InfuSystem (INFU) 10-Q 14 May 18 2018 Q1 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	3 Months Ended
	Mar. 31, 2018	May 04, 2018
Document Information [Line Items]
Entity Registrant Name	InfuSystem Holdings, Inc
Entity Central Index Key	1,337,013
Trading Symbol	infu
Current Fiscal Year End Date	--12-31
Entity Filer Category	Smaller Reporting Company
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Well-known Seasoned Issuer	No
Entity Common Stock, Shares Outstanding (in shares)		22,762,691
Document Type	10-Q
Document Period End Date	Mar. 31, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q1
Amendment Flag	false

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Current Period Unaudited) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
ASSETS
Cash and cash equivalents	$ 1,530	$ 3,469
Accounts receivable, less allowance for doubtful accounts of $6,420 and $6,514 at March 31, 2018 and December 31, 2017, respectively	11,087	11,385
Inventories	2,063	1,764
Other current assets	1,114	1,049
Total current assets	15,794	17,667
Medical equipment held for sale or rental	1,481	1,567
Medical equipment in rental service, net of accumulated depreciation	22,681	23,369
Property & equipment, net of accumulated depreciation	1,546	1,633
Intangible assets, net	23,327	24,514
Other assets	136	131
Total assets	64,965	68,881
LIABILITIES AND STOCKHOLDERS’ EQUITY
Accounts payable	5,545	5,516
Capital lease liability, current	389	505
Current portion of long-term debt	3,039	3,039
Other current liabilities	1,935	3,414
Total current liabilities	10,908	12,474
Long-term debt, net of current portion	22,719	25,352
Capital lease liability, long-term		33
Deferred income taxes	86	62
Other long-term liabilities	20	7
Total liabilities	33,733	37,928
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 23,003,435 and 22,773,511, respectively, as of March 31, 2018 and 22,978,398 and 22,780,738, respectively, as of December 31, 2017	2	2
Additional paid-in capital	92,659	92,584
Retained deficit	(61,429)	(61,633)
Total stockholders’ equity	31,232	30,953
Total liabilities and stockholders’ equity	$ 64,965	$ 68,881

Condensed Consolidated Balance3

Condensed Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Accounts receivable, allowance for doubtful accounts	$ 6,420	$ 6,514
Preferred stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Preferred stock, shares authorized (in shares)	1,000,000	1,000,000
Preferred stock, shares issued (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Common stock, authorized (in shares)	200,000,000	200,000,000
Common stock, issued (in shares)	23,003,435	22,978,398
Common stock, outstanding (in shares)	22,773,511	22,780,738

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Net revenues:
Rentals	$ 14,421	$ 15,137
Product sales	2,062	2,517
Net revenues	16,483	17,654
Cost of revenues:
Cost of revenues — Product, service and supply costs	4,479	4,536
Cost of revenues — Pump depreciation and disposals	1,931	2,469
Gross profit	10,073	10,649
Selling, general and administrative expenses:
Provision for doubtful accounts		1,856
Amortization of intangibles	1,187	1,411
Selling and marketing	2,301	2,886
General and administrative	5,997	6,465
Total selling, general and administrative	9,485	12,618
Operating income (loss)	588	(1,969)
Other expense:
Interest expense	(315)	(328)
Other expense	(11)	(37)
Income (loss) before income taxes	262	(2,334)
(Provision for) benefit from income taxes	(58)	856
Net income (loss)	$ 204	$ (1,478)
Net income (loss) per share:
Basic (in dollars per share)	$ 0.01	$ (0.07)
Diluted (in dollars per share)	$ 0.01	$ (0.07)
Weighted average shares outstanding:
Basic (in shares)	22,799,221	22,680,562
Diluted (in shares)	22,857,121	22,680,562

