InfuSystem (INFU) 10-Q 13 Nov 20 2020 Q3 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	9 Months Ended
	Sep. 30, 2020	Nov. 06, 2020
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 Interactive Data Current	Yes
Entity Common Stock, Shares Outstanding (in shares)		20,236,932
Entity Shell Company	false
Document Type	10-Q
Document Period End Date	Sep. 30, 2020
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q3
Amendment Flag	false
Title of 12(b) Security	Common Stock, par value $0.0001 per share

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Current Period Unaudited) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 1,939	$ 2,647
Accounts receivable, net	13,927	12,097
Inventories	3,973	2,899
Other current assets	1,587	1,662
Total current assets	21,426	19,305
Medical equipment for sale or rental	1,359	1,306
Medical equipment in rental service, net of accumulated depreciation	36,110	33,225
Property & equipment, net of accumulated depreciation	4,286	4,037
Intangible assets, net	12,238	15,463
Operating lease right of use assets	4,784	5,733
Other assets	105	155
Total assets	80,308	79,224
Current liabilities:
Accounts payable	6,936	7,962
Current portion of long-term debt	7,759	8,082
Other current liabilities	5,009	5,803
Total current liabilities	19,704	21,847
Long-term debt, net of current portion	27,034	30,295
Deferred income taxes	120	104
Operating lease liabilities, net of current portion	4,061	4,644
Total liabilities	50,919	56,890
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 23,755,421 and 20,236,932, respectively, as of September 30, 2020 and 23,400,625 and 19,882,136, respectively, as of December 31, 2019	2	2
Additional paid-in capital	84,092	83,699
Retained deficit	(54,705)	(61,367)
Total stockholders’ equity	29,389	22,334
Total liabilities and stockholders’ equity	$ 80,308	$ 79,224

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - $ / shares	Sep. 30, 2020	Dec. 31, 2019
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)	23,755,421	23,400,625
Common stock, shares outstanding (in shares)	20,236,932	19,882,136

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Net revenues	$ 25,125	$ 21,489	$ 72,677	$ 59,405
Cost of revenues	10,003	9,251	28,914	25,470
Gross profit	15,122	12,238	43,763	33,935
Selling, general and administrative expenses:
Provision for doubtful accounts	11	160	534	(30)
Amortization of intangibles	1,075	1,077	3,225	3,326
Selling and marketing	2,196	2,402	7,263	7,480
General and administrative	8,587	6,936	24,949	20,945
Total selling, general and administrative	11,869	10,575	35,971	31,721
Operating income	3,253	1,663	7,792	2,214
Other expense:
Interest expense	(283)	(488)	(1,018)	(1,436)
Other income (expense)	8	(11)	(20)	(71)
Income before income taxes	2,978	1,164	6,754	707
Provision for income taxes	(38)	(29)	(92)	(151)
Net income	$ 2,940	$ 1,135	$ 6,662	$ 556
Net income per share:
Basic (in dollars per share)	$ 0.15	$ 0.06	$ 0.33	$ 0.03
Diluted (in dollars per share)	$ 0.14	$ 0.05	$ 0.31	$ 0.03
Weighted average shares outstanding:
Basic (in shares)	20,179,056	19,781,527	20,060,416	19,690,737
Diluted (in shares)	21,663,414	20,679,431	21,637,481	20,503,933

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Equity (Unaudited) - USD ($) shares in Thousands, $ in Thousands	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	Treasury Stock [Member]	Total
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)	288
Stock-based shares issued upon vesting - gross		124			124
Stock-based compensation expense		770			770
Employee stock purchase plan (in shares)	33
Employee stock purchase plan		123			123
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation (in shares)	(61)
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation		(295)			(295)
Net income (in thousands)			556		556
Balances (in shares) at Sep. 30, 2019	23,356			(3,518)
Balances at Sep. 30, 2019	$ 2	83,889	(62,172)		21,719
Balances (in shares) at Jun. 30, 2019	23,237			(3,518)
Balances at Jun. 30, 2019	$ 2	83,557	(63,307)		20,252
Stock-based shares issued upon vesting - gross (in shares)	121
Stock-based shares issued upon vesting - gross		109			109
Stock-based compensation expense		240			240
Employee stock purchase plan (in shares)	14
Employee stock purchase plan		70			70
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation (in shares)	(16)
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation		(87)			(87)
Net income (in thousands)			1,135		1,135
Balances (in shares) at Sep. 30, 2019	23,356			(3,518)
Balances at Sep. 30, 2019	$ 2	83,889	(62,172)		21,719
Balances (in shares) at Dec. 31, 2019	23,401			(3,518)
Balances at Dec. 31, 2019	$ 2	83,699	(61,367)		22,334
Stock-based shares issued upon vesting - gross (in shares)	419
Stock-based shares issued upon vesting - gross
Stock-based compensation expense		1,222			1,222
Employee stock purchase plan (in shares)	29
Employee stock purchase plan		190			190
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation (in shares)	(122)
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation		(1,269)			(1,269)
Net income (in thousands)			6,662		6,662
Common stock - issued (in shares)	28
Common stock - issued		250			250
Balances (in shares) at Sep. 30, 2020	23,755			(3,518)
Balances at Sep. 30, 2020	$ 2	84,092	(54,705)		29,389
Balances (in shares) at Jun. 30, 2020	23,651			(3,518)
Balances at Jun. 30, 2020	$ 2	83,845	(57,645)		26,202
Stock-based shares issued upon vesting - gross (in shares)	127
Stock-based shares issued upon vesting - gross
Stock-based compensation expense		659			659
Employee stock purchase plan (in shares)	15
Employee stock purchase plan		116			116
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation (in shares)	(38)
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation		(528)			(528)
Net income (in thousands)			2,940		2,940
Balances (in shares) at Sep. 30, 2020	23,755			(3,518)
Balances at Sep. 30, 2020	$ 2	$ 84,092	$ (54,705)		$ 29,389

