016 and 2015, the Company did not repurchase any shares in the open market.

Employee Benefit Plans

Employee Benefit Plans	12 Months Ended
	Dec. 31, 2016
Compensation and Retirement Disclosure [Abstract]
Employee Benefit Plans	12. Employee Benefit Plans The Company has defined contribution plan in which the Company makes matching contributions for a certain percentage of employee contributions. For both of the years ended December 31, 2016 and 2015, the Company’s matching contributions were $0.7 million. The Company does not provide other post-retirement or post-employment benefits to its employees.

Summary of Significant Accoun19

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2016
Accounting Policies [Abstract]
Reclassifications	Reclassifications Certain prior period reclassifications were made to conform with the current period presentation. These reclassifications had no effect on reported (loss) income, cash flows, total assets, or stockholders’ equity as previously reported.
Presentation in the Consolidated Statements	Presentation in the Consolidated Statements The Company 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	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	Segments The Company operates in one reportable 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 selling, 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 its 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	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 valuations and income tax 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.
Business Combinations	Business Combinations The Company accounts for all business combinations using the acquisition method of accounting, which allocates the fair value of the purchase consideration to the tangible and intangible assets acquired and liabilities assumed based on their estimated fair values. The excess of the purchase consideration over the fair values of these identifiable assets and liabilities is recorded as goodwill. When determining the fair values of assets acquired and liabilities assumed, management makes significant estimates and assumptions. The Company may utilize third-party valuation specialists to assist the Company in the allocation. Initial purchase price allocations are subject to revision within the measurement period, not to exceed one year from the date of acquisition. Acquisition-related expenses and transaction costs associated with business combinations are expensed as incurred.
Cash and Cash Equivalents	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, Allowance for Doubtful Accounts and Contractual Allowances	Accounts Receivable, Allowance for Doubtful Accounts and Contractual Allowances 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 value. 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. The Company records an allowance for doubtful accounts and contractual allowance (to reduce gross billed charges to a contractual or estimated net realizable value from third-party payors) based on management’s assessment of historical and expected 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 for doubtful accounts for patients or the contractual allowance for third-party payors. The Company’s allowance for doubtful accounts and contractual allowance are a reduction to accounts receivable on the Company’s consolidated financial position. Additions to the contractual allowance each period offset gross billed charges, which are not publicly reported in the Company’s filings, to arrive at net revenue, which is publicly reported in the Company’s consolidated results of operations. Additions to the allowance for doubtful accounts, however, impact the bad debt expense line item of the Company’s consolidated results of operations. 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 the Company’s consolidated business, 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 Allowance for doubtful accounts — 2016 $ 4,737 $ 5,631 $ (5,379 ) $ 4,989 Allowance for doubtful accounts — 2015 $ 4,739 $ 5,234 $ (5,236 ) $ 4,737 (1) Deductions represent the write-off of uncollectible account receivable balances.
Inventories	Inventories The Company’s inventories consist of disposable products and related parts and supplies used in conjunction with medical equipment and are stated at the lower of cost (first-in, first-out basis) 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 and $0.1 million, respectively, as of December 31, 2016 and 2015.
Medical Equipment	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 seven years. The Company does not depreciate ME held for sale or rent. When ME in Rental Service 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 $0.6 million and $0.2 million, respectively, as of December 31, 2016 and 2015.
Property and Equipment	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. Externally purchased 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, 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 Intangible assets consist of trade names, physician and customer relationships, non-compete agreements and software. The physician and customer relationships and non-compete agreements arose primarily from the acquisitions of ISI and First Biomedical in 2010 and the acquisition of assets from Ciscura Holding Company, Inc. and its subsidiaries (“Ciscura”) in 2015. The Company amortizes the value assigned to the physician and customer relationships on a straight-line basis over the period of expected benefit, which ranges from fifteen to twenty 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. The useful lives of these relationships are 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 with the amortization periods ranging from two to five years and acquired software is amortized on a straight-line basis over three years. Trade names associated with the original acquisition of InfuSystem are not amortized while trade names from the Ciscura asset acquisition in 2015 are amortized over one year. Management tests trade names for impairment annually or as often as deemed necessary. The impairment test for intangible assets with indefinite lives consists of a comparison of the fair value of the intangible assets with their carrying amounts. If the carrying value of the intangible assets exceeds the fair value, an impairment loss is recognized in an amount equal to that excess. The Company determines the fair value of the reporting unit for goodwill impairment testing based on a discounted cash flow model. The Company determines the fair value of its intangibles assets with indefinite lives (trade names) through the royalty relief income valuation approach. The Company performed its annual impairment analysis as of October 2016 and determined that the fair value of the intangible assets with indefinite lives (trade names) was greater than their carrying value, resulting in no impairment.
Software Capitalization and Depreciation	Software Capitalization and Depreciation We capitalize certain costs incurred in connection with obtaining or developing internal-use software, including payroll and payroll-related costs for employees who are directly associated with the internal-use software project, external direct costs of materials and services and interest costs while developing the software. Capitalized software costs are included in intangible assets, net and are amortized using the straight-line method over the estimated useful life of three to five years. Capitalization of such costs ceases when the project is substantially complete and ready for its intended purpose. Costs incurred during the preliminary project and post-implementation stages, as well as software maintenance and training costs, are expensed in the period in which they are incurred. The company capitalized $3.5 million and $5.7 million of internal-use software for the years ended December 31, 2016 and 2015, respectively. Amortization expense for capitalized software was $1.7 million in 2016 and $0.4 million in 2015.
Impairment of Long-Lived Assets	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. The Company did not record any impairment related expenses for the years ended December 31, 2016 and 2015, respectively.
Operating and Capital Leases	Operating and Capital Leases Leases for all of our corporate and other operating locations are under operating leases and the Company recognizes rent expense on a straight-line basis over the lease terms. Rent holidays and rent escalation clauses, which provide for scheduled rent increases during the lease term, are taken into account in computing straight-line rent expense included in our consolidated statements of operations. The difference between the rent due under the stated periods of the leases compared to that of the straight-line basis is recorded as a component of other long-term liabilities in the consolidated balance sheets. Landlord funded lease incentives, including tenant improvement allowances provided for our benefit, are recorded as leasehold improvement assets and as deferred rent in the consolidated balance sheets and are amortized to depreciation expense and as rent expense credits, respectively. The Company periodically 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. Under the terms of all such capital leases, the Company does not hold title to these pumps and will not obtain title until such time as the capital lease obligations are settled in full. The weighted average interest rate under capital leases was 5.1% as of December 31, 2016.
Revenue Recognition	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, and billing the oncology practice, or the third-party payor (“TPP”) or alternative site setting 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 (i) receives a physician’s written order and assignment of benefits, signed by the physician and patient, respectively, (ii) has verified actual pump usage via a patient treatment log (“PTL”) and insurance coverage and (iii) receives patient acknowledgement of assignment of benefits. 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 while billings made directly to an oncology practice and alternative site setting are recorded at a pre-determined amount with any uncollectible amount is recorded as bad debt expense in general and administrative expenses. 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 the Company’s results of operations and cash flows. For 2016 and 2015, the Company’s largest contracted payor was Medicare, which accounted for approximately 21% and 32% of our net revenue from our Oncology Business for the years ended December 31, 2016 and 2015, respectively. Medicare represented 5% and 23% of the Company’s consolidated accounts receivable, net for the years ended December 31, 2016 and 2015, respectively. For 2016 and 2015, the Company’s second largest contracted payor was a national association comprised of multiple members, which, in the aggregate, accounted for approximately 19% and 18% of our net revenue from our Oncology Business for the years ended December 31, 2016 and 2015, respectively. This same contracted payor represented 26% and 31% of the Company’s consolidated accounts receivable, net for the years ended December 31, 2016 and 2015, respectively. The Company also contracted 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, accounted for greater than approximately 10% of the Company’s Oncology Business net revenue for 2016 or 2015.