Condensed Consolidated Stateme5

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
NET CASH PROVIDED BY (USED IN) OPERATING ACTIVITIES	$ 1,025	$ (1,442)
INVESTING ACTIVITIES
Purchase of medical equipment and property	(1,213)	(1,015)
Proceeds from sale of medical equipment and property	1,076	1,525
NET CASH (USED IN) PROVIDED BY INVESTING ACTIVITIES	(137)	510
FINANCING ACTIVITIES
Principal payments on revolving credit facility, term loans and capital lease obligations	(2,790)	(6,413)
Cash proceeds from revolving credit facility		4,099
Debt issuance costs		(25)
Common stock repurchased to satisfy statutory withholding on employee stock based compensation plans		(20)
Common stock repurchased as part of Repurchase Program	(83)
Cash proceeds from stock plans	46	87
NET CASH USED IN FINANCING ACTIVITIES	(2,827)	(2,272)
Net change in cash and cash equivalents	(1,939)	(3,204)
Cash and cash equivalents, beginning of period	3,469	3,398
Cash and cash equivalents, end of period	$ 1,530	$ 194

Note 1 - Basis of Presentation

Note 1 - Basis of Presentation and Nature of Operations and Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2018
Notes to Financial Statements
Basis of Presentation and Significant Accounting Policies [Text Block]	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 is a leading provider of infusion pumps and related services. The Company services hospitals, oncology practices and other alternative site healthcare providers. Headquartered in Madison Heights, Michigan, the Company delivers local, field-based customer support, and also operates pump repair Centers of Excellence in Michigan, Kansas, California, 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 not may 10 December 31, 2017 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.

Note 2 - Revenue Recognition

Note 2 - Revenue Recognition	3 Months Ended
	Mar. 31, 2018
Notes to Financial Statements
Revenue from Contract with Customer [Text Block]	2. Revenue Recognition A doption of ASC 606 Except for the changes below, we have consistently applied the accounting policies to all periods in these condensed consolidated financial statements. On January 1, 2018 606 606” two 606 no first 2018. 606 605 606 not ASC 606 five 606 not Performance Obligations The Company has two no The Company generates the majority of its revenue from the rental and servicing of infusion pumps to its customers and a minority of its revenue from product sales. Revenue related to rentals is recognized at the point in time that a patient concludes a treatment and the proper documentation has been received by the Company, or in certain arrangements, based on the number of pumps that a facility has onsite. Revenue related to product sales is recognized at the time that control of the product has been transferred to the customer; either at the time the product is shipped or the time the product has been received by the customer depending on the shipping terms. The Company does not Significant Judgments The Company employs certain significant judgments to estimate the dollar amount of revenue, and related concessions, allocated to the rental service and sale of products. These judgments include, among others, the estimation of variable consideration. Variable consideration, specifically related to the Company’s third 606. no Financial Impact of ASC 606 The following table presents the impact of ASC 606 three March 31, 2018 ( Three Months Ended March 31, 2018 As Reported Adjustments Pro-Forma as if Previous Accounting Guidance Was in Effect Net revenues: Rentals $ 14,421 $ 1,904 $ 16,325 Net revenues 16,483 1,904 18,387 Gross profit 10,073 1,904 11,977 Selling, general and administrative expenses: Provision for doubtful accounts - 1,904 1,904 Total selling, general and administrative $ 9,485 $ 1,904 $ 11,389 The following table presents disaggregated revenue by offering type: Three Months Ended March 31, 2018 Third-Party Payor Rentals 48.6% Direct Payor Rentals 38.9% Product Sales 12.5% Total - Net revenues 100.0%

Note 3 - Medical Equipment

Note 3 - Medical Equipment	3 Months Ended
	Mar. 31, 2018
Notes to Financial Statements
Medical Equipment and Property Disclosure [Text Block]	3 . Medical Equipment Medical equipment is comprised of the following (in thousands): March 31, December 31, 2018 2017 Medical Equipment held for sale or rental $ 1,481 $ 1,567 Medical Equipment in rental service 58,044 57,928 Medical Equipment in rental service - pump reserve (462 ) (482 ) Accumulated depreciation (34,901 ) (34,077 ) Medical Equipment in rental service - net 22,681 23,369 Total $ 24,162 $ 24,936 Depreciation expense for medical equipment for the three March 31, 2018 $1.5 $1.6

