InfuSystem (INFU) 10-K 22 Mar 21 2020 FY Annual report Financial data

Document And Entity Information

Document And Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2020	Mar. 16, 2021	Jun. 30, 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 Voluntary Filers	No
Entity Well-known Seasoned Issuer	No
Entity Emerging Growth Company	false
Entity Small Business	true
Entity Interactive Data Current	Yes
Entity Common Stock, Shares Outstanding (in shares)		20,336,671
Entity Public Float			$ 150,739,346
Entity Shell Company	false
Document Type	10-K
Document Period End Date	Dec. 31, 2020
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	FY
Amendment Flag	false
Title of 12(b) Security	Common Stock, par value $0.0001 per share

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 9,648	$ 2,647
Accounts receivable, net	14,720	12,097
Inventories	3,001	2,899
Other current assets	2,402	1,662
Total current assets	29,771	19,305
Medical equipment for sale or rental	1,603	1,306
Medical equipment in rental service, net of accumulated depreciation	35,611	33,225
Property & equipment, net of accumulated depreciation	4,296	4,037
Intangible assets, net	11,177	15,463
Operating lease right of use assets	4,461	5,733
Deferred income taxes	9,967
Other assets	105	155
Total assets	96,991	79,224
Current liabilities:
Accounts payable	6,779	7,962
Current portion of long-term debt	9,423	8,082
Other current liabilities	6,795	5,803
Total current liabilities	22,997	21,847
Long-term debt, net of current portion	29,378	30,295
Deferred income taxes		104
Operating lease liabilities, net of current portion	3,864	4,644
Total liabilities	56,239	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 23,816,193 and 20,297,704, as of December 31, 2020, respectively, and issued and outstanding 23,400,625 and 19,882,136, as of December 31, 2019, respectively.	2	2
Additional paid-in capital	84,785	83,699
Retained deficit	(44,035)	(61,367)
Total stockholders’ equity	40,752	22,334
Total liabilities and stockholders’ equity	$ 96,991	$ 79,224

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parentheticals) - $ / shares	Dec. 31, 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)	23,816,193	23,400,625
Common stock, shares outstanding (in shares)	20,297,704	19,882,136

Consolidated Statements of Oper

Consolidated Statements of Operations - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Net revenues	$ 97,388	$ 81,115
Cost of revenues	38,629	34,233
Gross profit	58,759	46,882
Selling, general and administrative expenses:
Provision for doubtful accounts	791	37
Amortization of intangibles	4,285	4,402
Selling and marketing	9,661	9,932
General and administrative	35,195	28,986
Total selling, general and administrative	49,932	43,357
Operating income	8,827	3,525
Other expense:
Interest expense	(1,255)	(1,904)
Other expense	(29)	(97)
Income before income taxes	7,543	1,524
Benefit from (provision for) income taxes	9,789	(163)
Net income	$ 17,332	$ 1,361
Net income per share:
Basic (in dollars per share)	$ 0.86	$ 0.07
Diluted (in dollars per share)	$ 0.80	$ 0.07
Weighted average common shares outstanding:
Basic (in shares)	20,106,940	19,731,498
Diluted (in shares)	21,717,216	20,839,396

Consolidated Statements of Stoc

Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	Treasury Stock [Member]	Total
Balances (in shares) at Dec. 31, 2018	23,096,000			(3,518,000)
Balances at Dec. 31, 2018	$ 2	$ 83,167	$ (62,728)		$ 20,441
Stock-based shares issued upon vesting - gross (in shares)	394,000
Stock-based shares issued upon vesting - gross		139			139
Stock-based compensation expense		997			$ 997
Employee stock purchase plan (in shares)	33,000				33,742
Employee stock purchase plan		113			$ 113
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation (in shares)	(122,000)				(100,000)
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation		(717)			$ (717)
Net income			1,361		1,361
Balances (in shares) at Dec. 31, 2019	23,401,000			(3,518,000)
Balances at Dec. 31, 2019	$ 2	83,699	(61,367)		22,334
Stock-based shares issued upon vesting - gross (in shares)	505,000
Stock-based shares issued upon vesting - gross
Stock-based compensation expense		2,610			$ 2,610
Employee stock purchase plan (in shares)	29,000				30,012
Employee stock purchase plan		190			$ 190
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation (in shares)	(147,000)				(100,000)
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation		(1,714)			$ (1,714)
Net income			17,332		17,332
Common stock - issued (in shares)	28,000
Common stock - issued
Balances (in shares) at Dec. 31, 2020	23,816,000			(3,518,000)
Balances at Dec. 31, 2020	$ 2	$ 84,785	$ (44,035)		$ 40,752

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2020	Dec. 31, 2019
OPERATING ACTIVITIES
Net income		$ 17,332	$ 1,361
Adjustments to reconcile net income to net cash provided by operating activities:
Provision for doubtful accounts		791	37
Depreciation		9,740	7,940
Loss on disposal of medical equipment and other assets		418	638
Gain on sale of medical equipment		(3,577)	(1,453)
Amortization of intangible assets		4,285	4,402
Amortization of deferred debt issuance costs		17	37
Stock-based compensation		2,610	997
Deferred income taxes		(10,071)	104
Changes in Assets - Increase:
Accounts receivable		(2,631)	(1,560)
Inventories		(102)	(645)
Other current assets		(740)	(290)
Other assets		(186)	(129)
Changes in Liabilities - Increase:
Accounts payable and other liabilities		2,394	2,436
NET CASH PROVIDED BY OPERATING ACTIVITIES		20,280	13,875
INVESTING ACTIVITIES
Purchase of medical equipment		(15,820)	(19,669)
Purchase of property and equipment		(1,094)	(2,926)
Proceeds from sale of medical equipment, property and equipment		4,752	2,952
NET CASH USED IN INVESTING ACTIVITIES		(12,162)	(19,643)
FINANCING ACTIVITIES
Principal payments on term loans, equipment line, revolving credit facility and other financing		(37,180)	(4,868)
Cash proceeds from 2019 equipment line, equipment line, revolving credit facility and other financing		37,587	9,436
Debt issuance costs			(6)
Common stock repurchased to satisfy statutory withholding on employee stock-based compensation plans		(1,714)	(717)
Cash proceeds from stock plans		190	252
NET CASH (USED IN) PROVIDED BY FINANCING ACTIVITIES		(1,117)	4,097
Net change in cash and cash equivalents		7,001	(1,671)
Cash and cash equivalents, beginning of year		2,647	4,318
Cash and cash equivalents, end of year		9,648	2,647
SUPPLEMENTAL DISCLOSURES
Cash paid for interest		1,214	1,705
Cash paid for income taxes		102	111
NON-CASH TRANSACTIONS
Additions to medical equipment and property	[1]	$ 793	$ 2,773
[1]	Amounts consist of current liabilities for medical equipment that have not been included in investing activities. These amounts have not been paid for as of December 31, 2020 and 2019, respectively, but will be included as a cash outflow from investing activities for purchases of medical equipment and property when paid.

Note 1 - Basis of Presentation

Note 1 - Basis of Presentation and Nature of Operations	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Basis of Accounting [Text Block]	1. Basis of Presentation and Nature of Operations InfuSystem Holdings, Inc. and its consolidated subsidiaries (the “Company”) are 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 from five The Company's core service is to supply electronic ambulatory infusion pumps and associated disposable supply kits to oncology clinics, infusion clinics and hospital outpatient chemotherapy clinics to be utilized in the treatment of a variety of cancers including colorectal cancer, pain management and other disease states. The majority of the Company's pumps are electronic infusion pumps. Smiths Medical, Inc. and Moog Medical Devices Group each supplied more than 10% 2020. 10% 2020. In addition, the Company sells or rents new and pre-owned pole-mounted and ambulatory infusion pumps to, and provides biomedical recertification, maintenance and repair services for oncology practices, as well as other alternate site settings including home care and home infusion providers, skilled nursing facilities, pain centers and others. The Company also provides these products and services to customers in the hospital market. The Company purchases new and pre-owned pole-mounted and ambulatory infusion pumps from a variety of sources on a non-exclusive basis. The Company repairs, refurbishes and provides biomedical certification for the devices as needed. The pumps are then available for sale, rental or to be used within the Company's ambulatory infusion pump management service. The accompanying consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) and the rules and regulations of the U.S. Securities and Exchange Commission (“SEC”).

