InfuSystem (INFU) 10-Q 9 Aug 17 2017 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2017	Aug. 04, 2017
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Jun. 30, 2017
Document Fiscal Year Focus	2,017
Document Fiscal Period Focus	Q2
Trading Symbol	INFU
Entity Registrant Name	InfuSystem Holdings, Inc
Entity Central Index Key	1,337,013
Current Fiscal Year End Date	--12-31
Entity Filer Category	Smaller Reporting Company
Entity Common Stock, Shares Outstanding		22,755,705

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2017	Dec. 31, 2016
Current Assets:
Cash and cash equivalents	$ 76	$ 3,398
Accounts receivable, less allowance for doubtful accounts of $6,189 and $4,989 at June 30, 2017 and December 31, 2016, respectively	11,547	11,581
Inventory	1,962	2,166
Other current assets	1,314	949
Deferred income taxes	0	2,675
Total Current Assets	14,899	20,769
Medical equipment held for sale or rental	1,289	1,642
Medical equipment in rental service, net of accumulated depreciation	25,715	28,036
Property & equipment, net of accumulated depreciation	1,815	1,997
Intangible assets, net	28,293	31,239
Deferred income taxes	16,638	12,436
Other assets	61	225
Total Assets	88,710	96,344
Current Liabilities:
Accounts payable	5,247	5,315
Capital leases	593	2,938
Current portion of long-term debt	2,660	5,314
Other current liabilities	2,494	2,872
Total Current Liabilities	10,994	16,439
Long-term debt, net of current portion	28,719	26,577
Capital leases	238	2,573
Other long-term liabilities	61	66
Total Long-Term Liabilities	29,018	29,216
Total Liabilities	40,012	45,655
Stockholders' Equity:
Preferred stock, $.0001 par value: authorized 1,000,000 shares; none issued	0
Common stock, $.0001 par value: authorized 200,000,000 shares; issued and outstanding 22,953,365 and 22,755,705, respectively, as of June 30, 2017 and 22,867,335 and 22,669,675, respectively, as of December 31, 2016	2	2
Additional paid-in capital	92,206	91,829
Retained deficit	(43,510)	(41,142)
Total Stockholders' Equity	48,698	50,689
Total Liabilities and Stockholders' Equity	$ 88,710	$ 96,344

Condensed Consolidated Balance3

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2017	Dec. 31, 2016
Statement of Financial Position [Abstract]
Accounts receivable, allowance for doubtful accounts	$ 6,189	$ 4,989
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	22,953,365	22,867,335
Common stock, shares outstanding	22,755,705	22,669,675

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2017	Jun. 30, 2016	Jun. 30, 2017	Jun. 30, 2016
Net revenues:
Rentals	$ 14,769	$ 16,242	$ 29,906	$ 32,730
Product Sales	2,173	1,881	4,690	3,687
Net revenues	16,942	18,123	34,596	36,417
Cost of revenues:
Cost of revenues - Product, service and supply costs	4,624	4,789	9,160	8,295
Cost of revenues - Pump depreciation and disposals	1,977	2,191	4,446	4,422
Gross profit	10,341	11,143	20,990	23,700
Selling, general and administrative expenses:
Provision for doubtful accounts	1,326	1,067	3,182	2,814
Amortization of intangibles	1,387	922	2,798	1,834
Selling and marketing	2,295	2,324	5,181	5,139
General and administrative	6,425	6,392	12,890	13,061
Total selling, general and administrative	11,433	10,705	24,051	22,848
Operating (loss) income	(1,092)	438	(3,061)	852
Other income (expense):
Interest expense	(333)	(327)	(661)	(632)
Other (expense) income	(66)	7	(103)	27
Total other expense	(399)	(320)	(764)	(605)
(Loss) income before income taxes	(1,491)	118	(3,825)	247
Income tax benefit (expense)	385	35	1,241	(53)
Net (loss) income	$ (1,106)	$ 153	$ (2,584)	$ 194
Net (loss) income per share:
Basic	$ (0.05)	$ 0.01	$ (0.11)	$ 0.01
Diluted	$ (0.05)	$ 0.01	$ (0.11)	$ 0.01
Weighted average shares outstanding:
Basic	22,740,050	22,620,386	22,710,470	22,584,462
Diluted	22,740,050	23,109,870	22,710,470	23,069,900

Condensed Consolidated Stateme5

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2017	Jun. 30, 2016
Statement of Cash Flows [Abstract]
NET CASH PROVIDED BY OPERATING ACTIVITIES	$ 1,231	$ 1,869
INVESTING ACTIVITIES
Purchase of medical equipment and property	(1,893)	(7,187)
Proceeds from sale of medical equipment and property	2,623	1,827
NET CASH PROVIDED BY (USED IN) INVESTING ACTIVITIES	730	(5,360)
FINANCING ACTIVITIES
Principal payments on revolving credit facility, term loans and capital lease obligations	(24,419)	(29,190)
Cash proceeds from revolving credit facility	19,105	32,575
Debt issuance costs	(28)
Common stock repurchased to satisfy statutory withholding on employee stock based compensation plans	(28)	(33)
Cash proceeds from stock plans	87	126
NET CASH (USED IN) PROVIDED BY FINANCING ACTIVITIES	(5,283)	3,478
Net change in cash and cash equivalents	(3,322)	(13)
Cash and cash equivalents, beginning of period	3,398	818
Cash and cash equivalents, end of period	$ 76	$ 805

Basis of Presentation, Nature o

Basis of Presentation, Nature of Operations and Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2017
Accounting Policies [Abstract]
Basis of Presentation, Nature of Operations and Summary of Significant Accounting Policies	1. Basis of Presentation, Nature of Operations and Summary of Significant Accounting Policies The terms “InfuSystem”, “the Company”, “we”, “our” and “us” are used herein to refer to InfuSystem Holdings, Inc. and its subsidiaries. InfuSystem Holdings, Inc. is a leading provider of infusion pumps and related services. The Company services hospitals, oncology practices and other alternative site healthcare providors. Headquartered in Madison Heights, Michigan, the Company delivers local, field-based customer support, and also operates pump repair Centers of Excellence in Michigan, Kansas, California, Texas, Georgia and Ontario, Canada. The accompanying unaudited condensed consolidated financial statements have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”) for interim financial information. Accordingly, the unaudited condensed consolidated financial statements do not include all of the information and notes required by U.S. Generally Accepted Accounting Principles (“GAAP”) for complete financial statements. The accompanying unaudited condensed consolidated financial statements include all adjustments, composed of normal recurring adjustments, considered necessary by management to fairly state the Company’s results of operations, financial position and cash flows. The operating results for the interim periods are not necessarily indicative of results that may be expected for any other interim period or for the full year. These unaudited condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2016 as filed with the SEC. The unaudited condensed consolidated financial statements are prepared in conformity with GAAP, which requires the use of estimates, judgments and assumptions that affect the amounts of assets and liabilities at the reporting date and the amounts of revenue and expenses in the periods presented. The Company believes that the accounting estimates employed are appropriate and the resulting balances are reasonable; however, due to the inherent uncertainties in making estimates, actual results could differ from the original estimates, requiring adjustments to these balances in future periods.