Note 4 - Property and Equipment

Note 4 - Property and Equipment	3 Months Ended
	Mar. 31, 2018
Notes to Financial Statements
Property, Plant and Equipment Disclosure [Text Block]	4 . Property and Equipment Property and equipment is comprised of the following (in thousands): March 31, 2018 December 31, 2017 Gross Assets Accumulated Depreciation Total Gross Assets Accumulated Depreciation Total Furniture, fixtures, and equipment $ 3,845 $ (3,340 ) $ 505 $ 3,824 $ (3,277 ) $ 547 Automobiles 118 (88 ) 30 118 (85 ) 33 Leasehold improvements 2,187 (1,176 ) 1,011 2,187 (1,134 ) 1,053 Total $ 6,150 $ (4,604 ) $ 1,546 $ 6,129 $ (4,496 ) $ 1,633 Depreciation expense for property and equipment for the three March 31, 2018 2017 $0.1

Note 5 - Intangible Assets

Note 5 - Intangible Assets	3 Months Ended
	Mar. 31, 2018
Notes to Financial Statements
Intangible Assets Disclosure [Text Block]	5 . Intangible Assets The carrying amount and accumulated amortization of intangible assets is comprised of the following (in thousands): March 31, 2018 December 31, 2017 Gross Assets Accumulated Amortization Net Gross Assets Accumulated Amortization Net Nonamortizable intangible assets: Trade names $ 2,000 $ - $ 2,000 $ 2,000 $ - $ 2,000 Amortizable intangible assets: Trade names 23 (23 ) - 23 (23 ) - Physician and customer relationships 36,534 (22,394 ) 14,140 36,534 (21,801 ) 14,733 Non-competition agreements 1,136 (1,131 ) 5 1,136 (1,125 ) 11 Software 11,230 (4,048 ) 7,182 11,230 (3,460 ) 7,770 Total nonamortizable and amortizable intangible assets $ 50,923 $ (27,596 ) $ 23,327 $ 50,923 $ (26,409 ) $ 24,514 Amortization expense for the three March 31, 2018 $1.2 $1.4 three March 31, 2017. March 31, 2017 4/1- 12/31/2018 2019 2020 2021 2022 2023 and thereafter Total Amortization expense $ 3,462 $ 4,402 $ 4,285 $ 3,930 $ 2,051 $ 3,197 $ 21,327

Note 6 - Debt

Note 6 - Debt	3 Months Ended
	Mar. 31, 2018
Notes to Financial Statements
Debt Disclosure [Text Block]	6 . Debt As of March 31, 2018, $25.9 March 31, December 31, 2018 2017 Revolver: Gross availability $ 10,000 $ 10,000 Outstanding draws - - Letter of credit (750 ) (750 ) Landlord reserves (68 ) (45 ) Net availability $ 9,182 $ 9,205 The Company had future maturities of its term loan as of March 31, 2018 2018 2019 2020 2021 Total Term Loan $ 2,300 $ 3,067 $ 3,067 $ 17,436 $ 25,870 Unamortized value of the debt issuance costs (22 ) (30 ) (30 ) (30 ) (112 ) Total $ 2,278 $ 3,037 $ 3,037 $ 17,406 $ 25,758 The following is a breakdown of the Company’s current and long-term debt as follows (in thousands): March 31, 2018 December 31, 2017 Current Portion of Long-Term Debt Long-Term Debt Total Current Portion of Long- Term Debt Long-Term Debt Total Term Loan $ 3,067 $ 22,803 $ 25,870 Term Loan $ 3,067 $ 25,444 $ 28,511 Unamortized value of the debt issuance costs (28 ) (84 ) (112 ) Unamortized value of the debt issuance costs (28 ) (92 ) (120 ) Total $ 3,039 $ 22,719 $ 25,758 Total $ 3,039 $ 25,352 $ 28,391 As of March 31, 2018, 30 2.00% 3.00% 2.50%, 1.00% 0.25%. March 31, 2018 4.63% 1.88% 2.75% As of March 31, 2018,

Note 7 - Income Taxes

Note 7 - Income Taxes	3 Months Ended
	Mar. 31, 2018
Notes to Financial Statements
Income Tax Disclosure [Text Block]	7 . Income Taxes During the three March 31, 2018, $0.1 $0.9 The Company’s realization of its deferred tax assets is dependent upon many factors, including, but not not not March 31, 2018 December 31, 2017. In December 2017, “2017 2017 35% 21% December 31, 2017. 2017 one September 27, 2017 2018, The Company recognized the income tax effects of the 2017 2017 No. 118, 740 740” 2017 2017 740 2017 740 2017 2018 may may may 2017 As of March 31, 2018, not 2017