Note 2 - Summary of Significant

Note 2 - Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Significant Accounting Policies [Text Block]	2. Summary of Significant Accounting Policies Reclassifications Certain prior period reclassifications were made to conform with the current period presentation. These reclassifications had no Presentation in the Consolidated Statements The Company rents and sells medical equipment. The Company purchases medical equipment directly for sale as well as medical equipment that is purchased for either rental or sale and that is unallocated at the time of purchase (“Unallocated Assets”). Management believes that the predominant source of revenues and cash flows from the Unallocated Assets is from rentals and most equipment purchased is likely to be rented prior to being sold. The Company concluded that (i) the assets specifically supporting its two Principles of Consolidation The consolidated financial statements include the accounts of the Company and all wholly owned organizations. All intercompany transactions and account balances have been eliminated in consolidation. Segments During the fourth 2019, one two 12 The Company's approach is to make operational decisions and assess performance based on delivering products and services that together provide solutions to its customer base utilizing a functional management structure. Based upon this business model, the Company's Chief Executive Officer, whom the Company has determined to be its chief operating decision-maker, reviews segment financial information. Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates, assumptions and judgments that affect the amounts reported in the financial statements, including the notes thereto. The Company considers critical accounting policies to be those that require more significant judgments and estimates in the preparation of its consolidated financial statements, including the following: revenue recognition, leases, accounts receivable and allowance for doubtful accounts, income taxes, and long-lived asset valuations. Management relies on historical experience and other assumptions believed to be reasonable in making its judgments and estimates. Actual results could differ materially from those estimates. Business Combinations The Company accounts for all business combinations using the acquisition method of accounting, which allocates the fair value of the purchase consideration to the tangible and intangible assets acquired and liabilities assumed based on their estimated fair values. The excess of the purchase consideration over the fair values of these identifiable assets and liabilities is recorded as goodwill. When determining the fair values of assets acquired and liabilities assumed, management makes significant estimates and assumptions. The Company may third not one Cash and Cash Equivalents The Company considers all highly liquid investments with original maturities of three two Accounts Receivable and Allowance for Doubtful Accounts Amounts billed that have not $1.0 $0.4 December 31, 2020 2019, Inventories The Company's inventories consist of disposable medical supplies, replacement parts and other supplies used in conjunction with medical equipment and are stated at the lower of cost ( first first $0.1 December 31, 2020 2019. Medical Equipment Medical Equipment (“Equipment”) consists of equipment that the Company purchases from third 1 2 seven not $0.9 $0.7 December 31, 2020 2019, $0.1 December 31, 2020 2019. Property and Equipment Property and equipment is stated at acquired cost and depreciated using the straight-line method over the estimated useful lives of the related assets, ranging from three seven three five Intangible Assets Intangible assets consist of trade names, physician and customer relationships and software. The physician and customer relationships arose primarily from previous acquisitions. The Company amortizes the value assigned to the physician and customer relationships on a straight-line basis over the period of expected benefit, which ranges from fifteen twenty three not Management tests indefinite life trade names for impairment annually or more frequently if deemed necessary. The impairment test for intangible assets with indefinite lives consists of a comparison of the fair value of the intangible assets with their carrying amounts. If the carrying value of the intangible assets exceeds the fair value, an impairment loss is recognized in an amount equal to that excess. The Company determines the fair value for trade names with indefinite lives through the royalty relief income valuation approach. The Company performed its annual impairment analysis as of the last day of October 2020 no Software Capitalization and Depreciation The Company capitalizes certain costs incurred in connection with obtaining or developing internal-use software, including payroll and payroll-related costs for employees who are directly associated with the internal-use software project, external direct costs of materials and services and interest costs while developing the software. Capitalized software costs are included in intangible assets, net and are amortized using the straight-line method over the estimated useful life of three five not December 31, 2020 2019, $1.9 2020 $2.0 2019. Impairment of Long-Lived Assets Long-lived assets held for use, which includes medical equipment in rental service, property and equipment and amortizable intangible assets, are reviewed for impairment when events or changes in circumstances indicate that their carrying value may not not The Company assesses impairment indicators related to its internally-developed, internal-use software, specifically looking at the effectiveness and useful lives of each project and sub-project to determine if impairment indicators are present. In December 2020 2019, none Leases On January 1, 2019 ( 2016 02, 842 2018 10, 842, 2018 11, 842” 842 842, twelve Topic 842 not not Topic 842 not In adopting Topic 842, ten not one five not not not not not not For the Company's equipment leases, the Company used and will use the implicit rate in the lease as the discount rate, when available. Otherwise, the Company uses its incremental borrowing rate as the discount rate. For the Company's office leases, the implicit rate is typically 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 Revenue Recognition Revenue is recognized at the time and in an amount that reflects the consideration expected to be received for the performance obligations that have been provided. Accounting Standards Codification (“ASC”) Topic 606 606” not The Company has two 606. no The Company generates the majority of its revenue from the rental of infusion pumps to its customers and a minority of its revenue from product sales. For the rental service performance obligation, revenue is based on its standalone price, determined by using reimbursement rates established by third not The Company employs certain significant judgments to estimate the dollar amount of revenue, and related concessions, allocated to the rental service and sale of products. These judgments include, among others, the estimation of variable consideration. Variable consideration, specifically related to the Company's third no Net revenues are adjusted when changes in estimates of variable consideration occur. Changes in estimates typically arise as a result of new information obtained, such as actual payment receipt or denial, or pricing adjustments by payers. Subsequent changes to estimates of transaction prices are recorded as adjustments to net revenue in the period of the change. Subsequent changes that are determined to be the result of an adverse change in the payer's ability to pay are recorded as an allowance for doubtful accounts. Due to the nature of the industry and the reimbursement environment in which the Company operates, certain estimates are required to record net revenues and accounts receivable at their net realizable values. Inherent in these estimates is the risk that the estimates will have to be revised or updated as additional information becomes available. Specifically, the complexity of many third may third Cost of Revenues Cost of revenues include the costs of servicing and maintaining pumps, products sold, shipping and other direct and indirect costs related to net revenues. Shipping and handling costs incurred after control over a product has transferred to a customer are accounted for as a fulfillment cost. Customer Concentration For 2020 2019, 14% 8% 2020 2019, 9% 5% 2020 2019, The Company also contracts with various other third no 7% Income Taxes The Company recognizes deferred income tax liabilities and assets based on (i) the differences between the financial statement carrying amounts and the tax basis of assets and liabilities, using enacted tax rates in effect in the years the differences are expected to reverse and (ii) the tax credit carryforwards. Deferred income tax (expense) benefit results from the change in net deferred tax assets or deferred tax liabilities. A valuation allowance is recorded when it is more likely than not not Provisions for federal, state and foreign taxes are calculated based on reported pre-tax earnings based on current tax law and include the cumulative effect of any changes in tax rates from those used previously in determining deferred tax assets and liabilities. Certain items of income and expense are recognized in different time periods for financial reporting than for income tax purposes; thus, such provisions differ from the amounts currently receivable or payable. The Company follows a two not not 50% The Company adopted ASU 2019 12, 740 fourth 2019. 740 December 15, 2020. not may December 31, 2019. not no Treasury Stock The Company periodically repurchases shares of its common stock. These repurchases take place either as part of a board-authorized program, which may may 10b5 1 Share-Based Payments The Company determines the fair value of stock option awards, restricted stock awards and stock appreciation rights (collectively, “Share-Based Awards”) on the date of grant using option-pricing models which are affected by the Company's stock price, as well as assumptions regarding a number of other inputs using the Black-Scholes pricing model. These variables include the Company's expected stock price volatility over the expected term of the Share-Based Awards, actual and projected employee stock option exercise behaviors, risk-free interest rates and expected dividends. The expected volatility is based on the historical volatility. The Company uses historical data to estimate Share-Based Awards exercise rates. The expected term represents the period over which the Share-Based Awards are expected to be outstanding. The dividend yield is an estimate of the expected dividend yield on the Company's stock. The risk-free rate is based on U.S. Treasury yields in effect at the time of the grant for the expected term of the Share-Based Awards. All Share-Based Awards are amortized based on their graded vesting over the requisite service period of the awards. Compensation costs are recognized over the requisite service period using the accelerated method and included in general and administrative expenses. Additionally, the Company also determines the fair value of performance-based restricted stock units (“PSUs”) based upon the type of performance measure. These awards typically vest after the Company's achievement of either Company performance relative to specified performance measure goals for a specific fiscal period or when the market value of the Company's stock price reaches a target value for a minimum number of consecutive trading days. Under Financial Accounting Standards Board (“FASB”) ASC Topic 718, third Deferred Debt Issuance Costs Capitalized debt issuance costs as of December 31, 2020 2019 Earnings Per Share The Company reports its earnings per share in accordance with ASU 2017 11, 260 2014 2017 11, 260 In accordance with this topic, the following table reconciles income and share amounts utilized to calculate basic and diluted net income per common share as of December 31 ( 2020 2019 Numerator: Net income (in thousands) $ 17,332 $ 1,361 Denominator: Weighted average common shares outstanding: Basic 20,106,940 19,731,498 Dilutive effect of restricted shares and options 1,610,276 1,107,898 Diluted 21,717,216 20,839,396 Stock options of less than 0.1 not December 31, 2020 2019 Fair Value of Financial Instruments The carrying amounts reported in the consolidated balance sheets as of December 31, 2020 2019 The Company has adopted ASC 820, For financial assets and liabilities measured at fair value on a recurring basis, fair value is the price the Company would receive to sell an asset or pay to transfer a liability in an orderly transaction with a market participant at the measurement date. A three Level I quoted prices in active markets for identical instruments; Level II quoted prices in active markets for similar instruments, quoted prices for identical instruments in markets that are not Level III significant inputs to the valuation model are unobservable. 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	12 Months Ended
	Dec. 31, 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 as of December 31 ( 2020 2019 Third-Party Payer Rentals $ 49,266 $ 40,510 Direct Payer Rentals $ 30,765 $ 26,269 Product Sales $ 17,357 $ 14,336 Total - Net revenues $ 97,388 $ 81,115 Third-Party Payer Rentals are entirely attributed to revenues of the ITS segment. Product Sales are entirely attributed to revenues of the DME Services segment. For the year ended December 31, 2020, $11.8 $19.0 December 31, 2019, $11.0 $15.3 The following table presents the Company's disaggregated revenue by offering type as a percentage of total net revenues as of December 31: 2020 2019 Third-Party Payer Rentals 50.6 % 49.9 % Direct Payer Rentals 31.6 % 32.4 % Product Sales 17.8 % 17.7 % Total - Net revenues 100.0 % 100.0 %

Note 4 - Medical Equipment

Note 4 - Medical Equipment	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Medical Equipment and Property Disclosure [Text Block]	4. Medical Equipment Medical equipment consisted of the following as of December 31 2020 2019 Medical Equipment for sale or rental $ 1,636 $ 1,334 Medical Equipment for sale or rental - pump reserve (33 ) (28 ) Medical Equipment for sale or rental - net 1,603 1,306 Medical Equipment in rental service 83,411 75,853 Medical Equipment in rental service - pump reserve (893 ) (720 ) Accumulated depreciation (46,907 ) (41,908 ) Medical Equipment in rental service - net 35,611 33,225 Total $ 37,214 $ 34,531 Depreciation expense for medical equipment for the years ended December 31, 2020 2019 $8.9 $7.5

Note 5 - Property and Equipment

Note 5 - Property and Equipment	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Property, Plant and Equipment Disclosure [Text Block]	5. Property and Equipment Property and equipment consisted of the following as of December 31 2020 Gross Assets Accumulated Depreciation Total Furniture, fixtures, and equipment $ 3,742 $ (2,018 ) $ 1,724 Automobiles 117 (102 ) 15 Leasehold improvements 3,416 (859 ) 2,557 Total $ 7,275 $ (2,979 ) $ 4,296 2019 Gross Assets Accumulated Depreciation Total Furniture, fixtures, and equipment $ 3,202 $ (1,928 ) $ 1,274 Automobiles 117 (90 ) 27 Leasehold improvements 3,366 (630 ) 2,736 Total $ 6,685 $ (2,648 ) $ 4,037 Depreciation expense for property and equipment for each of the years ended December 31, 2020 2019 $0.8 $0.5

Note 6 - Intangible Assets

Note 6 - Intangible Assets	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Intangible Assets Disclosure [Text Block]	6. Intangible Assets The carrying amount and accumulated amortization of intangible assets as of December 31, 2020 2019 2020 Gross Assets Accumulated Amortization Net Nonamortizable intangible assets Trade names $ 2,000 $ - $ 2,000 Amortizable intangible assets Trade names 23 (23 ) - Physician and customer relationships 36,534 (28,924 ) 7,610 Software 11,230 (9,663 ) 1,567 Total nonamortizable and amortizable intangible assets $ 49,787 $ (38,610 ) $ 11,177 2019 Gross Assets Accumulated Amortization Net Nonamortizable intangible assets Trade names $ 2,000 $ - $ 2,000 Amortizable intangible assets Trade names 23 (23 ) - Physician and customer relationships 36,534 (26,550 ) 9,984 Software 11,230 (7,751 ) 3,479 Total nonamortizable and amortizable intangible assets $ 49,787 $ (34,324 ) $ 15,463 The weighted average remaining lives of physician and customer relationships and software were seven one December 31, 2020. The Company assesses impairment indicators related to its internally-developed, internal-use software, specifically looking at the effectiveness and useful lives of each project and sub-project to determine if impairment indicators are present. In December 2020 2019, none Amortization expense for intangible assets for the years ended December 31, 2020 2019 $4.3 $4.4 five December 31, 2020 2021 2022 2023 2024 2025 2026 and thereafter Amortization expense $ 3,930 $ 2,051 $ 548 $ 548 $ 367 $ 1,733

Note 7 - Debt

Note 7 - Debt	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Debt Disclosure [Text Block]	7. Debt On February 5, 2019, fifth March 23, 2015 ( “2015 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 2015 ● 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. December 31, 2020 $0.9 On November 7, 2019, sixth 2015 2015 ● 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 2015 $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 2015 x 30 30 may These debt amendments were accounted for as debt modifications. As of December 31, 2020, 2015 As of December 31, 2020, 2019 2015 $21.9 $6.0 $10.0 2015 December 31, 2020, $15.6 $11.8 December 31, December 31, 2020 2019 Revolver: Gross availability $ 11,750 $ 11,750 Outstanding draws - - Letters of credit (800 ) (1,750 ) Landlord reserves (162 ) (150 ) Availability on Revolver $ 10,788 $ 9,850 The Company had future maturities of loans as of December 31, 2020 2021 2022 2023 2024 2025 and thereafter Total Term Loan $ 4,615 $ 4,615 $ 4,615 $ 8,075 $ - $ 21,920 Equipment Line 1,600 1,600 1,600 1,200 - 6,000 2019 Equipment Line 2,500 2,000 2,000 3,500 - 10,000 Unamortized value of debt issuance costs (17 ) (17 ) (17 ) (15 ) - (66 ) Other financing 725 222 - - - 947 Total $ 9,423 $ 8,420 $ 8,198 $ 12,760 $ - $ 38,801 The following is a breakdown of the Company's current and long-term debt as of December 31, 2020 December 31, 2019 ( December 31, 2020 December 31, 2019 Current Portion Long-Term Portion Total Current Portion Long-Term Portion Total Term Loan $ 4,615 $ 17,305 $ 21,920 $ 5,768 $ 21,919 $ 27,687 Equipment Line 1,600 4,400 6,000 1,600 6,000 7,600 2019 Equipment Line 2,500 7,500 10,000 79 1,495 1,574 Unamortized value of debt issuance costs (17 ) (49 ) (66 ) (17 ) (66 ) (83 ) Other financing 725 222 947 652 947 1,599 Total $ 9,423 $ 29,378 $ 38,801 $ 8,082 $ 30,295 $ 38,377 As of December 31, 2020, 30 2.00% 3.00% 2.50%, 1.00% 0.25% 2015 December 31, 2020 2.19% 0.19% 2.00% December 31, 2020 2.25% 3.25% 1.00% Subsequent to December 31, 2020, 2021 2015 2021 15 10

