InfuSystem (INFU) 10-Q 13 Nov 18 2018 Q3 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	9 Months Ended
	Sep. 30, 2018	Nov. 08, 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	Non-accelerated Filer
Entity Current Reporting Status	Yes
Entity Emerging Growth Company	false
Entity Small Business	true
Entity Common Stock, Shares Outstanding (in shares)		19,542,465
Document Type	10-Q
Document Period End Date	Sep. 30, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q3
Amendment Flag	false

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Current Period Unaudited) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 3,882	$ 3,469
Accounts receivable, less allowance for doubtful accounts of $5,769 and $6,514 at September 30, 2018 and December 31, 2017, respectively	10,043	11,385
Inventories	1,985	1,764
Other current assets	1,303	1,049
Total Current assets	17,213	17,667
Medical equipment held for sale or rental	2,214	1,567
Medical equipment in rental service, net of accumulated depreciation	21,932	23,369
Property & equipment, net of accumulated depreciation	1,494	1,633
Intangible assets, net	21,002	24,514
Other assets	137	131
Total assets	63,992	68,881
Current liabilities:
Accounts payable	7,059	5,516
Capital lease liability, current	101	505
Current portion of long-term debt	4,775	3,039
Other current liabilities	2,727	3,414
Total current liabilities	14,662	12,474
Long-term debt, net of current portion	28,661	25,352
Capital lease liability, long-term		33
Deferred income taxes	62	62
Other long-term liabilities		7
Total liabilities	43,385	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 23,050,984 and 19,565,091, respectively, as of September 30, 2018 and 22,978,398 and 22,780,738, respectively, as of December 31, 2017	2	2
Additional paid-in capital	83,058	92,584
Retained deficit	(62,453)	(61,633)
Total Stockholders’ equity	20,607	30,953
Total liabilities and stockholders’ equity	$ 63,992	$ 68,881

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Accounts receivable, allowance for doubtful accounts	$ 5,769	$ 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)	23,050,984	22,978,398
Common stock, outstanding (in shares)	19,565,091	22,780,738

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Net revenues:
Rentals	$ 13,773	$ 15,322	$ 42,246	$ 45,228
Product Sales	2,904	2,266	7,329	6,956
Net revenues	16,677	17,588	49,575	52,184
Cost of revenues:
Cost of revenues — Product, service and supply costs	4,896	4,452	14,180	13,612
Cost of revenues — Pump depreciation and disposals	2,233	2,095	6,221	6,541
Gross profit	9,548	11,041	29,174	32,031
Selling, general and administrative expenses:
Provision for doubtful accounts		1,274		4,456
Amortization of intangibles	1,160	1,384	3,512	4,182
Selling and marketing	2,323	2,262	6,950	7,443
General and administrative	6,160	5,561	18,423	18,451
Total selling, general and administrative	9,643	10,481	28,885	34,532
Operating (loss) income	(95)	560	289	(2,501)
Other expense:
Interest expense	(370)	(354)	(981)	(1,015)
Other expense	(9)	(8)	(19)	(111)
(Loss) income before income taxes	(474)	198	(711)	(3,627)
(Provision for) benefit from income taxes	(45)	(327)	(109)	914
Net loss	$ (519)	$ (129)	$ (820)	$ (2,713)
Net loss per share:
Basic and diluted (in dollars per share)	$ (0.03)	$ (0.01)	$ (0.04)	$ (0.12)
Weighted average shares outstanding:
Basic and diluted (in shares)	20,672,688	22,755,976	22,043,213	22,725,806