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
OPERATING ACTIVITIES
Net income (in thousands)	$ 6,662	$ 556
Adjustments to reconcile net income to net cash provided by operating activities:
Provision for doubtful accounts	534	(30)
Depreciation	7,267	5,727
Loss on disposal of medical equipment and other assets	150	390
Gain on sale of medical equipment	(2,949)	(1,264)
Amortization of intangible assets	3,225	3,326
Amortization of deferred debt issuance costs	13	29
Stock-based compensation	1,222	780
Deferred income taxes	16	76
Changes in assets - (Increase)/Decrease:
Accounts receivable	(1,490)	(735)
Inventories	(1,074)	(514)
Other current assets	75	(233)
Other assets	(114)	(326)
Changes in liabilities - Increase/(Decrease):
Accounts payable and other liabilities	(869)	1,752
NET CASH PROVIDED BY OPERATING ACTIVITIES	12,668	9,534
INVESTING ACTIVITIES
Purchase of medical equipment	(11,955)	(15,005)
Purchase of property and equipment	(865)	(1,415)
Proceeds from sale of medical equipment, property and equipment	3,870	2,239
NET CASH USED IN INVESTING ACTIVITIES	(8,950)	(14,181)
FINANCING ACTIVITIES
Principal payments on term loans, equipment line, revolving credit facility and other financing	(35,458)	(3,915)
Cash proceeds from 2019 equipment line, equipment line, revolving credit facility and other financing	31,861	7,462
Debt issuance costs		(3)
Common stock repurchased to satisfy statutory withholding on employee stock-based compensation plans	(1,269)	(295)
Cash proceeds from stock plans	190	237
Common stock - issued	250
NET CASH (USED IN) PROVIDED BY FINANCING ACTIVITIES	(4,426)	3,486
Net change in cash and cash equivalents	(708)	(1,161)
Cash and cash equivalents, beginning of period	2,647	4,318
Cash and cash equivalents, end of period	$ 1,939	$ 3,157

Note 1 - Basis of Presentation,

Note 1 - Basis of Presentation, Nature of Operations and Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2020
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 for patients in the home, oncology clinics, ambulatory surgery centers, and other sites of care. The Company provides products and services to hospitals, oncology practices and facilities and other alternative site health care providers. Headquartered in Rochester Hills, Michigan, the Company delivers local, field-based customer support, and also operates pump service and 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, 2019 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. In particular, the coronavirus (“COVID- 19” may not 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	9 Months Ended
	Sep. 30, 2020
Notes to Financial Statements
Accounting Standards Update and Change in Accounting Principle [Text Block]	2 . Recent Accounting Pronouncements and Developments In June 2016, No. 2016 13, 326 326 not 326 January 1, 2020, November 2019, December 15, 2022 326

Note 3 - Revenue Recognition

Note 3 - Revenue Recognition	9 Months Ended
	Sep. 30, 2020
Notes to Financial Statements
Revenue from Contract with Customer [Text Block]	3. Revenue Recognition The following table presents the Company's disaggregated revenue by offering type (in thousands): Three Months Ended Nine Months Ended September 30, September 30, 2020 2019 2020 2019 Third-Party Payer Rentals $ 12,672 $ 10,662 $ 36,660 $ 29,147 Direct Payer Rentals 7,933 6,617 22,733 19,444 Product Sales 4,520 4,210 13,284 10,814 Total - Net revenues $ 25,125 $ 21,489 $ 72,677 $ 59,405 Third-Party Payer Rentals are entirely attributed to revenues of the Integrated Therapy Services (“ITS”) segment. Product Sales are entirely attributed to revenues of the Durable Medical Equipment Services (“DME Services”) segment. For the three September 30, 2020, $3.0 $4.9 three September 30, 2019, $2.8 $3.8 For the nine September 30, 2020, $8.7 $14.0 nine September 30, 2019, $8.0 $11.4 The following table presents the Company's disaggregated revenue by offering type as a percentage of total net revenues: Three Months Ended Nine Months Ended September 30, September 30, 2020 2019 2020 2019 Third-Party Payer Rentals 50.4 % 49.6 % 50.4 % 49.1 % Direct Payer Rentals 31.6 % 30.8 % 31.3 % 32.7 % Product Sales 18.0 % 19.6 % 18.3 % 18.2 % Total - Net revenues 100.0 % 100.0 % 100.0 % 100.0 %

Note 4 - Medical Equipment

Note 4 - Medical Equipment	9 Months Ended
	Sep. 30, 2020
Notes to Financial Statements
Medical Equipment and Property Disclosure [Text Block]	4 . Medical Equipment Medical equipment consisted of the following (in thousands): September 30, December 31, 2020 2019 Medical Equipment for sale or rental $ 1,385 $ 1,334 Medical Equipment for sale or rental - pump reserve (26 ) (28 ) Medical Equipment for sale or rental - net 1,359 1,306 Medical Equipment in rental service 82,445 75,853 Medical Equipment in rental service - pump reserve (786 ) (720 ) Accumulated depreciation (45,549 ) (41,908 ) Medical Equipment in rental service - net 36,110 33,225 Total $ 37,469 $ 34,531 Depreciation expense for medical equipment for the three nine September 30, 2020 $2.3 $6.7 $2.0 $5.4

Note 5 - Property and Equipment

Note 5 - Property and Equipment	9 Months Ended
	Sep. 30, 2020
Notes to Financial Statements
Property, Plant and Equipment Disclosure [Text Block]	5. Property and Equipment Property and equipment consisted of the following (in thousands): September 30, 2020 December 31, 2019 Gross Assets Accumulated Depreciation Total Gross Assets Accumulated Depreciation Total Furniture, fixtures, and equipment $ 3,897 $ (2,267 ) $ 1,630 $ 3,202 $ (1,928 ) $ 1,274 Automobiles 117 (99 ) 18 117 (90 ) 27 Leasehold improvements 3,409 (771 ) 2,638 3,366 (630 ) 2,736 Total $ 7,423 $ (3,137 ) $ 4,286 $ 6,685 $ (2,648 ) $ 4,037 Depreciation expense for property and equipment for the three nine September 30, 2020 $0.2 $0.6 $0.1 $0.3

Note 6 - Intangible Assets

Note 6 - Intangible Assets	9 Months Ended
	Sep. 30, 2020
Notes to Financial Statements
Intangible Assets Disclosure [Text Block]	6 . Intangible Assets The carrying amount and accumulated amortization of intangible assets consisted of the following (in thousands): September 30, 2020 December 31, 2019 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 (28,331 ) 8,203 36,534 (26,550 ) 9,984 Software 11,230 (9,195 ) 2,035 11,230 (7,751 ) 3,479 Total nonamortizable and amortizable intangible assets $ 49,787 $ (37,549 ) $ 12,238 $ 49,787 $ (34,324 ) $ 15,463 Amortization expense for the three nine September 30, 2020 $1.1 $3.2 $1.1 $3.3 September 30, 2020 10/1 - 2025 and 12/31/2020 2021 2022 2023 2024 thereafter Total Amortization expense $ 1,060 $ 3,930 $ 2,051 $ 548 $ 548 $ 2,101 $ 10,238