Medical Equipment and Property

Medical Equipment and Property	6 Months Ended
	Jun. 30, 2017
Text Block [Abstract]
Medical Equipment and Property	2. Medical Equipment and Property Medical equipment consisted of the following as of June 30, 2017 and December 31, 2016 (in thousands): June 30, December 31, Medical Equipment held for sale or rental $ 1,289 $ 1,642 Medical Equipment in rental service 58,669 59,034 Medical Equipment in rental service - pump reserve (486 ) (551 ) Accumulated depreciation (32,468 ) (30,447 ) Medical Equipment in rental service - net 25,715 28,036 Total $ 27,004 $ 29,678 Depreciation expense for medical equipment for the three and six months ended June 30, 2017 was $1.6 million and $3.2 million, respectively, compared to $1.6 million and $3.1 million for the same prior year periods, which was recorded in cost of revenues – pump depreciation and disposals, for each period.

Property and Equipment

Property and Equipment	6 Months Ended
	Jun. 30, 2017
Property, Plant and Equipment [Abstract]
Property and Equipment	3. Property and Equipment Property and equipment is comprised of the following (in thousands): June 30, 2017 December 31, 2016 Gross Accumulated Total Gross Accumulated Total Furniture, fixtures, and equipment $ 3,834 $ (3,185 ) $ 649 $ 3,809 $ (3,071 ) $ 738 Automobiles 118 (79 ) 39 129 (83 ) 46 Leasehold improvements 2,177 (1,050 ) 1,127 2,177 (964 ) 1,213 Total $ 6,129 $ (4,314 ) $ 1,815 $ 6,115 $ (4,118 ) $ 1,997 Depreciation expense for property and equipment for the three and six months ended June 30, 2017 was $0.1 million and $0.2 million, respectively, compared to $0.1 million and $0.3 million for the same prior year periods. This expense was recorded in general and administrative expenses.

Intangible Assets

Intangible Assets	6 Months Ended
	Jun. 30, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Intangible Assets	4. Intangible Assets The carrying amount and accumulated amortization of intangible assets as of June 30, 2017 and December 31, 2016, are as follows (in thousands): June 30, 2017 Gross Accumulated Net Nonamortizable intangible assets Trade names $ 2,000 $ 0 $ 2,000 Amortizable intangible assets Trade names 23 23 0 Physician and customer relationships 36,534 20,613 15,921 Non-competition agreements 1,136 1,115 21 Software 13,594 3,243 10,351 Total nonamortizable and amortizable intangible assets $ 53,287 $ 24,994 $ 28,293 December 31, 2016 Gross 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-competition 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 Amortization expense for the three and six months ended June 30, 2017 was $1.4 million and $2.8 million, respectively, compared to $0.9 million and $1.8 million, respectively, for the three and six months ended June 30, 2016. Expected annual amortization expense for intangible assets recorded as of June 30, 2017, is as follows (in thousands): 7/1-12/31/2017 2018 2019 2020 2021 2022 and Amortization expense $ 2,773 $ 5,218 $ 4,785 $ 4,331 $ 3,951 $ 5,235

