InfuSystem (INFU) 10-Q 14 Aug 19 2019 Q2 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	6 Months Ended
	Jun. 30, 2019	Aug. 09, 2019
Document Information [Line Items]
Entity Registrant Name	InfuSystem Holdings, Inc
Entity Central Index Key	0001337013
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)		19,782,548
Entity Shell Company	false
Document Type	10-Q
Document Period End Date	Jun. 30, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q2
Amendment Flag	false
Title of 12(b) Security	Common Stock

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Current Period Unaudited) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Current assets:
Cash and cash equivalents	$ 1,702	$ 4,318
Accounts receivable, net	11,218	9,593
Inventories	2,742	2,254
Other current assets	1,368	1,372
Total current assets	17,030	17,537
Medical equipment for sale or rental	1,927	1,601
Medical equipment in rental service, net of accumulated depreciation	28,873	23,488
Property & equipment, net of accumulated depreciation	1,539	1,445
Intangible assets, net	17,616	19,865
Operating lease right of use assets	5,182
Other assets	194	137
Total assets	72,361	64,073
Current liabilities:
Accounts payable	10,206	7,091
Current portion of long-term debt	6,084	4,903
Other current liabilities	4,244	2,796
Total current liabilities	20,534	14,790
Long-term debt, net of current portion	27,478	28,842
Deferred income taxes	76
Operating lease liabilities, net of current portion	4,021
Total liabilities	52,109	43,632
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 23,237,703 and 19,719,214, respectively, as of June 30, 2019 and 23,095,513 and 19,577,024, respectively, as of December 31, 2018	2	2
Additional paid-in capital	83,557	83,167
Retained deficit	(63,307)	(62,728)
Total stockholders’ equity	20,252	20,441
Total liabilities and stockholders’ equity	$ 72,361	$ 64,073

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - $ / shares	Jun. 30, 2019	Dec. 31, 2018
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, shares authorized (in shares)	200,000,000	200,000,000
Common stock, shares issued (in shares)	23,237,703	23,095,513
Common stock, shares outstanding (in shares)	19,719,214	19,577,024

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (Unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Net revenues	$ 19,723	$ 16,415	$ 37,916	$ 32,898
Cost of revenues	8,367	6,729	16,219	12,975
Gross profit	11,356	9,686	21,697	19,923
Selling, general and administrative expenses:
Amortization of intangibles	1,124	1,165	2,249	2,352
Selling and marketing	2,476	2,326	5,078	4,627
General and administrative	6,785	6,399	13,819	12,560
Total selling, general and administrative	10,385	9,890	21,146	19,539
Operating income (loss)	971	(204)	551	384
Other expense:
Interest expense	(488)	(296)	(948)	(611)
Other (expense) income	(39)	1	(60)	(10)
Income (loss) before income taxes	444	(499)	(457)	(237)
Provision for income taxes	(63)	(6)	(122)	(64)
Net income (loss)	$ 381	$ (505)	$ (579)	$ (301)
Net income (loss) per share:
Basic (in dollars per share)	$ 0.02	$ (0.02)	$ (0.03)	$ (0.01)
Diluted (in dollars per share)	$ 0.02	$ (0.02)	$ (0.03)	$ (0.01)
Weighted average common shares outstanding:
Basic (in shares)	19,708,422	22,703,415	19,644,590	22,751,318
Diluted (in shares)	20,583,434	22,703,415	19,644,590	22,751,318

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Equity (Unaudited) - USD ($) $ in Thousands	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	Treasury Stock [Member]	Total
Balances (in shares) at Dec. 31, 2017	22,978			(198)
Balances at Dec. 31, 2017	$ 2	$ 92,584	$ (61,633)		$ 30,953
Stock based shares issued upon vesting - gross (in shares)	29
Stock based shares issued upon vesting - gross
Stock-based compensation expense		226			226
Employee stock purchase plan (in shares)	25
Employee stock purchase plan		46			46
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation (in shares)
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation		(5)			(5)
Common stock repurchased as part of Repurchase Program (in shares)				(380)
Common stock repurchased as part of Repurchase Program		(1,264)			(1,264)
Net income (loss)			(301)		(301)
Balances (in shares) at Jun. 30, 2018	23,032			(578)
Balances at Jun. 30, 2018	$ 2	91,587	(61,934)		29,655
Balances (in shares) at Mar. 31, 2018	23,003			(230)
Balances at Mar. 31, 2018	$ 2	92,659	(61,429)		31,232
Stock based shares issued upon vesting - gross (in shares)	4
Stock based shares issued upon vesting - gross
Stock-based compensation expense		114			114
Employee stock purchase plan (in shares)	25
Employee stock purchase plan
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation (in shares)
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation		(5)			(5)
Common stock repurchased as part of Repurchase Program (in shares)				(348)
Common stock repurchased as part of Repurchase Program		(1,181)			(1,181)
Net income (loss)			(505)		(505)
Balances (in shares) at Jun. 30, 2018	23,032			(578)
Balances at Jun. 30, 2018	$ 2	91,587	(61,934)		29,655
Balances (in shares) at Dec. 31, 2018	23,096			(3,518)
Balances at Dec. 31, 2018	$ 2	83,167	(62,728)		20,441
Stock based shares issued upon vesting - gross (in shares)	167
Stock based shares issued upon vesting - gross		15			15
Stock-based compensation expense		530			530
Employee stock purchase plan (in shares)	19
Employee stock purchase plan		53			53
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation (in shares)	(45)
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation		(208)			(208)
Net income (loss)			(579)		(579)
Balances (in shares) at Jun. 30, 2019	23,237			(3,518)
Balances at Jun. 30, 2019	$ 2	83,557	(63,307)		20,252
Balances (in shares) at Mar. 31, 2019	23,221			(3,518)
Balances at Mar. 31, 2019	$ 2	83,429	(63,688)		19,743
Stock based shares issued upon vesting - gross (in shares)	16
Stock based shares issued upon vesting - gross		15			15
Stock-based compensation expense		284			284
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation (in shares)
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation		(171)			(171)
Net income (loss)			381		381
Balances (in shares) at Jun. 30, 2019	23,237			(3,518)
Balances at Jun. 30, 2019	$ 2	$ 83,557	$ (63,307)		$ 20,252