Income Taxes	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 if 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 uncertain 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	Share Based Payments The determination of the fair value of stock option awards on the date of grant using option-pricing models is affected by the Company’s stock price, as well as assumptions regarding a number of other inputs using the Black-Scholes pricing model. These variables include the Company’s expected stock price volatility over the expected term of the awards, actual and projected employee stock option exercise behaviors, risk-free interest rates and expected dividends. The expected volatility is based on the historical volatility. The Company uses historical data to estimate stock option exercise and forfeiture rates. The expected term represents the period over which the share-based awards are expected to be outstanding. The dividend yield is an estimate of the expected dividend yield on the Company’s stock. The risk-free rate is based on U.S. Treasury yields in effect at the time of the grant for the expected term of the stock options. All stock option awards are amortized based on their graded vesting over the requisite service period of the awards. Compensation costs are recognized over the requisite service period using the accelerated method and included in selling expenses and general and administrative expenses, based upon the department to which the associated employee or non-employee resides.
Deferred Debt Issuance Costs	Deferred Debt Issuance Costs Capitalized debt issuance costs as of December 31, 2016 and 2015 relate to the Chase Credit Facility. The Company classified the costs related to the agreement as non-current liabilities and amortizes them using the interest method through the maturity date of the underlying debt.
Earnings Per Share	Earnings Per Share The Company reports its earnings per share in accordance with the “Earnings Per Share” topic of the Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”), which requires the presentation of both basic and diluted earnings per share on the statements of operations. The diluted weighted average common shares include adjustments for the potential effects of outstanding stock options but only in the periods in which such effect is dilutive under the treasury stock method. Included in our basic and diluted weighted average common shares are those stock options and common stock shares due to participants granted from the 2014 stock incentive plan. Antidilutive stock awards are comprised of stock options and unvested share awards, which would have been antidilutive in the application of the treasury stock method in accordance with “Earnings Per Share” topic of FASB ASC. In accordance with this topic, the following table reconciles income and share amounts utilized to calculate basic and diluted net (loss) income per common share (in thousands, except shares): 2016 2015 Numerator: Net (loss) income (in thousands) $ (222 ) $ 2,785 Denominator: Weighted average common shares outstanding: Basic 22,617,901 22,414,587 Dilutive effect of restricted shares, options and non-vested share awards — 428,648 Diluted 22,617,901 22,843,235 Antidilutive awards: 90,715 43,215 Stock options of 0.1 million were not included in the calculation for both of the years ended December 31, 2016 and 2015, because they would have an anti-dilutive effect.
Fair Value of Financial Instruments	Fair Value of Financial Instruments The carrying amounts reported in the consolidated balance sheets as of December 31, 2016 and 2015 for cash, accounts receivable, accounts payable and accrued expenses approximate fair value because of the short-term nature of these instruments (Level I). The carrying value of the Company’s long-term debt with variable interest rates approximates fair value based on instruments with similar terms (Level II). The Company has adopted ASC 820, Fair Value Measurements, which defines fair value, establishes a framework for assets and liabilities being measured and reported at fair value and appends disclosures about fair value measurements. For financial assets and liabilities measured at fair value on a recurring basis, fair value is the price the Company would receive to sell an asset or pay to transfer a liability in an orderly transaction with a market participant at the measurement date. A three-level fair value hierarchy prioritizes the inputs used to measure fair value as follows: Level I quoted prices in active markets for identical instruments; Level II quoted prices in active markets for similar instruments, quoted prices for identical instruments in markets that are not active, or other inputs that are observable or can be corroborated by observable data for substantially the full term of the instrument; and Level III significant inputs to the valuation model are unobservable.
Recent Accounting Pronouncements and Developments	Recent Accounting Pronouncements and Developments In August 2016, the FASB issued Accounting Standards Update (“ASU”) No. 2016-15 Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments. The amendments in this ASU introduce clarifications to the presentation of certain cash receipts and cash payments in the statement of cash flows. The primary updates include additions and clarifications of the classification of cash flows related to certain debt repayment activities, contingent consideration payments related to business combinations, proceeds from insurance policies, distributions from equity method investees and cash flows related to securitized receivables. This update is effective for annual periods beginning after December 15, 2017, including interim periods within those fiscal years. Early adoption of this ASU is permitted, including in interim periods. The ASU requires retrospective application to all prior periods presented upon adoption. The Company is currently evaluating the impact, if any, that the adoption of this guidance will have on its cash flows and/or disclosures, however, the Company does not anticipate that the adoption of this new standard will have a material impact on the Company’s financial position, results of operations or statements of cash flow upon adoption. In June 2016, the FASB issued ASU No. 2016-13, “Financial Instruments (Topic 326) Credit Losses.” ASU 2016-13 changes the impairment model for most financial assets and certain other instruments. Under the new standard, entities holding financial assets and net investment in leases that are not accounted for at fair value through net income are to be presented at the net amount expected to be collected. An allowance for credit losses will be a valuation account that will be deducted from the amortized cost basis of the financial asset to present the net carrying value at the amount expected to be collected on the financial asset. ASU 2016-13 is effective as of January 1, 2020. Early adoption is permitted. The Company is currently evaluating the impact of ASU 2016-13. The adoption of this standard is not expected to have a material impact on the Company’s consolidated financial statements or footnote disclosures. In March 2016, the FASB issued ASU No. 2016-09, Compensation — Stock Compensation (Topic 718) (“ASU 2016-09”). The guidance changes how companies account for certain aspects of equity-based payments to employees. Entities will be required to recognize income tax effects of awards in the income statement when the awards vest or are settled. The guidance also allows an employer to repurchase more of an employee’s shares than it can under current guidance for tax withholding purposes providing for withholding at the employee’s maximum rate as opposed to the minimum rate without triggering liability accounting and to make a policy election to account for forfeitures as they occur. The updated guidance is effective for annual periods beginning after December 15, 2016. Early adoption is permitted. Under today’s guidance, the Company does not recognize the income tax effects of awards that have vested or are settled until they actually reduce taxes payable. This standard will require the Company to recognize these effects when they are vested or are settled. The adoption of this standard is not expected to have a material impact on the Company’s financial position, results of operations or statements of cash flows upon adoption. In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) (“ASU 2016-02”). Under ASU 2016-02, an entity will be required to recognize right-of-use assets and lease liabilities on its balance sheet and disclose key information about leasing arrangements. ASU 2016-02 offers specific accounting guidance for a lessee, a lessor and sale and leaseback transactions. Lessees and lessors are required to disclose qualitative and quantitative information about leasing arrangements to enable a user of the financial statements to assess the amount, timing and uncertainty of cash flows arising from leases. For public companies, ASU 2016-02 is effective for annual reporting periods beginning after December 15, 2018, including interim periods within that reporting period, and requires a modified retrospective adoption, with early adoption permitted. The Company is currently evaluating the impact that the adoption of this guidance will have on its financial position, results of operations, cash flows and/or disclosures. However, the Company expects that the adoption of the provisions of ASU 2016-02 will have a material impact on its consolidated balance sheet, as currently most of its real estate is leased via operating leases. In April 2015, the FASB issued ASU No. 2015-03, Interest — Imputation of Interest (Subtopic 835-30): Simplifying the Presentation of Debt Issuance Costs (“ASU 2015-03”), and, in August 2015, the FASB issued ASU No. 2015-15, Interest — Imputation of Interest (Subtopic 835-30): Presentation and Subsequent Measurement of Debt Issuance Costs Associated with Line-of-Credit Arrangements — Amendments to SEC Paragraphs Pursuant to Staff Announcement at June 18, 2015 EITF Meeting (“ASU 2015-15”). ASU 2015-03 requires that debt issuance costs related to a recognized debt liability be presented in the balance sheet as a direct deduction from the carrying amount of that debt liability, consistent with debt discounts. ASU 2015-15 then clarified that debt issuance costs related to a line-of-credit arrangement can be presented as an asset on the balance sheet, regardless of whether there are any outstanding borrowings on the line-of-credit arrangement. These ASUs are effective for fiscal years beginning after December 15, 2015, and for interim periods within those fiscal years. The Company adopted this guidance as of January 1, 2016, and as a result, has recast the December 31, 2015 consolidated balance sheet to conform to the current period presentation. The adoption of this standard reduced previously presented other assets and long-term debt by $0.1 million, based upon the balance of unamortized debt issuance costs relating to its credit facility as of December 31, 2015. On May 28, 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers (“ASU 2014-09”),