Debt

Debt	6 Months Ended
	Jun. 30, 2017
Debt Disclosure [Abstract]
Debt	5. Debt On March 23, 2015, the Company and its direct and indirect subsidiaries (the “Borrowers”) entered into a credit agreement (the “Chase Credit Agreement”) with JPMorgan Chase Bank, N.A., as lender (the “Lender”). The Chase Credit Agreement originally provided for a $27.0 million Term Loan A, up to an $8.0 million Term Loan B and a $10.0 million revolving credit facility (the “Revolver”) and a maturity date of March 23, 2020, collectively (the “Credit Facility”). The Borrowers drew $27.0 million under the Term Loan A to repay and terminate the previously existing Credit Facility under the credit agreement dated November 30, 2012, as amended, by and among the Company, its direct and indirect subsidiaries, Wells Fargo Bank, National Association, as administrative agent, and certain lenders party thereto (the “WF 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 $8.0 million 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. The remaining available amount on Term Loan B expired on March 23, 2016. On December 5, 2016, the Company entered into a First Amendment to the Chase Credit Agreement to waive certain events of default then existing thereunder, as well as to make certain amendments to the Credit Facility, including but not limited to: (i) restructuring of the Credit Facility that effectively consolidated Term Loan A and Term Loan B into a new single term loan (the “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 under the Credit Facility; (ii) extending the maturity date of the Term Loan and the revolving credit line to December 5, 2021; (iii) setting 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; and (iv) amending the leverage ratio covenant to provide for the following schedule of maximum permitted ratios: (a) 2.75 to 1.0 at any time on or after December 31, 2015 but prior to March 31, 2017, (b) 2.50 to 1.0 at any time on or after March 31, 2017 but prior to March 31, 2018 or (c) 2.25 to 1.00 at any time on or after March 31, 2018. On March 22, 2017, the Company entered into a Second Amendment to the Chase Credit Agreement to make certain amendments to the Credit Facility, including but not limited to: (i) amending the definition of “Fixed Charges” to increase the Company’s ability to prepay its indebtedness under the Credit Facility without negatively impacting its financial covenants; and (ii) amending the leverage ratio covenant to provide for the following schedule of maximum permitted ratios: (a) 2.75 to 1.0 at any time on or after December 31, 2015 but prior to March 31, 2018, (b) 2.50 to 1.0 at any time on or after March 31, 2018 but prior to March 31, 2019 or (c) 2.25 to 1.00 at any time on or after March 31, 2019. As of March 31, 2017, the Company breached a financial covenant under its Credit Facility, which resulted in an event of default under the Credit Facility. Specifically, the Company was not in compliance with the leverage ratio covenant under the Credit Facility. The required maximum leverage ratio under the Credit Facility as of March 31, 2017 was 2.75 compared to an actual ratio of 2.96. The Company subsequently received a waiver from this breach from the Lender on May 10, 2017, which provided a limited, specific and one-time waiver from this breach but did not otherwise modify the terms of the Credit Facility. No fee was paid to the Lender in connection with this waiver. On June 28, 2017, the Company entered into a Third Amendment to the Chase Credit Agreement to make certain amendments to the Credit Facility, including but not limited to: (i) restates the chart within the definition of “Applicable Rate” in Section 1.01 of the Credit Agreement as follows: Leverage Ratio CBFR Spread Eurodollar Spread Commitment Fee Rate Level I < 1.5:1.0 -1.00% 2.00% 0.25% Level II < 2.0:1.0 to 1.0 but ³ -0.75% 2.25% 0.25% Level III < 2.5:1.0 to 1.0 but ³ -0.50% 2.50% 0.25% Level IV < 3.0:1.0 to 1.0 but ³ 0.00% 2.75% 0.25% Level V ³ 0.25% 3.00% 0.25% and further amends the definition of “Applicable Rate” in Section 1.01 of the Credit Agreement by adding the following to the end thereof: “The Applicable Rate will be set at Level V as of the Third Amendment Effective Date, and adjusted for the first time thereafter based on the financial statements required to be delivered hereunder for the fiscal quarter ending June 30, 2017.”; (ii) amend the definition of “Fixed Charge Coverage Ratio” in Section 1.01 of the Credit Agreement by adding the phrase “(it is acknowledged that, at all times, such unfinanced portion is either a deduction to EBITDA or, if unfinanced portion is ever interpreted to be a negative number, then zero)” to follow the phrase therein that reads “means, for any period, the ratio of (a) EBITDA minus the unfinanced portion of Capital Expenditures.”; (iii) amend clause (f)(ii) in the definition of “Permitted Acquisition” in Section 1.01 of the Credit Agreement by (a) replacing the reference therein to “$10,000,000” with “$5,000,000” and (b) by replacing the reference therein to “$25,000,000” with “$12,500,000.”; (iv) add the following definition of “Excess Cash Flow” to Section 1.01 of the Credit Agreement as follows: “Excess Cash Flow” means, for any fiscal year of the Company, (a) EBITDA for such fiscal year, minus (b) Capital Expenditures made or incurred during such fiscal year minus (c) Fixed Charges for such fiscal year. (v) restate Section 2.08(b) of the Credit Agreement as follows: (b) The Borrowers hereby unconditionally agree that the Term A Loans and the Term B Loans shall be replaced and refinanced in full as of the First Amendment Effective Date with a Term Loan in an aggregate amount equal to $32,000,000 made under Section 2.01(d), the Borrowers acknowledge and agree that the principal balance of such Term Loan as of the Third Amendment Effective Date is $30,665,999.98, and the Borrowers hereby unconditionally promise to pay to the Lender the principal amount of the Term Loans made under Section 2.01(d) after the Third Amendment Effective Date as follows: (i) on June 30, 2017, September 30, 2017 and December 31, 2017 in principal installments each in the amount of $577,500 (as adjusted from time to time pursuant to Section 2.09(d) or 2.16(b)), (ii) commencing with the last Business Day of March, 2018 and on the last Business Day of each March, June, September and December thereafter, in consecutive quarterly principal installments each in the amount of $766,650 (as adjusted from time to time pursuant to Section 2.09(d) or 2.16(b)) and (iii) to the extent not previously paid, all unpaid Term Loans shall be paid in full in cash by the Borrowers on the Term Maturity Date. (vi) restate Section 2.09(d) of the Credit Agreement as follows: (d) All prepayments required to be made pursuant to Section 2.09(c) shall be applied, first to prepay the Term Loans (and in the event Term Loans of more than one Class shall be outstanding at the time, shall be allocated among the Term Loans pro rata based on the aggregate principal amounts of outstanding Term Loans of each such Class), and such prepayments of the Term Loans shall be applied to reduce the remaining scheduled repayments of Term Loans of each Class in the inverse order of maturity (with any prepayments applied first to the payment at final maturity), second to prepay the Revolving Loans without a corresponding reduction in the Revolving Commitment and third to cash collateralize outstanding LC Exposure. Within each such category, such prepayments shall be applied first to CBFR Loans and then to Eurodollar Loans in order of Interest Period maturities (beginning with the earliest to mature). All prepayments required to be made pursuant to Section 2.09(f) shall be applied, first to prepay the Revolving Loans without a corresponding reduction in the Revolving Commitment, second to prepay the Term Loans (and in the event Term Loans of more than one Class shall be outstanding at the time, shall be allocated among the Term Loans pro rata based on the aggregate principal amounts of outstanding Term Loans of each such Class), and such prepayments of the Term Loans shall be applied to reduce the remaining scheduled repayments of Term Loans of each Class in the inverse order of maturity (with any prepayments applied first to the payment at final maturity), and third to cash collateralize outstanding LC Exposure. Within each such category, such prepayments shall be applied first to CBFR Loans and then to Eurodollar Loans in order of Interest Period maturities (beginning with the earliest to mature). (vii) add a new Section 2.09(f) to the Credit Agreement as follows: (f) Until the latest of the Revolving Credit Maturity Date, the Term A Maturity Date, the Term B Maturity Date or the Term Maturity Date, as the case may be, the Borrowers shall prepay the Obligations as set forth in Section 2.09(d) on the date that is ten days after the earlier of (i) the date on which the Company’s annual audited financial statements for the immediately preceding fiscal year are delivered pursuant to Section 5.01 or (ii) the date on which such annual audited financial statements were required to be delivered pursuant to Section 5.01, in an amount equal to: (I) seventy-five percent (75%) of the Company’s Excess Cash Flow for the immediately preceding fiscal year if the Company’s Leverage Ratio is greater than or equal to 2.5 to 1.0 for the immediately preceding fiscal year, (II) fifty percent (50%) of the Company’s Excess Cash Flow for the immediately preceding fiscal year if the Company’s Leverage Ratio is less than 2.5 to 1.0 but greater than or equal to 2.0 to 1.0 for the immediately preceding fiscal year, or (III) zero percent (0%) of the Company’s Excess Cash Flow for the immediately preceding fiscal year if the Company’s Leverage Ratio is less than 2.0 to 1.0 for the immediately preceding fiscal year. Each Excess Cash Flow prepayment shall be accompanied by a certificate signed by a Financial Officer of the Company certifying the manner in which Excess Cash Flow and the resulting prepayment was calculated, which certificate shall be in form and substance satisfactory to the Lender. (viii) amend Section 6.04(c) of the Credit Agreement by replacing the reference therein to “$5,000,000” with “$2,500,000.”; (ix) restate Sections 6.12(a) and (b) of the Credit Agreement as follows: (a) Leverage Ratio (b) Fixed Charge Coverage Ratio Simultaneous with the execution of Third Amendment, the Company entered into a Patent and Trademark Security Agreement, which replaces the Patent and Trademark Security Agreement entered into on March 23, 2015 at the time the Company entered into the Credit Agreement. The new Patent and Trademark Security Agreement was revised to make reference to the Third Amendment and the Company has provided the Lender with updated schedules listing the Company’s trademarks, patents, applications for trademarks and patents, and other intellectual properties owned or licensed. As a result of the changes to the definition of ‘Leverage Ratio” and “Fixed Charge Coverage Ratio” within the Third Amendment, the Company will have increased flexibility. The change to the definition of “Applicable Rate” will effectively increase the Company’s interest rate under the Credit Agreement by 50 basis points in the near term, while allowing for the Company to reduce that rate as its Leverage Ratio declines. 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 InfuSystem Holdings USA, Inc. (“Holdings USA”) and Holdings USA has pledged the shares of each of InfuSystem, Inc. and First Biomedical, Inc. 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 availability under the Revolver is based upon the Borrowers’ eligible accounts receivable and eligible inventory and is comprised as follows (in thousands): June 30, December 31, Revolver: Gross Availability $ 10,000 $ 10,000 Outstanding Draws (1,415 ) — Letter of Credit 0 — Landlord Reserves (45 ) (45 ) Availability on Revolver $ 8,540 $ 9,955 The Company had approximate future maturities of loans as of June 30, 2017 as follows (in thousands): 2017 2018 2019 2020 2021 Total Term Loan $ 1,155 $ 3,067 $ 3,067 $ 3,067 $ 19,732 $ 30,088 Unamortized value of the debt issuance costs (a) (14 ) (28 ) (28 ) (28 ) (26 ) (124 ) Revolver 0 — — — 1,415 1,415 Total $ 1,141 $ 3,039 $ 3,039 $ 3,039 $ 21,121 $ 31,379 (a) Includes the reclassification of the debt issuance costs as a result of the Company adopting ASU 2015-03 The following is a breakdown of the Company’s current and long-term debt as of June 30, 2017 and December 31, 2016 (in thousands): June 30, 2017 December 31, 2016 Current Long-Term Long-Term Debt Total Current Long-Term Long-Term Debt Total Term Loan $ 2,688 $ 27,400 $ 30,088 Term Loans $ 5,336 $ 26,664 $ 32,000 Unamortized value of the debt issuance costs (a) $ (28 ) $ (96 ) (124 ) Unamortized value of the debt issuance costs (a) $ (22 ) $ (87 ) (109 ) Revolver 0 1,415 1,415 Revolver — — — Total $ 2,660 $ 28,719 $ 31,379 Total $ 5,314 $ 26,577 $ 31,891 (a) Includes the reclassification of the debt issuance costs as a result of the Company adopting ASU 2015-03

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2017
Income Tax Disclosure [Abstract]
Income Taxes	6. Income Taxes During the three and six months ended June 30, 2017, the Company recorded income tax benefits of $0.4 million and $1.2 million, respectively. During the three and six months ended June 30, 2016, the Company recorded an income tax benefit of $0.1 million and income tax expense of $0.1 million, respectively. In computing its income tax provision, the Company estimates its effective tax rate for the full year and applies that rate to income earned through the reporting period. The Company’s effective income tax rate for the six months ended June 30, 2017 was 32.4% compared to 21.5% for the same prior year period.