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018
NET CASH PROVIDED BY OPERATING ACTIVITIES	$ 4,319	$ 4,846
INVESTING ACTIVITIES
Purchase of medical equipment, property and equipment	(7,893)	(2,743)
Proceeds from sale of medical equipment, property and equipment	1,333	1,720
NET CASH USED IN INVESTING ACTIVITIES	(6,560)	(1,023)
FINANCING ACTIVITIES
Principal payments on term loans, capital lease obligations and other financing	(2,256)	(3,708)
Cash proceeds from other financing	2,024
Debt issuance costs	(3)
Common stock repurchased to satisfy statutory withholding on employee stock based compensation plans	(208)	(5)
Common stock repurchased as part of Repurchase Program		(1,264)
Cash proceeds from stock plans	68	46
NET CASH USED IN FINANCING ACTIVITIES	(375)	(4,931)
Net change in cash and cash equivalents	(2,616)	(1,108)
Cash and cash equivalents, beginning of period	4,318	3,469
Cash and cash equivalents, end of period	$ 1,702	$ 2,361

Note 1 - Basis of Presentation,

Note 1 - Basis of Presentation, Nature of Operations and Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2019
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 products and services. The Company provides products and services to hospitals, oncology practices and facilities 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, 2018 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. Certain prior period reclassifications were made to conform with the current period presentation. These reclassifications had no

Note 2 - Recent Accounting Pron

Note 2 - Recent Accounting Pronouncements and Developments	6 Months Ended
	Jun. 30, 2019
Notes to Financial Statements
New Accounting Pronouncements and Changes in Accounting Principles [Text Block]	2 . Recent Accounting Pronouncements and Developments In June 2016, No. 2016 13, 326 326 not 326 January 1, 2020. 326

Note 3 - Revenue Recognition

Note 3 - Revenue Recognition	6 Months Ended
	Jun. 30, 2019
Notes to Financial Statements
Revenue from Contract with Customer [Text Block]	3. Revenue Recognition The following table presents disaggregated revenue by offering type: Three Months Ended Six Months Ended June 30 June 30 2019 2018 2019 2018 Third-Party Payor Rentals 49.4 % 47.5 % 48.8 % 48.0 % Direct Payor Rentals 33.0 % 38.1 % 33.8 % 38.5 % Product Sales 17.6 % 14.4 % 17.4 % 13.5 % Total - Net revenues 100.0 % 100.0 % 100.0 % 100.0 %

Note 4 - Medical Equipment

Note 4 - Medical Equipment	6 Months Ended
	Jun. 30, 2019
Notes to Financial Statements
Medical Equipment and Property Disclosure [Text Block]	4 . Medical Equipment Medical equipment consists of the following (in thousands): June 30, December 31, 2019 2018 Medical Equipment for sale or rental $ 1,927 $ 1,601 Medical Equipment in rental service 68,721 61,429 Medical Equipment in rental service - pump reserve (614 ) (530 ) Accumulated depreciation (39,234 ) (37,411 ) Medical Equipment in rental service - net 28,873 23,488 Total $ 30,800 $ 25,089 Depreciation expense for medical equipment for the three six June 30, 2019 $1.8 $3.5 $1.5 $3.0

Note 5 - Property and Equipment

Note 5 - Property and Equipment	6 Months Ended
	Jun. 30, 2019
Notes to Financial Statements
Property, Plant and Equipment Disclosure [Text Block]	5. Property and Equipment Property and equipment consists of the following (in thousands): June 30, 2019 December 31, 2018 Gross Assets Accumulated Depreciation Total Gross Assets Accumulated Depreciation Total Furniture, fixtures, and equipment $ 4,025 $ (3,385 ) $ 640 $ 3,717 $ (3,257 ) $ 460 Automobiles 117 (84 ) 33 118 (95 ) 23 Leasehold improvements 2,002 (1,136 ) 866 2,219 (1,257 ) 962 Total $ 6,144 $ (4,605 ) $ 1,539 $ 6,054 $ (4,609 ) $ 1,445 Depreciation expense for property and equipment for the three six June 30, 2019 $0.1 $0.2 $0.1 $0.2