Summary of Significant Accoun20

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2016
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 Allowance for doubtful accounts — 2016 $ 4,737 $ 5,631 $ (5,379 ) $ 4,989 Allowance for doubtful accounts — 2015 $ 4,739 $ 5,234 $ (5,236 ) $ 4,737 (1) Deductions represent the write-off of uncollectible account receivable balances.
Summary of Income and Share Amounts Utilized to Calculate Basic and Diluted Net Income Per Common Share	In accordance with this topic, the following table reconciles income and share amounts utilized to calculate basic and diluted net (loss) income per common share (in thousands, except shares): 2016 2015 Numerator: Net (loss) income (in thousands) $ (222 ) $ 2,785 Denominator: Weighted average common shares outstanding: Basic 22,617,901 22,414,587 Dilutive effect of restricted shares, options and non-vested share awards — 428,648 Diluted 22,617,901 22,843,235 Antidilutive awards: 90,715 43,215

Business Combinations (Tables)

Business Combinations (Tables)	12 Months Ended
	Dec. 31, 2016
Business Combinations [Abstract]
Summary of Final Purchase Price Allocation	The allocation of the final purchase price to the fair values of the assets acquired and liabilities assumed as of the Closing Date is presented below (in thousands): Amount Medical equipment in rental service $ 2,289 Trade names and Trademarks 23 Customer relationships 3,393 Furniture and fixtures 20 Leasehold improvements 185 Non-competition agreements 246 Total — final purchase price $ 6,156

Medical Equipment (Tables)

Medical Equipment (Tables)	12 Months Ended
	Dec. 31, 2016
Text Block [Abstract]
Summary of Medical Equipment	Medical equipment consisted of the following as of December 31 (in thousands): 2016 2015 Medical Equipment held for sale or rental $ 1,642 $ 2,277 Medical Equipment in rental service 59,034 53,681 Medical Equipment in rental service — pump reserve (551 ) (232 ) Accumulated depreciation (30,447 ) (25,612 ) Medical Equipment in rental service — net 28,036 27,837 Total $ 29,678 $ 30,114

Property and Equipment (Tables)

Property and Equipment (Tables)	12 Months Ended
	Dec. 31, 2016
Property, Plant and Equipment [Abstract]
Property and Equipment	Property and equipment consisted of the following as of December 31 (in thousands): 2016 Gross Accumulated Total Furniture, fixtures, and equipment $ 3,809 $ (3,071 ) $ 738 Automobiles 129 (83 ) 46 Leasehold improvements 2,177 (964 ) 1,213 Total $ 6,115 $ (4,118 ) $ 1,997 2015 Gross Accumulated Total Furniture, fixtures, and equipment $ 2,330 $ (1,382 ) $ 948 Automobiles 84 (76 ) 8 Leasehold improvements 2,240 (826 ) 1,414 Total $ 4,654 $ (2,284 ) $ 2,370

Intangible Assets (Tables)

Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2016
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): 2016 Gross Assets Accumulated Net Nonamortizable intangible assets Trade names $ 2,000 $ — $ 2,000 Amortizable intangible assets Trade names 23 23 — Physician and customer relationships 36,534 19,427 17,107 Non-compete agreements 1,136 1,064 72 Software 13,745 1,685 12,060 Total nonamortizable and amortizable intangible assets $ 53,438 $ 22,199 $ 31,239 2015 Gross Assets Accumulated Net Nonamortizable intangible assets Trade names $ 2,000 $ — $ 2,000 Amortizable intangible assets Trade names 23 15 8 Physician and customer relationships 36,258 17,049 19,209 Non-compete agreements 1,094 930 164 Software 11,942 1,789 10,153 Total nonamortizable and amortizable intangible assets $ 51,317 $ 19,783 $ 31,534
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, 2016 are as follows (in thousands): 2017 2018 2019 2020 2021 2022 and Amortization expense $ 5,649 $ 5,274 $ 4,841 $ 4,298 $ 3,943 $ 5,234

Debt (Tables)

Debt (Tables)	12 Months Ended
	Dec. 31, 2016
Debt Disclosure [Abstract]
Summary of Revolver Based upon Borrower's Eligible Accounts Receivable and Inventory	The availability under the Revolver is based upon the Borrower’s eligible accounts receivable and eligible inventory and is computed as of December 31 as follows (in thousands): 2016 2015 Gross availability $ 10,000 $ 10,000 Outstanding draws — — Letter of credit — (81 ) Landlord Reserves (45 ) (37 ) Availability on Revolver $ 9,955 $ 9,882
Summary of Future Maturities of Loans and Capital Leases	The Company had approximate future maturities of loans and capital leases as of December 31, 2016 as follows (in thousands): 2017 2018 2019 2020 2021 Total Term Loan A $ 5,336 $ 5,336 $ 5,336 $ 5,336 $ 10,656 $ 32,000 Unamortized value of the debt issuance costs (a) (22 ) (22 ) (22 ) (22 ) (21 ) (109 ) Total $ 5,314 $ 5,314 $ 5,314 $ 5,314 $ 10,635 $ 31,891 (a) Includes the reclassification of the debt issuance costs as a result of the Company adopting ASU 2015-03 (see Note 2)
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 December 31, 2016 and December 31, 2015 (in thousands): December 31, 2016 December 31, 2015 Current Long-Term Long-Term Total Current Long-Term Long-Term Total Term Loans $ 5,336 $ 26,664 $ 32,000 Term Loans $ 1,873 $ 26,651 $ 28,524 Unamortized value of the debt issuance costs (a) (22 ) (87 ) (109 ) Unamortized value of (31 ) (103 ) (134 ) Total $ 5,314 $ 26,577 $ 31,891 Total $ 1,842 $ 26,548 $ 28,390 (a) Includes the reclassification of the debt issuance costs as a result of the Company adopting ASU 2015-03 (see Note 2)

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Summary of (Loss) Income Before Income Taxes	The following table summarizes (loss) income before income taxes for the years ended December 31 (in thousands): 2016 2015 U.S (loss) income $ (600 ) $ 3,752 Non-U.S. income 236 237 (Loss) income before income taxes $ (364 ) $ 3,989
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): 2016 2015 U.S Federal income tax benefit (expense) Current $ — $ — Deferred 157 (970 ) Total U.S. Federal income tax benefit (expense) 157 (970 ) State and local income tax (expense) benefit Current (58 ) (101 ) Deferred 83 (168 ) Total state and local income tax benefit (expense) 25 (269 ) Foreign income tax (expense) benefit Current (40 ) 35 Total income tax benefit (expense) $ 142 $ (1,204 )
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: 2016 2015 Income tax expense at the statutory rate 34.00 % 34.00 % State and local income tax expense 9.16 % 5.81 % Foreign income tax (3.79 %) (0.33 %) Permanent differences (38.40 %) 1.05 % Research & Development Credits 37.81 % (10.47 %) Other adjustments 0.31 % 0.14 % Effective income tax rate 39.09 % 30.20 %
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): 2016 2015 Deferred Federal tax assets — Bad debt reserves $ 1,710 $ 1,612 Stock based compensation 668 636 Net operating loss 8,184 5,649 Accrued compensation 280 624 Alternative minimum tax credit 73 73 Inventories 69 52 Accrued rent 46 51 Goodwill and intangible assets 6,675 7,919 Research & Development Credits 534 418 Other Credits 5 3 Other 189 79 Total deferred Federal tax assets 18,433 17,116 Deferred Federal tax liabilities — Depreciation and asset basis differences (4,725 ) (3,358 ) Other (157 ) (364 ) Total deferred Federal tax liabilities (4,882 ) (3,722 ) Net deferred Federal tax assets 13,551 13,394 Net deferred state and local tax assets 1,560 1,477 Net deferred tax assets $ 15,111 $ 14,871
Classification of Net Deferred Income Taxes	The classification of net deferred income taxes as of December 31, 2016 is summarized (in thousands): Current Long-term Total Deferred tax assets $ 2,675 $ 19,067 $ 21,742 Deferred tax liabilities — (6,631 ) (6,631 ) Net deferred tax assets $ 2,675 $ 12,436 $ 15,111 The classification of net deferred tax assets as of December 31, 2015 is summarized (in thousands): Current Long-term Total Deferred tax assets $ 2,743 $ 17,278 $ 20,021 Deferred tax liabilities — (5,150 ) (5,150 ) Net deferred income taxes $ 2,743 $ 12,128 $ 14,871

Leases (Tables)

Leases (Tables)	12 Months Ended
	Dec. 31, 2016
Leases [Abstract]
Schedule of Future Minimum Rental Payments Pursuant to Capital and Operating Leases	Future minimum rental payments pursuant to leases that have an initial or remaining non-cancelable lease term in excess of one year as of December 31, 2016 are as follows (in thousands): Capital Operating Total 2017 $ 3,114 $ 990 $ 4,104 2018 1,826 831 2,657 2019 571 562 1,133 2020 274 178 452 2021 — 181 181 Thereafter — 938 938 Total require payments $ 5,785 $ 3,680 $ 9,465 Less amounts representing interest (3.1% to 10.5%) (274 ) Present value of minimum lease payments 5,511 Less current maturities (2,938 ) Long-term capital lease liability $ 2,573