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
NET CASH PROVIDED BY OPERATING ACTIVITIES	$ 8,095	$ 4,102
INVESTING ACTIVITIES
Purchase of medical equipment and property	(4,962)	(2,829)
Proceeds from sale of medical equipment and property	2,900	3,518
NET CASH (USED IN) PROVIDED BY INVESTING ACTIVITIES	(2,062)	689
FINANCING ACTIVITIES
Principal payments on revolving credit facility, term loans and capital lease obligations	(5,048)	(35,769)
Cash proceeds from credit facility	9,660	28,317
Debt issuance costs	(27)	(38)
Common stock repurchased to satisfy statutory withholding on employee stock based compensation plans	(5)	(27)
Common stock repurchased as part of Repurchase Program	(10,291)
Cash proceeds from stock plans	91	131
NET CASH USED IN FINANCING ACTIVITIES	(5,620)	(7,386)
Net change in cash and cash equivalents	413	(2,595)
Cash and cash equivalents, beginning of period	3,469	3,398
Cash and cash equivalents, end of period	$ 3,882	$ 803

Note 1 - Basis of Presentation,

Note 1 - Basis of Presentation, Nature of Operations and Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 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, Massachusetts 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	9 Months Ended
	Sep. 30, 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 three nine September 30, 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. The Company’s revenue related to rental services 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. The Company’s 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 September 30, 2018 ( Three Months Ended September 30, 2018 As Reported Adjustments Pro-Forma as if Previous Accounting Guidance Was in Effect Net revenues: Net rental revenues $ 13,773 $ 1,467 $ 15,240 Net revenues 16,677 1,467 18,144 Gross profit 9,548 1,467 11,015 Selling, general and administrative expenses: Provision for doubtful accounts - 1,467 1,467 Total selling, general and administrative 9,643 1,467 11,110 The following table presents the impact of ASC 606 nine September 30, 2018 ( Nine Months Ended September 30, 2018 As Reported Adjustments Pro-Forma as if Previous Accounting Guidance Was in Effect Net revenues: Net rental revenues $ 42,246 $ 4,804 $ 47,050 Net revenues 49,575 4,804 54,379 Gross profit 29,174 4,804 33,978 Selling, general and administrative expenses: Provision for doubtful accounts - 4,804 4,804 Total selling, general and administrative 28,885 4,804 33,689 The following table presents disaggregated revenue by offering type: Three Months Ended Nine Months Ended September 30, 2018 September 30, 2018 Third-Party Payor Rentals 46.8 % 47.6 % Direct Payor Rentals 35.8 % 37.6 % Product Sales 17.4 % 14.8 % Total - Net revenues 100.0 % 100.0 %

Note 3 - Medical Equipment and

Note 3 - Medical Equipment and Property	9 Months Ended
	Sep. 30, 2018
Notes to Financial Statements
Medical Equipment and Property Disclosure [Text Block]	3 . Medical Equipment and Property Medical equipment consists of the following (in thousands): September 30, December 31, 2018 2017 Medical Equipment held for sale or rental $ 2,214 $ 1,567 Medical Equipment in rental service 58,582 57,928 Medical Equipment in rental service - pump reserve (445 ) (482 ) Accumulated depreciation (36,205 ) (34,077 ) Medical Equipment in rental service - net 21,932 23,369 Total $ 24,146 $ 24,936 Depreciation expense for medical equipment for the three nine September 30, 2018 $1.5 $4.5 $1.7 $4.8

Note 4 - Property and Equipment

Note 4 - Property and Equipment	9 Months Ended
	Sep. 30, 2018
Notes to Financial Statements
Property, Plant and Equipment Disclosure [Text Block]	4 . Property and Equipment Property and equipment consists of the following (in thousands): September 30, 2018 December 31, 2017 Gross Assets Accumulated Depreciation Total Gross Assets Accumulated Depreciation Total Furniture, fixtures, and equipment $ 3,931 $ (3,469 ) $ 462 $ 3,824 $ (3,277 ) $ 547 Automobiles 118 (92 ) 26 118 (85 ) 33 Leasehold improvements 2,273 (1,267 ) 1,006 2,187 (1,134 ) 1,053 Total $ 6,322 $ (4,828 ) $ 1,494 $ 6,129 $ (4,496 ) $ 1,633 Depreciation expense for property and equipment for the three nine September 30, 2018 $0.1 $0.3 $0.1 $0.4