Note 6 - Intangible Assets

Note 6 - Intangible Assets	6 Months Ended
	Jun. 30, 2019
Notes to Financial Statements
Intangible Assets Disclosure [Text Block]	6 . Intangible Assets The carrying amount and accumulated amortization of intangible assets is comprised of the following (in thousands): June 30, 2019 December 31, 2018 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 (25,362 ) 11,172 36,534 (24,175 ) 12,359 Non-competition agreements 1,136 (1,136 ) - 1,136 (1,136 ) - Software 11,230 (6,786 ) 4,444 11,230 (5,724 ) 5,506 Total nonamortizable and amortizable intangible assets $ 50,923 $ (33,307 ) $ 17,616 $ 50,923 $ (31,058 ) $ 19,865 Amortization expense for the three six June 30, 2019 $1.1 $2.2 $1.2 $2.4 June 30, 2019 7/1 - 2024 and 12/31/2019 2020 2021 2022 2023 thereafter Amortization expense $ 2,153 $ 4,285 $ 3,930 $ 2,051 $ 548 $ 2,649

Note 7 - Debt

Note 7 - Debt	6 Months Ended
	Jun. 30, 2019
Notes to Financial Statements
Debt Disclosure [Text Block]	7 . Debt On April 15, 2019, $2.0 third 36 not 842. June 30, 2019 $1.9 On February 5, 2019, fifth 1 $8.0 2 December 31, 2018 2019, 3 December 31, 2019 $7.0 December 31, 2019, ( 4 5 December 31, 2018 December 31, 2019. As of June 30, 2019, $29.2 $2.6 June 30, December 31, 2019 2018 Revolver: Gross availability $ 11,000 $ 9,973 Outstanding draws - - Letters of credit (1,750 ) (750 ) Landlord reserves (71 ) (70 ) Net availability $ 9,179 $ 9,153 The Company had future maturities of loans and other financing as of June 30, 2019 2019 2020 2021 2022 2023 and thereafter Total Term Loan A $ 1,792 $ 3,584 $ 16,143 $ - $ - $ 21,519 Term Loan C 921 1,229 5,529 - - 7,679 Equipment Line 128 512 512 512 898 2,562 Unamortized value of the debt issuance costs (20 ) (39 ) (39 ) - - (98 ) Other financing 301 652 725 222 - 1,900 Total $ 3,122 $ 5,938 $ 22,870 $ 734 $ 898 $ 33,562 The following is a breakdown of the Company’s current and long-term debt as follows (in thousands): June 30, 2019 December 31, 2018 Current Portion Long-Term Portion Total Current Portion Long-Term Portion Total Term Loan A $ 3,584 $ 17,935 $ 21,519 Term Loan A $ 3,584 $ 19,727 $ 23,311 Term Loan C 1,536 6,143 7,679 Term Loan C 1,229 6,757 7,986 Equipment Line 384 2,178 2,562 Equipment Line 128 2,434 2,562 Unamortized value of debt issuance costs (39 ) (59 ) (98 ) Unamortized value of debt issuance costs (38 ) (76 ) (114 ) Other financing 619 1,281 1,900 Other financing - - - Total $ 6,084 $ 27,478 $ 33,562 Total $ 4,903 $ 28,842 $ 33,745 As of June 30, 2019, 30 2.00% 3.00% 2.50%, 1.00% 0.25%. June 30, 2019 5.19% 2.44% 2.75% June 30, 2019 5.50% 5.50% As of June 30, 2019,

Note 8 - Income Taxes

Note 8 - Income Taxes	6 Months Ended
	Jun. 30, 2019
Notes to Financial Statements
Income Tax Disclosure [Text Block]	8. Income Taxes During both the three six June 30, 2019, $0.1 three six June 30, 2018, $0.1 $0.1 The Company’s realization of its deferred tax assets is dependent upon many factors, including, but not not not June 30, 2019 December 31, 2018.

Note 9 - Commitments, Contingen

Note 9 - Commitments, Contingencies and Litigation	6 Months Ended
	Jun. 30, 2019
Notes to Financial Statements
Commitments and Contingencies Disclosure [Text Block]	9. 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 10 - Earnings (Loss) Per S

Note 10 - Earnings (Loss) Per Share	6 Months Ended
	Jun. 30, 2019
Notes to Financial Statements
Earnings Per Share [Text Block]	10. 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 June 30 Six Months Ended June 30 Numerator: 2019 2018 2019 2018 Net income (loss) (in thousands) $ 381 $ (505 ) $ (579 ) $ (301 ) Denominator: Weighted average common shares outstanding: Basic 19,708,422 22,703,415 19,644,590 22,751,318 Dilutive effect of non-vested awards 875,012 - - - Diluted 20,583,434 22,703,415 19,644,590 22,751,318 Net income (loss) per share: Basic $ 0.02 $ (0.02 ) $ (0.03 ) $ (0.01 ) Diluted $ 0.02 $ (0.02 ) $ (0.03 ) $ (0.01 ) For the three June 30, 2019, 0.1 not six June 30, 2019 three six June 30, 2018, not