Commitments, Contingencies and

Commitments, Contingencies and Litigation	6 Months Ended
	Jun. 30, 2017
Commitments and Contingencies Disclosure [Abstract]
Commitments, Contingencies and Litigation	7. Commitments, Contingencies and Litigation 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 consolidated financial statements as of December 31, 2015 and the first and second quarters 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 lawsuit 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 former 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. On April 18, 2017, the lead plaintiff filed an amended class-action complaint with the Court. On June 19, 2017, the Company and all defendants filed a Motion to Dismiss the amended complaint, and that motion is still being briefed before the Court. The Company believes that the allegations against it and its officers are without merit and intends to vigorously defend against the claims asserted. The ultimate resolution of this matter cannot be predicted, however, and it is not possible at this time for the Company to estimate any probable loss or range of losses because of the preliminary nature of the matter.

(Loss) Earnings Per Share

(Loss) Earnings Per Share	6 Months Ended
	Jun. 30, 2017
Earnings Per Share [Abstract]
(Loss) Earnings Per Share	8. (Loss) Earnings Per Share Basic (loss) income per share is computed by dividing net (loss) income by the weighted average number of common shares outstanding during the period. Diluted (loss) income per share assumes the issuance of potentially dilutive shares of common stock during the period. The following table reconciles the numerators and denominators of the basic and diluted (loss) income per share computations: Three Months Ended June 30 Six Months Ended June 30 Numerator: 2017 2016 2017 2016 Net (loss) income (in thousands) $ (1,106 ) $ 153 $ (2,584 ) $ 194 Denominator: Weighted average common shares outstanding: Basic 22,740,050 22,620,386 22,710,470 22,584,462 Dilutive effect of non-vested awards — 489,484 — 485,438 Diluted 22,740,050 23,109,870 22,710,470 23,069,900 Net (loss) income per share: Basic $ (0.05 ) $ 0.01 $ (0.11 ) $ 0.01 Diluted $ (0.05 ) $ 0.01 $ (0.11 ) $ 0.01 For the three and six months ended June 30, 2017, 1.0 million and 0.6 million of stock options were not included in the calculation because they would have an anti-dilutive effect, compared to less than 0.1 million for the same prior year periods.

Leases

Leases	6 Months Ended
	Jun. 30, 2017
Leases [Abstract]
Leases	9. Leases The Company leases office space, service facility centers and equipment under non-cancelable capital and operating lease arrangements. 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. The weighted average interest rate under capital leases was 4.3% as of June 30, 2017. The leases for office space and service facility centers used in the Company’s logistics operations are operating leases. In most cases, the Company expects its 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 June 30, 2017 are as follows (in thousands): Capital Operating Total 2017 $ 306 $ 424 $ 730 2018 514 1,003 1,517 2019 33 902 935 2020 — 178 178 2021 — 181 181 Thereafter — 938 938 Total require payments $ 853 $ 3,626 $ 4,479 Less amounts representing interest (3.5%) (22 ) Present value of minimum lease payments 831 Less current maturities (593 ) Long-term capital lease liability $ 238 At June 30, 2017 and December 31, 2016, pump assets obtained under capital leases, had a cost of approximately $14.0 million and $13.9 million, respectively, and accumulated depreciation of $4.9 million and $3.9 million, respectively. 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 for the three and six months ended June 30, 2017 was $0.3 million and $0.5 million, respectively, compared to $0.3 million and $0.5 million for the same three and six months ended June 30, 2016.

Subsequent Events

Subsequent Events	6 Months Ended
	Jun. 30, 2017
Subsequent Events [Abstract]
Subsequent Events	10. Subsequent Events The Company has evaluated subsequent events through the date of issuance for the unaudited condensed consolidated financial statements as of June 30, 2017.

Recent Accounting Pronouncement

Recent Accounting Pronouncements and Developments	6 Months Ended
	Jun. 30, 2017
Accounting Changes and Error Corrections [Abstract]
Recent Accounting Pronouncements and Developments	11. Recent Accounting Pronouncements and Developments In May 2017, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2017-09, “Stock Compensation—Scope of Modification Accounting”, which provides guidance on which changes to the terms or conditions of a share-based payment award require an entity to apply modification accounting in Topic 718. The new standard is effective for fiscal years beginning after December 15, 2017 (i.e. a January 1, 2018 effective date). The Company believes the adoption will not have a material impact on its consolidated financial statements. In January 2017, the FASB issued ASU No. 2017-04, “Intangibles—Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment”, which changes the subsequent measurement of goodwill impairment by eliminating Step 2 from the impairment test. Under the new guidance, an entity will measure impairment using the difference between the carrying amount and the fair value of the reporting unit. The new standard is effective for fiscal years beginning after December 15, 2019 (i.e. a January 1, 2020 effective date), with early adoption permitted for goodwill impairment tests with measurement dates after January 1, 2017. The Company believes the adoption will not have a material impact on its consolidated financial statements. On May 28, 2014, the FASB issued ASU No. 2014-09, 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, if any, that the adoption of this guidance will have on its financial position, results of operations, cash flows and/or 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. Effective January 1, 2017, the Company adopted the accounting guidance contained within ASU 2016-09. Thus, the Company recorded a $0.2 million deferred tax asset and a $0.2 million increase to retained earnings on January 1, 2017 to recognize the Company’s excess tax benefits that existed as of December 31, 2016 (modified retrospective application). In June 2016, the FASB issued ASU No. 2016-13, “Financial Instruments (Topic 326) Credit Losses” (“ASU 2016-13”). ASU 2016-13 ASU 2016-13. In August 2016, the FASB issued ASU No. 2016-15, “Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments” (“ASU 2016-15”). 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. ASU 2016-15 is effective for annual periods beginning after December 15, 2017, including interim periods within those fiscal years. Early adoption is permitted, including in interim periods. ASU 2016-15 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 flows upon adoption. In November 2015, the FASB issued ASU No. 2015-17, “Income Taxes (Topic 740): Balance Sheet Classification of Deferred Taxes” (“ASU 2015-17”), simplifying the balance sheet classification of deferred taxes by requiring all deferred taxes, along with any related valuation allowance, to be presented as noncurrent. ASU 2015-17 is effective for the Company beginning in the first quarter of 2017 and may be applied either prospectively or retrospectively. The Company has chosen to apply this guidance prospectively, thus prior periods were not retrospectively adjusted. The adoption of this guidance resulted in the balance sheet reclassification of $2.7 million of current deferred tax assets to noncurrent.