Note 5 - Intangible Assets

Note 5 - Intangible Assets	9 Months Ended
	Sep. 30, 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): September 30, 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 (23,582 ) 12,952 36,534 (21,801 ) 14,733 Non-competition agreements 1,136 (1,136 ) - 1,136 (1,125 ) 11 Software 11,230 (5,180 ) 6,050 11,230 (3,460 ) 7,770 Total nonamortizable and amortizable intangible assets $ 50,923 $ (29,921 ) $ 21,002 $ 50,923 $ (26,409 ) $ 24,514 Amortization expense for the three nine September 30, 2018 $1.2 $3.5 $1.4 $4.2 September 30, 2018 October 1 - 2023 and December 31, 2018 2019 2020 2021 2022 thereafter Amortization expense $ 1,137 $ 4,402 $ 4,285 $ 3,930 $ 2,051 $ 3,197

Note 6 - Debt

Note 6 - Debt	9 Months Ended
	Sep. 30, 2018
Notes to Financial Statements
Debt Disclosure [Text Block]	6 . Debt On July 31, 2018, March 23, 2015 ( 2.8 second not $8.6 not $6.4 no December 31, 2019 1.25:1.0 1.15:1.0. December 6, 2021, December 31, 2024. As of September 30, 2018, $32.5 $1.1 September 30, December 31, 2018 2017 Revolver: Gross availability $ 9,909 $ 10,000 Outstanding draws - - Letter of credit (750 ) (750 ) Landlord reserves (69 ) (45 ) Net availability $ 9,090 $ 9,205 The Company had future maturities of its term loans and equipment line as of September 30, 2018 2018 2019 2020 2021 2022 and thereafter Total Term Loans $ 1,203 $ 4,813 $ 4,813 $ 21,671 $ - $ 32,500 Equipment Line - 53 212 212 583 1,060 Unamortized value of the debt issuance costs (10 ) (38 ) (38 ) (38 ) - (124 ) Total $ 1,193 $ 4,828 $ 4,987 $ 21,845 $ 583 $ 33,436 The following is a breakdown of the Company’s current and long-term debt as follows (in thousands): September 30, 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 Loans $ 4,813 $ 27,687 $ 32,500 Term Loans $ 3,067 $ 25,444 $ 28,511 Equipment Line - 1,060 1,060 Equipment Line - - - Unamortized value of the debt issuance costs (38 ) (86 ) (124 ) Unamortized value of the debt issuance costs (28 ) (92 ) (120 ) Total $ 4,775 $ 28,661 $ 33,436 Total $ 3,039 $ 25,352 $ 28,391 As of September 30, 2018, 30 2.00% 3.00% 2.50%, 1.00% 0.25%. September 30, 2018 4.75% 2.25% 2.50% September 30, 2018 4.75% 5.25% 0.50% As of September 30, 2018,

Note 7 - Income Taxes

Note 7 - Income Taxes	9 Months Ended
	Sep. 30, 2018
Notes to Financial Statements
Income Tax Disclosure [Text Block]	7 . Income Taxes During the three nine September 30, 2018, $0.1 $0.1 three nine September 30, 2017, $0.3 $0.9 The Company’s realization of its deferred tax assets is dependent upon many factors, including, but not not not September 30, 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 not 2017 2018 may may may 2017 As of September 30, 2018, not 2017

Note 8 - Commitments, Contingen

Note 8 - Commitments, Contingencies and Litigation	9 Months Ended
	Sep. 30, 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 The Company is not

Note 9 - Loss Per Share

Note 9 - Loss Per Share	9 Months Ended
	Sep. 30, 2018
Notes to Financial Statements
Earnings Per Share [Text Block]	9 . Loss Per Share Basic loss per share is computed by dividing net loss by the weighted average number of common shares outstanding during the period. Diluted 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 loss per share computations: Three Months Ended September 30 Nine Months Ended September 30 Numerator: 2018 2017 2018 2017 Net loss (in thousands) $ (519 ) $ (129 ) $ (820 ) $ (2,713 ) Denominator: Weighted average common shares outstanding: Basic 20,672,688 22,755,976 22,043,213 22,725,806 Dilutive effect of non-vested awards - - - - Diluted 20,672,688 22,755,976 22,043,213 22,725,806 Net loss per share: Basic and diluted $ (0.03 ) $ (0.01 ) $ (0.04 ) $ (0.12 ) For both the three nine September 30, 2018, 0.1 not 0.7 0.6