Note 11 - Leases

Note 11 - Leases	6 Months Ended
	Jun. 30, 2019
Notes to Financial Statements
Lessee, Operating Leases [Text Block]	11. Leases On January 1, 2019 ( 2016 02, 842 2018 10, 842, 2018 11, 842” 842 842, twelve The Effective Date is the Company’s date of initial application. Consequently, our financial information was not not January 1, 2019. Topic 842 not not The most significant effects related to this adoption relate to (i) the recognition of new ROU assets and lease liabilities on our balance sheet for our real estate and equipment operating leases; and (ii) significant new disclosures about our leasing activities. Upon adoption, we recognized approximately $3.1 Topic 842 not In adopting Topic 842, ten not one five not not not not not not For our equipment leases, we have used and will use the implicit rate in the lease as the discount rate, when available, otherwise, we use our incremental borrowing rate as the discount rate. For our office leases, the implicit rate is typically not Payments due under our operating leases include fixed payments as well as variable payments. For our office leases, variable payments include amounts for the Company’s proportionate share of operating expenses, utilities, property taxes, insurance, common area maintenance and other facility-related expenses. For our equipment leases, variable payments may The components of lease costs for the three six June 30, 2019 Three Months Ended Six Months Ended June 30, 2019 June 30, 2019 Operating lease cost $ 290 $ 677 Variable lease cost 53 126 Total lease cost $ 343 $ 803 Operating lease expense for the three six June 30, 2018 $0.4 $0.7 Amounts reported in the condensed consolidated balance sheet as of June 30, 2019 June 30, 2019 Operating lease ROU assets $ 5,182 Current operating lease liabilities (included in other current liabilities) $ 1,374 Operating lease liabilities, net of current portion 4,021 Total operating lease liabilities $ 5,395 Supplemental cash flow information and non-cash activity related to our leases are as follows (in thousands): Six Months Ended June 30, 2019 Cash paid for amounts included in the measurement of lease liabilities and ROU assets: Operating cash flow from operating leases $ 771 ROU assets obtained in exchange for lease obligations: Operating leases $ 3,015 Weighted average remaining lease terms and discount rates for our leases as of June 30, 2019 Years Weighted average remaining lease term: Operating leases 7.3 Rate Weighted average discount rate: Operating leases 7.5 % Future maturities of lease liabilities as of June 30, 2019 Operating Leases (a) 2019 $ 779 2020 1,262 2021 716 2022 655 2023 666 Thereafter 3,430 Total undiscounted lease payments 7,508 Less: Imputed interest (2,113 ) Total lease liabilities $ 5,395 (a) Excludes $0.3 not six 2019. The Company disclosed in our 2018 10 December 31, 2018, 840. March 31, 2019, December 31, 2018 10 2018 10 $121 2019, $370 2020, $381 2021, $392 2022, $404 2023 $2,528 The Company assessed the materiality of this error, considering both the qualitative and quantitative factors and determined that for the year ended December 31, 2018, December 31, 2018 Operating Capital Leases Leases (As Revised) Total (As Revised) 2019 $ 33 $ 1,745 $ 1,778 2020 - 1,347 1,347 2021 - 726 726 2022 - 624 624 2023 - 636 636 Thereafter - 3,071 3,071 Total require payments $ 33 $ 8,149 $ 8,182 Less amounts representing interest (3.5%) - Present value of minimum lease payments 33 Less current maturities (33 ) Long-term capital lease liability $ -

Note 3 - Revenue Recognition (T

Note 3 - Revenue Recognition (Tables)	6 Months Ended
	Jun. 30, 2019
Notes Tables
Disaggregation of Revenue [Table Text Block]	Three Months Ended Six Months Ended June 30 June 30 2019 2018 2019 2018 Third-Party Payor Rentals 49.4 % 47.5 % 48.8 % 48.0 % Direct Payor Rentals 33.0 % 38.1 % 33.8 % 38.5 % Product Sales 17.6 % 14.4 % 17.4 % 13.5 % Total - Net revenues 100.0 % 100.0 % 100.0 % 100.0 %

Note 4 - Medical Equipment (Tab

Note 4 - Medical Equipment (Tables)	6 Months Ended
	Jun. 30, 2019
Notes Tables
Schedule of Medical Equipment [Table Text Block]	June 30, December 31, 2019 2018 Medical Equipment for sale or rental $ 1,927 $ 1,601 Medical Equipment in rental service 68,721 61,429 Medical Equipment in rental service - pump reserve (614 ) (530 ) Accumulated depreciation (39,234 ) (37,411 ) Medical Equipment in rental service - net 28,873 23,488 Total $ 30,800 $ 25,089

Note 5 - Property and Equipme_2

Note 5 - Property and Equipment (Tables)	6 Months Ended
	Jun. 30, 2019
Notes Tables
Property, Plant and Equipment [Table Text Block]	June 30, 2019 December 31, 2018 Gross Assets Accumulated Depreciation Total Gross Assets Accumulated Depreciation Total Furniture, fixtures, and equipment $ 4,025 $ (3,385 ) $ 640 $ 3,717 $ (3,257 ) $ 460 Automobiles 117 (84 ) 33 118 (95 ) 23 Leasehold improvements 2,002 (1,136 ) 866 2,219 (1,257 ) 962 Total $ 6,144 $ (4,605 ) $ 1,539 $ 6,054 $ (4,609 ) $ 1,445