Note 8 - Commitments and Contin

Note 8 - Commitments and Contingencies and Litigation	3 Months Ended
	Mar. 31, 2018
Notes to Financial Statements
Commitments and Contingencies Disclosure [Text Block]	8 . Commitments , Contingencies and Litigation From time to time in the ordinary course of its business, the Company may may not not, not not On January 29, 2018, No. 2:16 08295 November 8, 2016 two June 19, 2017, December 15, 2017, first December 20, 2017, January 19, 2018. January 19, 2018, January 29, 2018. February 28, 2018, 9th The Company is not

Note 9 - Earnings (Loss) Per Sh

Note 9 - Earnings (Loss) Per Share	3 Months Ended
	Mar. 31, 2018
Notes to Financial Statements
Earnings Per Share [Text Block]	9 . Earnings (Loss) Per Share Basic income (loss) per share is computed by dividing net income (loss) by the weighted average number of common shares outstanding during the period. Diluted income (loss) per share assumes the issuance of potentially dilutive shares of common stock during the period. The following table reconciles the numerators and denominators of the basic and diluted income (loss) per share computations: Three Months Ended March 31 2018 2017 Numerator: Net income (loss) (in thousands) $ 204 $ (1,478 ) Denominator: Weighted average common shares outstanding: Basic 22,799,221 22,680,562 Dilutive effect of non-vested awards 57,900 - Diluted 22,857,121 22,680,562 Net income (loss) per share: Basic $ 0.01 $ (0.07 ) Diluted $ 0.01 $ (0.07 ) For the three March 31, 2018, 0.3 not three March 31, 2017, 0.6 not

Note 10 - Leases

Note 10 - Leases	3 Months Ended
	Mar. 31, 2018
Notes to Financial Statements
Leases of Lessee Disclosure [Text Block]	10 . 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 (“Pump Assets”). The Pumps Assets 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 3.7% March 31, 2018. Future minimum rental payments pursuant to leases that have an initial or remaining non-cancelable lease term in excess of one March 31, 2018 Capital Leases Operating Leases Total 2018 $ 361 $ 1,019 $ 1,380 2019 33 1,263 1,296 2020 - 733 733 2021 - 219 219 2022 - 229 229 Thereafter - 841 841 Total required payments 394 $ 4,304 $ 4,698 Less amounts representing interest (3.5%) (5 ) Present value of minimum lease payments 389 Less current maturities (389 ) Long-term capital lease liability $ - At March 31, 2018 December 31, 2017, $ 14.0 $6.6 $6.1 The Company had minimum future operating lease commitments, mainly related to its leased facilities. Related rental expense for facilities and other equipment from third three March 31, 2018 2017 $0.3 $0.2

Note 11 - Recent Accounting Pro

Note 11 - Recent Accounting Pronouncements and Developments	3 Months Ended
	Mar. 31, 2018
Notes to Financial Statements
New Accounting Pronouncements and Changes in Accounting Principles [Text Block]	11. Recent Accounting Pronouncements and Developments In January 2017, No. 2017 04, 350 2 December 15, 2019 ( January 1, 2020 January 1, 2017. not In February 2016, No. 2016 02, 842 2016 02” 2016 02, 2016 02 2016 02 December 15, 2018, 2016 02 In June 2016, No. 2016 13, 326 2016 13” 2016 13 not 2016 13 January 1, 2020. 2016 13

Significant Accounting Policies

Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2018
Accounting Policies [Abstract]
New Accounting Pronouncements, Policy [Policy Text Block]	In January 2017, No. 2017 04, 350 2 December 15, 2019 ( January 1, 2020 January 1, 2017. not In February 2016, No. 2016 02, 842 2016 02” 2016 02, 2016 02 2016 02 December 15, 2018, 2016 02 In June 2016, No. 2016 13, 326 2016 13” 2016 13 not 2016 13 January 1, 2020. 2016 13