Note 7 - Debt

Note 7 - Debt	9 Months Ended
	Sep. 30, 2020
Notes to Financial Statements
Debt Disclosure [Text Block]	7 . Debt On February 5, 2019, fifth March 23, 2015 ( ● increase our borrowing capacity under the equipment line to $8.0 ● revise the definition of earnings before interest, taxes, depreciation and amortization (“EBITDA”), a non-GAAP financial measure, to include additional add-back adjustments for the years ended December 31, 2018 2019; ● revise the definition of fixed charge coverage ratio for the year ended December 31, 2019 $7.0 December 31, 2019; ● revise the Credit Agreement's maximum permitted indebtedness to finance the acquisition, construction or improvement of any fixed or capital assets; and ● revise the maximum leverage ratio for each of the quarters during December 31, 2018 December 31, 2019. On April 15, 2019, $2.0 third 36 not 842. September 30, 2020 $1.1 On November 7, 2019, sixth ● provide for a 2019 “2019 $10.0 $8.0 may December 31, 2020, not 90.0% ● increase the commitment for the revolving credit facility (the “Revolver”) under the Credit Agreement to $11.8 ● revise the definition of EBITDA to include the following additional or revised add-back adjustments: (i) one not $0.3 December 31, 2019 one not $0.3 December 31, 2019 not x $0.1 December 31, 2018; ( $0.2 December 31, 2018 March 31, 2019; $0.2 September 30, 2019 December 31, 2020; ● revise the definition of Fixed Charge Coverage Ratio to mean, for any period, the ratio of (a) EBITDA minus Maintenance Capital Expenditures (defined to mean, for any period, 50.0% ● revise the definitions of Revolving Credit Maturity Date and Term Maturity Date to mean the date five 2019 ● reflect the refinancing of the Term A Loans, Term B Loans and Term C Loan as a single term loan (the “Term Loan”) on the Sixth Amendment Effective Date and, commencing on the last Business Day of December 2019, $1.2 ● revise Section 5.01 x 30 30 may These debt amendments were accounted for as debt modifications. As of September 30, 2020, As of September 30, 2020, 2019 $23.1 $6.4 $4.3 September 30, 2020, $15.5 $11.8 September 30, December 31, 2020 2019 Revolver: Gross availability $ 11,750 $ 11,750 Outstanding draws - - Letters of credit (1,750 ) (1,750 ) Landlord reserves (162 ) (150 ) Availability on Revolver $ 9,838 $ 9,850 The Company had future maturities of loans and other financings as of September 30, 2020 2020 2021 2022 2023 2024 and thereafter Total Term Loan $ 1,154 $ 4,615 $ 4,615 $ 4,615 $ 8,074 $ 23,073 Equipment Line 400 1,600 1,600 1,600 1,200 6,400 2019 Equipment Line 214 855 855 855 1,495 4,274 Unamortized value of the debt issuance costs (4 ) (17 ) (17 ) (17 ) (15 ) (70 ) Other financing 169 725 222 - - 1,116 Total $ 1,933 $ 7,778 $ 7,275 $ 7,053 $ 10,754 $ 34,793 The following is a breakdown of the Company's current and long-term debt (in thousands): September 30, 2020 December 31, 2019 Current Portion Long-Term Portion Total Current Portion Long-Term Portion Total Term Loan $ 4,615 $ 18,458 $ 23,073 Term Loan $ 5,768 $ 21,919 $ 27,687 Equipment Line 1,600 4,800 6,400 Equipment Line 1,600 6,000 7,600 2019 Equipment Line 855 3,419 4,274 2019 Equipment Line 79 1,495 1,574 Unamortized value of debt issuance costs (17 ) (53 ) (70 ) Unamortized value of debt issuance costs (17 ) (66 ) (83 ) Other financing 706 410 1,116 Other financing 652 947 1,599 Total $ 7,759 $ 27,034 $ 34,793 Total $ 8,082 $ 30,295 $ 38,377 As of September 30, 2020, 30 2.00% 3.00% 2.50%, 1.00% 0.25% September 30, 2020 2.44% 0.19% 2.25% September 30, 2020 2.50% 3.25% 0.75%

Note 8 - Income Taxes

Note 8 - Income Taxes	9 Months Ended
	Sep. 30, 2020
Notes to Financial Statements
Income Tax Disclosure [Text Block]	8. Income Taxes During the three nine September 30, 2020, $0.1 $0.1 three nine September 30, 2019, $0.1 $0.2 The Company's realization of its deferred tax assets is dependent upon many factors, including, but not December 31, 2019, no not 2020, second third fourth 2020, September 30, 2020 December 31, 2019. On March 27, 2020, 19 19 not April 15, 2020, $4.1 May 7, 2020.

Note 9 - Commitments, Contingen

Note 9 - Commitments, Contingencies and Litigation	9 Months Ended
	Sep. 30, 2020
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 Per Share

Note 10 - Earnings Per Share	9 Months Ended
	Sep. 30, 2020
Notes to Financial Statements
Earnings Per Share [Text Block]	10. Earnings Per Share Basic income per share is computed by dividing net income by the weighted average number of common shares outstanding during the period. Diluted income per share assumes the issuance of potentially dilutive shares of common stock during the period. The following table reconciles the numerators and denominators of the basic and diluted income per share computations: Three Months Ended September 30, Nine Months Ended September 30, Numerator: 2020 2019 2020 2019 Net income (in thousands) $ 2,940 $ 1,135 $ 6,662 $ 556 Denominator: Weighted average common shares outstanding: Basic 20,179,056 19,781,527 20,060,416 19,690,737 Dilutive effect of common stock equivalents 1,484,358 897,904 1,577,065 813,196 Diluted 21,663,414 20,679,431 21,637,481 20,503,933 Net income per share: Basic $ 0.15 $ 0.06 $ 0.33 $ 0.03 Diluted $ 0.14 $ 0.05 $ 0.31 $ 0.03 For both the three nine September 30, 2020, 0.1 not three nine September 30, 2019, 0.1 0.1 not