Note 6 - Intangible Assets (Tab

Note 6 - Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2019
Notes Tables
Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets [Table Text Block]	June 30, 2019 December 31, 2018 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 (25,362 ) 11,172 36,534 (24,175 ) 12,359 Non-competition agreements 1,136 (1,136 ) - 1,136 (1,136 ) - Software 11,230 (6,786 ) 4,444 11,230 (5,724 ) 5,506 Total nonamortizable and amortizable intangible assets $ 50,923 $ (33,307 ) $ 17,616 $ 50,923 $ (31,058 ) $ 19,865
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense [Table Text Block]	7/1 - 2024 and 12/31/2019 2020 2021 2022 2023 thereafter Amortization expense $ 2,153 $ 4,285 $ 3,930 $ 2,051 $ 548 $ 2,649

Note 7 - Debt (Tables)

Note 7 - Debt (Tables)	6 Months Ended
	Jun. 30, 2019
Notes Tables
Schedule of Line of Credit Facilities [Table Text Block]	June 30, December 31, 2019 2018 Revolver: Gross availability $ 11,000 $ 9,973 Outstanding draws - - Letters of credit (1,750 ) (750 ) Landlord reserves (71 ) (70 ) Net availability $ 9,179 $ 9,153
Schedule of Maturities of Long-term Debt [Table Text Block]	2019 2020 2021 2022 2023 and thereafter Total Term Loan A $ 1,792 $ 3,584 $ 16,143 $ - $ - $ 21,519 Term Loan C 921 1,229 5,529 - - 7,679 Equipment Line 128 512 512 512 898 2,562 Unamortized value of the debt issuance costs (20 ) (39 ) (39 ) - - (98 ) Other financing 301 652 725 222 - 1,900 Total $ 3,122 $ 5,938 $ 22,870 $ 734 $ 898 $ 33,562
Schedule of Debt [Table Text Block]	June 30, 2019 December 31, 2018 Current Portion Long-Term Portion Total Current Portion Long-Term Portion Total Term Loan A $ 3,584 $ 17,935 $ 21,519 Term Loan A $ 3,584 $ 19,727 $ 23,311 Term Loan C 1,536 6,143 7,679 Term Loan C 1,229 6,757 7,986 Equipment Line 384 2,178 2,562 Equipment Line 128 2,434 2,562 Unamortized value of debt issuance costs (39 ) (59 ) (98 ) Unamortized value of debt issuance costs (38 ) (76 ) (114 ) Other financing 619 1,281 1,900 Other financing - - - Total $ 6,084 $ 27,478 $ 33,562 Total $ 4,903 $ 28,842 $ 33,745

Note 10 - Earnings (Loss) Per_2

Note 10 - Earnings (Loss) Per Share (Tables)	6 Months Ended
	Jun. 30, 2019
Notes Tables
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	Three Months Ended June 30 Six Months Ended June 30 Numerator: 2019 2018 2019 2018 Net income (loss) (in thousands) $ 381 $ (505 ) $ (579 ) $ (301 ) Denominator: Weighted average common shares outstanding: Basic 19,708,422 22,703,415 19,644,590 22,751,318 Dilutive effect of non-vested awards 875,012 - - - Diluted 20,583,434 22,703,415 19,644,590 22,751,318 Net income (loss) per share: Basic $ 0.02 $ (0.02 ) $ (0.03 ) $ (0.01 ) Diluted $ 0.02 $ (0.02 ) $ (0.03 ) $ (0.01 )

Note 11 - Leases (Tables)

Note 11 - Leases (Tables)	6 Months Ended
	Jun. 30, 2019
Notes Tables
Lease, Cost [Table Text Block]	Three Months Ended Six Months Ended June 30, 2019 June 30, 2019 Operating lease cost $ 290 $ 677 Variable lease cost 53 126 Total lease cost $ 343 $ 803 Six Months Ended June 30, 2019 Cash paid for amounts included in the measurement of lease liabilities and ROU assets: Operating cash flow from operating leases $ 771 ROU assets obtained in exchange for lease obligations: Operating leases $ 3,015 Years Weighted average remaining lease term: Operating leases 7.3 Rate Weighted average discount rate: Operating leases 7.5 %
Lessee, Operating Lease, Assets and Liabilities [Table Text Block]	June 30, 2019 Operating lease ROU assets $ 5,182 Current operating lease liabilities (included in other current liabilities) $ 1,374 Operating lease liabilities, net of current portion 4,021 Total operating lease liabilities $ 5,395
Lessee, Operating Lease, Liability, Maturity [Table Text Block]	Operating Leases (a) 2019 $ 779 2020 1,262 2021 716 2022 655 2023 666 Thereafter 3,430 Total undiscounted lease payments 7,508 Less: Imputed interest (2,113 ) Total lease liabilities $ 5,395
Schedule of Future Minimum Lease Payments for Capital and Operating Leases [Table Text Block]	Operating Capital Leases Leases (As Revised) Total (As Revised) 2019 $ 33 $ 1,745 $ 1,778 2020 - 1,347 1,347 2021 - 726 726 2022 - 624 624 2023 - 636 636 Thereafter - 3,071 3,071 Total require payments $ 33 $ 8,149 $ 8,182 Less amounts representing interest (3.5%) - Present value of minimum lease payments 33 Less current maturities (33 ) Long-term capital lease liability $ -