Note 8 - Income Taxes

Note 8 - Income Taxes	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Income Tax Disclosure [Text Block]	8. Income Taxes The following table summarizes the Company's income before income taxes for the years ended December 31 ( 2020 2019 U.S income $ 6,623 $ 1,413 Non-U.S. income 920 111 Income before income taxes $ 7,543 $ 1,524 The following table summarizes the Company's components of the consolidated benefit from (provision for) income taxes for the years ended December 31 2020 2019 U.S Federal income tax benefit (expense) Current $ (11 ) $ - Deferred 8,346 (104 ) Total U.S. Federal income tax benefit (expense) 8,335 (104 ) State and local income tax benefit (expense) Current (66 ) (29 ) Deferred 1,725 - Total state and local income tax benefit (expense) 1,659 (29 ) Foreign income tax expense Current (205 ) (30 ) Total income tax benefit (expense) $ 9,789 $ (163 ) The following table summarizes activity related to the Company's valuation allowance for the years ended December 31 ( 2020 2019 Valuation allowance at the Beginning of Period $ (11,250 ) $ (11,370 ) Income tax expense - - Release of valuation allowance 11,250 120 Valuation allowance at the End of Period $ - $ (11,250 ) The following table summarizes a reconciliation of the Company's effective income tax rate to the U.S. federal statutory rate for the years ended December 31: 2020 2019 Income tax expense at the statutory rate 21.0 % 21.0 % State and local income tax expense 5.1 % 2.0 % Foreign income tax 0.2 % 2.0 % Permanent differences (8.4 %) (5.8 %) Decrease in valuation allowance (149.2 %) (7.9 %) Other adjustments 1.5 % (0.6 %) Effective income tax rate (129.8 %) 10.7 % The following table summarizes the temporary differences and carryforwards that give rise to deferred tax assets and liabilities as of December 31 ( 2020 2019 Deferred Federal tax assets – Bad debt reserves $ 1,570 $ 1,459 Stock-based compensation 656 443 Net operating loss 7,337 7,991 Operating lease liabilities 1,014 1,271 Accrued compensation 757 451 Inventories 214 27 Goodwill and intangible assets 832 1,688 Research & development credits 533 533 Other credits 30 25 Other 54 194 Total deferred Federal tax assets 12,997 14,082 Less: valuation allowance - (9,553 ) Net deferred Federal tax assets 12,997 4,529 Deferred Federal tax liabilities – Depreciation and asset basis differences (3,393 ) (3,366 ) Right-of-use assets (937 ) (1,204 ) Total deferred Federal tax liabilities (4,330 ) (4,570 ) Net deferred Federal tax assets (liabilities) 8,667 (41 ) Total deferred state and local tax assets (a) 1,300 1,634 Less: valuation allowance - (1,697 ) Net deferred state and local tax assets (liabilities) 1,300 (63 ) Net deferred tax assets (liabilities) $ 9,967 $ (104 ) (a) at December 31, 2020 2019, $1.2 $1.4 The Company's U.S. federal net operating loss carryforward for tax purposes was $34.9 December 31, 2020, $7.3 $31.5 2029. $3.4 $1.2 5 20 2021, 2021. $0.1 The Company continues to monitor shifts in past ownership (as defined under Section 382 December 31, 2019. $1.8 $4.5 In the fourth 2020 no $11.2 not no The Company had no December 31, 2020 2019. The Company is subject to taxation for Federal and various state jurisdictions in the United States and Canada. The Federal income tax returns of the Company for the years 2017 2020 2018 may 2017 four 2016 2020 On March 27, 2020, 19 $0.7 December 31, 2020, $0.7 two December 31, 2021 2022, April 15, 2020, $4.1 May 7, 2020.

Note 9 - Commitments and Contin

Note 9 - Commitments and Contingencies	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Commitments and Contingencies Disclosure [Text Block]	9. Commitments and Contingencies 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 - Leases

Note 10 - Leases	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Lessee, Operating Leases [Text Block]	10. Leases The Company has historically entered into a number of lease agreements under which the Company is the lessee for equipment and office leases. During the year ended December 31, 2020, four The components of the Company's lease costs consisted of the following as of December 31 ( 2020 2019 Operating lease cost $ 1,617 $ 1,948 Variable lease cost 315 291 Total lease cost $ 1,932 $ 2,239 Lease costs for the year ended December 31, 2020 $1.3 $0.6 December 31, 2019 $1.2 $1.0 Supplemental cash flow information and non-cash activity related to the Company's leases was as follows (in thousands): 2020 2019 Cash paid for amounts included in the measurement of lease liabilities and ROU assets: Operating cash flow from operating leases $ 1,603 $ 1,610 ROU assets obtained in exchange for lease obligations: Operating leases $ 264 $ 4,545 Reductions to ROU assets resulting from reductions to lease obligations: Operating leases $ - $ 22 Weighted average remaining lease terms and discount rates for the Company's leases as of December 31, 2019 2020 2019 Years Years Weighted average remaining lease term: Operating leases 7.0 7.4 Rate Rate Weighted average discount rate: Operating leases 7.8 % 7.7 % Future maturities of lease liabilities as of December 31, 2020 Operating Leases 2021 $ 1,108 2022 1,045 2023 941 2024 949 2025 914 Thereafter 2,253 Total undiscounted lease payments 7,210 Less: Imputed interest (2,380 ) Total lease liabilities $ 4,830

Note 11 - Share-based Compensat

Note 11 - Share-based Compensation	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Share-based Payment Arrangement [Text Block]	11. Share-based Compensation All stock option awards are amortized based on their graded vesting over the requisite service period of the awards. Compensation costs are recognized over the requisite service period using the accelerated method and included in general and administrative expenses. Stock Incentive Plan The Company has various stock option and stock-based incentive plans and agreements whereby stock options, restricted stock awards (“RSUs”) and PSUs were made available to certain employees, directors and others approved by the Company's Board of Directors (the “Board”) or Compensation Committee. Stock options are granted at, or above, fair market value and generally expire in five ten three three may On April 23, 2014, 2014 “2014 2014 2014 2014 2.0 July 19, 2018, 1.0 2014 May 15, 2019, 1.0 2014 December 31, 2020, 0.4 2014 The Company granted stock options under the 2014 December 31, 2020 2019, Shares Forgone to Satisfy Minimum Statutory Withholdings During the years ended December 31, 2020 2019, December 31, 2020 2019, 0.1 Restricted Stock Awards During the year ended December 31, 2020, 0.2 December 31, 2019, 0.1 The following table summarizes the Company's restricted share activity, excluding the Company's employee stock purchase plan, for the years ended December 31: Weighted average grant Number of date fair Aggregate shares value fair value Unvested at December 31, 2018 129,583 $ 1.42 Granted 26,000 7.04 Vested (58,314 ) 3.17 $ 712,969 Vested shares forgone to satisfy minimum statutory withholding (71,269 ) 3.17 $ 422,779 Forfeitures - - Unvested at December 31, 2019 26,000 7.04 Granted 156,250 10.12 Vested (28,432 ) 9.28 $ 367,273 Vested shares forgone to satisfy minimum statutory withholding (6,818 ) 9.28 $ 62,479 Forfeitures (2,000 ) 11.68 Unvested at December 31, 2020 145,000 $ 9.78 As of December 31, 2020, $1.0 2023. Performance-Based Restricted Stock Units During the year ended December 31, 2020, 0.2 December 31, 2019, not three 2020 one fourth third 50% 200% Under FASB ASC Topic 718, third The following table summarizes the Company's PSU activity for the years ended December 31: Weighted average grant Number of date fair Aggregate shares value fair value Unvested at December 31, 2019 - - Granted 232,500 9.06 Unvested at December 31, 2020 232,500 $ 9.06 As of December 31, 2020, $1.7 2022. Employee Stock Purchase Plan In May 2014, October 2014 ( 200,000 15% six September 7, 2016, 350,000 No may $25,000 may December 31, 2020, 187,676 December 31: 2020 2019 Compensation expense $ 108,589 $ 43,030 Shares of stock sold to employees 30,012 33,742 Weighted average fair value per ESPP award $ 7.43 $ 3.94 Stock Options The Company calculates the fair value of stock option awards using the Black-Scholes option pricing model, which incorporates various assumptions including volatility, expected term, risk-free interest rates and dividend yields. The expected volatility assumption is based on historical volatility of the Company's common stock over the most recent period commensurate with the expected life of the stock option granted. The Company uses historical volatility because management believes such volatility is representative of prospective trends. The risk-free interest rate assumption is based upon observed interest rates appropriate for the expected life of the stock option awarded. The Company uses historical exercise data to determine the expected lives. Dividend yields have not not During the year ended December 31, 2020, 0.3 0.1 five 12 December 31, 2019, 0.7 0.1 12 December 31: Weighted- Average Number Weighted- Remaining Aggregate of Authorized Average Exercise Contractual Intrinsic 2014 Plan (Options) Shares Price Term (in Years) Value Outstanding at December 31, 2018 2,224,167 $ 2.67 3.01 $ - Granted 670,000 $ 3.77 4.40 Exercised (213,056 ) 2.33 624,462 Exercised shares forgone to satisfy minimum statutory withholding (51,339 ) 2.33 Cashless exercise (184,493 ) 2.33 Forfeited (101,946 ) 3.63 Outstanding at December 31, 2019 2,343,333 $ 2.99 1.81 $ 12,989,767 Exercisable at December 31, 2019 1,501,750 $ 2.69 Granted 331,000 10.38 8.59 Exercised (334,184 ) 2.77 3,135,211 Exercised shares forgone to satisfy minimum statutory withholding (125,714 ) 2.77 Cashless exercise (164,751 ) 2.77 Forfeited (90,336 ) 3.96 Outstanding at December 31, 2020 1,959,348 $ 4.26 4.42 $ 28,449,362 Exercisable at December 31, 2020 1,362,932 $ 3.33 Aggregate Intrinsic Value = Excess of market value over the option exercise price of all in-the-money stock options. Weighted- Average Number Weighted- Remaining Aggregate Inducement of Authorized Average Exercise Contractual Intrinsic Options Shares ( 1 ) Price Term (in Years) Value Outstanding at December 31, 2018 125,000 $ 2.55 5.42 $ 111,250 Granted - - - - Exercised - - - - Forfeited - - - - Outstanding at December 31, 2019 125,000 $ 2.55 4.42 $ 747,500 Granted - - - - Exercised (27,940 ) 2.55 - 242,519 Exercised shares forgone to satisfy minimum statutory withholding (12,417 ) 2.55 - - Cashless exercise (14,330 ) 2.55 - - Forfeited (70,313 ) 2.55 - - Outstanding at December 31, 2020 - $ - - $ - Exercisable at December 31, 2020 - $ - Aggregate Intrinsic Value = Excess of market value over the option exercise price of all in-the-money stock options. ( 1 The following table summarizes information about stock options outstanding at December 31, 2020: Options Outstanding Options Exercisable 2014 Plan (Options): Range of Exercise Prices Number of Shares Outstanding Weighted-Average Remaining Contractual Life Weighted-Average Exercise Price Number of Shares Exercisable Weighted-Average Exercise Price $2.01 - $3.00 870,011 3.20 $ 2.26 784,178 $ 2.26 $3.01 - $4.00 423,336 2.74 $ 3.23 301,669 $ 3.21 $4.01 - $5.00 335,001 5.60 $ 4.70 198,335 $ 4.70 $6.01 - $7.00 50,000 4.21 $ 6.82 - $ - $8.01 - $9.00 20,000 9.02 $ 8.55 - $ - $11.01 - $12.00 245,000 9.38 $ 11.07 78,750 $ 11.07 $13.01 - $14.00 16,000 9.62 $ 13.30 - $ - Outstanding at December 31, 2020 1,959,348 4.42 $ 4.26 1,362,932 $ 3.33 The following is the average fair value per share estimated on the date of grant and the assumptions used for options granted during the years ended December 31: Stock Options: 2020 2019 Expected volatility 42% to 51% 36% to 38% Risk free interest rate 0.20% to 1.56% 1.80% to 2.36% Expected lives at date of grant (in years) 3.25 4.63 Weighted average fair value of options granted $3.87 $1.61 Stock-based compensation expense The following table presents the total stock-based compensation expense, which is included in selling, general and administrative expenses for the years ended December 31 ( 2020 2019 Restricted share expense $ 1,687 $ 190 Stock option and SARs expense 923 807 Total stock-based compensation expense $ 2,610 $ 997 Share Repurchase Program On September 30, 2019, $5.0 2020. may may 10b5 1 not may As of December 31, 2020, not

Note 12 - Business Segment Info

Note 12 - Business Segment Information	12 Months Ended
	Dec. 31, 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: 2020 Corporate/ (in thousands) ITS DME Services Eliminations Total Net revenues - external $ 61,072 $ 36,316 $ - $ 97,388 Net revenues - internal - 5,370 (5,370 ) - Total net revenues 61,072 41,686 (5,370 ) 97,388 Gross profit 39,773 18,986 - 58,759 Selling , general and administrative expenses 49,932 49,932 Interest expense (1,255 ) (1,255 ) Other expense (29 ) (29 ) Benefit from income taxes 9,789 9,789 Net income $ 17,332 Total assets $ 68,472 $ 26,519 $ 2,000 $ 96,991 Purchases of medical equipment $ 9,583 $ 6,237 $ - $ 15,820 Depreciation and amortization of intangible assets $ 10,708 $ 3,317 $ - $ 14,025 2019 Corporate/ (in thousands) ITS DME Services Eliminations Total Net revenues - external $ 51,540 $ 29,575 $ - $ 81,115 Net revenues - internal - 3,788 (3,788 ) - Total net revenues 51,540 33,363 (3,788 ) 81,115 Gross profit 33,063 13,819 - 46,882 Selling, general and administrative expenses 43,357 43,357 Interest expense (1,904 ) (1,904 ) Other expense (97 ) (97 ) Provision for income taxes (163 ) (163 ) Net income $ 1,361 Total assets $ 54,292 $ 22,932 $ 2,000 $ 79,224 Purchases of medical equipment $ 14,216 $ 5,453 $ - $ 19,669 Depreciation and amortization of intangible assets $ 9,457 $ 2,885 $ - $ 12,342 The presentation of gross profit above was revised from the 2019