Note 10 - Leases

Note 10 - Leases	9 Months Ended
	Sep. 30, 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 Pump 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 4.0% September 30, 2018. Future minimum rental payments pursuant to leases that have an initial or remaining non-cancelable lease term in excess of one September 30, 2018 Capital Leases Operating Leases Total 2018 $ 69 $ 411 $ 480 2019 33 1,524 1,557 2020 - 938 938 2021 - 338 338 2022 - 229 229 Thereafter - 841 841 Total required payments $ 102 $ 4,281 $ 4,383 Less amounts representing interest (3.5%) (1 ) Present value of minimum lease payments 101 Less current maturities (101 ) Long-term capital lease liability $ - At September 30, 2018 December 31, 2017, $1.7 $0.7 $0.5 second 2018, 420 $0.1 The Company has minimum future operating lease commitments, mainly related to its leased facilities. Associated rental expense for facilities and other equipment from third three nine September 30, 2018 $0.4 $1.1 $0.2 $0.7

Note 11 - Subsequent Events

Note 11 - Subsequent Events	9 Months Ended
	Sep. 30, 2018
Notes to Financial Statements
Subsequent Events [Text Block]	1 1 . Subsequent Event s The Company has evaluated subsequent events through the date of issuance for the unaudited condensed consolidated financial statements as of September 30, 2018.

Note 12 - Recent Accounting Pro

Note 12 - Recent Accounting Pronouncements and Developments	9 Months Ended
	Sep. 30, 2018
Notes to Financial Statements
New Accounting Pronouncements and Changes in Accounting Principles [Text Block]	1 2 . 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, 842 842, 842 842 December 15, 2018, July 2018, 2018 10, 842, July 2018, 2018 11, 842 January 1, 2019 842 not 842 In June 2016, No. 2016 13, 326 326 not 326 January 1, 2020. 326

Note 2 - Revenue Recognition (T

Note 2 - Revenue Recognition (Tables)	9 Months Ended
	Sep. 30, 2018
Notes Tables
Schedule of New Accounting Pronouncements and Changes in Accounting Principles [Table Text Block]	Three Months Ended September 30, 2018 As Reported Adjustments Pro-Forma as if Previous Accounting Guidance Was in Effect Net revenues: Net rental revenues $ 13,773 $ 1,467 $ 15,240 Net revenues 16,677 1,467 18,144 Gross profit 9,548 1,467 11,015 Selling, general and administrative expenses: Provision for doubtful accounts - 1,467 1,467 Total selling, general and administrative 9,643 1,467 11,110 Nine Months Ended September 30, 2018 As Reported Adjustments Pro-Forma as if Previous Accounting Guidance Was in Effect Net revenues: Net rental revenues $ 42,246 $ 4,804 $ 47,050 Net revenues 49,575 4,804 54,379 Gross profit 29,174 4,804 33,978 Selling, general and administrative expenses: Provision for doubtful accounts - 4,804 4,804 Total selling, general and administrative 28,885 4,804 33,689
Disaggregation of Revenue [Table Text Block]	Three Months Ended Nine Months Ended September 30, 2018 September 30, 2018 Third-Party Payor Rentals 46.8 % 47.6 % Direct Payor Rentals 35.8 % 37.6 % Product Sales 17.4 % 14.8 % Total - Net revenues 100.0 % 100.0 %

Note 3 - Medical Equipment an_2

Note 3 - Medical Equipment and Property (Tables)	9 Months Ended
	Sep. 30, 2018
Notes Tables
Schedule of Medical Equipment [Table Text Block]	September 30, December 31, 2018 2017 Medical Equipment held for sale or rental $ 2,214 $ 1,567 Medical Equipment in rental service 58,582 57,928 Medical Equipment in rental service - pump reserve (445 ) (482 ) Accumulated depreciation (36,205 ) (34,077 ) Medical Equipment in rental service - net 21,932 23,369 Total $ 24,146 $ 24,936