Note 2 - Revenue Recognition (T

Note 2 - Revenue Recognition (Tables)	3 Months Ended
	Mar. 31, 2018
Notes Tables
Schedule of New Accounting Pronouncements and Changes in Accounting Principles [Table Text Block]	Three Months Ended March 31, 2018 As Reported Adjustments Pro-Forma as if Previous Accounting Guidance Was in Effect Net revenues: Rentals $ 14,421 $ 1,904 $ 16,325 Net revenues 16,483 1,904 18,387 Gross profit 10,073 1,904 11,977 Selling, general and administrative expenses: Provision for doubtful accounts - 1,904 1,904 Total selling, general and administrative $ 9,485 $ 1,904 $ 11,389
Disaggregation of Revenue [Table Text Block]	Three Months Ended March 31, 2018 Third-Party Payor Rentals 48.6% Direct Payor Rentals 38.9% Product Sales 12.5% Total - Net revenues 100.0%

Note 3 - Medical Equipment (Tab

Note 3 - Medical Equipment (Tables)	3 Months Ended
	Mar. 31, 2018
Notes Tables
Schedule of Medical Equipment [Table Text Block]	March 31, December 31, 2018 2017 Medical Equipment held for sale or rental $ 1,481 $ 1,567 Medical Equipment in rental service 58,044 57,928 Medical Equipment in rental service - pump reserve (462 ) (482 ) Accumulated depreciation (34,901 ) (34,077 ) Medical Equipment in rental service - net 22,681 23,369 Total $ 24,162 $ 24,936

Note 4 - Property and Equipme20

Note 4 - Property and Equipment (Tables)	3 Months Ended
	Mar. 31, 2018
Notes Tables
Property, Plant and Equipment [Table Text Block]	March 31, 2018 December 31, 2017 Gross Assets Accumulated Depreciation Total Gross Assets Accumulated Depreciation Total Furniture, fixtures, and equipment $ 3,845 $ (3,340 ) $ 505 $ 3,824 $ (3,277 ) $ 547 Automobiles 118 (88 ) 30 118 (85 ) 33 Leasehold improvements 2,187 (1,176 ) 1,011 2,187 (1,134 ) 1,053 Total $ 6,150 $ (4,604 ) $ 1,546 $ 6,129 $ (4,496 ) $ 1,633

Note 5 - Intangible Assets (Tab

Note 5 - Intangible Assets (Tables)	3 Months Ended
	Mar. 31, 2018
Notes Tables
Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets [Table Text Block]	March 31, 2018 December 31, 2017 Gross Assets Accumulated Amortization Net Gross Assets Accumulated Amortization Net Nonamortizable intangible assets: Trade names $ 2,000 $ - $ 2,000 $ 2,000 $ - $ 2,000 Amortizable intangible assets: Trade names 23 (23 ) - 23 (23 ) - Physician and customer relationships 36,534 (22,394 ) 14,140 36,534 (21,801 ) 14,733 Non-competition agreements 1,136 (1,131 ) 5 1,136 (1,125 ) 11 Software 11,230 (4,048 ) 7,182 11,230 (3,460 ) 7,770 Total nonamortizable and amortizable intangible assets $ 50,923 $ (27,596 ) $ 23,327 $ 50,923 $ (26,409 ) $ 24,514
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense [Table Text Block]	4/1- 12/31/2018 2019 2020 2021 2022 2023 and thereafter Total Amortization expense $ 3,462 $ 4,402 $ 4,285 $ 3,930 $ 2,051 $ 3,197 $ 21,327

Note 6 - Debt (Tables)