Note 13 - Employee Benefit Plan

Note 13 - Employee Benefit Plans and Other	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Retirement Benefits [Text Block]	13. Employee Benefit Plans and Other The Company has a defined contribution plan in which the Company makes discretionary matching contributions for a certain percentage of employee contributions. For the years ended December 31, 2020 2019, $0.8 $0.7 not December 31, 2020 2019, $2.8 $3.5

Note 14 - COVID-19

Note 14 - COVID-19	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Effect of Covid-19 Pandemic [Text Block]	14. 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 December 31, 2020, 19 may may 19

Note 15 - Subsequent Events

Note 15 - Subsequent Events	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Subsequent Events [Text Block]	15. Subsequent Events Acquisition On February 3, 2021, $1.4 Credit Agreement On February 5, 2021, “2021 2021 The 2021 $75 February 5, 2026. may $25 2021 may $7 February 5, 2021, $30 $8.2 March 23, 2015 ( “2015 Amounts outstanding under the Revolving Facility bear interest at a variable rate equal to, at the Company's election, a LIBO Rate for Eurodollar loans or an Alternate Base Rate for ABR loans, as defined by the 2021 2.00% 3.00% 1.00% 2.00% 2021 2.00% 1.00% The 2021 ● a minimum fixed charge coverage ratio (defined as the ratio of consolidated EBITDA (as defined in the 2021 50% 2021 four 1.20 1.00; ● a maximum leverage ratio (defined as total indebtedness to EBITDA for the prior four 3.50 1.00. The 2021 Pledge and Security Agreement Simultaneous with the execution of the 2021 first 2015 On February 5, 2020, 2021 2015 2015 2015 2015 $0.8 2021

Significant Accounting Policies

Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2020
Accounting Policies [Abstract]
Reclassification, Comparability Adjustment [Policy Text Block]	Reclassifications Certain prior period reclassifications were made to conform with the current period presentation. These reclassifications had no
Presentation in Consolidated Statements [Policy Text Block]	Presentation in the Consolidated Statements The Company rents and sells medical equipment. The Company purchases medical equipment directly for sale as well as medical equipment that is purchased for either rental or sale and that is unallocated at the time of purchase (“Unallocated Assets”). Management believes that the predominant source of revenues and cash flows from the Unallocated Assets is from rentals and most equipment purchased is likely to be rented prior to being sold. The Company concluded that (i) the assets specifically supporting its two
Consolidation, Policy [Policy Text Block]	Principles of Consolidation The consolidated financial statements include the accounts of the Company and all wholly owned organizations. All intercompany transactions and account balances have been eliminated in consolidation.
Segment Reporting, Policy [Policy Text Block]	Segments During the fourth 2019, one two 12 The Company's approach is to make operational decisions and assess performance based on delivering products and services that together provide solutions to its customer base utilizing a functional management structure. Based upon this business model, the Company's Chief Executive Officer, whom the Company has determined to be its chief operating decision-maker, reviews segment financial information.
Use of Estimates, Policy [Policy Text Block]	Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates, assumptions and judgments that affect the amounts reported in the financial statements, including the notes thereto. The Company considers critical accounting policies to be those that require more significant judgments and estimates in the preparation of its consolidated financial statements, including the following: revenue recognition, leases, accounts receivable and allowance for doubtful accounts, income taxes, and long-lived asset valuations. Management relies on historical experience and other assumptions believed to be reasonable in making its judgments and estimates. Actual results could differ materially from those estimates.
Business Combinations Policy [Policy Text Block]	Business Combinations The Company accounts for all business combinations using the acquisition method of accounting, which allocates the fair value of the purchase consideration to the tangible and intangible assets acquired and liabilities assumed based on their estimated fair values. The excess of the purchase consideration over the fair values of these identifiable assets and liabilities is recorded as goodwill. When determining the fair values of assets acquired and liabilities assumed, management makes significant estimates and assumptions. The Company may third not one
Cash and Cash Equivalents, Policy [Policy Text Block]	Cash and Cash Equivalents The Company considers all highly liquid investments with original maturities of three two
Accounts Receivable [Policy Text Block]	Accounts Receivable and Allowance for Doubtful Accounts Amounts billed that have not $1.0 $0.4 December 31, 2020 2019,
Inventory, Policy [Policy Text Block]	Inventories The Company's inventories consist of disposable medical supplies, replacement parts and other supplies used in conjunction with medical equipment and are stated at the lower of cost ( first first $0.1 December 31, 2020 2019.
Medical Equipment [Policy Text Block]	Medical Equipment Medical Equipment (“Equipment”) consists of equipment that the Company purchases from third 1 2 seven not $0.9 $0.7 December 31, 2020 2019, $0.1 December 31, 2020 2019.
Property, Plant and Equipment, Policy [Policy Text Block]	Property and Equipment Property and equipment is stated at acquired cost and depreciated using the straight-line method over the estimated useful lives of the related assets, ranging from three seven three five
Goodwill and Intangible Assets, Intangible Assets, Policy [Policy Text Block]	Intangible Assets Intangible assets consist of trade names, physician and customer relationships and software. The physician and customer relationships arose primarily from previous acquisitions. The Company amortizes the value assigned to the physician and customer relationships on a straight-line basis over the period of expected benefit, which ranges from fifteen twenty three not Management tests indefinite life trade names for impairment annually or more frequently if deemed necessary. The impairment test for intangible assets with indefinite lives consists of a comparison of the fair value of the intangible assets with their carrying amounts. If the carrying value of the intangible assets exceeds the fair value, an impairment loss is recognized in an amount equal to that excess. The Company determines the fair value for trade names with indefinite lives through the royalty relief income valuation approach. The Company performed its annual impairment analysis as of the last day of October 2020 no
Capitalization of Internal Costs, Policy [Policy Text Block]	Software Capitalization and Depreciation The Company capitalizes certain costs incurred in connection with obtaining or developing internal-use software, including payroll and payroll-related costs for employees who are directly associated with the internal-use software project, external direct costs of materials and services and interest costs while developing the software. Capitalized software costs are included in intangible assets, net and are amortized using the straight-line method over the estimated useful life of three five not December 31, 2020 2019, $1.9 2020 $2.0 2019.
Impairment or Disposal of Long-Lived Assets, Policy [Policy Text Block]	Impairment of Long-Lived Assets Long-lived assets held for use, which includes medical equipment in rental service, property and equipment and amortizable intangible assets, are reviewed for impairment when events or changes in circumstances indicate that their carrying value may not not The Company assesses impairment indicators related to its internally-developed, internal-use software, specifically looking at the effectiveness and useful lives of each project and sub-project to determine if impairment indicators are present. In December 2020 2019, none
Lessee, Leases [Policy Text Block]	Leases On January 1, 2019 ( 2016 02, 842 2018 10, 842, 2018 11, 842” 842 842, twelve Topic 842 not not Topic 842 not In adopting Topic 842, ten not one five not not not not not not For the Company's equipment leases, the Company used and will use the implicit rate in the lease as the discount rate, when available. Otherwise, the Company uses its incremental borrowing rate as the discount rate. For the Company's office leases, the implicit rate is typically 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
Revenue from Contract with Customer [Policy Text Block]	Revenue Recognition Revenue is recognized at the time and in an amount that reflects the consideration expected to be received for the performance obligations that have been provided. Accounting Standards Codification (“ASC”) Topic 606 606” not The Company has two 606. no The Company generates the majority of its revenue from the rental of infusion pumps to its customers and a minority of its revenue from product sales. For the rental service performance obligation, revenue is based on its standalone price, determined by using reimbursement rates established by third not The Company employs certain significant judgments to estimate the dollar amount of revenue, and related concessions, allocated to the rental service and sale of products. These judgments include, among others, the estimation of variable consideration. Variable consideration, specifically related to the Company's third no Net revenues are adjusted when changes in estimates of variable consideration occur. Changes in estimates typically arise as a result of new information obtained, such as actual payment receipt or denial, or pricing adjustments by payers. Subsequent changes to estimates of transaction prices are recorded as adjustments to net revenue in the period of the change. Subsequent changes that are determined to be the result of an adverse change in the payer's ability to pay are recorded as an allowance for doubtful accounts. Due to the nature of the industry and the reimbursement environment in which the Company operates, certain estimates are required to record net revenues and accounts receivable at their net realizable values. Inherent in these estimates is the risk that the estimates will have to be revised or updated as additional information becomes available. Specifically, the complexity of many third may third
Revenue Recognition, Cost of Revenue [Policy Text Block]	Cost of Revenues Cost of revenues include the costs of servicing and maintaining pumps, products sold, shipping and other direct and indirect costs related to net revenues. Shipping and handling costs incurred after control over a product has transferred to a customer are accounted for as a fulfillment cost.
Concentration Risk, Credit Risk, Policy [Policy Text Block]	Customer Concentration For 2020 2019, 14% 8% 2020 2019, 9% 5% 2020 2019, The Company also contracts with various other third no 7%
Income Tax, Policy [Policy Text Block]	Income Taxes The Company recognizes deferred income tax liabilities and assets based on (i) the differences between the financial statement carrying amounts and the tax basis of assets and liabilities, using enacted tax rates in effect in the years the differences are expected to reverse and (ii) the tax credit carryforwards. Deferred income tax (expense) benefit results from the change in net deferred tax assets or deferred tax liabilities. A valuation allowance is recorded when it is more likely than not not Provisions for federal, state and foreign taxes are calculated based on reported pre-tax earnings based on current tax law and include the cumulative effect of any changes in tax rates from those used previously in determining deferred tax assets and liabilities. Certain items of income and expense are recognized in different time periods for financial reporting than for income tax purposes; thus, such provisions differ from the amounts currently receivable or payable. The Company follows a two not not 50% The Company adopted ASU 2019 12, 740 fourth 2019. 740 December 15, 2020. not may December 31, 2019. not no
Treasury Stock, Policy [Policy Text Block]	Treasury Stock The Company periodically repurchases shares of its common stock. These repurchases take place either as part of a board-authorized program, which may may 10b5 1
Share-based Payment Arrangement [Policy Text Block]	Share-Based Payments The Company determines the fair value of stock option awards, restricted stock awards and stock appreciation rights (collectively, “Share-Based Awards”) on the date of grant using option-pricing models which are affected by the Company's stock price, as well as assumptions regarding a number of other inputs using the Black-Scholes pricing model. These variables include the Company's expected stock price volatility over the expected term of the Share-Based Awards, actual and projected employee stock option exercise behaviors, risk-free interest rates and expected dividends. The expected volatility is based on the historical volatility. The Company uses historical data to estimate Share-Based Awards exercise rates. The expected term represents the period over which the Share-Based Awards are expected to be outstanding. The dividend yield is an estimate of the expected dividend yield on the Company's stock. The risk-free rate is based on U.S. Treasury yields in effect at the time of the grant for the expected term of the Share-Based Awards. All Share-Based Awards are amortized based on their graded vesting over the requisite service period of the awards. Compensation costs are recognized over the requisite service period using the accelerated method and included in general and administrative expenses. Additionally, the Company also determines the fair value of performance-based restricted stock units (“PSUs”) based upon the type of performance measure. These awards typically vest after the Company's achievement of either Company performance relative to specified performance measure goals for a specific fiscal period or when the market value of the Company's stock price reaches a target value for a minimum number of consecutive trading days. Under Financial Accounting Standards Board (“FASB”) ASC Topic 718, third
Deferred Charges, Policy [Policy Text Block]	Deferred Debt Issuance Costs Capitalized debt issuance costs as of December 31, 2020 2019
Earnings Per Share, Policy [Policy Text Block]	Earnings Per Share The Company reports its earnings per share in accordance with ASU 2017 11, 260 2014 2017 11, 260 In accordance with this topic, the following table reconciles income and share amounts utilized to calculate basic and diluted net income per common share as of December 31 ( 2020 2019 Numerator: Net income (in thousands) $ 17,332 $ 1,361 Denominator: Weighted average common shares outstanding: Basic 20,106,940 19,731,498 Dilutive effect of restricted shares and options 1,610,276 1,107,898 Diluted 21,717,216 20,839,396 Stock options of less than 0.1 not December 31, 2020 2019
Fair Value of Financial Instruments, Policy [Policy Text Block]	Fair Value of Financial Instruments The carrying amounts reported in the consolidated balance sheets as of December 31, 2020 2019 The Company has adopted ASC 820, For financial assets and liabilities measured at fair value on a recurring basis, fair value is the price the Company would receive to sell an asset or pay to transfer a liability in an orderly transaction with a market participant at the measurement date. A three Level I quoted prices in active markets for identical instruments; Level II quoted prices in active markets for similar instruments, quoted prices for identical instruments in markets that are not Level III significant inputs to the valuation model are unobservable.
New Accounting Pronouncements, Policy [Policy Text Block]	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 2 - Summary of Significa_2