Note 4 - Property and Equipme_2

Note 4 - Property and Equipment (Tables)	9 Months Ended
	Sep. 30, 2018
Notes Tables
Property, Plant and Equipment [Table Text Block]	September 30, 2018 December 31, 2017 Gross Assets Accumulated Depreciation Total Gross Assets Accumulated Depreciation Total Furniture, fixtures, and equipment $ 3,931 $ (3,469 ) $ 462 $ 3,824 $ (3,277 ) $ 547 Automobiles 118 (92 ) 26 118 (85 ) 33 Leasehold improvements 2,273 (1,267 ) 1,006 2,187 (1,134 ) 1,053 Total $ 6,322 $ (4,828 ) $ 1,494 $ 6,129 $ (4,496 ) $ 1,633

Note 5 - Intangible Assets (Tab

Note 5 - Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2018
Notes Tables
Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets [Table Text Block]	September 30, 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 (23,582 ) 12,952 36,534 (21,801 ) 14,733 Non-competition agreements 1,136 (1,136 ) - 1,136 (1,125 ) 11 Software 11,230 (5,180 ) 6,050 11,230 (3,460 ) 7,770 Total nonamortizable and amortizable intangible assets $ 50,923 $ (29,921 ) $ 21,002 $ 50,923 $ (26,409 ) $ 24,514
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense [Table Text Block]	October 1 - 2023 and December 31, 2018 2019 2020 2021 2022 thereafter Amortization expense $ 1,137 $ 4,402 $ 4,285 $ 3,930 $ 2,051 $ 3,197

Note 6 - Debt (Tables)

Note 6 - Debt (Tables)	9 Months Ended
	Sep. 30, 2018
Notes Tables
Schedule of Line of Credit Facilities [Table Text Block]	September 30, December 31, 2018 2017 Revolver: Gross availability $ 9,909 $ 10,000 Outstanding draws - - Letter of credit (750 ) (750 ) Landlord reserves (69 ) (45 ) Net availability $ 9,090 $ 9,205
Schedule of Maturities of Long-term Debt [Table Text Block]	2018 2019 2020 2021 2022 and thereafter Total Term Loans $ 1,203 $ 4,813 $ 4,813 $ 21,671 $ - $ 32,500 Equipment Line - 53 212 212 583 1,060 Unamortized value of the debt issuance costs (10 ) (38 ) (38 ) (38 ) - (124 ) Total $ 1,193 $ 4,828 $ 4,987 $ 21,845 $ 583 $ 33,436
Schedule of Debt [Table Text Block]	September 30, 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 Loans $ 4,813 $ 27,687 $ 32,500 Term Loans $ 3,067 $ 25,444 $ 28,511 Equipment Line - 1,060 1,060 Equipment Line - - - Unamortized value of the debt issuance costs (38 ) (86 ) (124 ) Unamortized value of the debt issuance costs (28 ) (92 ) (120 ) Total $ 4,775 $ 28,661 $ 33,436 Total $ 3,039 $ 25,352 $ 28,391

Note 9 - Loss Per Share (Tables

Note 9 - Loss Per Share (Tables)	9 Months Ended
	Sep. 30, 2018
Notes Tables
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	Three Months Ended September 30 Nine Months Ended September 30 Numerator: 2018 2017 2018 2017 Net loss (in thousands) $ (519 ) $ (129 ) $ (820 ) $ (2,713 ) Denominator: Weighted average common shares outstanding: Basic 20,672,688 22,755,976 22,043,213 22,725,806 Dilutive effect of non-vested awards - - - - Diluted 20,672,688 22,755,976 22,043,213 22,725,806 Net loss per share: Basic and diluted $ (0.03 ) $ (0.01 ) $ (0.04 ) $ (0.12 )

Note 10 - Leases (Tables)