Note 11 - Leases

Note 11 - Leases	9 Months Ended
	Sep. 30, 2020
Notes to Financial Statements
Lessee, Operating Leases [Text Block]	1 1 . Leases The Company's operating leases are primarily for office space, service facility centers and equipment under operating lease arrangements that expire at various dates over the next ten not one five not not not not Payments due under the Company's operating leases include fixed payments as well as variable payments. For the Company's 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 the Company's equipment leases, variable payments may The components of lease costs for the three nine September 30, 2020 2019 Three Months Ended Nine Months Ended September 30, September 30, 2020 2019 2020 2019 Operating lease cost $ 410 $ 533 $ 1,238 $ 1,425 Variable lease cost 64 56 253 182 Total lease cost $ 474 $ 589 $ 1,491 $ 1,607 Supplemental cash flow information and non-cash activity related to the Company's leases are as follows (in thousands): Nine Months Ended September 30, 2020 2019 Cash paid for amounts included in the measurement of lease liabilities and ROU assets: Operating cash flow from operating leases $ 1,130 $ 1,201 ROU assets obtained in exchange for lease obligations: Operating leases $ 260 $ 3,338 Weighted average remaining lease terms and discount rates for the Company's leases are as follows: As of September 30, 2020 2019 Years Years Weighted average remaining lease term: Operating leases 7.1 7.5 Rate Rate Weighted average discount rate: Operating leases 7.8 % 7.6 % Future maturities of lease liabilities as of September 30, 2020 Operating Leases 2020 $ 371 2021 1,107 2022 1,043 2023 940 2024 948 Thereafter 3,166 Total undiscounted lease payments 7,575 Less: Imputed interest (2,435 ) Total lease liabilities $ 5,140

Note 12 - Business Segment Info

Note 12 - Business Segment Information	9 Months Ended
	Sep. 30, 2020
Notes to Financial Statements
Segment Reporting Disclosure [Text Block]	12. Business Segment Information During the fourth 2019, one two third The financial information summarized below is presented by reportable segment for the three September 30, 2020 2019: 2020 Corporate/ (in thousands) ITS DME Services Eliminations Total Net revenues - external $ 15,638 $ 9,487 $ - $ 25,125 Net revenues - internal - 1,459 (1,459 ) - Total net revenues 15,638 10,946 (1,459 ) 25,125 Gross profit 10,095 5,027 - 15,122 Selling , general and administrative expenses 11,869 11,869 Interest expense (283 ) (283 ) Other income 8 8 Provision for income taxes (38 ) (38 ) Net income $ 2,940 Total Assets $ 51,547 $ 26,761 $ 2,000 $ 80,308 Purchases of medical equipment $ 1,685 $ 1,487 $ - $ 3,172 Depreciation and amortization of intangible assets $ 2,694 $ 866 $ - $ 3,560 2019 Corporate/ (in thousands) ITS DME Services Eliminations Total Net revenues - external $ 13,468 $ 8,021 $ - $ 21,489 Net revenues - internal - 968 (968 ) - Total net revenues 13,468 8,989 (968 ) 21,489 Gross profit 8,652 3,586 - 12,238 Selling, general and administrative expenses 10,575 10,575 Interest expense (488 ) (488 ) Other expense (11 ) (11 ) Provision for income taxes (29 ) (29 ) Net income 1,135 Total Assets $ 54,757 $ 21,138 $ 2,000 $ 77,895 Purchases of medical equipment $ 5,695 $ 1,715 $ - $ 7,410 Depreciation and amortization of intangible assets $ 2,412 $ 716 $ - $ 3,128 The financial information summarized below is presented by reportable segment for the nine September 30, 2020 2019: 2020 Corporate/ (in thousands) ITS DME Services Eliminations Total Net revenues - external $ 45,369 $ 27,308 $ - $ 72,677 Net revenues - internal - 3,955 (3,955 ) - Total net revenues 45,369 31,263 (3,955 ) 72,677 Gross profit 29,480 14,283 - 43,763 Selling , general and administrative expenses 35,971 35,971 Interest expense (1,018 ) (1,018 ) Other expense (20 ) (20 ) Provision for income taxes (92 ) (92 ) Net income $ 6,662 Total Assets $ 51,547 $ 26,761 $ 2,000 $ 80,308 Purchases of medical equipment $ 6,705 $ 5,250 $ - $ 11,955 Depreciation and amortization of intangible assets $ 8,042 $ 2,450 $ - $ 10,492 2019 Corporate/ (in thousands) ITS DME Services Eliminations Total Net revenues - external $ 37,182 $ 22,223 $ - $ 59,405 Net revenues - internal - 2,789 (2,789 ) - Total net revenues 37,182 25,012 (2,789 ) 59,405 Gross profit 23,482 10,453 - 33,935 Selling, general and administrative expenses 31,721 31,721 Interest expense (1,436 ) (1,436 ) Other expense (71 ) (71 ) Provision for income taxes (151 ) (151 ) Net income 556 Total Assets $ 54,757 $ 21,138 $ 2,000 $ 77,895 Purchases of medical equipment $ 10,500 $ 4,505 $ - $ 15,005 Depreciation and amortization of intangible assets $ 6,903 $ 2,150 $ - $ 9,053

Note 13 - COVID-19

Note 13 - COVID-19	9 Months Ended
	Sep. 30, 2020
Notes to Financial Statements
Effect of Covid-19 Pandemic [Text Block]	1 3 . COVID- 19 On March 11, 2020, 19 We have taken a number of precautionary and preemptive steps to protect the safety and well-being of our employees while ensuring continuity of service to our clients, including, transitioning our employees to a remote work environment, suspending employee travel, canceling participation in industry events and in-person group meetings, promoting social distancing and enhanced cleaning and sanitization efforts across office locations, and implementing protocols to quarantine employees who may 19, 19 19 not 19 may may 19

Significant Accounting Policies

Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
New Accounting Pronouncements, Policy [Policy Text Block]	In June 2016, No. 2016 13, 326 326 not 326 January 1, 2020, November 2019, December 15, 2022 326