Note 3 - Revenue Recognition -

Note 3 - Revenue Recognition - Disaggregated Revenue by Revenue Stream (Details) - Customer Concentration Risk [Member]	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Third-Party Payor Rental Revenue [Member]
Revenue	49.40%	47.50%	48.80%	48.00%
Director Payer Rentals [Member]
Revenue	33.00%	38.10%	33.80%	38.50%
Revenue, Product and Service Benchmark [Member]
Revenue	17.60%	14.40%	17.40%	13.50%
Revenue from Contract with Customer Benchmark [Member]
Revenue	100.00%	100.00%	100.00%	100.00%

Note 4 - Medical Equipment (Det

Note 4 - Medical Equipment (Details Textual) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Depreciation Expense Related to Medical Equipment	$ 1.8	$ 1.5	$ 3.5	$ 3

Note 4 - Medical Equipment - Su

Note 4 - Medical Equipment - Summary of Medical Equipment (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Medical Equipment for sale or rental	$ 1,927	$ 1,601
Medical Equipment in rental service	68,721	61,429
Medical Equipment in rental service - pump reserve	(614)	(530)
Accumulated depreciation	(39,234)	(37,411)
Medical Equipment in rental service - net	28,873	23,488
Total	$ 30,800	$ 25,089

Note 5 - Property and Equipme_3

Note 5 - Property and Equipment (Details Textual) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Depreciation, Nonproduction	$ 0.1	$ 0.1	$ 0.2	$ 0.2

Note 5 - Property and Equipme_4

Note 5 - Property and Equipment - Property and Equipment (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Gross Assets	$ 6,144	$ 6,054
Accumulated Depreciation	(4,605)	(4,609)
Total	1,539	1,445
Furniture and Fixtures [Member]
Gross Assets	4,025	3,717
Accumulated Depreciation	(3,385)	(3,257)
Total	640	460
Automobiles [Member]
Gross Assets	117	118
Accumulated Depreciation	(84)	(95)
Total	33	23
Leasehold Improvements [Member]
Gross Assets	2,002	2,219
Accumulated Depreciation	(1,136)	(1,257)
Total	$ 866	$ 962

Note 6 - Intangible Assets (Det

Note 6 - Intangible Assets (Details Textual) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Amortization of Intangible Assets, Total	$ 1,124	$ 1,165	$ 2,249	$ 2,352

Note 6 - Intangible Assets - Su

Note 6 - Intangible Assets - Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Amortizable intangible assets, accumulated amortization	$ (33,307)	$ (31,058)
Total nonamortizable and amortizable intangible assets, gross assets	50,923	50,923
Total nonamortizable and amortizable intangible assets, net	17,616	19,865
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	(25,362)	(24,175)
Amortizable intangible assets, net	11,172	12,359
Noncompete Agreements [Member]
Amortizable intangible assets, gross assets	1,136	1,136
Amortizable intangible assets, accumulated amortization	(1,136)	(1,136)
Amortizable intangible assets, net
Computer Software, Intangible Asset [Member]
Amortizable intangible assets, gross assets	11,230	11,230
Amortizable intangible assets, accumulated amortization	(6,786)	(5,724)
Amortizable intangible assets, net	4,444	5,506
Trade Names 1 [Member]
Nonamortizable intangible assets	$ 2,000	$ 2,000

Note 6 - Intangible Assets - Ex

Note 6 - Intangible Assets - Expected Annual Amortization Expense for Intangible Assets (Details) $ in Thousands	Jun. 30, 2019USD ($)
Amortization expense, 2019	$ 2,153
Amortization expense, 2020	4,285
Amortization expense, 2021	3,930
Amortization expense, 2022	2,051
Amortization expense, 2023	548
Amortization expense, 2024 and thereafter	$ 2,649

Note 7 - Debt (Details Textual)