Note 10 - Leases (Tables)	9 Months Ended
	Sep. 30, 2018
Notes Tables
Schedule of Future Minimum Lease Payments for Capital and Operating Leases [Table Text Block]	Capital Leases Operating Leases Total 2018 $ 69 $ 411 $ 480 2019 33 1,524 1,557 2020 - 938 938 2021 - 338 338 2022 - 229 229 Thereafter - 841 841 Total required payments $ 102 $ 4,281 $ 4,383 Less amounts representing interest (3.5%) (1 ) Present value of minimum lease payments 101 Less current maturities (101 ) 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		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Rentals	$ 13,773	$ 15,322	$ 42,246	$ 45,228
Net revenues	16,677	17,588	49,575	52,184
Gross profit	9,548	11,041	29,174	32,031
Provision for doubtful accounts		1,274		4,456
Total selling, general and administrative	9,643	$ 10,481	28,885	$ 34,532
Difference between Revenue Guidance in Effect before and after Topic 606 [Member]
Rentals	1,467		4,804
Net revenues	1,467		4,804
Gross profit	1,467		4,804
Provision for doubtful accounts	1,467		4,804
Total selling, general and administrative	1,467		4,804
Calculated under Revenue Guidance in Effect before Topic 606 [Member]
Rentals	15,240		47,050
Net revenues	18,144		54,379
Gross profit	11,015		33,978
Provision for doubtful accounts	1,467		4,804
Total selling, general and administrative	$ 11,110		$ 33,689

Note 2 - Revenue Recognition _2

Note 2 - Revenue Recognition - Disaggregated Revenue by Revenue Stream (Details) - Customer Concentration Risk [Member]	3 Months Ended	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2018
Third-Party Payor Rental Revenue [Member]
Revenue	46.80%	47.60%
Director Payer Rentals [Member]
Revenue	35.80%	37.60%
Sales Revenue, Product Line [Member]
Revenue	17.40%	14.80%
Revenue from Contract with Customer [Member]
Revenue	100.00%	100.00%

Note 3 - Medical Equipment an_3

Note 3 - Medical Equipment and Property (Details Textual) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Depreciation Expense Related to Medical Equipment	$ 1.5	$ 1.7	$ 4.5	$ 4.8

Note 3 - Medical Equipment an_4

Note 3 - Medical Equipment and Property - Summary of Medical Equipment (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Medical Equipment held for sale or rental	$ 2,214	$ 1,567
Medical Equipment in rental service	58,582	57,928
Medical Equipment in rental service - pump reserve	(445)	(482)
Accumulated depreciation	(36,205)	(34,077)
Medical Equipment in rental service - net	21,932	23,369
Total	$ 24,146	$ 24,936

Note 4 - Property and Equipme_3

Note 4 - Property and Equipment (Details Textual) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Depreciation, Total	$ 0.1	$ 0.1	$ 0.3	$ 0.4

Note 4 - Property and Equipme_4

Note 4 - Property and Equipment - Property and Equipment (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Gross Assets	$ 6,322	$ 6,129
Accumulated Depreciation	(4,828)	(4,496)
Total	1,494	1,633
Furniture and Fixtures [Member]
Gross Assets	3,931	3,824
Accumulated Depreciation	(3,469)	(3,277)
Total	462	547
Automobiles [Member]
Gross Assets	118	118
Accumulated Depreciation	(92)	(85)
Total	26	33
Leasehold Improvements [Member]
Gross Assets	2,273	2,187
Accumulated Depreciation	(1,267)	(1,134)
Total	$ 1,006	$ 1,053

Note 5 - Intangible Assets (Det

Note 5 - Intangible Assets (Details Textual) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Amortization of Intangible Assets, Total	$ 1,160	$ 1,384	$ 3,512	$ 4,182