Share-based Compensation (Table

Share-based Compensation (Tables)	12 Months Ended
	Dec. 31, 2016
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Summary of Restricted Share Activity, Excluding Company's Employee Stock Purchase Plan	The following table summarizes restricted share activity, excluding the Company’s employee stock purchase plan, for the years ended December 31: Number of Weighted Aggregate Unvested at December 31, 2014 256,003 $ 1.78 Granted 61,663 2.60 Vested (83,029 ) 1.53 $ 244,319 Vested shares forgone to satisfy minimum statutory withholding (24,031 ) 2.96 $ 71,445 Forfeitures (39,774 ) 1.79 Unvested at December 31, 2015 170,832 2.09 Granted — — Vested (64,182 ) 1.74 $ 236,161 Vested shares forgone to satisfy minimum statutory withholding (16,484 ) 2.81 $ 49,592 Forfeitures (32,833 ) 2.18 Unvested at December 31, 2016 57,333 $ 2.21
Summary of Activity Relating to Company's ESPP Program	The following table summarizes the activity relating to the Company’s ESPP program for the years ended December 31: 2016 2015 Compensation expense $ 113,531 $ 40,233 Shares of stock sold to employees 88,109 98,070 Weighted average fair value per ESPP award $ 2.73 $ 2.73
Summary of Stock Option and Inducement Stock Option Activity	The following table details the various stock option and inducement stock option activity for the years ended December 31: 2007 Plan (Options) Number of Weighted- Weighted- Aggregate Outstanding at December 31, 2014 595,000 $ 2.19 1.51 $ 571,717 Granted — — — Exercised (52,030 ) 1.64 140,368 Exercised shares forgone to satisfy minimum statutory withholding (7,688 ) 1.76 Cashless exercise (41,950 ) 1.70 Forfeited (5,000 ) 1.93 Outstanding at December 31, 2015 488,332 $ 2.31 0.41 $ 348,415 Granted — — — Exercised — — — Exercised shares forgone to satisfy minimum statutory withholding — — Cashless exercise — — Forfeited — — Outstanding at December 31, 2016 488,332 $ 2.31 0.25 $ 118,899 Exercisable at December 31, 2016 483,332 $ 2.29 Aggregate Intrinsic Value = Excess of market value over the option exercise price of all in-the-money stock options. 2014 Plan (Options) Number Weighted- Weighted- Aggregate Outstanding at December 31, 2014 530,000 $ 2.69 5.00 $ 243,800 Granted 470,000 $ 2.90 3.25 $ — Exercised — Exercised shares forgone to satisfy minimum statutory withholding — Forfeited (30,000 ) 2.69 Outstanding at December 31, 2015 970,000 $ 2.79 3.58 $ 222,200 Exercisable at December 31, 2015 410,903 $ 2.85 Granted 600,000 2.76 4.60 Exercised (1,866 ) 2.69 Exercised shares forgone to satisfy minimum statutory withholding (798 ) 2.69 Cashless exercise (12,614 ) 2.69 Forfeited (304,723 ) 2.70 Outstanding at December 31, 2016 1,249,999 $ 2.80 4.26 $ — Exercisable at December 31, 2016 616,597 $ 2.87 Aggregate Intrinsic Value = Excess of market value over the option exercise price of all in-the-money stock options. Inducement Options Number of Weighted- Weighted- Aggregate Outstanding at December 31, 2014 800,000 $ 2.25 3.89 $ 720,000 Granted — — — — Exercised — — — — Forfeited — — — — Outstanding at December 31, 2015 800,000 $ 2.25 2.90 $ 616,000 Granted — — — — Exercised — — — — Forfeited — — — — Outstanding at December 31, 2016 800,000 $ 2.25 2.26 $ 240,000 Exercisable at December 31, 2016 756,250 $ 2.25 Aggregate Intrinsic Value = Excess of market value over the option exercise price of all in-the-money stock options.
Schedule of Stock Options Outstanding	The following table summarizes information about stock options outstanding at December 31, 2016: 2007 Plan (Options): Options Outstanding Options Exercisable Range of Exercise Prices Number of Weighted- Weighted- Number of Weighted- $1.50 - $1.75 110,000 — $ 1.51 110,000 $ 1.51 $1.76 - $2.00 91,666 — 1.93 91,666 1.70 $2.01 - $3.00 286,666 0.25 2.71 281,666 2.71 Outstanding at December 31, 2016 488,332 0.25 $ 2.31 483,332 $ 2.29 2014 Plan (Options): Options Outstanding Options Exercisable Range of Exercise Prices Number of Weighted- Weighted- Number of Weighted- $2.01 - $3.00 1,249,999 4.26 $ 2.80 616,597 $ 2.87 Outstanding at December 31, 2016 1,249,999 4.26 $ 2.80 616,597 $ 2.87 Inducement Options: Options Outstanding Options Exercisable Range of Exercise Prices Number of Weighted- Weighted- Number of Weighted- $1.50 - $1.75 400,000 2.26 $ 1.75 381,250 $ 1.75 $2.26 - $2.75 400,000 2.26 2.75 375,000 2.75 Outstanding at December 31, 2016 800,000 2.26 $ 2.25 756,250 $ 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 years ended December 31: Stock Options: 2016 2015 Expected volatility 35% 50% to 54% Risk free interest rate 0.69% 0.25% to 0.66% Expected lives at date of grant (in years) 5.01 4.43 Weighted average fair value of options granted $ 2.76 $ 2.90
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): 2016 2015 Restricted share expense $ 151 $ 107 Stock option expense 311 889 Total stock-based compensation expense $ 462 $ 996

Basis of Presentation and Nat29

Basis of Presentation and Nature of Operations - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2016Location
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of locations in United States and Canada	6
Concentration risk of ambulatory pumps purchased, percentage	10.00%

Summary of Significant Accoun30

Summary of Significant Accounting Policies - Additional Information (Detail)	Dec. 31, 2016USD ($)Financial_Institutions	Oct. 31, 2016USD ($)	Dec. 31, 2015USD ($)	Dec. 31, 2016USD ($)Financial_InstitutionsCustomerSegmentshares	Dec. 31, 2015USD ($)Customershares
Summary Of Significant Accounting Policies [Line Items]
Number of reportable segments | Segment				1
Maintenance of cash and cash equivalents with number of financial institutions | Financial_Institutions	2			2
Liquid Investments with original maturities period				Three months or less
Estimated obsolete inventory	$ 200,000		$ 100,000	$ 200,000	$ 100,000
Medical equipment in rental services useful life				7 years
Medical equipment held for sale or rental reserves	600,000		200,000	$ 600,000	200,000
Impairment of intangible assets		$ 0
Capitalized internal-use software cost	$ 3,500,000		$ 5,700,000	3,500,000	5,700,000
Amortization expense for capitalized software				$ 1,700,000	$ 400,000
Shares with anti-dilutive effect | shares				90,715	43,215
Software [Member]
Summary Of Significant Accounting Policies [Line Items]
Estimated useful life Period				3 years
Trade Names [Member]
Summary Of Significant Accounting Policies [Line Items]
Estimated useful life Period				1 year
Computers Equipment and Software [Member]
Summary Of Significant Accounting Policies [Line Items]
Estimated useful lives				3 years
Stock Options [Member]
Summary Of Significant Accounting Policies [Line Items]
Shares with anti-dilutive effect | shares				100,000	100,000
Capital Leases [Member]
Summary Of Significant Accounting Policies [Line Items]
Weighted average interest rate under capital leases	5.10%			5.10%
Sales Revenue, Net [Member] | Customer Concentration Risk [Member]
Summary Of Significant Accounting Policies [Line Items]
Number of payors having greater than 10% of the Company's revenue | Customer				0	0
Sales Revenue, Net [Member] | Customer Concentration Risk [Member] | Medicare [Member]
Summary Of Significant Accounting Policies [Line Items]
Concentration risk percentage				21.00%	32.00%
Sales Revenue, Net [Member] | Customer Concentration Risk [Member] | Blue Cross/Blue Shield affiliates [Member]
Summary Of Significant Accounting Policies [Line Items]
Concentration risk percentage				19.00%	18.00%
Accounts Receivable [Member] | Customer Concentration Risk [Member] | Medicare [Member]
Summary Of Significant Accounting Policies [Line Items]
Concentration risk percentage	5.00%		23.00%
Accounts Receivable [Member] | Customer Concentration Risk [Member] | Blue Cross/Blue Shield affiliates [Member]
Summary Of Significant Accounting Policies [Line Items]
Concentration risk percentage	26.00%		31.00%
Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Estimated useful lives				3 years
Likelihood of tax benefit being sustained				50.00%
Minimum [Member] | Physician and Customer Relationships [Member]
Summary Of Significant Accounting Policies [Line Items]
Estimated useful life Period				15 years
Minimum [Member] | Non-Compete Agreements [Member]
Summary Of Significant Accounting Policies [Line Items]
Estimated useful life Period				2 years
Minimum [Member] | Software Development [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
Maximum [Member] | Physician and Customer Relationships [Member]
Summary Of Significant Accounting Policies [Line Items]
Estimated useful life Period				20 years
Maximum [Member] | Non-Compete Agreements [Member]
Summary Of Significant Accounting Policies [Line Items]
Estimated useful life Period				5 years
Maximum [Member] | Software Development [Member]
Summary Of Significant Accounting Policies [Line Items]
Estimated useful lives				5 years
Maximum [Member] | Sales Revenue, Net [Member] | Customer Concentration Risk [Member]
Summary Of Significant Accounting Policies [Line Items]
Concentration risk percentage				10.00%	10.00%