Recent Accounting Pronounceme17

Recent Accounting Pronouncements and Developments (Policies)	6 Months Ended
	Jun. 30, 2017
Accounting Changes and Error Corrections [Abstract]
Recent Accounting Pronouncements and Developments	In May 2017, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2017-09, “Stock Compensation—Scope of Modification Accounting”, which provides guidance on which changes to the terms or conditions of a share-based payment award require an entity to apply modification accounting in Topic 718. The new standard is effective for fiscal years beginning after December 15, 2017 (i.e. a January 1, 2018 effective date). The Company believes the adoption will not have a material impact on its consolidated financial statements. In January 2017, the FASB issued ASU No. 2017-04, “Intangibles—Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment”, which changes the subsequent measurement of goodwill impairment by eliminating Step 2 from the impairment test. Under the new guidance, an entity will measure impairment using the difference between the carrying amount and the fair value of the reporting unit. The new standard is effective for fiscal years beginning after December 15, 2019 (i.e. a January 1, 2020 effective date), with early adoption permitted for goodwill impairment tests with measurement dates after January 1, 2017. The Company believes the adoption will not have a material impact on its consolidated financial statements. On May 28, 2014, the FASB issued ASU No. 2014-09, 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, if any, that the adoption of this guidance will have on its financial position, results of operations, cash flows and/or 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. Effective January 1, 2017, the Company adopted the accounting guidance contained within ASU 2016-09. Thus, the Company recorded a $0.2 million deferred tax asset and a $0.2 million increase to retained earnings on January 1, 2017 to recognize the Company’s excess tax benefits that existed as of December 31, 2016 (modified retrospective application). In June 2016, the FASB issued ASU No. 2016-13, “Financial Instruments (Topic 326) Credit Losses” (“ASU 2016-13”). ASU 2016-13 ASU 2016-13. In August 2016, the FASB issued ASU No. 2016-15, “Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments” (“ASU 2016-15”). 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. ASU 2016-15 is effective for annual periods beginning after December 15, 2017, including interim periods within those fiscal years. Early adoption is permitted, including in interim periods. ASU 2016-15 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 flows upon adoption. In November 2015, the FASB issued ASU No. 2015-17, “Income Taxes (Topic 740): Balance Sheet Classification of Deferred Taxes” (“ASU 2015-17”), simplifying the balance sheet classification of deferred taxes by requiring all deferred taxes, along with any related valuation allowance, to be presented as noncurrent. ASU 2015-17 is effective for the Company beginning in the first quarter of 2017 and may be applied either prospectively or retrospectively. The Company has chosen to apply this guidance prospectively, thus prior periods were not retrospectively adjusted. The adoption of this guidance resulted in the balance sheet reclassification of $2.7 million of current deferred tax assets to noncurrent.

Medical Equipment and Property

Medical Equipment and Property (Tables)	6 Months Ended
	Jun. 30, 2017
Text Block [Abstract]
Summary of Medical Equipment	Medical equipment consisted of the following as of June 30, 2017 and December 31, 2016 (in thousands): June 30, December 31, Medical Equipment held for sale or rental $ 1,289 $ 1,642 Medical Equipment in rental service 58,669 59,034 Medical Equipment in rental service - pump reserve (486 ) (551 ) Accumulated depreciation (32,468 ) (30,447 ) Medical Equipment in rental service - net 25,715 28,036 Total $ 27,004 $ 29,678

Property and Equipment (Tables)

Property and Equipment (Tables)	6 Months Ended
	Jun. 30, 2017
Property, Plant and Equipment [Abstract]
Property and Equipment	Property and equipment is comprised of the following (in thousands): June 30, 2017 December 31, 2016 Gross Accumulated Total Gross Accumulated Total Furniture, fixtures, and equipment $ 3,834 $ (3,185 ) $ 649 $ 3,809 $ (3,071 ) $ 738 Automobiles 118 (79 ) 39 129 (83 ) 46 Leasehold improvements 2,177 (1,050 ) 1,127 2,177 (964 ) 1,213 Total $ 6,129 $ (4,314 ) $ 1,815 $ 6,115 $ (4,118 ) $ 1,997

Intangible Assets (Tables)

Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets	The carrying amount and accumulated amortization of intangible assets as of June 30, 2017 and December 31, 2016, are as follows (in thousands): June 30, 2017 Gross Accumulated Net Nonamortizable intangible assets Trade names $ 2,000 $ 0 $ 2,000 Amortizable intangible assets Trade names 23 23 0 Physician and customer relationships 36,534 20,613 15,921 Non-competition agreements 1,136 1,115 21 Software 13,594 3,243 10,351 Total nonamortizable and amortizable intangible assets $ 53,287 $ 24,994 $ 28,293 December 31, 2016 Gross 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-competition 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
Schedule of Expected Annual Amortization Expense for Intangible Assets	Expected annual amortization expense for intangible assets recorded as of June 30, 2017, is as follows (in thousands): 7/1-12/31/2017 2018 2019 2020 2021 2022 and Amortization expense $ 2,773 $ 5,218 $ 4,785 $ 4,331 $ 3,951 $ 5,235

Debt (Tables)

Debt (Tables)	6 Months Ended
	Jun. 30, 2017
Debt Disclosure [Abstract]
Schedule of Applicable Rates and Commitment Fees Percentage	On June 28, 2017, the Company entered into a Third Amendment to the Chase Credit Agreement to make certain amendments to the Credit Facility, including but not limited to: (i) restates the chart within the definition of “Applicable Rate” in Section 1.01 of the Credit Agreement as follows: Leverage Ratio CBFR Spread Eurodollar Spread Commitment Fee Rate Level I < 1.5:1.0 -1.00% 2.00% 0.25% Level II < 2.0:1.0 to 1.0 but ³ -0.75% 2.25% 0.25% Level III < 2.5:1.0 to 1.0 but ³ -0.50% 2.50% 0.25% Level IV < 3.0:1.0 to 1.0 but ³ 0.00% 2.75% 0.25% Level V ³ 0.25% 3.00% 0.25%
Summary of Revolver Based upon Borrowers' Eligible Accounts Receivable and Inventory	The availability under the Revolver is based upon the Borrowers’ eligible accounts receivable and eligible inventory and is comprised as follows (in thousands): June 30, December 31, Revolver: Gross Availability $ 10,000 $ 10,000 Outstanding Draws (1,415 ) — Letter of Credit 0 — Landlord Reserves (45 ) (45 ) Availability on Revolver $ 8,540 $ 9,955
Summary of Future Maturities of Loans	The Company had approximate future maturities of loans as of June 30, 2017 as follows (in thousands): 2017 2018 2019 2020 2021 Total Term Loan $ 1,155 $ 3,067 $ 3,067 $ 3,067 $ 19,732 $ 30,088 Unamortized value of the debt issuance costs (a) (14 ) (28 ) (28 ) (28 ) (26 ) (124 ) Revolver 0 — — — 1,415 1,415 Total $ 1,141 $ 3,039 $ 3,039 $ 3,039 $ 21,121 $ 31,379 (a) Includes the reclassification of the debt issuance costs as a result of the Company adopting ASU 2015-03
Summary of Company's Current and Long-Term Debt	The following is a breakdown of the Company’s current and long-term debt as of June 30, 2017 and December 31, 2016 (in thousands): June 30, 2017 December 31, 2016 Current Long-Term Long-Term Debt Total Current Long-Term Long-Term Debt Total Term Loan $ 2,688 $ 27,400 $ 30,088 Term Loans $ 5,336 $ 26,664 $ 32,000 Unamortized value of the debt issuance costs (a) $ (28 ) $ (96 ) (124 ) Unamortized value of the debt issuance costs (a) $ (22 ) $ (87 ) (109 ) Revolver 0 1,415 1,415 Revolver — — — Total $ 2,660 $ 28,719 $ 31,379 Total $ 5,314 $ 26,577 $ 31,891 (a) Includes the reclassification of the debt issuance costs as a result of the Company adopting ASU 2015-03