Note 6 - Debt (Tables)	3 Months Ended
	Mar. 31, 2018
Notes Tables
Schedule of Line of Credit Facilities [Table Text Block]	March 31, December 31, 2018 2017 Revolver: Gross availability $ 10,000 $ 10,000 Outstanding draws - - Letter of credit (750 ) (750 ) Landlord reserves (68 ) (45 ) Net availability $ 9,182 $ 9,205
Schedule of Maturities of Long-term Debt [Table Text Block]	2018 2019 2020 2021 Total Term Loan $ 2,300 $ 3,067 $ 3,067 $ 17,436 $ 25,870 Unamortized value of the debt issuance costs (22 ) (30 ) (30 ) (30 ) (112 ) Total $ 2,278 $ 3,037 $ 3,037 $ 17,406 $ 25,758
Schedule of Debt [Table Text Block]	March 31, 2018 December 31, 2017 Current Portion of Long-Term Debt Long-Term Debt Total Current Portion of Long- Term Debt Long-Term Debt Total Term Loan $ 3,067 $ 22,803 $ 25,870 Term Loan $ 3,067 $ 25,444 $ 28,511 Unamortized value of the debt issuance costs (28 ) (84 ) (112 ) Unamortized value of the debt issuance costs (28 ) (92 ) (120 ) Total $ 3,039 $ 22,719 $ 25,758 Total $ 3,039 $ 25,352 $ 28,391

Note 9 - Earnings (Loss) Per 23

Note 9 - Earnings (Loss) Per Share (Tables)	3 Months Ended
	Mar. 31, 2018
Notes Tables
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	Three Months Ended March 31 2018 2017 Numerator: Net income (loss) (in thousands) $ 204 $ (1,478 ) Denominator: Weighted average common shares outstanding: Basic 22,799,221 22,680,562 Dilutive effect of non-vested awards 57,900 - Diluted 22,857,121 22,680,562 Net income (loss) per share: Basic $ 0.01 $ (0.07 ) Diluted $ 0.01 $ (0.07 )

Note 10 - Leases (Tables)

Note 10 - Leases (Tables)	3 Months Ended
	Mar. 31, 2018
Notes Tables
Schedule of Future Minimum Lease Payments for Capital and Operating Leases [Table Text Block]	Capital Leases Operating Leases Total 2018 $ 361 $ 1,019 $ 1,380 2019 33 1,263 1,296 2020 - 733 733 2021 - 219 219 2022 - 229 229 Thereafter - 841 841 Total required payments 394 $ 4,304 $ 4,698 Less amounts representing interest (3.5%) (5 ) Present value of minimum lease payments 389 Less current maturities (389 ) Long-term capital lease liability $ -

Note 2 - Revenue Recognition -

Note 2 - Revenue Recognition - Impact of ASC 606 On the Condensed Consolidated Statements of Operations (Unaudited) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Net revenues:
Rentals	$ 14,421	$ 15,137
Net revenues	16,483	17,654
Gross profit	10,073	10,649
Selling, general and administrative expenses:
Provision for doubtful accounts		1,856
Total selling, general and administrative	9,485	$ 12,618
Difference between Revenue Guidance in Effect before and after Topic 606 [Member]
Net revenues:
Rentals	1,904
Net revenues	1,904
Gross profit	1,904
Selling, general and administrative expenses:
Provision for doubtful accounts	1,904
Total selling, general and administrative	1,904
Calculated under Revenue Guidance in Effect before Topic 606 [Member]
Net revenues:
Rentals	16,325
Net revenues	18,387
Gross profit	11,977
Selling, general and administrative expenses:
Provision for doubtful accounts	1,904
Total selling, general and administrative	$ 11,389

Note 2 - Revenue Recognition 26

Note 2 - Revenue Recognition - Disaggregated Revenue by Revenue Stream (Details) - Customer Concentration Risk [Member]	3 Months Ended
	Mar. 31, 2018
Third-Party Payor Rental Revenue [Member]
Revenue	48.60%
Director Payer Rentals [Member]
Revenue	38.90%
Sales Revenue, Product Line [Member]
Revenue	12.50%
Revenue from Contract with Customer [Member]
Revenue	100.00%

Note 3 - Medical Equipment (Det

Note 3 - Medical Equipment (Details Textual) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Depreciation Expense Related to Medical Equipment	$ 1.5	$ 1.6

Note 3 - Medical Equipment - Su

Note 3 - Medical Equipment - Summary of Medical Equipment (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Medical Equipment held for sale or rental	$ 1,481	$ 1,567
Medical Equipment in rental service	58,044	57,928
Medical Equipment in rental service - pump reserve	(462)	(482)
Accumulated depreciation	(34,901)	(34,077)
Medical Equipment in rental service - net	22,681	23,369
Total	$ 24,162	$ 24,936