Summary of Significant Accoun31

Summary of Significant Accounting Policies - Analysis of Allowance for Doubtful Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Accounting Policies [Abstract]
Balance at beginning of Year	$ 4,737	$ 4,739
Charged to costs and expenses	5,631	5,234
Deductions	(5,379)	(5,236)
Balance at end of Year	$ 4,989	$ 4,737

Summary of Significant Accoun32

Summary of Significant Accounting Policies - Summary of Income and Share Amounts Utilized to Calculate Basic and Diluted Net Income Per Common Share (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Numerator:
Net (loss) income	$ (222)	$ 2,785
Weighted average common shares outstanding:
Basic	22,617,901	22,414,587
Dilutive effect of restricted shares, options and non-vested share awards		428,648
Diluted	22,617,901	22,843,235
Antidilutive awards:	90,715	43,215

Business Combinations - Additio

Business Combinations - Additional Information (Detail) $ in Millions	Dec. 31, 2015USD ($)	Apr. 20, 2015USD ($)Medical_FacilityInfusionPump	Dec. 31, 2016
Minimum [Member]
Business Acquisition [Line Items]
Property and equipment, estimated remaining lives			3 years
Maximum [Member]
Business Acquisition [Line Items]
Property and equipment, estimated remaining lives			7 years
Ciscura [Member]
Business Acquisition [Line Items]
Purchase price		$ 6.2
Number of medical facility relationships prior to acquisition | Medical_Facility		100
Number of infusion pumps acquired | InfusionPump		1,800
Ciscura [Member] | General and Administrative Expenses [Member]
Business Acquisition [Line Items]
Professional and other related expenses	$ 0.7
Ciscura [Member] | Minimum [Member]
Business Acquisition [Line Items]
Property and equipment, estimated remaining lives			1 year
Ciscura [Member] | Maximum [Member]
Business Acquisition [Line Items]
Property and equipment, estimated remaining lives			7 years

Business Combinations - Summary

Business Combinations - Summary of Final Purchase Price Allocation (Detail) - Ciscura [Member] $ in Thousands	Apr. 20, 2015USD ($)
Business Acquisition [Line Items]
Medical equipment in rental service	$ 2,289
Total - final purchase price	6,156
Furniture, Fixtures, and Equipment [Member]
Business Acquisition [Line Items]
Property, plant, and equipment	20
Leasehold Improvements [Member]
Business Acquisition [Line Items]
Property, plant, and equipment	185
Trademarks and Trade Names [Member]
Business Acquisition [Line Items]
Finite-lived intangible assets	23
Customer Relationships [Member]
Business Acquisition [Line Items]
Finite-lived intangible assets	3,393
Non-Compete Agreements [Member]
Business Acquisition [Line Items]
Finite-lived intangible assets	$ 246

Medical Equipment - Summary of

Medical Equipment - Summary of Medical Equipment (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Medical Equipment And Property [Abstract]
Medical equipment held for sale or rental	$ 1,642	$ 2,277
Medical Equipment in rental service	59,034	53,681
Medical Equipment in rental service - pump reserve	(551)	(232)
Accumulated depreciation	(30,447)	(25,612)
Medical Equipment in rental service - net	28,036	27,837
Total	$ 29,678	$ 30,114

Medical Equipment - Additional

Medical Equipment - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Property, Plant and Equipment [Abstract]
Depreciation expense for medical equipment	$ 6.3	$ 4.8

Property and Equipment - Proper

Property and Equipment - Property and Equipment (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Property, Plant and Equipment [Line Items]
Gross Assets	$ 6,115	$ 4,654
Accumulated Depreciation	(4,118)	(2,284)
Total	1,997	2,370
Furniture, Fixtures, and Equipment [Member]
Property, Plant and Equipment [Line Items]
Gross Assets	3,809	2,330
Accumulated Depreciation	(3,071)	(1,382)
Total	738	948
Automobiles [Member]
Property, Plant and Equipment [Line Items]
Gross Assets	129	84
Accumulated Depreciation	(83)	(76)
Total	46	8
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Gross Assets	2,177	2,240
Accumulated Depreciation	(964)	(826)
Total	$ 1,213	$ 1,414

Property and Equipment - Additi

Property and Equipment - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Property, Plant and Equipment [Abstract]
Total depreciation expense recorded	$ 0.6	$ 0.6

Intangible Assets - Summary of

Intangible Assets - Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Indefinite Lived And Finite Lived Intangible Assets [Line Items]
Total nonamortizable and amortizable intangible assets, Gross Assets	$ 53,438	$ 51,317
Total nonamortizable and amortizable intangible assets, Accumulated Amortization	22,199	19,783
Total nonamortizable and amortizable intangible assets, Net	31,239	31,534
Trade Names [Member]
Indefinite Lived And Finite Lived Intangible Assets [Line Items]
Amortizable intangible assets, Gross Assets	23	23
Amortizable intangible assets, Accumulated Amortization	23	15
Amortizable intangible assets, Net		8
Physician and Customer Relationships [Member]
Indefinite Lived And Finite Lived Intangible Assets [Line Items]
Amortizable intangible assets, Gross Assets	36,534	36,258
Amortizable intangible assets, Accumulated Amortization	19,427	17,049
Amortizable intangible assets, Net	17,107	19,209
Non-Compete Agreements [Member]
Indefinite Lived And Finite Lived Intangible Assets [Line Items]
Amortizable intangible assets, Gross Assets	1,136	1,094
Amortizable intangible assets, Accumulated Amortization	1,064	930
Amortizable intangible assets, Net	72	164
Software [Member]
Indefinite Lived And Finite Lived Intangible Assets [Line Items]
Amortizable intangible assets, Gross Assets	13,745	11,942
Amortizable intangible assets, Accumulated Amortization	1,685	1,789
Amortizable intangible assets, Net	12,060	10,153
Trade Names [Member]
Indefinite Lived And Finite Lived Intangible Assets [Line Items]
Nonamortizable intangible assets	$ 2,000	$ 2,000

Intangible Assets - Additional

Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Finite-Lived Intangible Assets [Line Items]
Amortization of intangible assets	$ 3,849	$ 2,884
Physician and Customer Relationships [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted average remaining lives	8 years
Non-Compete 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	3 years

Intangible Assets - Schedule of

Intangible Assets - Schedule of Expected Annual Amortization Expense for Intangible Assets (Detail) $ in Thousands	Dec. 31, 2016USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense, 2017	$ 5,649
Amortization expense, 2018	5,274
Amortization expense, 2019	4,841
Amortization expense, 2020	4,298
Amortization expense, 2021	3,943
Amortization expense, 2022 and thereafter	$ 5,234