(Loss) Earnings Per Share (Tabl

(Loss) Earnings Per Share (Tables)	6 Months Ended
	Jun. 30, 2017
Earnings Per Share [Abstract]
Numerators and Denominators of Basic and Diluted Income per Share	The following table reconciles the numerators and denominators of the basic and diluted (loss) income per share computations: Three Months Ended June 30 Six Months Ended June 30 Numerator: 2017 2016 2017 2016 Net (loss) income (in thousands) $ (1,106 ) $ 153 $ (2,584 ) $ 194 Denominator: Weighted average common shares outstanding: Basic 22,740,050 22,620,386 22,710,470 22,584,462 Dilutive effect of non-vested awards — 489,484 — 485,438 Diluted 22,740,050 23,109,870 22,710,470 23,069,900 Net (loss) income per share: Basic $ (0.05 ) $ 0.01 $ (0.11 ) $ 0.01 Diluted $ (0.05 ) $ 0.01 $ (0.11 ) $ 0.01

Leases (Tables)

Leases (Tables)	6 Months Ended
	Jun. 30, 2017
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 June 30, 2017 are as follows (in thousands): Capital Operating Total 2017 $ 306 $ 424 $ 730 2018 514 1,003 1,517 2019 33 902 935 2020 — 178 178 2021 — 181 181 Thereafter — 938 938 Total require payments $ 853 $ 3,626 $ 4,479 Less amounts representing interest (3.5%) (22 ) Present value of minimum lease payments 831 Less current maturities (593 ) Long-term capital lease liability $ 238

Medical Equipment and Propert24

Medical Equipment and Property - Summary of Medical Equipment (Detail) - USD ($) $ in Thousands	Jun. 30, 2017	Dec. 31, 2016
Medical Equipment And Property [Abstract]
Medical equipment held for sale or rental	$ 1,289	$ 1,642
Medical Equipment in rental service	58,669	59,034
Medical Equipment in rental service - pump reserve	(486)	(551)
Accumulated depreciation	(32,468)	(30,447)
Medical Equipment in rental service - net	25,715	28,036
Total	$ 27,004	$ 29,678

Medical Equipment and Propert25

Medical Equipment and Property - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2017	Jun. 30, 2016	Jun. 30, 2017	Jun. 30, 2016
Property, Plant and Equipment [Abstract]
Depreciation expense for medical equipment	$ 1.6	$ 1.6	$ 3.2	$ 3.1

Property and Equipment - Proper

Property and Equipment - Property and Equipment (Detail) - USD ($) $ in Thousands	Jun. 30, 2017	Dec. 31, 2016
Property, Plant and Equipment [Line Items]
Gross Assets	$ 6,129	$ 6,115
Accumulated Depreciation	(4,314)	(4,118)
Total	1,815	1,997
Furniture, Fixtures, and Equipment [Member]
Property, Plant and Equipment [Line Items]
Gross Assets	3,834	3,809
Accumulated Depreciation	(3,185)	(3,071)
Total	649	738
Automobiles [Member]
Property, Plant and Equipment [Line Items]
Gross Assets	118	129
Accumulated Depreciation	(79)	(83)
Total	39	46
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Gross Assets	2,177	2,177
Accumulated Depreciation	(1,050)	(964)
Total	$ 1,127	$ 1,213

Property and Equipment - Additi

Property and Equipment - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2017	Jun. 30, 2016	Jun. 30, 2017	Jun. 30, 2016
Property, Plant and Equipment [Abstract]
Total depreciation expense recorded	$ 0.1	$ 0.1	$ 0.2	$ 0.3

Intangible Assets - Summary of

Intangible Assets - Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets (Detail) - USD ($) $ in Thousands	Jun. 30, 2017	Dec. 31, 2016
Indefinite Lived And Finite Lived Intangible Assets [Line Items]
Total nonamortizable and amortizable intangible assets, Gross Assets	$ 53,287	$ 53,438
Total nonamortizable and amortizable intangible assets, Accumulated Amortization	24,994	22,199
Total nonamortizable and amortizable intangible assets, Net	28,293	31,239
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	23
Amortizable intangible assets, Net	0
Physician and Customer Relationships [Member]
Indefinite Lived And Finite Lived Intangible Assets [Line Items]
Amortizable intangible assets, Gross Assets	36,534	36,534
Amortizable intangible assets, Accumulated Amortization	20,613	19,427
Amortizable intangible assets, Net	15,921	17,107
Non-Competition Agreements [Member]
Indefinite Lived And Finite Lived Intangible Assets [Line Items]
Amortizable intangible assets, Gross Assets	1,136	1,136
Amortizable intangible assets, Accumulated Amortization	1,115	1,064
Amortizable intangible assets, Net	21	72
Software [Member]
Indefinite Lived And Finite Lived Intangible Assets [Line Items]
Amortizable intangible assets, Gross Assets	13,594	13,745
Amortizable intangible assets, Accumulated Amortization	3,243	1,685
Amortizable intangible assets, Net	10,351	12,060
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	3 Months Ended		6 Months Ended
	Jun. 30, 2017	Jun. 30, 2016	Jun. 30, 2017	Jun. 30, 2016
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization of intangible assets	$ 1,387	$ 922	$ 2,798	$ 1,834

Intangible Assets - Schedule of

Intangible Assets - Schedule of Expected Annual Amortization Expense for Intangible Assets (Detail) $ in Thousands	Jun. 30, 2017USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense, 2017	$ 2,773
Amortization expense, 2018	5,218
Amortization expense, 2019	4,785
Amortization expense, 2020	4,331
Amortization expense, 2021	3,951
Amortization expense, 2022 and thereafter	$ 5,235