Note 5 - Intangible Assets - Su

Note 5 - Intangible Assets - Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Amortizable intangible assets, accumulated amortization	$ 29,921	$ 26,409
Total nonamortizable and amortizable intangible assets, gross assets	50,923	50,923
Total nonamortizable and amortizable intangible assets, net	21,002	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	23,582	21,801
Amortizable intangible assets, net	12,952	14,733
Noncompete Agreements [Member]
Amortizable intangible assets, gross assets	1,136	1,136
Amortizable intangible assets, accumulated amortization	1,136	1,125
Amortizable intangible assets, net		11
Computer Software, Intangible Asset [Member]
Amortizable intangible assets, gross assets	11,230	11,230
Amortizable intangible assets, accumulated amortization	5,180	3,460
Amortizable intangible assets, net	6,050	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	Sep. 30, 2018USD ($)
Amortization expense, 2018	$ 1,137
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

Note 6 - Debt (Details Textual)

Note 6 - Debt (Details Textual) $ in Thousands, shares in Millions	Jul. 31, 2018USD ($)shares	Jul. 30, 2018	Sep. 30, 2018USD ($)	Dec. 31, 2017USD ($)
Stock Repurchase Agreement, Shares to be Repurchased | shares	2.8
Long-term Debt, Total			$ 33,436	$ 28,391
Equipment Line [Member]
Long-term Debt, Total			1,060
Term Loan [Member]
Long-term Debt, Total			32,500	$ 28,511
Credit Facility [Member]
Fixed Charge Coverage Ratio	1.15	1.25
Credit Facility [Member] | Equipment Line [Member]
Line of Credit Facility, Maximum Borrowing Capacity	$ 6,400
Long-term Line of Credit, Total			1,100
Credit Facility [Member] | Term Loan C [Member]
Long-term Debt, Total	$ 8,600
Credit Facility [Member] | Term Loan [Member]
Long-term Debt, Total			$ 32,500
Credit Facility [Member] | Eurodollar Loan [Member]
Debt Instrument, Interest Rate, Effective Percentage			4.75%
LIBOR Rate			2.25%
Credit Facility [Member] | Eurodollar Loan [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate			2.50%
Credit Facility [Member] | Eurodollar Loan [Member] | Minimum [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate			2.00%
Credit Facility [Member] | Eurodollar Loan [Member] | Maximum [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate			3.00%
Credit Facility [Member] | CB Floating Rate Loan [Member]
Debt Instrument, Interest Rate, Effective Percentage			4.75%
Lender Prime Rate			5.25%
Credit Facility [Member] | CB Floating Rate Loan [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate, Before Margin Rate			2.50%
Credit Facility [Member] | CB Floating Rate Loan [Member] | Prime Rate [Member]
Debt Instrument, Basis Spread on Variable Rate			(0.50%)
Credit Facility [Member] | CB Floating Rate Loan [Member] | Minimum [Member] | Greater of Prime Rate or LIBOR Plus 2.5% [Member]
Debt Instrument, Basis Spread on Variable Rate			(1.00%)
Credit Facility [Member] | CB Floating Rate Loan [Member] | Maximum [Member] | Greater of Prime Rate or LIBOR Plus 2.5% [Member]
Debt Instrument, Basis Spread on Variable 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	Sep. 30, 2018	Dec. 31, 2017
Gross availability	$ 9,909	$ 10,000
Outstanding draws
Letter of credit	(750)	(750)
Landlord reserves	(69)	(45)
Net availability	$ 9,090	$ 9,205

Note 6 - Debt - Summary of Futu

Note 6 - Debt - Summary of Future Maturities of Loans (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
2,018	$ 1,193
2,019	4,828
2,020	4,987
2,021	21,845
2022 and thereafter	583
Total	33,436	$ 28,391
Unamortized value of the debt issuance costs, 2018	(10)
Unamortized value of the debt issuance costs, 2019	(38)
Unamortized value of the debt issuance costs, 2020	(38)
Unamortized value of the debt issuance costs, 2021	(38)
Unamortized value of the debt issuance costs, 2022 and thereafter
Unamortized value of the debt issuance costs, Total	(124)	(120)
2,018	1,193
2,019	4,828
2,020	4,987
2,021	21,845
2022 and thereafter	583
Long-term Debt, Total	33,436	28,391
Equipment Line [Member]
2,018
2,019	53
2,020	212
2,021	212
2022 and thereafter	583
Total	1,060
2,018
2,019	53
2,020	212
2,021	212
2022 and thereafter	583
Long-term Debt, Total	1,060
Term Loan [Member]
2,018	1,203
2,019	4,813
2,020	4,813
2,021	21,671
2022 and thereafter
Total	32,500	28,511
2,018	1,203
2,019	4,813
2,020	4,813
2,021	21,671
2022 and thereafter
Long-term Debt, Total	$ 32,500	$ 28,511