Debt - Additional Information (

Debt - Additional Information (Detail) - USD ($)	Dec. 05, 2016	Dec. 31, 2016	Dec. 31, 2015	Mar. 23, 2015	Jan. 23, 2015
Line of Credit Facility [Line Items]
Credit facility, maturity date		Nov. 30, 2016
Amendment to Credit Agreement, description		Third Amendment increased the maximum Leverage Covenant ratio for the period ending December 31, 2014 and all subsequent periods to 2.00:1.00. Prior to this amendment, the maximum Leverage Covenant ratio for the periods ending (a) December 31, 2014 through March 31, 2015 was 1.50:1.00, (b) June 30, 2015 through September 30, 2015 was 1.25:1.00, (c) December 31, 2015 through September 30, 2016 was 1.00:1.00.
Loss on extinguishment of long-term debt			$ (1,599,000)
Deadline of annual financial plan and forecast period		30 days
First Amended Credit Agreement [Member]
Line of Credit Facility [Line Items]
Amendment to Credit Agreement, description		Amend the Leverage Ratio covenant to provide for the following schedule of maximum permitted ratios (i) 3.0 to 1.0 at any time on or after the effective date but prior to December 31, 2015, (ii) 2.75 to 1.0 at any time on or after December 31, 2015 but prior to March 31, 2017, (iii) 2.50 to 1.0 at any time on or after March 31, 2017 but prior to March 31, 2018 or (iv) 2.25 to 1.00 at any time on or after March 31, 2018.
JP Morgan Chase Bank [Member]
Line of Credit Facility [Line Items]
Credit facility, maturity date		Mar. 23, 2020
Term Loan A [Member]
Line of Credit Facility [Line Items]
Line of credit facility					$ 12,000,000
Current borrowings under credit facility				$ 27,000,000
Debt instrument period payment, principal amount		$ 1,000,000
Optional pre-payments			4,800,000
Prepayment of debt			1,900,000
Remaining future repayment of debt			2,900,000
Term Loan A [Member] | JP Morgan Chase Bank [Member]
Line of Credit Facility [Line Items]
Line of credit facility				27,000,000
Term Loan B [Member]
Line of Credit Facility [Line Items]
Line of credit facility					14,500,000
Current borrowings under credit facility			6,300,000
Additional available balance			1,700,000
Frequency of period payment		Under the terms of the Chase Credit Agreement, principal payments equal to $1.0 million are due on Term Loan A on the last business day of each quarter beginning with the last business day of September 2015 and are due until the maturity date of the Chase Credit Facility. Principal payments on Term Loan B are due on the last business day of each fiscal quarter beginning with the last business day of March 2016.
Term Loan B [Member] | First Eight Quarterly Payments [Member]
Line of Credit Facility [Line Items]
Percentage of principal balance		3.575%
Term Loan B [Member] | Next Eight Quarterly Payments [Member]
Line of Credit Facility [Line Items]
Percentage of principal balance		4.475%
Term Loan B [Member] | JP Morgan Chase Bank [Member]
Line of Credit Facility [Line Items]
Line of credit facility				8,000,000
Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Line of credit facility					$ 10,000,000
Current borrowings under credit facility		$ 0	$ 0
Revolving Credit Facility [Member] | JP Morgan Chase Bank [Member]
Line of Credit Facility [Line Items]
Line of credit facility				$ 10,000,000
CBFR Loans [Member]
Line of Credit Facility [Line Items]
Interest on the credit facility, description		CBFR Loan, which bears interest at a per annum rate equal to (a) the Lender's prime rate or (b) LIBOR for a 30-day interest period, plus 2.50%, in each case plus a margin ranging from -0.75% to -0.25%
Credit Facility [Member]
Line of Credit Facility [Line Items]
Minimum fixed charge coverage ratio		125.00%
Minimum net worth		$ 37,500,000
Term Loan [Member]
Line of Credit Facility [Line Items]
Frequency of period payment		Set the quarterly mandatory principal payment due on the Term Loan to $1.3 million due on the last business day of each fiscal quarter with any remaining unpaid and outstanding amount due at maturity.
Credit facility, maturity period		5 years
Term Loan [Member] | First Amended Credit Agreement [Member]
Line of Credit Facility [Line Items]
Current borrowings under credit facility	$ 32,000,000
Additional available balance	5,000,000
Debt instrument period payment, principal amount	$ 1,300,000
LIBOR [Member]
Line of Credit Facility [Line Items]
Effective floating interest rate		2.50%
Effective fixed interest rate		3.27%
Debt instrument floor rate		0.77%
LIBOR [Member] | CBFR Loans [Member]
Line of Credit Facility [Line Items]
Effective floating interest rate		2.50%
Eurodollar [Member]
Line of Credit Facility [Line Items]
Interest on the credit facility, description		Eurodollar Loan, which bears interest at a per annum rate equal to LIBOR, plus a margin ranging from 2.00% to 2.50%
Maximum [Member]
Line of Credit Facility [Line Items]
Leverage Covenant ratio		2
Prior to amendment, maximum leverage covenant ratio for the period December 31, 2014 through March 31, 2015		150.00%
Prior to amendment, maximum leverage covenant ratio for the period June 30, 2015 through September 30, 2015		125.00%
Prior to amendment, maximum leverage covenant ratio for the period December 31, 2015 through September 30, 2016		100.00%
Maximum [Member] | First Amended Credit Agreement [Member]
Line of Credit Facility [Line Items]
After amendment, maximum leverage covenant ratio at any time on or after the effective date but prior to December 31, 2015	300.00%
After amendment, maximum leverage covenant ratio at any time on or after December 31, 2015 but prior to March 31, 2017	275.00%
After amendment, maximum leverage covenant ratio at any time on or after March 31, 2017 but prior to March 31, 2018	250.00%
After amendment, maximum leverage covenant ratio at any time on or after March 31, 2018	225.00%
Maximum [Member] | Credit Facility [Member]
Line of Credit Facility [Line Items]
Leverage ratio for remainder period		300.00%
Maximum [Member] | LIBOR [Member] | CBFR Loans [Member]
Line of Credit Facility [Line Items]
Effective floating interest rate		(0.75%)
Maximum [Member] | Eurodollar LIBOR Rate [Member]
Line of Credit Facility [Line Items]
Effective floating interest rate		2.50%
Minimum [Member] | Credit Facility [Member]
Line of Credit Facility [Line Items]
Leverage ratio for remainder period		225.00%
Minimum [Member] | LIBOR [Member] | CBFR Loans [Member]
Line of Credit Facility [Line Items]
Effective floating interest rate		(0.25%)
Minimum [Member] | Eurodollar LIBOR Rate [Member]
Line of Credit Facility [Line Items]
Effective floating interest rate		2.00%

Debt - Summary of Revolver Base

Debt - Summary of Revolver Based upon Borrower's Eligible Accounts Receivable and Inventory (Detail) - Revolving Credit Facility [Member] - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Line of Credit Facility [Line Items]
Gross availability	$ 10,000	$ 10,000
Outstanding draws	0	0
Letter of credit		(81)
Landlord Reserves	(45)	(37)
Availability on Revolver	$ 9,955	$ 9,882

Debt - Summary of Future Maturi

Debt - Summary of Future Maturities of Loans and Capital Leases (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Line of Credit Facility [Line Items]
2,017	$ 5,314
2,018	5,314
2,019	5,314
2,020	5,314
2,021	10,635
Total	31,891	$ 28,390
Unamortized value of the debt issuance costs, 2017	(22)
Unamortized value of the debt issuance costs, 2018	(22)
Unamortized value of the debt issuance costs, 2019	(22)
Unamortized value of the debt issuance costs, 2020	(22)
Unamortized value of the debt issuance costs, 2021	(21)
Unamortized value of the debt issuance costs, Total	(109)	$ (134)
Term Loan A [Member]
Line of Credit Facility [Line Items]
2,017	5,336
2,018	5,336
2,019	5,336
2,020	5,336
2,021	10,656
Total	$ 32,000

Debt - Summary of Company's Cur

Debt - Summary of Company's Current and Long-Term Debt (Including Capital Leases) (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Line of Credit Facility [Line Items]
Current Portion of Long-Term Debt	$ 5,314	$ 1,842
Long-Term Debt	26,577	26,548
Total	31,891	28,390
Unamortized value of the debt issuance costs, Current Portion of Long-Term Debt	(22)	(31)
Unamortized value of the debt issuance costs, Long-Term Debt	(87)	(103)
Unamortized value of the debt issuance costs, Total	(109)	(134)
Term Loans [Member]
Line of Credit Facility [Line Items]
Current Portion of Long-Term Debt	5,336	1,873
Long-Term Debt	26,664	26,651
Total	$ 32,000	$ 28,524

Income Taxes - Summary of (Loss

Income Taxes - Summary of (Loss) Income Before Income Taxes (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Income Tax Disclosure [Abstract]
U.S (loss) income	$ (600)	$ 3,752
Non-U.S. income	236	237
(Loss) income before income taxes	$ (364)	$ 3,989