Note 3 - Revenue Recognition (T

Note 3 - Revenue Recognition (Tables)	9 Months Ended
	Sep. 30, 2020
Notes Tables
Disaggregation of Revenue [Table Text Block]	Three Months Ended Nine Months Ended September 30, September 30, 2020 2019 2020 2019 Third-Party Payer Rentals $ 12,672 $ 10,662 $ 36,660 $ 29,147 Direct Payer Rentals 7,933 6,617 22,733 19,444 Product Sales 4,520 4,210 13,284 10,814 Total - Net revenues $ 25,125 $ 21,489 $ 72,677 $ 59,405 Three Months Ended Nine Months Ended September 30, September 30, 2020 2019 2020 2019 Third-Party Payer Rentals 50.4 % 49.6 % 50.4 % 49.1 % Direct Payer Rentals 31.6 % 30.8 % 31.3 % 32.7 % Product Sales 18.0 % 19.6 % 18.3 % 18.2 % Total - Net revenues 100.0 % 100.0 % 100.0 % 100.0 %

Note 4 - Medical Equipment (Tab

Note 4 - Medical Equipment (Tables)	9 Months Ended
	Sep. 30, 2020
Notes Tables
Schedule of Medical Equipment [Table Text Block]	September 30, December 31, 2020 2019 Medical Equipment for sale or rental $ 1,385 $ 1,334 Medical Equipment for sale or rental - pump reserve (26 ) (28 ) Medical Equipment for sale or rental - net 1,359 1,306 Medical Equipment in rental service 82,445 75,853 Medical Equipment in rental service - pump reserve (786 ) (720 ) Accumulated depreciation (45,549 ) (41,908 ) Medical Equipment in rental service - net 36,110 33,225 Total $ 37,469 $ 34,531

Note 5 - Property and Equipme_2

Note 5 - Property and Equipment (Tables)	9 Months Ended
	Sep. 30, 2020
Notes Tables
Property, Plant and Equipment [Table Text Block]	September 30, 2020 December 31, 2019 Gross Assets Accumulated Depreciation Total Gross Assets Accumulated Depreciation Total Furniture, fixtures, and equipment $ 3,897 $ (2,267 ) $ 1,630 $ 3,202 $ (1,928 ) $ 1,274 Automobiles 117 (99 ) 18 117 (90 ) 27 Leasehold improvements 3,409 (771 ) 2,638 3,366 (630 ) 2,736 Total $ 7,423 $ (3,137 ) $ 4,286 $ 6,685 $ (2,648 ) $ 4,037

Note 6 - Intangible Assets (Tab

Note 6 - Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2020
Notes Tables
Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets [Table Text Block]	September 30, 2020 December 31, 2019 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 (28,331 ) 8,203 36,534 (26,550 ) 9,984 Software 11,230 (9,195 ) 2,035 11,230 (7,751 ) 3,479 Total nonamortizable and amortizable intangible assets $ 49,787 $ (37,549 ) $ 12,238 $ 49,787 $ (34,324 ) $ 15,463
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense [Table Text Block]	10/1 - 2025 and 12/31/2020 2021 2022 2023 2024 thereafter Total Amortization expense $ 1,060 $ 3,930 $ 2,051 $ 548 $ 548 $ 2,101 $ 10,238

Note 7 - Debt (Tables)

Note 7 - Debt (Tables)	9 Months Ended
	Sep. 30, 2020
Notes Tables
Schedule of Line of Credit Facilities [Table Text Block]	September 30, December 31, 2020 2019 Revolver: Gross availability $ 11,750 $ 11,750 Outstanding draws - - Letters of credit (1,750 ) (1,750 ) Landlord reserves (162 ) (150 ) Availability on Revolver $ 9,838 $ 9,850
Schedule of Maturities of Long-term Debt [Table Text Block]	2020 2021 2022 2023 2024 and thereafter Total Term Loan $ 1,154 $ 4,615 $ 4,615 $ 4,615 $ 8,074 $ 23,073 Equipment Line 400 1,600 1,600 1,600 1,200 6,400 2019 Equipment Line 214 855 855 855 1,495 4,274 Unamortized value of the debt issuance costs (4 ) (17 ) (17 ) (17 ) (15 ) (70 ) Other financing 169 725 222 - - 1,116 Total $ 1,933 $ 7,778 $ 7,275 $ 7,053 $ 10,754 $ 34,793
Schedule of Debt [Table Text Block]	September 30, 2020 December 31, 2019 Current Portion Long-Term Portion Total Current Portion Long-Term Portion Total Term Loan $ 4,615 $ 18,458 $ 23,073 Term Loan $ 5,768 $ 21,919 $ 27,687 Equipment Line 1,600 4,800 6,400 Equipment Line 1,600 6,000 7,600 2019 Equipment Line 855 3,419 4,274 2019 Equipment Line 79 1,495 1,574 Unamortized value of debt issuance costs (17 ) (53 ) (70 ) Unamortized value of debt issuance costs (17 ) (66 ) (83 ) Other financing 706 410 1,116 Other financing 652 947 1,599 Total $ 7,759 $ 27,034 $ 34,793 Total $ 8,082 $ 30,295 $ 38,377

Note 10 - Earnings Per Share (T

Note 10 - Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2020
Notes Tables
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	Three Months Ended September 30, Nine Months Ended September 30, Numerator: 2020 2019 2020 2019 Net income (in thousands) $ 2,940 $ 1,135 $ 6,662 $ 556 Denominator: Weighted average common shares outstanding: Basic 20,179,056 19,781,527 20,060,416 19,690,737 Dilutive effect of common stock equivalents 1,484,358 897,904 1,577,065 813,196 Diluted 21,663,414 20,679,431 21,637,481 20,503,933 Net income per share: Basic $ 0.15 $ 0.06 $ 0.33 $ 0.03 Diluted $ 0.14 $ 0.05 $ 0.31 $ 0.03

Note 11 - Leases (Tables)

Note 11 - Leases (Tables)	9 Months Ended
	Sep. 30, 2020
Notes Tables
Lease, Cost [Table Text Block]	Three Months Ended Nine Months Ended September 30, September 30, 2020 2019 2020 2019 Operating lease cost $ 410 $ 533 $ 1,238 $ 1,425 Variable lease cost 64 56 253 182 Total lease cost $ 474 $ 589 $ 1,491 $ 1,607 Nine Months Ended September 30, 2020 2019 Cash paid for amounts included in the measurement of lease liabilities and ROU assets: Operating cash flow from operating leases $ 1,130 $ 1,201 ROU assets obtained in exchange for lease obligations: Operating leases $ 260 $ 3,338 As of September 30, 2020 2019 Years Years Weighted average remaining lease term: Operating leases 7.1 7.5 Rate Rate Weighted average discount rate: Operating leases 7.8 % 7.6 %
Lessee, Operating Lease, Liability, Maturity [Table Text Block]	Operating Leases 2020 $ 371 2021 1,107 2022 1,043 2023 940 2024 948 Thereafter 3,166 Total undiscounted lease payments 7,575 Less: Imputed interest (2,435 ) Total lease liabilities $ 5,140