Note 7 - Debt (Details Textual) - USD ($) $ in Thousands	Apr. 15, 2019	Jun. 30, 2019	Dec. 31, 2019	Feb. 05, 2019	Dec. 31, 2018
Long-term Debt, Total		$ 33,562			$ 33,745
Equipment Line [Member]
Long-term Debt, Total		2,562			2,562
Financing Agreement [Member]
Long-term Debt, Total		1,900
Financing Agreement [Member] | Medical Equipment [Member]
Line of Credit Facility, Maximum Borrowing Capacity	$ 2,000
Debt Instrument, Term	3 years
Line of Credit Facility, Current Borrowing Capacity		$ 1,900
Credit Facility [Member] | Eurodollar Loan [Member]
Debt Instrument, Interest Rate, Effective Percentage		5.19%
LIBOR Rate		2.44%
Credit Facility [Member] | CB Floating Rate Loan [Member]
Debt Instrument, Interest Rate, Effective Percentage		5.50%
Lender Prime Rate		5.50%
Credit Facility [Member] | London Interbank Offered Rate (LIBOR) [Member] | Eurodollar Loan [Member]
Debt Instrument, Basis Spread on Variable Rate		2.75%
Credit Facility [Member] | London Interbank Offered Rate (LIBOR) [Member] | CB Floating Rate Loan [Member]
Debt Instrument, Basis Spread on Variable Rate, Before Margin Rate		2.50%
Credit Facility [Member] | Maximum [Member] | London Interbank Offered Rate (LIBOR) [Member] | Eurodollar Loan [Member]
Debt Instrument, Basis Spread on Variable Rate		3.00%
Credit Facility [Member] | Maximum [Member] | Greater of Prime Rate or LIBOR Plus 2.5% [Member] | CB Floating Rate Loan [Member]
Debt Instrument, Basis Spread on Variable Rate		0.25%
Credit Facility [Member] | Minimum [Member] | London Interbank Offered Rate (LIBOR) [Member] | Eurodollar Loan [Member]
Debt Instrument, Basis Spread on Variable Rate		2.00%
Credit Facility [Member] | Minimum [Member] | Greater of Prime Rate or LIBOR Plus 2.5% [Member] | CB Floating Rate Loan [Member]
Debt Instrument, Basis Spread on Variable Rate		(1.00%)
Credit Facility [Member] | Equipment Line [Member]
Line of Credit Facility, Maximum Borrowing Capacity				$ 8,000
Long-term Debt, Total		$ 29,200
Long-term Line of Credit, Total		$ 2,600
Credit Facility [Member] | Equipment Line [Member] | Maximum [Member] | Forecast [Member]
Capital Expenditures Incurred but Not yet Paid			$ 7,000

Note 7 - Debt - Summary of Revo

Note 7 - Debt - Summary of Revolver Based Upon Borrowers' Eligible Accounts Receivable and Inventory (Details) - Revolving Credit Facility [Member] - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Gross availability	$ 11,000	$ 9,973
Outstanding draws
Letters of credit	(1,750)	(750)
Landlord reserves	(71)	(70)
Net availability	$ 9,179	$ 9,153

Note 7 - Debt - Summary of Futu

Note 7 - Debt - Summary of Future Maturities of Loans (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
2019	$ 3,122
2020	5,938
2021	22,870
2022	734
2023 and thereafter	898
Long-term Debt, Total	33,562	$ 33,745
Unamortized value of the debt issuance costs, 2019	(20)
Unamortized value of the debt issuance costs, 2020	(39)
Unamortized value of the debt issuance costs, 2021	(39)
Unamortized value of the debt issuance costs, 2022
Unamortized value of the debt issuance costs, 2023 and thereafter
Unamortized value of the debt issuance costs, Total	(98)	(114)
Financing Agreement [Member]
2019	301
2020	652
2021	725
2022	222
2023 and thereafter
Long-term Debt, Total	1,900
Equipment Line [Member]
2019	128
2020	512
2021	512
2022	512
2023 and thereafter	898
Long-term Debt, Total	2,562	2,562
Term Loan A [Member]
2019	1,792
2020	3,584
2021	16,143
2022
2023 and thereafter
Long-term Debt, Total	21,519	23,311
Term Loan C [Member]
2019	921
2020	1,229
2021	5,529
2022
2023 and thereafter
Long-term Debt, Total	$ 7,679	$ 7,986

Note 7 - Debt - Summary of Comp

Note 7 - Debt - Summary of Company's Current and Long-term Debt (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Current portion of long-term debt	$ 6,084	$ 4,903
Long-term debt	27,478	28,842
Total	33,562	33,745
Unamortized value of the debt issuance costs, current portion of long-term debt	(39)	(38)
Unamortized value of the debt issuance costs, long-term debt	(59)	(76)
Unamortized value of the debt issuance costs, Total	(98)	(114)
Financing Agreement [Member]
Current portion of long-term debt	619
Long-term debt	1,281
Total	1,900
Equipment Line [Member]
Current portion of long-term debt	384	128
Long-term debt	2,178	2,434
Total	2,562	2,562
Term Loan A [Member]
Current portion of long-term debt	3,584	3,584
Long-term debt	17,935	19,727
Total	21,519	23,311
Term Loan C [Member]
Current portion of long-term debt	1,536	1,229
Long-term debt	6,143	6,757
Total	$ 7,679	$ 7,986

Note 8 - Income Taxes (Details

Note 8 - Income Taxes (Details Textual) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Income Tax Expense (Benefit), Total	$ 63	$ 6	$ 122	$ 64

Note 10 - Earnings (Loss) Per_3

Note 10 - Earnings (Loss) Per Share (Details Textual) shares in Millions	3 Months Ended
	Jun. 30, 2019shares
Share-based Payment Arrangement, Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	0.1

Note 10 - Earnings (Loss) Per_4

Note 10 - 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		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Net income (loss) (in thousands)	$ 381	$ (505)	$ (579)	$ (301)
Weighted average common shares outstanding:
Basic (in shares)	19,708,422	22,703,415	19,644,590	22,751,318
Dilutive effect of non-vested awards (in shares)	875,012
Diluted (in shares)	20,583,434	22,703,415	19,644,590	22,751,318
Basic (in dollars per share)	$ 0.02	$ (0.02)	$ (0.03)	$ (0.01)
Diluted (in dollars per share)	$ 0.02	$ (0.02)	$ (0.03)	$ (0.01)