Note 2 - Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	2020 2019 Numerator: Net income (in thousands) $ 17,332 $ 1,361 Denominator: Weighted average common shares outstanding: Basic 20,106,940 19,731,498 Dilutive effect of restricted shares and options 1,610,276 1,107,898 Diluted 21,717,216 20,839,396

Note 3 - Revenue Recognition (T

Note 3 - Revenue Recognition (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Disaggregation of Revenue [Table Text Block]	2020 2019 Third-Party Payer Rentals $ 49,266 $ 40,510 Direct Payer Rentals $ 30,765 $ 26,269 Product Sales $ 17,357 $ 14,336 Total - Net revenues $ 97,388 $ 81,115 2020 2019 Third-Party Payer Rentals 50.6 % 49.9 % Direct Payer Rentals 31.6 % 32.4 % Product Sales 17.8 % 17.7 % Total - Net revenues 100.0 % 100.0 %

Note 4 - Medical Equipment (Tab

Note 4 - Medical Equipment (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Schedule of Medical Equipment [Table Text Block]	2020 2019 Medical Equipment for sale or rental $ 1,636 $ 1,334 Medical Equipment for sale or rental - pump reserve (33 ) (28 ) Medical Equipment for sale or rental - net 1,603 1,306 Medical Equipment in rental service 83,411 75,853 Medical Equipment in rental service - pump reserve (893 ) (720 ) Accumulated depreciation (46,907 ) (41,908 ) Medical Equipment in rental service - net 35,611 33,225 Total $ 37,214 $ 34,531

Note 5 - Property and Equipme_2

Note 5 - Property and Equipment (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Property, Plant and Equipment [Table Text Block]	2020 Gross Assets Accumulated Depreciation Total Furniture, fixtures, and equipment $ 3,742 $ (2,018 ) $ 1,724 Automobiles 117 (102 ) 15 Leasehold improvements 3,416 (859 ) 2,557 Total $ 7,275 $ (2,979 ) $ 4,296 2019 Gross Assets Accumulated Depreciation Total Furniture, fixtures, and equipment $ 3,202 $ (1,928 ) $ 1,274 Automobiles 117 (90 ) 27 Leasehold improvements 3,366 (630 ) 2,736 Total $ 6,685 $ (2,648 ) $ 4,037

Note 6 - Intangible Assets (Tab

Note 6 - Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets [Table Text Block]	2020 Gross Assets Accumulated Amortization Net Nonamortizable intangible assets Trade names $ 2,000 $ - $ 2,000 Amortizable intangible assets Trade names 23 (23 ) - Physician and customer relationships 36,534 (28,924 ) 7,610 Software 11,230 (9,663 ) 1,567 Total nonamortizable and amortizable intangible assets $ 49,787 $ (38,610 ) $ 11,177 2019 Gross Assets Accumulated Amortization Net Nonamortizable intangible assets Trade names $ 2,000 $ - $ 2,000 Amortizable intangible assets Trade names 23 (23 ) - Physician and customer relationships 36,534 (26,550 ) 9,984 Software 11,230 (7,751 ) 3,479 Total nonamortizable and amortizable intangible assets $ 49,787 $ (34,324 ) $ 15,463
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense [Table Text Block]	2021 2022 2023 2024 2025 2026 and thereafter Amortization expense $ 3,930 $ 2,051 $ 548 $ 548 $ 367 $ 1,733

Note 7 - Debt (Tables)

Note 7 - Debt (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Schedule of Line of Credit Facilities [Table Text Block]	December 31, December 31, 2020 2019 Revolver: Gross availability $ 11,750 $ 11,750 Outstanding draws - - Letters of credit (800 ) (1,750 ) Landlord reserves (162 ) (150 ) Availability on Revolver $ 10,788 $ 9,850
Schedule of Maturities of Long-term Debt [Table Text Block]	2021 2022 2023 2024 2025 and thereafter Total Term Loan $ 4,615 $ 4,615 $ 4,615 $ 8,075 $ - $ 21,920 Equipment Line 1,600 1,600 1,600 1,200 - 6,000 2019 Equipment Line 2,500 2,000 2,000 3,500 - 10,000 Unamortized value of debt issuance costs (17 ) (17 ) (17 ) (15 ) - (66 ) Other financing 725 222 - - - 947 Total $ 9,423 $ 8,420 $ 8,198 $ 12,760 $ - $ 38,801
Schedule of Debt [Table Text Block]	December 31, 2020 December 31, 2019 Current Portion Long-Term Portion Total Current Portion Long-Term Portion Total Term Loan $ 4,615 $ 17,305 $ 21,920 $ 5,768 $ 21,919 $ 27,687 Equipment Line 1,600 4,400 6,000 1,600 6,000 7,600 2019 Equipment Line 2,500 7,500 10,000 79 1,495 1,574 Unamortized value of debt issuance costs (17 ) (49 ) (66 ) (17 ) (66 ) (83 ) Other financing 725 222 947 652 947 1,599 Total $ 9,423 $ 29,378 $ 38,801 $ 8,082 $ 30,295 $ 38,377

Note 8 - Income Taxes (Tables)

Note 8 - Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Schedule of Income before Income Tax, Domestic and Foreign [Table Text Block]	2020 2019 U.S income $ 6,623 $ 1,413 Non-U.S. income 920 111 Income before income taxes $ 7,543 $ 1,524
Schedule of Components of Income Tax Expense (Benefit) [Table Text Block]	2020 2019 U.S Federal income tax benefit (expense) Current $ (11 ) $ - Deferred 8,346 (104 ) Total U.S. Federal income tax benefit (expense) 8,335 (104 ) State and local income tax benefit (expense) Current (66 ) (29 ) Deferred 1,725 - Total state and local income tax benefit (expense) 1,659 (29 ) Foreign income tax expense Current (205 ) (30 ) Total income tax benefit (expense) $ 9,789 $ (163 )
Summary of Valuation Allowance [Table Text Block]	2020 2019 Valuation allowance at the Beginning of Period $ (11,250 ) $ (11,370 ) Income tax expense - - Release of valuation allowance 11,250 120 Valuation allowance at the End of Period $ - $ (11,250 )
Schedule of Effective Income Tax Rate Reconciliation [Table Text Block]	2020 2019 Income tax expense at the statutory rate 21.0 % 21.0 % State and local income tax expense 5.1 % 2.0 % Foreign income tax 0.2 % 2.0 % Permanent differences (8.4 %) (5.8 %) Decrease in valuation allowance (149.2 %) (7.9 %) Other adjustments 1.5 % (0.6 %) Effective income tax rate (129.8 %) 10.7 %
Schedule of Deferred Tax Assets and Liabilities [Table Text Block]	2020 2019 Deferred Federal tax assets – Bad debt reserves $ 1,570 $ 1,459 Stock-based compensation 656 443 Net operating loss 7,337 7,991 Operating lease liabilities 1,014 1,271 Accrued compensation 757 451 Inventories 214 27 Goodwill and intangible assets 832 1,688 Research & development credits 533 533 Other credits 30 25 Other 54 194 Total deferred Federal tax assets 12,997 14,082 Less: valuation allowance - (9,553 ) Net deferred Federal tax assets 12,997 4,529 Deferred Federal tax liabilities – Depreciation and asset basis differences (3,393 ) (3,366 ) Right-of-use assets (937 ) (1,204 ) Total deferred Federal tax liabilities (4,330 ) (4,570 ) Net deferred Federal tax assets (liabilities) 8,667 (41 ) Total deferred state and local tax assets (a) 1,300 1,634 Less: valuation allowance - (1,697 ) Net deferred state and local tax assets (liabilities) 1,300 (63 ) Net deferred tax assets (liabilities) $ 9,967 $ (104 )

Note 10 - Leases (Tables)

Note 10 - Leases (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Lease, Cost [Table Text Block]	2020 2019 Operating lease cost $ 1,617 $ 1,948 Variable lease cost 315 291 Total lease cost $ 1,932 $ 2,239 2020 2019 Cash paid for amounts included in the measurement of lease liabilities and ROU assets: Operating cash flow from operating leases $ 1,603 $ 1,610 ROU assets obtained in exchange for lease obligations: Operating leases $ 264 $ 4,545 Reductions to ROU assets resulting from reductions to lease obligations: Operating leases $ - $ 22 2020 2019 Years Years Weighted average remaining lease term: Operating leases 7.0 7.4 Rate Rate Weighted average discount rate: Operating leases 7.8 % 7.7 %
Lessee, Operating Lease, Liability, Maturity [Table Text Block]	Operating Leases 2021 $ 1,108 2022 1,045 2023 941 2024 949 2025 914 Thereafter 2,253 Total undiscounted lease payments 7,210 Less: Imputed interest (2,380 ) Total lease liabilities $ 4,830

Note 11 - Share-based Compens_2

Note 11 - Share-based Compensation (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Nonvested Restricted Stock Shares Activity [Table Text Block]	Weighted average grant Number of date fair Aggregate shares value fair value Unvested at December 31, 2018 129,583 $ 1.42 Granted 26,000 7.04 Vested (58,314 ) 3.17 $ 712,969 Vested shares forgone to satisfy minimum statutory withholding (71,269 ) 3.17 $ 422,779 Forfeitures - - Unvested at December 31, 2019 26,000 7.04 Granted 156,250 10.12 Vested (28,432 ) 9.28 $ 367,273 Vested shares forgone to satisfy minimum statutory withholding (6,818 ) 9.28 $ 62,479 Forfeitures (2,000 ) 11.68 Unvested at December 31, 2020 145,000 $ 9.78
Share-based Payment Arrangement, Performance Shares, Activity [Table Text Block]	Weighted average grant Number of date fair Aggregate shares value fair value Unvested at December 31, 2019 - - Granted 232,500 9.06 Unvested at December 31, 2020 232,500 $ 9.06
Schedule of Share-based Compensation, Employee Stock Purchase Plan, Activity [Table Text Block]	2020 2019 Compensation expense $ 108,589 $ 43,030 Shares of stock sold to employees 30,012 33,742 Weighted average fair value per ESPP award $ 7.43 $ 3.94
Schedule of Nonvested Share Activity [Table Text Block]	Weighted- Average Number Weighted- Remaining Aggregate of Authorized Average Exercise Contractual Intrinsic 2014 Plan (Options) Shares Price Term (in Years) Value Outstanding at December 31, 2018 2,224,167 $ 2.67 3.01 $ - Granted 670,000 $ 3.77 4.40 Exercised (213,056 ) 2.33 624,462 Exercised shares forgone to satisfy minimum statutory withholding (51,339 ) 2.33 Cashless exercise (184,493 ) 2.33 Forfeited (101,946 ) 3.63 Outstanding at December 31, 2019 2,343,333 $ 2.99 1.81 $ 12,989,767 Exercisable at December 31, 2019 1,501,750 $ 2.69 Granted 331,000 10.38 8.59 Exercised (334,184 ) 2.77 3,135,211 Exercised shares forgone to satisfy minimum statutory withholding (125,714 ) 2.77 Cashless exercise (164,751 ) 2.77 Forfeited (90,336 ) 3.96 Outstanding at December 31, 2020 1,959,348 $ 4.26 4.42 $ 28,449,362 Exercisable at December 31, 2020 1,362,932 $ 3.33 Weighted- Average Number Weighted- Remaining Aggregate Inducement of Authorized Average Exercise Contractual Intrinsic Options Shares ( 1 ) Price Term (in Years) Value Outstanding at December 31, 2018 125,000 $ 2.55 5.42 $ 111,250 Granted - - - - Exercised - - - - Forfeited - - - - Outstanding at December 31, 2019 125,000 $ 2.55 4.42 $ 747,500 Granted - - - - Exercised (27,940 ) 2.55 - 242,519 Exercised shares forgone to satisfy minimum statutory withholding (12,417 ) 2.55 - - Cashless exercise (14,330 ) 2.55 - - Forfeited (70,313 ) 2.55 - - Outstanding at December 31, 2020 - $ - - $ - Exercisable at December 31, 2020 - $ -
Share-based Payment Arrangement, Option, Exercise Price Range [Table Text Block]	Options Outstanding Options Exercisable 2014 Plan (Options): Range of Exercise Prices Number of Shares Outstanding Weighted-Average Remaining Contractual Life Weighted-Average Exercise Price Number of Shares Exercisable Weighted-Average Exercise Price $2.01 - $3.00 870,011 3.20 $ 2.26 784,178 $ 2.26 $3.01 - $4.00 423,336 2.74 $ 3.23 301,669 $ 3.21 $4.01 - $5.00 335,001 5.60 $ 4.70 198,335 $ 4.70 $6.01 - $7.00 50,000 4.21 $ 6.82 - $ - $8.01 - $9.00 20,000 9.02 $ 8.55 - $ - $11.01 - $12.00 245,000 9.38 $ 11.07 78,750 $ 11.07 $13.01 - $14.00 16,000 9.62 $ 13.30 - $ - Outstanding at December 31, 2020 1,959,348 4.42 $ 4.26 1,362,932 $ 3.33
Schedule of Share-based Payment Award, Employee Stock Purchase Plan, Valuation Assumptions [Table Text Block]	Stock Options: 2020 2019 Expected volatility 42% to 51% 36% to 38% Risk free interest rate 0.20% to 1.56% 1.80% to 2.36% Expected lives at date of grant (in years) 3.25 4.63 Weighted average fair value of options granted $3.87 $1.61
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Table Text Block]	2020 2019 Restricted share expense $ 1,687 $ 190 Stock option and SARs expense 923 807 Total stock-based compensation expense $ 2,610 $ 997