Note 12 - Business Segment In_2

Note 12 - Business Segment Information (Tables)	9 Months Ended
	Sep. 30, 2020
Notes Tables
Schedule of Segment Reporting Information, by Segment [Table Text Block]	2020 Corporate/ (in thousands) ITS DME Services Eliminations Total Net revenues - external $ 15,638 $ 9,487 $ - $ 25,125 Net revenues - internal - 1,459 (1,459 ) - Total net revenues 15,638 10,946 (1,459 ) 25,125 Gross profit 10,095 5,027 - 15,122 Selling , general and administrative expenses 11,869 11,869 Interest expense (283 ) (283 ) Other income 8 8 Provision for income taxes (38 ) (38 ) Net income $ 2,940 Total Assets $ 51,547 $ 26,761 $ 2,000 $ 80,308 Purchases of medical equipment $ 1,685 $ 1,487 $ - $ 3,172 Depreciation and amortization of intangible assets $ 2,694 $ 866 $ - $ 3,560 2019 Corporate/ (in thousands) ITS DME Services Eliminations Total Net revenues - external $ 13,468 $ 8,021 $ - $ 21,489 Net revenues - internal - 968 (968 ) - Total net revenues 13,468 8,989 (968 ) 21,489 Gross profit 8,652 3,586 - 12,238 Selling, general and administrative expenses 10,575 10,575 Interest expense (488 ) (488 ) Other expense (11 ) (11 ) Provision for income taxes (29 ) (29 ) Net income 1,135 Total Assets $ 54,757 $ 21,138 $ 2,000 $ 77,895 Purchases of medical equipment $ 5,695 $ 1,715 $ - $ 7,410 Depreciation and amortization of intangible assets $ 2,412 $ 716 $ - $ 3,128 2020 Corporate/ (in thousands) ITS DME Services Eliminations Total Net revenues - external $ 45,369 $ 27,308 $ - $ 72,677 Net revenues - internal - 3,955 (3,955 ) - Total net revenues 45,369 31,263 (3,955 ) 72,677 Gross profit 29,480 14,283 - 43,763 Selling , general and administrative expenses 35,971 35,971 Interest expense (1,018 ) (1,018 ) Other expense (20 ) (20 ) Provision for income taxes (92 ) (92 ) Net income $ 6,662 Total Assets $ 51,547 $ 26,761 $ 2,000 $ 80,308 Purchases of medical equipment $ 6,705 $ 5,250 $ - $ 11,955 Depreciation and amortization of intangible assets $ 8,042 $ 2,450 $ - $ 10,492 2019 Corporate/ (in thousands) ITS DME Services Eliminations Total Net revenues - external $ 37,182 $ 22,223 $ - $ 59,405 Net revenues - internal - 2,789 (2,789 ) - Total net revenues 37,182 25,012 (2,789 ) 59,405 Gross profit 23,482 10,453 - 33,935 Selling, general and administrative expenses 31,721 31,721 Interest expense (1,436 ) (1,436 ) Other expense (71 ) (71 ) Provision for income taxes (151 ) (151 ) Net income 556 Total Assets $ 54,757 $ 21,138 $ 2,000 $ 77,895 Purchases of medical equipment $ 10,500 $ 4,505 $ - $ 15,005 Depreciation and amortization of intangible assets $ 6,903 $ 2,150 $ - $ 9,053

Note 3 - Revenue Recognition (D

Note 3 - Revenue Recognition (Details Textual) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Revenues, Total	$ 25,125	$ 21,489	$ 72,677	$ 59,405
Direct Payer Rentals [Member]
Revenues, Total	7,933	6,617	22,733	19,444
ITS Segment [Member] | Direct Payer Rentals [Member]
Revenues, Total	3,000	2,800	8,700	8,000
DME Services Segment [Member] | Direct Payer Rentals [Member]
Revenues, Total	$ 4,900	$ 3,800	$ 14,000	$ 11,400

Note 3 - Revenue Recognition -

Note 3 - Revenue Recognition - Disaggregated Revenue by Revenue Stream (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Revenues, Total	$ 25,125	$ 21,489	$ 72,677	$ 59,405
Customer Concentration Risk [Member] | Third-Party Payor Rental Revenue [Member]
Revenue	50.40%	49.60%	50.40%	49.10%
Customer Concentration Risk [Member] | Direct Payer Rentals [Member]
Revenue	31.60%	30.80%	31.30%	32.70%
Customer Concentration Risk [Member] | Revenue, Product and Service Benchmark [Member]
Revenue	18.00%	19.60%	18.30%	18.20%
Customer Concentration Risk [Member] | Revenue from Contract with Customer Benchmark [Member]
Revenue	100.00%	100.00%	100.00%	100.00%
Third-Party Payor Rental Revenue [Member]
Revenues, Total	$ 12,672	$ 10,662	$ 36,660	$ 29,147
Direct Payer Rentals [Member]
Revenues, Total	7,933	6,617	22,733	19,444
Product Sales [Member]
Revenues, Total	$ 4,520	$ 4,210	$ 13,284	$ 10,814

Note 4 - Medical Equipment (Det

Note 4 - Medical Equipment (Details Textual) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Depreciation Expense Related to Medical Equipment	$ 2.3	$ 2	$ 6.7	$ 5.4

Note 4 - Medical Equipment - Su

Note 4 - Medical Equipment - Summary of Medical Equipment (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Medical Equipment for sale or rental	$ 1,385	$ 1,334
Medical Equipment for sale or rental - pump reserve	(26)	(28)
Medical Equipment for sale or rental - net	1,359	1,306
Medical Equipment in rental service	82,445	75,853
Medical Equipment in rental service - pump reserve	(786)	(720)
Accumulated depreciation	(45,549)	(41,908)
Medical Equipment in rental service - net	36,110	33,225
Total	$ 37,469	$ 34,531

Note 5 - Property and Equipme_3

Note 5 - Property and Equipment (Details Textual) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Depreciation, Nonproduction	$ 0.2	$ 0.1	$ 0.6	$ 0.3