Income Taxes - Summary of Compo

Income Taxes - Summary of Components of Consolidated Provision for Income Taxes (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
U.S Federal income tax benefit (expense)
U.S Federal income tax benefit (expense) Current	$ 0	$ 0
U.S Federal income tax benefit (expense) Deferred	157	(970)
Total U.S. Federal income tax benefit (expense)	157	(970)
State and local income tax (expense) benefit
State and local income tax (expense) benefit Current	(58)	(101)
State and local income tax (expense) benefit Deferred	83	(168)
Total state and local income tax benefit (expense)	25	(269)
Foreign income tax (expense) benefit
Foreign income tax (expense) benefit Current	(40)	35
Total income tax benefit (expense)	$ 142	$ (1,204)

Income Taxes - Reconciliations

Income Taxes - Reconciliations of Effective Income Tax Rate to Federal Statutory Rate (Detail)	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Income tax expense at the statutory rate	34.00%	34.00%
State and local income tax expense	9.16%	5.81%
Foreign income tax	(3.79%)	(0.33%)
Permanent differences	(38.40%)	1.05%
Research & Development Credits	37.81%	(10.47%)
Other adjustments	0.31%	0.14%
Effective income tax rate	39.09%	30.20%

Income Taxes - Summary of Tempo

Income Taxes - Summary of Temporary Differences and Carryforwards that Gives Rise to Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Deferred Federal tax assets -
Total deferred Federal tax assets	$ 21,742	$ 20,021
Deferred Federal tax liabilities -
Total deferred Federal tax liabilities	(6,631)	(5,150)
Net deferred tax assets	15,111	14,871
Deferred Federal Tax [Member]
Deferred Federal tax assets -
Bad debt reserves	1,710	1,612
Stock based compensation	668	636
Net operating loss	8,184	5,649
Accrued compensation	280	624
Alternative minimum tax credit	73	73
Inventories	69	52
Accrued rent	46	51
Goodwill and intangible assets	6,675	7,919
Research & Development Credits	534	418
Other Credits	5	3
Other	189	79
Total deferred Federal tax assets	18,433	17,116
Deferred Federal tax liabilities -
Depreciation and asset basis differences	(4,725)	(3,358)
Other	(157)	(364)
Total deferred Federal tax liabilities	(4,882)	(3,722)
Net deferred tax assets	13,551	13,394
Deferred State and Local Tax [Member]
Deferred Federal tax liabilities -
Net deferred tax assets	$ 1,560	$ 1,477

Income Taxes - Classification o

Income Taxes - Classification of Net Deferred Income Taxes (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Deferred tax assets, Current	$ 2,675	$ 2,743
Deferred tax liabilities, Current	0	0
Net deferred income taxes, Current	2,675	2,743
Deferred tax assets, Long-term	19,067	17,278
Deferred tax liabilities, Long-term	(6,631)	(5,150)
Net deferred income taxes, Long-term	12,436	12,128
Total deferred Federal income tax assets	21,742	20,021
Total deferred Federal income tax liabilities	(6,631)	(5,150)
Net deferred income taxes	$ 15,111	$ 14,871

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Operating Loss Carryforwards [Line Items]
Research and development credits	$ 600,000
U.S. Federal NOL carryforwards relating to deductions taken with respect to stock option exercises	600,000
Uncertain tax positions	$ 0
Operating loss carryforwards, limitations on use	The Company is subject to an annual limitation of $1.8 million on its use of remaining pre-ownership change net operating loss carryforwards of $4.7 million (and certain other pre-change tax attributes).
Annual limitation on use of net operating loss carryforwards	$ 1,800,000
Remaining pre-ownership change net operating loss carryforwards	4,700,000
Deferred Federal Tax [Member]
Operating Loss Carryforwards [Line Items]
Federal and state operating loss carryforwards	$ 24,100,000	$ 15,500,000
Federal and state net operating losses expiry time period	Dec. 31, 2028
Deferred State and Local Tax [Member]
Operating Loss Carryforwards [Line Items]
Federal and state operating loss carryforwards	$ 800,000
Federal and state net operating losses expiry time period	Dec. 31, 2017
Net operating loss substantial portion expiration period	2,017
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

Leases - Additional Information

Leases - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Leases [Line Items]
Pump equipment	$ 13.9	$ 11.2
Accumulated depreciation related to leased assets	3.9	2.4
Depreciation expense for medical equipment	6.3	$ 4.8
Operating lease rental expenses	$ 1
Capital Leases [Member]
Leases [Line Items]
Weighted average interest rate under capital leases	5.10%

Leases - Schedule of Future Min

Leases - Schedule of Future Minimum Rental Payments Pursuant to Capital and Operating Leases (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Leases [Abstract]
Capital leases, 2017	$ 3,114
Capital leases, 2018	1,826
Capital leases, 2019	571
Capital leases, 2020	274
Capital leases, 2021	0
Capital leases, Thereafter	0
Total capital leases require payments	5,785
Less amounts representing interest (3.1% to 10.5%)	(274)
Present value of minimum lease payments	5,511
Present value of minimum lease payments	5,511
Less current maturities	(2,938)	$ (3,187)
Long-term capital lease liability	2,573	$ 3,233
Operating leases, 2017	990
Operating leases, 2018	831
Operating leases, 2019	562
Operating leases, 2020	178
Operating leases, 2021	181
Operating leases, Thereafter	938
Total operating leases require payments	3,680
Capital and operating leases, 2017	4,104
Capital and operating leases, 2018	2,657
Capital and operating leases, 2019	1,133
Capital and operating leases, 2020	452
Capital and operating leases, 2021	181
Capital and operating leases, Thereafter	938
Total Capital and operating leases require payments	$ 9,465

Leases - Schedule of Future M54

Leases - Schedule of Future Minimum Rental Payments Pursuant to Capital and Operating Leases (Parenthetical) (Detail)	Dec. 31, 2016
Minimum [Member]
Capital Leases And Operating Leases [Line Items]
Capital lease interest rate	3.10%
Maximum [Member]
Capital Leases And Operating Leases [Line Items]
Capital lease interest rate	10.50%

Share-based Compensation - Addi

Share-based Compensation - Additional Information (Detail) - USD ($)	Sep. 07, 2016	May 31, 2014	Dec. 31, 2016	Dec. 31, 2015	Apr. 23, 2014	May 27, 2011
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares received from employees for tax withholding obligations			100,000	100,000
Shares of common stock authorized for purchase by eligible employees at a discount through payroll deductions		200,000
Maximum fair market value of shares an employee can purchase		$ 25,000
Employee stock purchase plan, discount rate		15.00%
Additional shares approved for issuance under plan	350,000
Shares available for future issuance			363,821
Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of Shares, Granted			0	61,663
Period of recognize the cost				2,019
Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Issuance of shares of common stock			500,000
Vesting period				12 months
Stock options granted			600,000	500,000
Stock Options [Member] | Chief Executive Officer [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options granted			0	200,000
Minimum [Member] | Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period			3 years
Minimum [Member] | Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expiration period			3 years
Maximum [Member] | Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expiration period			4 years
Issuance of shares of common stock			100,000
Vesting period			4 years
Pre-tax total unrecognized compensation cost related to non-vested restricted shares				$ 100,000
Maximum [Member] | Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expiration period			10 years
2014 Amended and Restated Stock Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Issuance of shares of common stock			2,000,000		2,000,000
Availability of common shares			700,000
Additional share issued under stock incentive plan						3,000,000

Share-based Compensation - Summ

Share-based Compensation - Summary of Restricted Share Activity, Excluding Company's Employee Stock Purchase Plan (Detail) - Restricted Stock [Member] - USD ($)	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unvested Number of Shares, Beginning Balance	170,832	256,003
Number of Shares, Granted	0	61,663
Number of Shares, Vested	(64,182)	(83,029)
Vested shares forgone to satisfy minimum statutory withholding	(16,484)	(24,031)
Number of Shares, Forfeitures	(32,833)	(39,774)
Unvested Number of Shares, Ending Balance	57,333	170,832
Unvested Weighted average grant date fair value, Beginning Balance	$ 2.09	$ 1.78
Weighted average grant date fair value, Granted		2.60
Weighted average grant date fair value, Vested	1.74	1.53
Weighted average grant date fair value, Vested shares forgone to satisfy minimum statutory withholding	2.81	2.96
Weighted average grant date fair value, Forfeitures	2.18	1.79
Unvested Weighted average grant date fair value, Ending Balance	$ 2.21	$ 2.09
Aggregate fair value, Vested	$ 236,161	$ 244,319
Aggregate fair value, Vested shares forgone to satisfy minimum statutory withholding	$ 49,592	$ 71,445