Note 12 - Business Segment In_2

Note 12 - Business Segment Information (Tables)	12 Months Ended
	Dec. 31, 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 $ 61,072 $ 36,316 $ - $ 97,388 Net revenues - internal - 5,370 (5,370 ) - Total net revenues 61,072 41,686 (5,370 ) 97,388 Gross profit 39,773 18,986 - 58,759 Selling , general and administrative expenses 49,932 49,932 Interest expense (1,255 ) (1,255 ) Other expense (29 ) (29 ) Benefit from income taxes 9,789 9,789 Net income $ 17,332 Total assets $ 68,472 $ 26,519 $ 2,000 $ 96,991 Purchases of medical equipment $ 9,583 $ 6,237 $ - $ 15,820 Depreciation and amortization of intangible assets $ 10,708 $ 3,317 $ - $ 14,025 2019 Corporate/ (in thousands) ITS DME Services Eliminations Total Net revenues - external $ 51,540 $ 29,575 $ - $ 81,115 Net revenues - internal - 3,788 (3,788 ) - Total net revenues 51,540 33,363 (3,788 ) 81,115 Gross profit 33,063 13,819 - 46,882 Selling, general and administrative expenses 43,357 43,357 Interest expense (1,904 ) (1,904 ) Other expense (97 ) (97 ) Provision for income taxes (163 ) (163 ) Net income $ 1,361 Total assets $ 54,292 $ 22,932 $ 2,000 $ 79,224 Purchases of medical equipment $ 14,216 $ 5,453 $ - $ 19,669 Depreciation and amortization of intangible assets $ 9,457 $ 2,885 $ - $ 12,342

Note 1 - Basis of Presentatio_2

Note 1 - Basis of Presentation and Nature of Operations (Details Textual)	12 Months Ended
	Dec. 31, 2020
Number of Operating Locations	5
Supplier Concentration Risk [Member] | Cost of Goods and Service, Product and Service Benchmark [Member] | Ambulatory Pumps [Member] | Smiths Medical, Inc. [Member] | Minimum [Member]
Concentration Risk, Percentage	10.00%
Supplier Concentration Risk [Member] | Cost of Goods and Service, Product and Service Benchmark [Member] | Ambulatory Pumps [Member] | Moog Medical Devices Group [Member] | Minimum [Member]
Concentration Risk, Percentage	10.00%
Supplier Concentration Risk [Member] | Cost of Goods and Service, Product and Service Benchmark [Member] | NPWT Medical Equipment [Member] | Cardinal Health, Inc. [Member] | Minimum [Member]
Concentration Risk, Percentage	10.00%

Note 2 - Summary of Significa_3

Note 2 - Summary of Significant Accounting Policies (Details Textual) $ in Thousands, shares in Millions	1 Months Ended	3 Months Ended	9 Months Ended	12 Months Ended
	Oct. 31, 2020USD ($)	Dec. 31, 2019USD ($)	Sep. 30, 2019	Dec. 31, 2020USD ($)shares	Dec. 31, 2019USD ($)shares
Number of Reportable Segments		2	1	2
Number of Financial Institutions		2			2
Accounts Receivable, Allowance for Credit Loss, Current		$ 400		$ 1,000	$ 400
Inventory Valuation Reserves, Ending Balance		100		$ 100	100
Medical Equipment in Rental Services, Useful Life (Year)				7 years
Medical Equipment in Rental Services Reserve		720		$ 893	720
Medical Equipment for Sale or Rental, Reserve		28		33	28
Impairment of Intangible Assets, Indefinite-lived (Excluding Goodwill)	$ 0
Impairment of Long-Lived Assets Held-for-use				0	0
Capitalized Computer Software, Net, Ending Balance		0		0	0
Capitalized Computer Software, Amortization				$ 1,900	$ 2,000
Share-based Payment Arrangement, Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount (in shares) | shares				0.1	0.1
Revenue, Product and Service Benchmark [Member] | Customer Concentration Risk [Member]
Concentration Risk, Percentage				17.80%	17.70%
Revenue, Product and Service Benchmark [Member] | Customer Concentration Risk [Member] | National Association 2 [Member] | Oncology Business [Member]
Concentration Risk, Percentage				14.00%	8.00%
Revenue Benchmark [Member] | Customer Concentration Risk [Member] | National Association 2 [Member]
Concentration Risk, Percentage				9.00%	5.00%
Computer Software, Intangible Asset [Member]
Finite-Lived Intangible Asset, Useful Life (Year)				3 years
Information Technology Software [Member]
Property, Plant and Equipment, Useful Life (Year)				3 years
Computer Equipment [Member]
Property, Plant and Equipment, Useful Life (Year)				5 years
Maximum [Member]
Medical Equipment for Sale or Rental, Reserve		$ 100		$ 100	$ 100
Property, Plant and Equipment, Useful Life (Year)				7 years
Lessee, Operating Lease, Renewal Term (Year)				5 years
Maximum [Member] | Physician and Customer Relationships [Member]
Finite-Lived Intangible Asset, Useful Life (Year)				20 years
Maximum [Member] | Software Development [Member]
Property, Plant and Equipment, Useful Life (Year)				5 years
Minimum [Member]
Property, Plant and Equipment, Useful Life (Year)				3 years
Lessee, Operating Lease, Renewal Term (Year)				1 year
Minimum [Member] | Physician and Customer Relationships [Member]
Finite-Lived Intangible Asset, Useful Life (Year)				15 years
Minimum [Member] | Software Development [Member]
Property, Plant and Equipment, Useful Life (Year)				3 years

Note 2 - Summary of Significa_4

Note 2 - Summary of Significant Accounting Policies - Summary of Income and Share Amounts Utilized to Calculate Basic and Diluted Net Income Per Common Share (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Numerator:
Net income (in thousands)	$ 17,332	$ 1,361
Weighted average common shares outstanding:
Basic (in shares)	20,106,940	19,731,498
Dilutive effect of restricted shares and options (in shares)	1,610,276	1,107,898
Diluted (in shares)	21,717,216	20,839,396

Note 3 - Revenue Recognition (D

Note 3 - Revenue Recognition (Details Textual) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Revenues, Total	$ 97,388	$ 81,115
Direct Payer Rentals [Member]
Revenues, Total	30,765	26,269
ITS Segment [Member] | Direct Payer Rentals [Member]
Revenues, Total	11,800	11,000
DME Services Segment [Member] | Direct Payer Rentals [Member]
Revenues, Total	$ 19,000	$ 15,300

Note 3 - Revenue Recognition -

Note 3 - Revenue Recognition - Disaggregated Revenue by Revenue Stream (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Revenues, Total	$ 97,388	$ 81,115
Customer Concentration Risk [Member] | Third-Party Payor Rental Revenue [Member]
Concentration Risk, Percentage	50.60%	49.90%
Customer Concentration Risk [Member] | Direct Payer Rentals [Member]
Concentration Risk, Percentage	31.60%	32.40%
Customer Concentration Risk [Member] | Revenue, Product and Service Benchmark [Member]
Concentration Risk, Percentage	17.80%	17.70%
Customer Concentration Risk [Member] | Revenue from Contract with Customer Benchmark [Member]
Concentration Risk, Percentage	100.00%	100.00%
Third-Party Payor Rental Revenue [Member]
Revenues, Total	$ 49,266	$ 40,510
Direct Payer Rentals [Member]
Revenues, Total	30,765	26,269
Product Sales [Member]
Revenues, Total	$ 17,357	$ 14,336

Note 4 - Medical Equipment (Det

Note 4 - Medical Equipment (Details Textual) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Depreciation Expense Related to Medical Equipment	$ 8.9	$ 7.5

Note 4 - Medical Equipment - Su

Note 4 - Medical Equipment - Summary of Medical Equipment (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Medical Equipment for sale or rental	$ 1,636	$ 1,334
Medical Equipment for sale or rental - pump reserve	(33)	(28)
Medical Equipment for sale or rental - net	1,603	1,306
Medical Equipment in rental service	83,411	75,853
Medical Equipment in rental service - pump reserve	(893)	(720)
Accumulated depreciation	(46,907)	(41,908)
Medical Equipment in rental service - net	35,611	33,225
Total	$ 37,214	$ 34,531

Note 5 - Property and Equipme_3

Note 5 - Property and Equipment (Details Textual) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Depreciation, Nonproduction	$ 0.8	$ 0.5

Note 5 - Property and Equipme_4

Note 5 - Property and Equipment - Property and Equipment (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Gross Assets	$ 7,275	$ 6,685
Accumulated Depreciation	(2,979)	(2,648)
Total	4,296	4,037
Furniture and Fixtures [Member]
Gross Assets	3,742	3,202
Accumulated Depreciation	(2,018)	(1,928)
Total	1,724	1,274
Automobiles [Member]
Gross Assets	117	117
Accumulated Depreciation	(102)	(90)
Total	15	27
Leasehold Improvements [Member]
Gross Assets	3,416	3,366
Accumulated Depreciation	(859)	(630)
Total	$ 2,557	$ 2,736

Note 6 - Intangible Assets (Det

Note 6 - Intangible Assets (Details Textual) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Impairment of Intangible Assets, Finite-lived	$ 0	$ 0
Amortization of Intangible Assets, Total	$ 4,285	$ 4,402
Physician and Customer Relationships [Member]
Finite-Lived Intangible Assets, Remaining Amortization Period (Year)	7 years
Computer Software, Intangible Asset [Member]
Finite-Lived Intangible Assets, Remaining Amortization Period (Year)	1 year

Note 6 - Intangible Assets - Su

Note 6 - Intangible Assets - Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Amortizable intangible assets, accumulated amortization	$ (38,610)	$ (34,324)
Total nonamortizable and amortizable intangible assets, gross assets	49,787	49,787
Total nonamortizable and amortizable intangible assets, net	11,177	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	(28,924)	(26,550)
Amortizable intangible assets, net	7,610	9,984
Computer Software, Intangible Asset [Member]
Amortizable intangible assets, gross assets	11,230	11,230
Amortizable intangible assets, accumulated amortization	(9,663)	(7,751)
Amortizable intangible assets, net	1,567	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	Dec. 31, 2020USD ($)
Amortization expense, 2021	$ 3,930
Amortization expense, 2022	2,051
Amortization expense, 2023	548
Amortization expense, 2024	548
Amortization expense, 2025	367
Amortization expense, 2026 and thereafter	$ 1,733

Note 7 - Debt (Details Textual)

Note 7 - Debt (Details Textual) - USD ($) $ in Thousands		Nov. 07, 2019	Apr. 15, 2019	Dec. 31, 2020	Dec. 31, 2019	Mar. 31, 2019	Feb. 05, 2019	Dec. 31, 2018
Capital Expenditures Incurred but Not yet Paid	[1]			$ 793	$ 2,773
Long-term Debt, Total				38,801	38,377
Term Loan [Member]
Long-term Debt, Total				21,920	27,687
Equipment Line [Member]
Long-term Debt, Total				6,000	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				10,000	1,574
Credit Facility [Member] | Term Loan [Member]
Long-term Debt, Total				$ 21,900
Credit Facility [Member] | Eurodollar Loan [Member]
Debt Instrument, Interest Rate, Effective Percentage				2.19%
LIBOR Rate				0.19%
Credit Facility [Member] | Eurodollar Loan [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate				2.00%
Credit Facility [Member] | CB Floating Rate Loan [Member]
Debt Instrument, Interest Rate, Effective Percentage				2.25%
Credit Facility [Member] | CB Floating Rate Loan [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate, Before Margin Rate				2.50%
Credit Facility [Member] | CB Floating Rate Loan [Member] | CB Floating Rate [Member]
Debt Instrument, Basis Spread on Variable Rate				(1.00%)
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		$ 200		$ 100
Debt Instrument, Periodic Payment, Principal		1,200
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				15,600
Financing Agreement [Member]
Long-term Debt, Total				947	$ 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				$ 900
[1]	Amounts consist of current liabilities for medical equipment that have not been included in investing activities. These amounts have not been paid for as of December 31, 2020 and 2019, respectively, but will be included as a cash outflow from investing activities for purchases of medical equipment and property when paid.