Note 5 - Property and Equipme_4

Note 5 - Property and Equipment - Property and Equipment (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Gross Assets	$ 7,423	$ 6,685
Accumulated Depreciation	(3,137)	(2,648)
Total	4,286	4,037
Furniture and Fixtures [Member]
Gross Assets	3,897	3,202
Accumulated Depreciation	(2,267)	(1,928)
Total	1,630	1,274
Automobiles [Member]
Gross Assets	117	117
Accumulated Depreciation	(99)	(90)
Total	18	27
Leasehold Improvements [Member]
Gross Assets	3,409	3,366
Accumulated Depreciation	(771)	(630)
Total	$ 2,638	$ 2,736

Note 6 - Intangible Assets (Det

Note 6 - Intangible Assets (Details Textual) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Amortization of Intangible Assets, Total	$ 1,075	$ 1,077	$ 3,225	$ 3,326

Note 6 - Intangible Assets - Su

Note 6 - Intangible Assets - Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Amortizable intangible assets, accumulated amortization	$ (37,549)	$ (34,324)
Amortizable intangible assets, net	10,238
Total nonamortizable and amortizable intangible assets, gross assets	49,787	49,787
Total nonamortizable and amortizable intangible assets, net	12,238	15,463
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	(28,331)	(26,550)
Amortizable intangible assets, net	8,203	9,984
Computer Software, Intangible Asset [Member]
Amortizable intangible assets, gross assets	11,230	11,230
Amortizable intangible assets, accumulated amortization	(9,195)	(7,751)
Amortizable intangible assets, net	2,035	3,479
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	Sep. 30, 2020USD ($)
Amortization expense, 2020	$ 1,060
Amortization expense, 2021	3,930
Amortization expense, 2022	2,051
Amortization expense, 2023	548
Amortization expense, 2024	548
Amortization expense, 2025 and after	2,101
Amortization expense, Total	$ 10,238

Note 7 - Debt (Details Textual)

Note 7 - Debt (Details Textual) - USD ($) $ in Thousands	Nov. 07, 2019	Apr. 15, 2019	Sep. 30, 2020	Dec. 31, 2019	Dec. 31, 2020	Mar. 31, 2019	Feb. 05, 2019	Dec. 31, 2018
Long-term Debt, Total			$ 34,793	$ 38,377
Term Loan [Member]
Long-term Debt, Total			23,073	27,687
Equipment Line [Member]
Long-term Debt, Total			6,400	7,600
Revolving Credit Facility [Member]
Line of Credit Facility, Current Borrowing Capacity			11,750	11,750
The 2019 Equipment Line [Member]
Long-term Debt, Total			4,274	1,574
Credit Facility [Member] | Term Loan [Member]
Long-term Debt, Total			$ 23,100
Credit Facility [Member] | Eurodollar Loan [Member]
Debt Instrument, Interest Rate, Effective Percentage			2.44%
LIBOR Rate			0.19%
Credit Facility [Member] | Eurodollar Loan [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate			2.25%
Credit Facility [Member] | CB Floating Rate Loan [Member]
Debt Instrument, Interest Rate, Effective Percentage			2.50%
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] | CB Floating Rate [Member]
Debt Instrument, Basis Spread on Variable Rate			(0.75%)
Lender Prime Rate			3.25%
Credit Facility [Member] | Maximum [Member] | Eurodollar Loan [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate			3.00%
Credit Facility [Member] | Maximum [Member] | CB Floating Rate Loan [Member] | Greater of Prime Rate or LIBOR Plus 2.5% [Member]
Debt Instrument, Basis Spread on Variable Rate			0.25%
Credit Facility [Member] | Minimum [Member] | Eurodollar Loan [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate			2.00%
Credit Facility [Member] | Minimum [Member] | CB Floating Rate Loan [Member] | Greater of Prime Rate or LIBOR Plus 2.5% [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
Line of Credit Facility Additional Maximum Borrowing Capacity	$ 10,000
Line of Credit Facility, Invoiced Hard Cost Maximum Percent	90.00%
Line of Credit Facility, Maximum One-time Charges	$ 300
Line of Credit Facility, Maximum Lease Buyout Expenses						$ 200		$ 100
Debt Instrument, Periodic Payment, Principal	1,200
Credit Facility [Member] | Equipment Line [Member] | Forecast [Member]
Line of Credit Facility, Maximum Lease Buyout Expenses					$ 200
Credit Facility [Member] | Equipment Line [Member] | Maximum [Member]
Capital Expenditures Incurred but Not yet Paid				7,000
Credit Facility [Member] | Revolving Credit Facility [Member]
Line of Credit Facility, Maximum Borrowing Capacity	$ 11,800		$ 11,800
Line of Credit Facility, Borrowing Base			15,500
Financing Agreement [Member]
Long-term Debt, Total			1,116	$ 1,599
Financing Agreement [Member] | Medical Equipment [Member]
Line of Credit Facility, Maximum Borrowing Capacity		$ 2,000
Debt Instrument, Term (Month)		3 years
Line of Credit Facility, Current Borrowing Capacity			$ 1,100

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	Sep. 30, 2020	Dec. 31, 2019
Gross availability	$ 11,750	$ 11,750
Outstanding draws
Letters of credit	(1,750)	(1,750)
Landlord reserves	(162)	(150)
Availability on Revolver	$ 9,838	$ 9,850

Note 7 - Debt - Summary of Futu

Note 7 - Debt - Summary of Future Maturities of Loans (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
2020	$ 1,933
2021	7,778
2022	7,275
2023	7,053
2024 and thereafter	10,754
Long-term Debt, Total	34,793	$ 38,377
Unamortized value of the debt issuance costs	(4)
Unamortized value of the debt issuance costs, 2021	(17)
Unamortized value of the debt issuance costs, 2022	(17)
Unamortized value of the debt issuance costs, 2023	(17)
Unamortized value of the debt issuance costs, 2024 and thereafter	(15)
Unamortized value of the debt issuance costs	(70)
Financing Agreement [Member]
2020	169
2021	725
2022	222
2023
2024 and thereafter
Long-term Debt, Total	1,116	1,599
Equipment Line [Member]
2020	400
2021	1,600
2022	1,600
2023	1,600
2024 and thereafter	1,200
Long-term Debt, Total	6,400	7,600
The 2019 Equipment Line [Member]
2020	214
2021	855
2022	855
2023	855
2024 and thereafter	1,495
Long-term Debt, Total	4,274	1,574
Term Loan [Member]
2020	1,154
2021	4,615
2022	4,615
2023	4,615
2024 and thereafter	8,074
Long-term Debt, Total	$ 23,073	$ 27,687