Debt - Additional Information (

Debt - Additional Information (Detail)	Dec. 05, 2016USD ($)	Mar. 31, 2017	Jun. 30, 2017USD ($)	Jun. 28, 2017USD ($)	Jun. 27, 2017USD ($)	Mar. 22, 2017	Mar. 23, 2015USD ($)
Line of Credit Facility [Line Items]
Actual leverage ratio		2.96
First Amended Credit Agreement [Member]
Line of Credit Facility [Line Items]
Amendment to Credit Agreement, description			Amending the leverage ratio covenant to provide for the following schedule of maximum permitted ratios (a) 2.75 to 1.0 at any time on or after December 31, 2015 but prior to March 31, 2017, (b) 2.50 to 1.0 at any time on or after March 31, 2017 but prior to March 31, 2018 or (c) 2.25 to 1.00 at any time on or after March 31, 2018.
Second Amended Credit Agreement [Member]
Line of Credit Facility [Line Items]
Amendment to Credit Agreement, description			Amending the leverage ratio covenant to provide for the following schedule of maximum permitted ratios (a) 2.75 to 1.0 at any time on or after December 31, 2015 but prior to March 31, 2018, (b) 2.50 to 1.0 at any time on or after March 31, 2018 but prior to March 31, 2019 or (c) 2.25 to 1.00 at any time on or after March 31, 2019.
Third Amended Credit Agreement [Member]
Line of Credit Facility [Line Items]
Current borrowings under credit facility			$ 30,665,999.98
Debt instrument period payment, principal amount			577,500
Aggregate amount of term loan				$ 2,500,000	$ 5,000,000
Periodic payment of debt			$ 766,650
Increase in basis points of interest rate under credit agreement			0.50%
Third Amended Credit Agreement [Member] | Leverage Ratio Greater than or Equal to 2.5 to 1.0 [Member]
Line of Credit Facility [Line Items]
Percentage of excess cashflow to prepay debt			75.00%
Third Amended Credit Agreement [Member] | Leverage Ratio Less than 2.5 to 1.0 but Greater than or Equal to 2.0 to 1.0 [Member]
Line of Credit Facility [Line Items]
Percentage of excess cashflow to prepay debt			50.00%
Third Amended Credit Agreement [Member] | Leverage Ratio Less than 2.0 to 1.0 [Member]
Line of Credit Facility [Line Items]
Percentage of excess cashflow to prepay debt			0.00%
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]
Current borrowings under credit facility							$ 27,000,000
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]
Current borrowings under credit facility							8,000,000
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]
Current borrowings under credit facility			$ 1,415,000
Revolving Credit Facility [Member] | Third Amended Credit Agreement [Member]
Line of Credit Facility [Line Items]
Aggregate amount of term loan				12,500,000	25,000,000
Revolving Credit Facility [Member] | JP Morgan Chase Bank [Member]
Line of Credit Facility [Line Items]
Line of credit facility							$ 10,000,000
Revolving Credit Facility [Member] | JP Morgan Chase Bank [Member] | Third Amended Credit Agreement [Member]
Line of Credit Facility [Line Items]
Aggregate amount of term loan				$ 5,000,000	$ 10,000,000
Term Loan [Member]
Line of Credit Facility [Line Items]
Frequency of period payment			Setting 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
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
Term Loan [Member] | Third Amended Credit Agreement [Member]
Line of Credit Facility [Line Items]
Aggregate amount of term loan	$ 32,000,000
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 December 31, 2015 but prior to March 31, 2017	2.75%
After amendment, maximum leverage covenant ratio at any time on or after March 31, 2017 but prior to March 31, 2018	2.50%
After amendment, maximum leverage covenant ratio at any time on or after March 31, 2018	2.25%
Maximum [Member] | Second Amended Credit Agreement [Member]
Line of Credit Facility [Line Items]
After amendment, maximum leverage covenant ratio at any time on or after December 31, 2015 but prior to March 31, 2018						2.75%
After amendment, maximum leverage covenant ratio at any time on or after March 31, 2018 but prior to March 31, 2019						2.50%
After amendment, maximum leverage covenant ratio at any time on or after March 31, 2019						2.25%
Maximum [Member] | Third Amended Credit Agreement [Member] | Leverage Ratio Greater than or Equal to 2.5 to 1.0 [Member]
Line of Credit Facility [Line Items]
Actual leverage ratio			2.5
Maximum [Member] | Third Amended Credit Agreement [Member] | Leverage Ratio Less than 2.0 to 1.0 [Member]
Line of Credit Facility [Line Items]
Actual leverage ratio			2
Maximum [Member] | Leverage Ratio Less than 4.0 to 1.0 at any Time on or After the Effective Date but Prior to December 31, 2017 [Member] | Third Amended Credit Agreement [Member]
Line of Credit Facility [Line Items]
Actual leverage ratio			4
Maximum [Member] | Leverage Ratio Less than 3.75 to 1.0 at any Time on or After December 31, 2017 but Prior to June 30, 2018 [Member] | Third Amended Credit Agreement [Member]
Line of Credit Facility [Line Items]
Actual leverage ratio			3.75
Maximum [Member] | Leverage Ratio Less than 3.50 to 1.0 at any Time on or After June 30, 2018 but Prior to December 31, 2018 [Member] | Third Amended Credit Agreement [Member]
Line of Credit Facility [Line Items]
Actual leverage ratio			3.50
Maximum [Member] | Leverage Ratio Less than 3.00 to 1.00 at any Time on or After December 31, 2018 [Member] | Third Amended Credit Agreement [Member]
Line of Credit Facility [Line Items]
Actual leverage ratio			3
Minimum [Member] | Third Amended Credit Agreement [Member]
Line of Credit Facility [Line Items]
Actual leverage ratio			2.5
Minimum [Member] | Third Amended Credit Agreement [Member] | Leverage Ratio Less than 2.5 to 1.0 but Greater than or Equal to 2.0 to 1.0 [Member]
Line of Credit Facility [Line Items]
Actual leverage ratio			2
Minimum [Member] | Leverage Ratio Greater than 1.15:1.0 at any Time on or After the Effective Date but Prior to March 31, 2018 [Member] | Third Amended Credit Agreement [Member]
Line of Credit Facility [Line Items]
Fixed Charge Coverage Ratio			1.15
Minimum [Member] | Leverage Ratio Greater than 1.25:1.0 at any Time on or After March 31, 2018 [Member] | Third Amended Credit Agreement [Member]
Line of Credit Facility [Line Items]
Fixed Charge Coverage Ratio			1.25

Debt - Schedule of Applicable R

Debt - Schedule of Applicable Rates and Commitment Fees Percentage (Detail) - Third Amended Credit Agreement [Member]	Jun. 28, 2017
Leverage Ratio Level I Less than 1.5:1.0 [Member]
Line of Credit Facility [Line Items]
Commitment Fee Rate	0.25%
Leverage Ratio Level II Less than 2.0:1.0 to 1.0 but Greater than or Equal to 1.5:1.0 [Member]
Line of Credit Facility [Line Items]
Commitment Fee Rate	0.25%
Leverage Ratio Level III Less than 2.5:1.0 to 1.0 but Greater than or Equal to 2.0:1.0 [Member]
Line of Credit Facility [Line Items]
Commitment Fee Rate	0.25%
Leverage Ratio Level IV Less than 3.0:1.0 to1.0 but Greater than or Equal to 2.5:1.0 [Member]
Line of Credit Facility [Line Items]
Commitment Fee Rate	0.25%
Leverage Ratio Level V Greater than or Equal to 3.0:1.0 [Member]
Line of Credit Facility [Line Items]
Commitment Fee Rate	0.25%
CBFR Spread [Member] | Leverage Ratio Level I Less than 1.5:1.0 [Member]
Line of Credit Facility [Line Items]
CBFR/Eurodollar Spread	(1.00%)
CBFR Spread [Member] | Leverage Ratio Level II Less than 2.0:1.0 to 1.0 but Greater than or Equal to 1.5:1.0 [Member]
Line of Credit Facility [Line Items]
CBFR/Eurodollar Spread	(0.75%)
CBFR Spread [Member] | Leverage Ratio Level III Less than 2.5:1.0 to 1.0 but Greater than or Equal to 2.0:1.0 [Member]
Line of Credit Facility [Line Items]
CBFR/Eurodollar Spread	(0.50%)
CBFR Spread [Member] | Leverage Ratio Level IV Less than 3.0:1.0 to1.0 but Greater than or Equal to 2.5:1.0 [Member]
Line of Credit Facility [Line Items]
CBFR/Eurodollar Spread	0.00%
CBFR Spread [Member] | Leverage Ratio Level V Greater than or Equal to 3.0:1.0 [Member]
Line of Credit Facility [Line Items]
CBFR/Eurodollar Spread	0.25%
Eurodollar Spread [Member] | Leverage Ratio Level I Less than 1.5:1.0 [Member]
Line of Credit Facility [Line Items]
CBFR/Eurodollar Spread	2.00%
Eurodollar Spread [Member] | Leverage Ratio Level II Less than 2.0:1.0 to 1.0 but Greater than or Equal to 1.5:1.0 [Member]
Line of Credit Facility [Line Items]
CBFR/Eurodollar Spread	2.25%
Eurodollar Spread [Member] | Leverage Ratio Level III Less than 2.5:1.0 to 1.0 but Greater than or Equal to 2.0:1.0 [Member]
Line of Credit Facility [Line Items]
CBFR/Eurodollar Spread	2.50%
Eurodollar Spread [Member] | Leverage Ratio Level IV Less than 3.0:1.0 to1.0 but Greater than or Equal to 2.5:1.0 [Member]
Line of Credit Facility [Line Items]
CBFR/Eurodollar Spread	2.75%
Eurodollar Spread [Member] | Leverage Ratio Level V Greater than or Equal to 3.0:1.0 [Member]
Line of Credit Facility [Line Items]
CBFR/Eurodollar Spread	3.00%