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	Dec. 31, 2020	Dec. 31, 2019
Gross availability	$ 11,750	$ 11,750
Outstanding draws
Letters of credit	(800)	(1,750)
Landlord reserves	(162)	(150)
Availability on Revolver	$ 10,788	$ 9,850

Note 7 - Debt - Summary of Futu

Note 7 - Debt - Summary of Future Maturities of Loans (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
2021	$ 9,423
2022	8,420
2023	8,198
2024	12,760
2025 and thereafter
Long-term Debt, Total	38,801	$ 38,377
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	(15)
Unamortized value of the debt issuance costs, 2025 and thereafter
Unamortized value of debt issuance costs	(66)
Financing Agreement [Member]
2021	725
2022	222
2023
2024
2025 and thereafter
Long-term Debt, Total	947	1,599
Equipment Line [Member]
2021	1,600
2022	1,600
2023	1,600
2024	1,200
2025 and thereafter
Long-term Debt, Total	6,000	7,600
The 2019 Equipment Line [Member]
2021	2,500
2022	2,000
2023	2,000
2024	3,500
2025 and thereafter
Long-term Debt, Total	10,000	1,574
Term Loan [Member]
2021	4,615
2022	4,615
2023	4,615
2024	8,075
2025 and thereafter
Long-term Debt, Total	$ 21,920	$ 27,687

Note 7 - Debt - Summary of Comp

Note 7 - Debt - Summary of Company's Current and Long-term Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Current portion of long-term debt	$ 9,423	$ 8,082
Long-term debt	29,378	30,295
Total	38,801	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	(49)	(66)
Unamortized value of the debt issuance costs, Total	(66)	(83)
Financing Agreement [Member]
Current portion of long-term debt	725	652
Long-term debt	222	947
Total	947	1,599
Equipment Line [Member]
Current portion of long-term debt	1,600	1,600
Long-term debt	4,400	6,000
Total	6,000	7,600
The 2019 Equipment Line [Member]
Current portion of long-term debt	2,500	79
Long-term debt	7,500	1,495
Total	10,000	1,574
Term Loan [Member]
Current portion of long-term debt	4,615	5,768
Long-term debt	17,305	21,919
Total	$ 21,920	$ 27,687

Note 8 - Income Taxes (Details

Note 8 - Income Taxes (Details Textual) - USD ($) $ in Thousands	May 07, 2020	Apr. 15, 2020	Dec. 31, 2020	Dec. 31, 2020	Dec. 31, 2019
Net Operating Loss Carryforwards Limitation on Use				$ 1,800
Remaining Preownership Net Operating Loss Carryforwards			$ 4,500	4,500
Valuation Allowance, Deferred Tax Asset, Increase (Decrease), Amount			(11,200)
Unrecognized Tax Benefits, Ending Balance			0	0	$ 0
Paycheck Protection Program CARES Act [Member]
Proceeds from Issuance of Long-term Debt, Total		$ 4,100
Repayments of Long-term Debt, Total	$ 4,100
Other Liabilities [Member]
Accrued Payroll Taxes			700	700
State and Local Jurisdiction [Member]
Operating Loss Carryforwards, Total			1,200	1,200	1,400
Operating Loss Carryforwards with a Definite Life			100	$ 100
State and Local Jurisdiction [Member] | Minimum [Member]
Operating Loss Carryforwards Expiration Periods (Year)				5 years
State and Local Jurisdiction [Member] | Maximum [Member]
Operating Loss Carryforwards Expiration Periods (Year)				20 years
Domestic Tax Authority [Member]
Operating Loss Carryforwards, Total			34,900	$ 34,900
Deferred Tax Assets, Operating Loss Carryforwards, Total			7,337	7,337	$ 7,991
Operating Loss Carryforwards with a Definite Life			31,500	31,500
Operating Loss Carryforwards with Indefinite Life			$ 3,400	$ 3,400
Domestic Tax Authority [Member] | Internal Revenue Service (IRS) [Member]
Open Tax Year				2017 2018 2019 2020
Income Tax Examination, Year under Examination				2018
Foreign Tax Authority [Member] | Canada Revenue Agency [Member]
Open Tax Year				2016 2017 2018 2019 2020

Note 8 - Income Taxes - Summary

Note 8 - Income Taxes - Summary of (Loss) Income Before Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
U.S income	$ 6,623	$ 1,413
Non-U.S. income	920	111
Income before income taxes	$ 7,543	$ 1,524

Note 8 - Income Taxes - Summa_2

Note 8 - Income Taxes - Summary of Components of Consolidated Provision for Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
U.S Federal income tax benefit (expense)
Current, federal	$ (11)
Deferred, federal	8,346	(104)
Total U.S. Federal income tax benefit (expense)	8,335	(104)
Current, state and local	(66)	(29)
Deferred, state and local	1,725
Total state and local income tax benefit (expense)	1,659	(29)
Current	(205)	(30)
Total income tax benefit (expense)	$ 9,789	$ (163)

Note 8 - Income Taxes - Changes

Note 8 - Income Taxes - Changes in Valuation Allowance (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Valuation allowance at the Beginning of Period	$ (11,250)	$ (11,370)
Income tax expense
Release of valuation allowance	11,250	120
Valuation allowance at the End of Period		$ (11,250)

Note 8 - Income Taxes - Reconci

Note 8 - Income Taxes - Reconciliations of Effective Income Tax Rate to Federal Statutory Rate (Details)	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Income tax expense at the statutory rate	21.00%	21.00%
State and local income tax expense	5.10%	2.00%
Foreign income tax	0.20%	2.00%
Permanent differences	(8.40%)	(5.80%)
Decrease in valuation allowance	(149.20%)	(7.90%)
Other adjustments	1.50%	(0.60%)
Effective income tax rate	(129.80%)	10.70%

Note 8 - Income Taxes - Summa_3

Note 8 - Income Taxes - Summary of Temporary Differences and Carryforwards That Give Rise to Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Thousands		Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Less: valuation allowance			$ (11,250)	$ (11,370)
Net deferred tax assets		9,967
Net deferred tax liabilities			(104)
Net deferred tax assets		9,967
Net deferred tax liabilities			104
Domestic Tax Authority [Member]
Bad debt reserves		1,570	1,459
Stock-based compensation		656	443
Net operating loss		7,337	7,991
Operating lease liabilities		1,014	1,271
Accrued compensation		757	451
Inventories		214	27
Goodwill and intangible assets		832	1,688
Research & development credits		533	533
Other credits		30	25
Other		54	194
Total deferred tax assets		12,997	14,082
Less: valuation allowance			(9,553)
Net deferred Federal tax assets		12,997	4,529
Depreciation and asset basis differences		(3,393)	(3,366)
Right-of-use assets		(937)	(1,204)
Total deferred Federal tax liabilities		(4,330)	(4,570)
Net deferred tax assets		8,667
Net deferred tax liabilities			(41)
Total deferred tax assets		12,997	14,082
Net deferred tax assets		8,667
Net deferred tax liabilities			41
State and Local Jurisdiction [Member]
Total deferred tax assets	[1]	1,300	1,634
Less: valuation allowance			(1,697)
Net deferred tax assets		1,300
Net deferred tax liabilities			(63)
Total deferred tax assets	[1]	1,300	1,634
Net deferred tax assets		$ 1,300
Net deferred tax liabilities			$ 63
[1]	at December 31, 2019, this includes state and local net operating losses of $1.4 million

Note 10 - Leases (Details Textu

Note 10 - Leases (Details Textual) $ in Thousands	12 Months Ended
	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)
Number of Leases Entered Into During the Period for Equipment	4
Lease, Cost, Total	$ 1,932	$ 2,239
General and Administrative Expense [Member]
Lease, Cost, Total	1,300	1,200
Cost of Sales [Member]
Lease, Cost, Total	$ 600	$ 1,000

Note 10 - Leases - Lease Cost (

Note 10 - Leases - Lease Cost (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Operating lease cost	$ 1,617	$ 1,948
Variable lease cost	315	291
Total lease cost	1,932	2,239
Operating cash flow from operating leases	1,603	1,610
ROU assets obtained in exchange for lease obligations: Operating leases	264	4,545
Reductions to ROU assets resulting from reductions to lease obligations: Operating leases		$ 22
Weighted average remaining lease term: Operating leases (Year)	7 years	7 years 146 days
Operating leases	7.80%	7.70%

Note 10 - Leases - Maturities o

Note 10 - Leases - Maturities of Lease Liabilities (Details) $ in Thousands	Dec. 31, 2020USD ($)
2021	$ 1,108
2022	1,045
2023	941
2024	949
2025	914
Thereafter	2,253
Total undiscounted lease payments	7,210
Less: Imputed interest	(2,380)
Total lease liabilities	$ 4,830

Note 11 - Share-based Compens_3

Note 11 - Share-based Compensation (Details Textual) - USD ($)	May 15, 2019	Jul. 19, 2018	Sep. 07, 2016	May 31, 2014	Dec. 31, 2020	Dec. 31, 2019	Sep. 30, 2019	Apr. 23, 2014
Share-based Compensation Arrangement by Share-based Payment Award, Number of Additional Shares Authorized (in shares)			350,000
Share-based Payment Arrangement, Shares Withheld for Tax Withholding Obligation (in shares)					100,000	100,000
Employee Stock Ownership Plan (ESOP), Shares Contributed to ESOP (in shares)				200,000
Employee Stock Purchase Plan Discount Rate				15.00%
Employee Stock Ownership Plan ESOP Purchase Per Employee Maximum				$ 25,000
Stock Issued During Period Shares Employee Stock Ownership Plan Number of Remaining Shares Available for Future Issuance (in shares)					187,676
Share Repurchase Program, 2020 Repurchases [Member]
Stock Repurchase Program, Authorized Amount							$ 5,000,000
2014 Amended and Restated Stock Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Available for Grant (in shares)					400,000			2,000,000
Share-based Compensation Arrangement by Share-based Payment Award, Number of Additional Shares Authorized (in shares)	1,000,000	1,000,000
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Gross (in shares)					331,000	670,000
Share-based Payment Arrangement, Option [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period (Year)					1 year	1 year
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Gross (in shares)					300,000	700,000
Share-based Payment Arrangement, Option [Member] | Chief Executive Officer [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Gross (in shares)					100,000	100,000
Share-based Payment Arrangement, Option [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period (Year)					5 years
Share-based Payment Arrangement, Option [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period (Year)					10 years
Restricted Stock Units (RSUs) [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period (Year)					3 years
Performance Shares [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period (in shares)					232,500	0
Share-based Payment Arrangement, Nonvested Award, Excluding Option, Cost Not yet Recognized, Amount					$ 1,700,000
Performance Shares [Member] | Share-based Payment Arrangement, Achieving Minimum Threshold [Member]
Share-based Compensation Arrangement By Share-based Payment Award Percentage of Target Number of Shares to be Earned					50.00%
Performance Shares [Member] | Share-based Payment Arrangement, Exceeding Minimum Threshold [Member]
Share-based Compensation Arrangement By Share-based Payment Award Percentage of Target Number of Shares to be Earned					200.00%
Performance Shares [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period (Year)					3 years
Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period (in shares)					156,250	26,000
Share-based Payment Arrangement, Nonvested Award, Excluding Option, Cost Not yet Recognized, Amount					$ 1,000,000
Restricted Stock [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period (in shares)						100,000