Note 6 - Debt - Summary of Comp

Note 6 - Debt - Summary of Company's Current and Long-term Debt (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Current portion of long-term debt	$ 4,775	$ 3,039
Long-term debt	28,661	25,352
Total	33,436	28,391
Unamortized value of the debt issuance costs, current portion of long-term debt	(38)	(28)
Unamortized value of the debt issuance costs, long-term debt	(86)	(92)
Unamortized value of the debt issuance costs, Total	(124)	(120)
Equipment Line [Member]
Current portion of long-term debt
Long-term debt	1,060
Total	1,060
Term Loan [Member]
Current portion of long-term debt	4,813	3,067
Long-term debt	27,687	25,444
Total	$ 32,500	$ 28,511

Note 7 - Income Taxes (Details

Note 7 - Income Taxes (Details Textual) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2018	Dec. 31, 2017
Income Tax Expense (Benefit), Total	$ 45	$ 327	$ 109	$ (914)
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%
Maximum [Member]
Income Tax Expense (Benefit), Total	$ 100		$ 100

Note 9 - Loss Per Share (Detail

Note 9 - Loss Per Share (Details Textual) - shares shares in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Employee Stock Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	0.1	0.7	0.1	0.6

Note 9 - Loss Per Share - Summa

Note 9 - 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		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Net loss (in thousands)	$ (519)	$ (129)	$ (820)	$ (2,713)
Basic (in shares)	20,672,688	22,755,976	22,043,213	22,725,806
Dilutive effect of non-vested awards (in shares)
Diluted (in shares)	20,672,688	22,755,976	22,043,213	22,725,806
Basic and diluted (in dollars per share)	$ (0.03)	$ (0.01)	$ (0.04)	$ (0.12)

Note 10 - Leases (Details Textu

Note 10 - Leases (Details Textual) - USD ($) $ in Millions	3 Months Ended			9 Months Ended
	Sep. 30, 2018	Jun. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Mar. 31, 2018	Dec. 31, 2017
Operating Leases, Rent Expense, Net, Total	$ 0.4		$ 0.2	$ 1.1	$ 0.7
Maximum [Member]
Future Lease Payments Expense, Exited Leases		$ 0.1
Pump Assets [Member]
Capital Leased Assets, Gross, Total	1.7			1.7		$ 14	$ 1.7
Capital Leases, Lessee Balance Sheet, Assets by Major Class, Accumulated Depreciation	$ 0.7			$ 0.7			$ 0.5
Capital Leases [Member]
Debt, Weighted Average Interest Rate	4.00%			4.00%

Note 10 - Leases - Schedule of

Note 10 - Leases - Schedule of Future Minimum Rental Payments Pursuant to Capital and Operating Leases (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
2018, capital leases	$ 69
2018, operating leases	411
2,018	480
2019, capital leases	33
2019, operating leases	1,524
2,019	1,557
2020, capital leases
2020, operating leases	938
2,020	938
2021, capital leases
2021, operating leases	338
2,021	338
2022, capital leases
2022, operating leases	229
2,022	229
Thereafter, capital leases
Thereafter, operating leases	841
Thereafter	841
Total required payments	102
Total required payments	4,281
Total required payments	4,383
Less amounts representing interest (3.5%), capital leases	(1)
Present value of minimum lease payments, capital leases	101
Less current maturities, capital leases	(101)	$ (505)
Long-term capital lease liability, capital leases		$ 33

Note 10 - Leases - Schedule o_2

Note 10 - Leases - Schedule of Future Minimum Rental Payments Pursuant to Capital and Operating Leases (Details) (Parentheticals)	Sep. 30, 2018
Capital lease interest	3.50%