Note 4 - Property and Equipme29

Note 4 - Property and Equipment (Details Textual) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Depreciation, Nonproduction	$ 0.1	$ 0.1

Note 4 - Property and Equipme30

Note 4 - Property and Equipment - Property and Equipment (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Gross Assets	$ 6,150	$ 6,129
Accumulated Depreciation	(4,604)	(4,496)
Total	1,546	1,633
Furniture and Fixtures [Member]
Gross Assets	3,845	3,824
Accumulated Depreciation	(3,340)	(3,277)
Total	505	547
Automobiles [Member]
Gross Assets	118	118
Accumulated Depreciation	(88)	(85)
Total	30	33
Leasehold Improvements [Member]
Gross Assets	2,187	2,187
Accumulated Depreciation	(1,176)	(1,134)
Total	$ 1,011	$ 1,053

Note 5 - Intangible Assets (Det

Note 5 - Intangible Assets (Details Textual) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Amortization of Intangible Assets, Total	$ 1,187	$ 1,411

Note 5 - Intangible Assets - Su

Note 5 - Intangible Assets - Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Amortizable intangible assets, accumulated amortization	$ 27,596	$ 26,409
Amortizable intangible assets, net	21,327
Total nonamortizable and amortizable intangible assets, gross assets	50,923	50,923
Total nonamortizable and amortizable intangible assets, net	23,327	24,514
Trade Names [Member]
Amortizable intangible assets, gross assets	23	23
Amortizable intangible assets, accumulated amortization	23	23
Amortizable intangible assets, net
Physician and Customer Relationships [Member]
Amortizable intangible assets, gross assets	36,534	36,534
Amortizable intangible assets, accumulated amortization	22,394	21,801
Amortizable intangible assets, net	14,140	14,733
Noncompete Agreements [Member]
Amortizable intangible assets, gross assets	1,136	1,136
Amortizable intangible assets, accumulated amortization	1,131	1,125
Amortizable intangible assets, net	5	11
Computer Software, Intangible Asset [Member]
Amortizable intangible assets, gross assets	11,230	11,230
Amortizable intangible assets, accumulated amortization	4,048	3,460
Amortizable intangible assets, net	7,182	7,770
Trade Names 1 [Member]
Nonamortizable intangible assets	$ 2,000	$ 2,000

Note 5 - Intangible Assets - Ex

Note 5 - Intangible Assets - Expected Annual Amortization Expense for Intangible Assets (Details) $ in Thousands	Mar. 31, 2018USD ($)
Amortization expense, 2018	$ 3,462
Amortization expense, 2019	4,402
Amortization expense, 2020	4,285
Amortization expense, 2021	3,930
Amortization expense, 2022	2,051
Amortization expense, 2023 and thereafter	3,197
Amortization expense	$ 21,327

Note 6 - Debt (Details Textual)

Note 6 - Debt (Details Textual) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Dec. 31, 2017
Long-term Debt, Total	$ 25,758	$ 28,391
Term Loan [Member]
Long-term Debt, Total	25,870	$ 28,511
Term Loan [Member] | Credit Facility [Member]
Long-term Debt, Total	$ 25,900
LIBOR Rate	1.88%
Term Loan [Member] | Credit Facility [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate	2.75%
Debt Instrument, Interest Rate, Effective Percentage	4.63%
Term Loan [Member] | Credit Facility [Member] | Minimum [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate	2.00%
Applicable Margin Rate	(1.00%)
Term Loan [Member] | Credit Facility [Member] | Maximum [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate	3.00%
Debt Instrument, Basis Spread on Variable Rate, Before Margin Rate	2.50%
Applicable Margin Rate	0.25%

Note 6 - Debt - Summary of Revo

Note 6 - Debt - Summary of Revolver Based Upon Borrowers' Eligible Accounts Receivable and Inventory (Details) - Revolving Credit Facility [Member] - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Gross availability	$ 10,000	$ 10,000
Outstanding draws
Letter of credit	(750)	(750)
Landlord reserves	(68)	(45)
Net availability	$ 9,182	$ 9,205