Debt - Summary of Revolver Base

Debt - Summary of Revolver Based upon Borrowers' Eligible Accounts Receivable and Inventory (Detail) - Revolving Credit Facility [Member] - USD ($) $ in Thousands	Jun. 30, 2017	Dec. 31, 2016
Line of Credit Facility [Line Items]
Gross Availability	$ 10,000	$ 10,000
Outstanding Draws	(1,415)
Letter of Credit	0
Landlord Reserves	(45)	(45)
Availability on Revolver	$ 8,540	$ 9,955

Debt - Summary of Future Maturi

Debt - Summary of Future Maturities of Loans (Detail) - USD ($) $ in Thousands	Jun. 30, 2017	Dec. 31, 2016
Line of Credit Facility [Line Items]
2,017	$ 1,141
2,018	3,039
2,019	3,039
2,020	3,039
2,021	21,121
Total	31,379	$ 31,891
Unamortized value of the debt issuance costs, 2017	(14)
Unamortized value of the debt issuance costs, 2018	(28)
Unamortized value of the debt issuance costs, 2019	(28)
Unamortized value of the debt issuance costs, 2020	(28)
Unamortized value of the debt issuance costs, 2021	(26)
Unamortized value of the debt issuance costs, Total	(124)	(109)
Term Loan [Member]
Line of Credit Facility [Line Items]
2,017	1,155
2,018	3,067
2,019	3,067
2,020	3,067
2,021	19,732
Total	30,088	$ 32,000
Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
2,017	0
2,021	1,415
Total	$ 1,415

Debt - Summary of Company's Cur

Debt - Summary of Company's Current and Long-Term Debt (Detail) - USD ($) $ in Thousands	Jun. 30, 2017	Dec. 31, 2016
Line of Credit Facility [Line Items]
Current portion of long-term debt	$ 2,660	$ 5,314
Long-Term Debt	28,719	26,577
Total	31,379	31,891
Unamortized value of the debt issuance costs, Current Portion of Long-Term Debt	(28)	(22)
Unamortized value of the debt issuance costs, Long-Term Debt	(96)	(87)
Unamortized value of the debt issuance costs, Total	(124)	(109)
Term Loan [Member]
Line of Credit Facility [Line Items]
Current portion of long-term debt	2,688	5,336
Long-Term Debt	27,400	26,664
Total	30,088	$ 32,000
Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Current portion of long-term debt	0
Long-Term Debt	1,415
Total	$ 1,415

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2017	Jun. 30, 2016	Jun. 30, 2017	Jun. 30, 2016
Income Tax Disclosure [Abstract]
Income tax expense (benefit)	$ (385)	$ (35)	$ (1,241)	$ 53
Effective income tax rate			32.40%	21.50%

Commitments, Contingencies an37

Commitments, Contingencies and Litigation - Additional Information (Detail)	6 Months Ended
	Jun. 30, 2017
Pending Litigation [Member] | The Complaint [Member]
Loss Contingencies [Line Items]
Lawsuit Filing Date	Nov. 8, 2016

(Loss) Earnings Per Share - Num

(Loss) Earnings Per Share - Numerators and Denominators of Basic and Diluted Income per Share (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2017	Jun. 30, 2016	Jun. 30, 2017	Jun. 30, 2016
Numerator:
Net (loss) income	$ (1,106)	$ 153	$ (2,584)	$ 194
Weighted average common shares outstanding:
Basic	22,740,050	22,620,386	22,710,470	22,584,462
Dilutive effect of non-vested awards		489,484		485,438
Diluted	22,740,050	23,109,870	22,710,470	23,069,900
Net (loss) income per share:
Basic	$ (0.05)	$ 0.01	$ (0.11)	$ 0.01
Diluted	$ (0.05)	$ 0.01	$ (0.11)	$ 0.01

(Loss) Earnings Per Share - Add

(Loss) Earnings Per Share - Additional Information (Detail) - Stock Options [Member] - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2017	Jun. 30, 2016	Jun. 30, 2017	Jun. 30, 2016
Summary Of Significant Accounting Policies [Line Items]
Shares with anti-dilutive effect	1,000,000		600,000
Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Shares with anti-dilutive effect		100,000		100,000

Leases - Additional Information

Leases - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2017	Jun. 30, 2016	Jun. 30, 2017	Jun. 30, 2016	Dec. 31, 2016
Leases [Line Items]
Pump equipment			$ 14		$ 13.9
Accumulated depreciation related to leased assets	$ 4.9		4.9		$ 3.9
Operating lease rental expenses	$ 0.3	$ 0.3	$ 0.5	$ 0.5
Capital Leases [Member]
Leases [Line Items]
Weighted average interest rate under capital leases	4.30%		4.30%

Leases - Schedule of Future Min

Leases - Schedule of Future Minimum Rental Payments Pursuant to Capital and Operating Leases (Detail) - USD ($) $ in Thousands	Jun. 30, 2017	Dec. 31, 2016
Leases [Abstract]
Capital leases, 2017	$ 306
Capital leases, 2018	514
Capital leases, 2019	33
Capital leases, 2020	0
Capital leases, 2021	0
Capital leases, Thereafter	0
Total capital leases require payments	853
Less amounts representing interest (3.5%)	(22)
Present value of minimum lease payments	831
Present value of minimum lease payments	831
Less current maturities	(593)	$ (2,938)
Long-term capital lease liability	238	$ 2,573
Operating leases, 2017	424
Operating leases, 2018	1,003
Operating leases, 2019	902
Operating leases, 2020	178
Operating leases, 2021	181
Operating leases, Thereafter	938
Total operating leases require payments	3,626
Capital and operating leases, 2017	730
Capital and operating leases, 2018	1,517
Capital and operating leases, 2019	935
Capital and operating leases, 2020	178
Capital and operating leases, 2021	181
Capital and operating leases, Thereafter	938
Total Capital and operating leases require payments	$ 4,479

Leases - Schedule of Future M42

Leases - Schedule of Future Minimum Rental Payments Pursuant to Capital and Operating Leases (Parenthetical) (Detail)	Jun. 30, 2017
Leases [Abstract]
Capital lease interest rate	3.50%

Recent Accounting Pronounceme43

Recent Accounting Pronouncements and Developments - Additional Information (Detail) - Adjustments for New Accounting Principle, Early Adoption [Member] - USD ($) $ in Millions	Jan. 01, 2017	Jun. 30, 2017
Retained Deficit [Member] | ASU 2016-09 [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Impact of reclassification adjustment due to adoption of new accounting pronouncement	$ 0.2
Deferred Tax Asset [Member] | ASU 2016-09 [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Impact of reclassification adjustment due to adoption of new accounting pronouncement	$ 0.2
Deferred Tax Asset Non Current [Member] | ASU 2015-17 [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Impact of reclassification adjustment due to adoption of new accounting pronouncement		$ 2.7