Note 7 - Debt - Summary of Comp

Note 7 - Debt - Summary of Company's Current and Long-term Debt (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Current portion of long-term debt	$ 7,759	$ 8,082
Long-term debt	27,034	30,295
Total	34,793	38,377
Unamortized value of the debt issuance costs, current portion of long-term debt	(17)	(17)
Unamortized value of the debt issuance costs, long-term debt	(53)	(66)
Unamortized value of the debt issuance costs, Total	(70)	(83)
Financing Agreement [Member]
Current portion of long-term debt	706	652
Long-term debt	410	947
Total	1,116	1,599
Equipment Line [Member]
Current portion of long-term debt	1,600	1,600
Long-term debt	4,800	6,000
Total	6,400	7,600
The 2019 Equipment Line [Member]
Current portion of long-term debt	855	79
Long-term debt	3,419	1,495
Total	4,274	1,574
Term Loan [Member]
Current portion of long-term debt	4,615	5,768
Long-term debt	18,458	21,919
Total	$ 23,073	$ 27,687

Note 8 - Income Taxes (Details

Note 8 - Income Taxes (Details Textual) - USD ($) $ in Thousands	May 07, 2020	Apr. 15, 2020	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Income Tax Expense (Benefit), Total			$ 38	$ 29	$ 92	$ 151
Paycheck Protection Program CARES Act [Member]
Proceeds from Issuance of Long-term Debt, Total		$ 4,100
Repayments of Long-term Debt, Total	$ 4,100
Maximum [Member]
Income Tax Expense (Benefit), Total			$ 100	$ 100	$ 100	$ 200

Note 10 - Earnings Per Share (D

Note 10 - Earnings Per Share (Details Textual) - shares shares in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount (in shares)	0.1	0.1	0.1	0.1

Note 10 - Earnings Per Share -

Note 10 - Earnings 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, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Net income (in thousands)	$ 2,940	$ 1,135	$ 6,662	$ 556
Basic (in shares)	20,179,056	19,781,527	20,060,416	19,690,737
Dilutive effect of common stock equivalents (in shares)	1,484,358	897,904	1,577,065	813,196
Diluted (in shares)	21,663,414	20,679,431	21,637,481	20,503,933
Basic (in dollars per share)	$ 0.15	$ 0.06	$ 0.33	$ 0.03
Diluted (in dollars per share)	$ 0.14	$ 0.05	$ 0.31	$ 0.03

Note 11 - Leases - Lease Cost (

Note 11 - Leases - Lease Cost (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Operating lease cost	$ 410	$ 533	$ 1,238	$ 1,425
Variable lease cost	64	56	253	182
Total lease cost	$ 474	$ 589	1,491	1,607
Operating cash flow from operating leases			1,130	1,201
ROU assets obtained in exchange for lease obligations: Operating leases			$ 260	$ 3,338
Weighted average remaining lease term: Operating leases (Year)	7 years 36 days	7 years 182 days	7 years 36 days	7 years 182 days
Operating leases	7.80%	7.60%	7.80%	7.60%

Note 11 - Leases - Maturities o

Note 11 - Leases - Maturities of Lease Liabilities (Details) $ in Thousands	Sep. 30, 2020USD ($)
2020	$ 371
2021	1,107
2022	1,043
2023	940
2024	948
Thereafter	3,166
Total undiscounted lease payments	7,575
Less: Imputed interest	(2,435)
Total lease liabilities	$ 5,140

Note 12 - Business Segment In_3

Note 12 - Business Segment Information (Details Textual)	3 Months Ended	9 Months Ended
	Dec. 31, 2019	Sep. 30, 2020
Number of Reportable Segments	1	2

Note 12 - Business Segment In_4

Note 12 - Business Segment Information - Summary of Financial Information By Reportable Segment (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Net revenues - external	$ 25,125	$ 21,489	$ 72,677	$ 59,405
Net revenues - internal
Total net revenues	25,125	21,489	72,677	59,405
Gross profit	15,122	12,238	43,763	33,935
Selling , general and administrative expenses	11,869	10,575	35,971	31,721
Interest expense	(283)	(488)	(1,018)	(1,436)
Other income (expense)	8	(11)	(20)	(71)
Provision for income taxes	(38)	(29)	(92)	(151)
Net income	2,940	1,135	6,662	556
Total Assets	80,308	77,895	80,308	77,895	$ 79,224
Purchases of medical equipment	3,172	7,410	11,955	15,005
Depreciation and amortization of intangible assets	3,560	3,128	10,492	9,053
Corporate and Eliminations [Member]
Net revenues - external
Net revenues - internal	(1,459)	(968)	(3,955)	(2,789)
Total net revenues	(1,459)	(968)	(3,955)	(2,789)
Gross profit
Selling , general and administrative expenses	11,869	10,575	35,971	31,721
Interest expense	(283)	(488)	(1,018)	(1,436)
Other income (expense)	8	(11)	(20)	(71)
Provision for income taxes	(38)	(29)	(92)	(151)
Total Assets	2,000	2,000	2,000	2,000
Purchases of medical equipment
Depreciation and amortization of intangible assets
ITS Segment [Member] | Operating Segments [Member]
Net revenues - external	15,638	13,468	45,369	37,182
Net revenues - internal
Total net revenues	15,638	13,468	45,369	37,182
Gross profit	10,095	8,652	29,480	23,482
Total Assets	51,547	54,757	51,547	54,757
Purchases of medical equipment	1,685	5,695	6,705	10,500
Depreciation and amortization of intangible assets	2,694	2,412	8,042	6,903
DME Services Segment [Member] | Operating Segments [Member]
Net revenues - external	9,487	8,021	27,308	22,223
Net revenues - internal	1,459	968	3,955	2,789
Total net revenues	10,946	8,989	31,263	25,012
Gross profit	5,027	3,586	14,283	10,453
Total Assets	26,761	21,138	26,761	21,138
Purchases of medical equipment	1,487	1,715	5,250	4,505
Depreciation and amortization of intangible assets	$ 866	$ 716	$ 2,450	$ 2,150