Share-based Compensation - Su57

Share-based Compensation - Summary of Activity Relating to Company's ESPP Program (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Compensation expense	$ 113,531	$ 40,233
Shares of stock sold to employees	88,109	98,070
Weighted average fair value per ESPP award	$ 2.73	$ 2.73

Share-based Compensation - Su58

Share-based Compensation - Summary of Stock Option and Inducement Stock Option Activity (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
2007 Plan (Options) [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of Authorized Shares, Options outstanding, beginning balance	488,332	595,000
Number of Authorized Shares, Exercised		(52,030)
Number of Authorized Shares, Exercised shares forgone to satisfy minimum statutory withholding		(7,688)
Number of Authorized Shares, Cashless exercise		(41,950)
Number of Authorized Shares, Forfeited		(5,000)
Number of Authorized Shares, Options outstanding, ending balance	488,332	488,332	595,000
Weighted-Average Exercise Price, Outstanding, beginning balance	$ 2.31	$ 2.19
Number of Authorized Shares, Exercisable	483,332
Weighted-Average Exercise Price, Exercised		1.64
Weighted-Average Exercise Price, Exercised shares forgone to satisfy minimum statutory withholding		1.76
Cashless exercise		1.70
Weighted-Average Exercise Price, Forfeited		1.93
Weighted-Average Exercise Price, Outstanding, ending balance	$ 2.31	$ 2.31	$ 2.19
Aggregate Intrinsic value, Outstanding, beginning balance	$ 348,415	$ 571,717
Weighted-Average Exercise Price, Exercisable	$ 2.29
Aggregate Intrinsic value, Exercised		$ 140,368
Weighted-Average Remaining Contractual Term (in Years), Granted	0 years	0 years
Aggregate Intrinsic value, Outstanding, ending balance	$ 118,899	$ 348,415	$ 571,717
Weighted-Average Remaining Contractual Term (in Years)	3 months	4 months 28 days	1 year 6 months 4 days
2014 Plan (Options) [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of Authorized Shares, Options outstanding, beginning balance	970,000	530,000
Number of Authorized Shares, Granted	600,000	470,000
Number of Authorized Shares, Exercised	(1,866)
Number of Authorized Shares, Exercised shares forgone to satisfy minimum statutory withholding	(798)
Number of Authorized Shares, Cashless exercise	(12,614)
Number of Authorized Shares, Forfeited	(304,723)	(30,000)
Number of Authorized Shares, Options outstanding, ending balance	1,249,999	970,000	530,000
Weighted-Average Exercise Price, Outstanding, beginning balance	$ 2.79	$ 2.69
Number of Authorized Shares, Exercisable	616,597	410,903
Weighted-Average Exercise Price, Granted	$ 2.76	$ 2.90
Weighted-Average Exercise Price, Exercised	2.69
Weighted-Average Exercise Price, Exercised shares forgone to satisfy minimum statutory withholding	2.69
Cashless exercise	2.69
Weighted-Average Exercise Price, Forfeited	2.70	2.69
Weighted-Average Exercise Price, Outstanding, ending balance	$ 2.80	$ 2.79	$ 2.69
Aggregate Intrinsic value, Outstanding, beginning balance	$ 222,200	$ 243,800
Weighted-Average Exercise Price, Exercisable	$ 2.87	$ 2.85
Weighted-Average Remaining Contractual Term (in Years), Granted	4 years 7 months 6 days	3 years 3 months
Aggregate Intrinsic value, Outstanding, ending balance		$ 222,200	$ 243,800
Weighted-Average Remaining Contractual Term (in Years)	4 years 3 months 4 days	3 years 6 months 29 days	5 years
Inducement Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of Authorized Shares, Options outstanding, beginning balance	800,000	800,000
Number of Authorized Shares, Options outstanding, ending balance	800,000	800,000	800,000
Weighted-Average Exercise Price, Outstanding, beginning balance	$ 2.25	$ 2.25
Number of Authorized Shares, Exercisable	756,250
Weighted-Average Exercise Price, Outstanding, ending balance	$ 2.25	$ 2.25	$ 2.25
Aggregate Intrinsic value, Outstanding, beginning balance	$ 616,000	$ 720,000
Weighted-Average Exercise Price, Exercisable	$ 2.25
Aggregate Intrinsic value, Outstanding, ending balance	$ 240,000	$ 616,000	$ 720,000
Weighted-Average Remaining Contractual Term (in Years)	2 years 3 months 4 days	2 years 10 months 24 days	3 years 10 months 21 days

Share-based Compensation - Sche

Share-based Compensation - Schedule of Stock Options Outstanding (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
2007 Plan (Options) [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options Outstanding, Number of shares outstanding	488,332
Options Outstanding, Weighted-Average Remaining Contractual Life	3 months
Options Outstanding, Weighted-Average Exercise Price	$ 2.31	$ 2.31	$ 2.19
Options Exercisable, Number of Shares Exercisable	483,332
Options Exercisable, Weighted-Average Exercise Price	$ 2.29
2014 Plan (Options) [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options Outstanding, Number of shares outstanding	1,249,999
Options Outstanding, Weighted-Average Remaining Contractual Life	4 years 3 months 4 days
Options Outstanding, Weighted-Average Exercise Price	$ 2.80	2.79	2.69
Options Exercisable, Number of Shares Exercisable	616,597
Options Exercisable, Weighted-Average Exercise Price	$ 2.87
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	2 years 3 months 4 days
Options Outstanding, Weighted-Average Exercise Price	$ 2.25	$ 2.25	$ 2.25
Options Exercisable, Number of Shares Exercisable	756,250
Options Exercisable, Weighted-Average Exercise Price	$ 2.25
$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	110,000
Options Outstanding, Weighted-Average Remaining Contractual Life	0 years
Options Outstanding, Weighted-Average Exercise Price	$ 1.51
Options Exercisable, Number of Shares Exercisable	110,000
Options Exercisable, Weighted-Average Exercise Price	$ 1.51
$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	2 years 3 months 4 days
Options Outstanding, Weighted-Average Exercise Price	$ 1.75
Options Exercisable, Number of Shares Exercisable	381,250
Options Exercisable, Weighted-Average Exercise Price	$ 1.75
$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	91,666
Options Outstanding, Weighted-Average Remaining Contractual Life	0 years
Options Outstanding, Weighted-Average Exercise Price	$ 1.93
Options Exercisable, Number of Shares Exercisable	91,666
Options Exercisable, Weighted-Average Exercise Price	$ 1.70
$2.01 - $3.00 [Member] | 2007 Plan (Options) [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options Outstanding, Number of shares outstanding	286,666
Options Outstanding, Weighted-Average Remaining Contractual Life	3 months
Options Outstanding, Weighted-Average Exercise Price	$ 2.71
Options Exercisable, Number of Shares Exercisable	281,666
Options Exercisable, Weighted-Average Exercise Price	$ 2.71
$2.01 - $3.00 [Member] | 2014 Plan (Options) [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options Outstanding, Number of shares outstanding	1,249,999
Options Outstanding, Weighted-Average Remaining Contractual Life	4 years 3 months 4 days
Options Outstanding, Weighted-Average Exercise Price	$ 2.80
Options Exercisable, Number of Shares Exercisable	616,597
Options Exercisable, Weighted-Average Exercise Price	$ 2.87
$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	2 years 3 months 4 days
Options Outstanding, Weighted-Average Exercise Price	$ 2.75
Options Exercisable, Number of Shares Exercisable	375,000
Options Exercisable, Weighted-Average Exercise Price	$ 2.75

Share-based Compensation - Sc60

Share-based Compensation - Schedule of Share-Based Compensation Expense Based on Fair Value of Options (Detail) - Stock Options [Member] - $ / shares	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected volatility	35.00%
Risk free interest rate	0.69%
Expected lives at date of grant (in years)	5 years 4 days	4 years 5 months 5 days
Weighted average fair value of options granted	$ 2.76	$ 2.90
Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected volatility		50.00%
Risk free interest rate		0.25%
Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected volatility		54.00%
Risk free interest rate		0.66%

Share-based Compensation - Stoc

Share-based Compensation - Stock Based Compensation (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Share-based Compensation [Abstract]
Restricted share expense	$ 151	$ 107
Stock option expense	311	889
Total stock-based compensation expense	$ 462	$ 996

Employee Benefit Plans - Additi

Employee Benefit Plans - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Compensation and Retirement Disclosure [Abstract]
Employer contributions	$ 0.7	$ 0.7