Note 6 - Debt - Summary of Futu

Note 6 - Debt - Summary of Future Maturities of Loans (Details) $ in Thousands	Mar. 31, 2018USD ($)
2,018	$ 2,278
2,019	3,037
2,020	3,037
2,021	17,406
2,022	25,758
Unamortized value of the debt issuance costs, 2018	(22)
Unamortized value of the debt issuance costs, 2019	(30)
Unamortized value of the debt issuance costs, 2020	(30)
Unamortized value of the debt issuance costs, 2021	(30)
Unamortized value of the debt issuance costs, 2022	(112)
Term Loan [Member]
2,018	2,300
2,019	3,067
2,020	3,067
2,021	17,436
2,022	$ 25,870

Note 6 - Debt - Summary of Comp

Note 6 - Debt - Summary of Company's Current and Long-term Debt (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Term Loan	$ 3,039	$ 3,039
Term Loan	22,719	25,352
Term Loan	25,758	28,391
Unamortized value of the debt issuance costs, Current portion of long-term debt	(28)	(28)
Unamortized value of the debt issuance costs, Long-term debt	(84)	(92)
Unamortized value of the debt issuance costs, Total	(112)	(120)
Long-term debt	22,719	25,352
Term Loan [Member]
Term Loan	3,067	3,067
Term Loan	22,803	25,444
Term Loan	25,870	28,511
Long-term debt	$ 22,803	$ 25,444

Note 7 - Income Taxes (Details

Note 7 - Income Taxes (Details Textual) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017
Income Tax Expense (Benefit), Total	$ 58	$ (856)
Effective Income Tax Rate Reconciliation, at Federal Statutory Income Tax Rate, Percent				35.00%
Scenario, Forecast [Member]
Effective Income Tax Rate Reconciliation, at Federal Statutory Income Tax Rate, Percent			21.00%

Note 9 - Earnings (Loss) Per 39

Note 9 - Earnings (Loss) Per Share (Details Textual) - shares shares in Millions	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Employee Stock Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	0.3	0.6

Note 9 - Earnings (Loss) Per 40

Note 9 - Earnings (Loss) Per Share - Summary of Income and Share Amounts Utilized to Calculate Basic and Diluted Net Income Per Common Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Net income (loss) (in thousands)	$ 204	$ (1,478)
Weighted average shares outstanding:
Basic (in shares)	22,799,221	22,680,562
Dilutive effect of non-vested awards (in shares)	57,900
Diluted (in shares)	22,857,121	22,680,562
Net income (loss) per share:
Basic (in dollars per share)	$ 0.01	$ (0.07)
Diluted (in dollars per share)	$ 0.01	$ (0.07)

Note 10 - Leases (Details Textu

Note 10 - Leases (Details Textual) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Dec. 31, 2017
Operating Leases, Rent Expense, Net, Total	$ 0.3	$ 0.2
Pump Assets [Member]
Capital Leased Assets, Gross, Total	14		$ 14
Capital Leases, Lessee Balance Sheet, Assets by Major Class, Accumulated Depreciation	$ 6.6		$ 6.1
Capital Leases [Member]
Debt, Weighted Average Interest Rate	3.70%

Note 10 - Leases - Schedule of

Note 10 - Leases - Schedule of Future Minimum Rental Payments Pursuant to Capital and Operating Leases (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
2018, capital leases	$ 361
2018, operating leases	1,019
2,018	1,380
2019, capital leases	33
2019, operating leases	1,263
2,019	1,296
2020, capital leases
2020, operating leases	733
2,020	733
2021, capital leases
2021, operating leases	219
2,021	219
2022, capital leases
2022, operating leases	229
2,022	229
Thereafter, capital leases
Thereafter, operating leases	841
Thereafter	841
Total required payments	394
Total required payments	4,304
Total required payments	4,698
Less amounts representing interest (3.5%), capital leases	(5)
Present value of minimum lease payments, capital leases	389
Less current maturities, capital leases	(389)	$ (505)
Long-term capital lease liability, capital leases		$ 33

Note 10 - Leases - Schedule o43

Note 10 - Leases - Schedule of Future Minimum Rental Payments Pursuant to Capital and Operating Leases (Details) (Parentheticals)	Mar. 31, 2018
Capital lease interest	3.50%