Note 11 - Leases (Details Textu

Note 11 - Leases (Details Textual) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019		Jun. 30, 2019		Jan. 01, 2019	Dec. 31, 2018
Operating Lease, Liability, Total	$ 5,395	[1]	$ 5,395	[1]	$ 3,100
Operating Lease, Expense	400		700
Lessee, Operating Lease, Lease Not yet Commenced, Amount	$ 300		$ 300
Lessor, Operating Lease, Lease Not yet Commenced, Term of Contract	6 years		6 years
Operating Leases, Future Minimum Payments Due, Next Twelve Months						$ 1,745
Operating Leases, Future Minimum Payments, Due in Two Years						1,347
Operating Leases, Future Minimum Payments, Due in Three Years						726
Operating Leases, Future Minimum Payments, Due in Four Years						624
Operating Leases, Future Minimum Payments, Due in Five Years						636
Operating Leases, Future Minimum Payments, Due Thereafter						3,071
Operating Lease, Right-of-Use Asset	$ 5,182		$ 5,182		$ 3,100
Restatement Adjustment [Member] | Error Correction for Overstated Lease Maturities Under Previous Lease Accounting as of December 31, 2018 [Member]
Operating Leases, Future Minimum Payments Due, Next Twelve Months	(121)		(121)
Operating Leases, Future Minimum Payments, Due in Two Years	(370)		(370)
Operating Leases, Future Minimum Payments, Due in Three Years	(381)		(381)
Operating Leases, Future Minimum Payments, Due in Four Years	(392)		(392)
Operating Leases, Future Minimum Payments, Due in Five Years	(404)		(404)
Operating Leases, Future Minimum Payments, Due Thereafter	$ (2,528)		$ (2,528)
Minimum [Member]
Lessee, Operating Lease, Renewal Term	1 year		1 year
Maximum [Member]
Lessee, Operating Lease, Renewal Term	5 years		5 years
[1]	Excludes $0.3 million of legally binding minimum lease payments for an office lease signed but not yet commenced. This lease has an expected term of six years and is expected to commence later in 2019.

Note 11 - Leases - Lease Cost (

Note 11 - Leases - Lease Cost (Details) $ in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2019USD ($)	Jun. 30, 2019USD ($)
Operating lease cost	$ 290	$ 677
Variable lease cost	53	126
Total lease cost	$ 343	803
Operating cash flow from operating leases		771
Operating leases		$ 3,015
Operating leases (Year)	7 years 109 days	7 years 109 days
Operating leases	7.50%	7.50%

Note 11 - Leases - Operating Le

Note 11 - Leases - Operating Lease Assets and Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2019		Jan. 01, 2019	Dec. 31, 2018
Operating Lease, Right-of-Use Asset	$ 5,182		$ 3,100
Current operating lease liabilities (included in other current liabilities)	1,374
Operating lease liabilities, net of current portion	4,021
Total operating lease liabilities	$ 5,395	[1]	$ 3,100
[1]	Excludes $0.3 million of legally binding minimum lease payments for an office lease signed but not yet commenced. This lease has an expected term of six years and is expected to commence later in 2019.

Note 11 - Leases - Maturities o

Note 11 - Leases - Maturities of Lease Liabilities (Details) - USD ($) $ in Thousands		Jun. 30, 2019		Jan. 01, 2019
2019	[1]	$ 779
2020	[1]	1,262
2021	[1]	716
2022	[1]	655
2023	[1]	666
Thereafter	[1]	3,430
Total undiscounted lease payments	[1]	7,508
Less: Imputed interest	[1]	(2,113)
Total lease liabilities		$ 5,395	[1]	$ 3,100
[1]	Excludes $0.3 million of legally binding minimum lease payments for an office lease signed but not yet commenced. This lease has an expected term of six years and is expected to commence later in 2019.

Note 11 - Leases - Schedule of

Note 11 - Leases - Schedule of Future Minimum Rental Payments Pursuant to Capital and Operating Leases (Details) $ in Thousands	Dec. 31, 2018USD ($)
2019, capital leases	$ 33
Operating Leases, Future Minimum Payments Due, Next Twelve Months	1,745
2019	1,778
2020, capital leases
Operating Leases, Future Minimum Payments, Due in Two Years	1,347
2020	1,347
2021, capital leases
Operating Leases, Future Minimum Payments, Due in Three Years	726
2021	726
2022, capital leases
Operating Leases, Future Minimum Payments, Due in Four Years	624
2022	624
2023, capital leases
Operating Leases, Future Minimum Payments, Due in Five Years	636
2023	636
Thereafter, capital leases
Operating Leases, Future Minimum Payments, Due Thereafter	3,071
Thereafter	3,071
Total required payments, capital leases	33
Total required payments, operating leases	8,149
Total required payments	8,182
Less amounts representing interest (3.5%), capital leases
Present value of minimum lease payments, capital leases	33
Less current maturities, capital leases	(33)
Long-term capital lease liability, capital leases

Note 11 - Leases - Schedule o_2

Note 11 - Leases - Schedule of Future Minimum Rental Payments Pursuant to Capital and Operating Leases (Details) (Parentheticals)	Dec. 31, 2018
Capital lease interest	3.50%