Note 11 - Share-based Compens_4

Note 11 - Share-based Compensation - Summary of Restricted Share Activity, Excluding Company's Employee Stock Purchase Plan (Details) - Restricted Stock [Member] - USD ($)	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Unvested, number of shares (in shares)	26,000	129,583
Unvested, weighted average grant date fair value (in dollars per share)	$ 7.04	$ 1.42
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period (in shares)	156,250	26,000
Granted, weighted average grant date fair value (in dollars per share)	$ 10.12	$ 7.04
Vested, number of shares (in shares)	(28,432)	(58,314)
Vested, weighted average grant date fair value (in dollars per share)	$ 9.28	$ 3.17
Vested, aggregate fair value	$ 367,273	$ 712,969
Vested shares forgone to satisfy minimum statutory withholding, number of shares (in shares)	(6,818)	(71,269)
Vested shares forgone to satisfy minimum statutory withholding, weighted average grant date fair value (in dollars per share)	$ 9.28	$ 3.17
Vested shares forgone to satisfy minimum statutory withholding, aggregate fair value	$ 62,479	$ 422,779
Forfeitures, number of shares (in shares)	(2,000)
Forfeitures, weighted average grant date fair value (in dollars per share)	$ 11.68
Unvested, number of shares (in shares)	145,000	26,000
Unvested, weighted average grant date fair value (in dollars per share)	$ 9.78	$ 7.04

Note 11 - Share-based Compens_5

Note 11 - Share-based Compensation - PSU Activity (Details) - Performance Shares [Member] - $ / shares	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Unvested, number of shares (in shares)
Unvested, weighted average grant date fair value (in dollars per share)
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period (in shares)	232,500	0
Granted, weighted average grant date fair value (in dollars per share)	$ 9.06
Unvested, number of shares (in shares)	232,500
Unvested, weighted average grant date fair value (in dollars per share)	$ 9.06

Note 11 - Share-based Compens_6

Note 11 - Share-based Compensation - Summary of Activity Relating to Company's ESPP Program (Details) - USD ($)	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Compensation expense	$ 108,589	$ 43,030
Shares of stock sold to employees (in shares)	30,012	33,742
Weighted average fair value per ESPP award (in dollars per share)	$ 7.43	$ 3.94

Note 11 - Share-based Compens_7

Note 11 - Share-based Compensation - Summary of Stock Option and Inducement Stock Option Activity (Details) - USD ($)		12 Months Ended
		Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation (in shares)		(100,000)	(100,000)
Inducement Stock Options [Member]
Outstanding, number of authorized shares (in shares)	[1]	125,000	125,000
Outstanding, weighted average exercise price (in dollars per share)		$ 2.55	$ 2.55
Outstanding, weighted average remaining contractual term (Year)			4 years 153 days	5 years 153 days
Outstanding, aggregate intrinsic value			$ 747,500	$ 111,250
Granted, number of authorized shares (in shares)	[1]
Granted, weighted average exercise price (in dollars per share)
Granted, weighted average remaining contractual term (Year)
Exercised, number of authorized shares (in shares)	[1]	(27,940)
Cashless exercise, number of authorized shares (in shares)		(14,330)
Cashless exercise, weighted average exercise price (in dollars per share)		$ 2.55
Forfeited, number of authorized shares (in shares)	[1]	(70,313)
Exercisable, number of authorized shares (in shares)	[1]
Exercisable, weighted average exercise price (in dollars per share)
Outstanding, number of authorized shares (in shares)	[1]		125,000	125,000
Outstanding, weighted average exercise price (in dollars per share)			$ 2.55	$ 2.55
Granted, aggregate intrinsic value
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation (in shares)		(12,417)
Exercised shares forgone to satisfy minimum statutory withholding (in dollars per share)		$ 2.55
2014 Amended and Restated Stock Incentive Plan [Member]
Outstanding, number of authorized shares (in shares)		2,343,333	2,224,167
Outstanding, weighted average exercise price (in dollars per share)		$ 2.99	$ 2.67
Outstanding, weighted average remaining contractual term (Year)		4 years 153 days	1 year 295 days	3 years 3 days
Outstanding, aggregate intrinsic value		$ 28,449,362	$ 12,989,767
Granted, number of authorized shares (in shares)		331,000	670,000
Granted, weighted average exercise price (in dollars per share)		$ 10.38	$ 3.77
Granted, weighted average remaining contractual term (Year)		8 years 215 days	4 years 146 days
Exercised, number of authorized shares (in shares)		(334,184)	(213,056)
Exercised, weighted average exercise price (in dollars per share)		$ 2.77	$ 2.33
Exercised, aggregate intrinsic value		$ 3,135,211	$ 624,462
Exercised shares forgone to satisfy minimum statutory withholding, number of authorized shares (in shares)		(125,714)	(51,339)
Exercised shares forgone to satisfy minimum statutory withholding, weighted average exercise price (in dollars per share)		$ 2.77	$ 2.33
Cashless exercise, number of authorized shares (in shares)		(164,751)	(184,493)
Cashless exercise, weighted average exercise price (in dollars per share)		$ 2.77	$ 2.33
Forfeited, number of authorized shares (in shares)		(90,336)	(101,946)
Forfeited, weighted average exercise price (in dollars per share)		$ 3.96	$ 3.63
Exercisable, number of authorized shares (in shares)		1,362,932	1,501,750
Exercisable, weighted average exercise price (in dollars per share)		$ 3.33	$ 2.69
Outstanding, number of authorized shares (in shares)		1,959,348	2,343,333	2,224,167
Outstanding, weighted average exercise price (in dollars per share)		$ 4.26	$ 2.99	$ 2.67
[1]	Represents inducement stock options to purchase shares of the Company's Common Stock to executive level managers.

Note 11 - Share-based Compens_8

Note 11 - Share-based Compensation - Schedule of Stock Options Outstanding (Details) - 2014 Amended and Restated Stock Incentive Plan [Member]	12 Months Ended
	Dec. 31, 2020$ / sharesshares
Options outstanding, number of shares outstanding (in shares) | shares	1,959,348
Options outstanding, weighted-average remaining contractual life (Year)	4 years 153 days
Options outstanding, weighted-average exercise price (in dollars per share)	$ 4.26
Options exercisable, number of shares exercisable (in shares) | shares	1,362,932
Options exercisable, weighted-average exercise price (in dollars per share)	$ 3.33
Range 1 [Member]
Exercise price, lower range (in dollars per share)	2.01
Exercise price, upper range (in dollars per share)	$ 3
Options outstanding, number of shares outstanding (in shares) | shares	870,011
Options outstanding, weighted-average remaining contractual life (Year)	3 years 73 days
Options outstanding, weighted-average exercise price (in dollars per share)	$ 2.26
Options exercisable, number of shares exercisable (in shares) | shares	784,178
Options exercisable, weighted-average exercise price (in dollars per share)	$ 2.26
Range 2 [Member]
Exercise price, lower range (in dollars per share)	3.01
Exercise price, upper range (in dollars per share)	$ 4
Options outstanding, number of shares outstanding (in shares) | shares	423,336
Options outstanding, weighted-average remaining contractual life (Year)	2 years 270 days
Options outstanding, weighted-average exercise price (in dollars per share)	$ 3.23
Options exercisable, number of shares exercisable (in shares) | shares	301,669
Options exercisable, weighted-average exercise price (in dollars per share)	$ 3.21
Range 3 [Member]
Exercise price, lower range (in dollars per share)	4.01
Exercise price, upper range (in dollars per share)	$ 5
Options outstanding, number of shares outstanding (in shares) | shares	335,001
Options outstanding, weighted-average remaining contractual life (Year)	5 years 219 days
Options outstanding, weighted-average exercise price (in dollars per share)	$ 4.70
Options exercisable, number of shares exercisable (in shares) | shares	198,335
Options exercisable, weighted-average exercise price (in dollars per share)	$ 4.70
Range 4 [Member]
Exercise price, lower range (in dollars per share)	6.01
Exercise price, upper range (in dollars per share)	$ 7
Options outstanding, number of shares outstanding (in shares) | shares	50,000
Options outstanding, weighted-average remaining contractual life (Year)	4 years 76 days
Options outstanding, weighted-average exercise price (in dollars per share)	$ 6.82
Options exercisable, number of shares exercisable (in shares) | shares
Options exercisable, weighted-average exercise price (in dollars per share)
Range 5 [Member]
Exercise price, lower range (in dollars per share)	8.01
Exercise price, upper range (in dollars per share)	$ 9
Options outstanding, number of shares outstanding (in shares) | shares	20,000
Options outstanding, weighted-average remaining contractual life (Year)	9 years 7 days
Options outstanding, weighted-average exercise price (in dollars per share)	$ 8.55
Options exercisable, number of shares exercisable (in shares) | shares
Options exercisable, weighted-average exercise price (in dollars per share)
Range 6 [Member]
Exercise price, lower range (in dollars per share)	11.01
Exercise price, upper range (in dollars per share)	$ 12
Options outstanding, number of shares outstanding (in shares) | shares	245,000
Options outstanding, weighted-average remaining contractual life (Year)	9 years 138 days
Options outstanding, weighted-average exercise price (in dollars per share)	$ 11.07
Options exercisable, number of shares exercisable (in shares) | shares	78,750
Options exercisable, weighted-average exercise price (in dollars per share)	$ 11.07
Range 7 [Member]
Exercise price, lower range (in dollars per share)	13.01
Exercise price, upper range (in dollars per share)	$ 14
Options outstanding, number of shares outstanding (in shares) | shares	16,000
Options outstanding, weighted-average remaining contractual life (Year)	9 years 226 days
Options outstanding, weighted-average exercise price (in dollars per share)	$ 13.30
Options exercisable, number of shares exercisable (in shares) | shares
Options exercisable, weighted-average exercise price (in dollars per share)

Note 11 - Share-based Compens_9

Note 11 - Share-based Compensation - Schedule of Share-based Compensation Expense Based on Fair Value of Options (Details) - $ / shares	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Expected lives at date of grant (in years) (Year)	3 years 91 days	4 years 229 days
Weighted average fair value of options granted (in dollars per share)	$ 3.87	$ 1.61
Minimum [Member]
Expected volatility	42.00%	36.00%
Risk free interest rate	0.20%	1.80%
Maximum [Member]
Expected volatility	51.00%	38.00%
Risk free interest rate	1.56%	2.36%

Note 11 - Share-based Compen_10

Note 11 - Share-based Compensation - Stock-based Compensation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Restricted share expense	$ 1,687	$ 190
Stock option and SARs expense	923	807
Total stock-based compensation expense	$ 2,610	$ 997

Note 12 - Business Segment In_3

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

Note 12 - Business Segment In_4

Note 12 - Business Segment Information - Summary of Financial Information By Reportable Segment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Net revenues - external	$ 97,388	$ 81,115
Net revenues - internal
Total net revenues	97,388	81,115
Gross profit	58,759	46,882
Selling , general and administrative expenses	49,932	43,357
Interest expense	(1,255)	(1,904)
Other expense	(29)	(97)
Benefit from income taxes	9,789	(163)
Net income	17,332	1,361
Total assets	96,991	79,224
Purchases of medical equipment	15,820	19,669
Depreciation and amortization of intangible assets	14,025	12,342
Corporate and Eliminations [Member]
Net revenues - external
Net revenues - internal	(5,370)	(3,788)
Total net revenues	(5,370)	(3,788)
Gross profit
Selling , general and administrative expenses	49,932	43,357
Interest expense	(1,255)	(1,904)
Other expense	(29)	(97)
Benefit from income taxes	9,789	(163)
Total assets	2,000	2,000
Purchases of medical equipment
Depreciation and amortization of intangible assets
ITS Segment [Member] | Operating Segments [Member]
Net revenues - external	61,072	51,540
Net revenues - internal
Total net revenues	61,072	51,540
Gross profit	39,773	33,063
Other expense
Benefit from income taxes
Total assets	68,472	54,292
Purchases of medical equipment	9,583	14,216
Depreciation and amortization of intangible assets	10,708	9,457
DME Services Segment [Member] | Operating Segments [Member]
Net revenues - external	36,316	29,575
Net revenues - internal	5,370	3,788
Total net revenues	41,686	33,363
Gross profit	18,986	13,819
Other expense
Benefit from income taxes
Total assets	26,519	22,932
Purchases of medical equipment	6,237	5,453
Depreciation and amortization of intangible assets	$ 3,317	$ 2,885

Note 13 - Employee Benefit Pl_2

Note 13 - Employee Benefit Plans and Other (Details Textual) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Defined Benefit Plan, Plan Assets, Contributions by Employer	$ 0.8	$ 0.7
Other Current Liabilities [Member]
Employee-related Liabilities, Current, Total	$ 2.8	$ 3.5

Note 15 - Subsequent Events (De

Note 15 - Subsequent Events (Details Textual) $ in Millions	Feb. 05, 2021USD ($)	Feb. 03, 2021USD ($)	Dec. 31, 2020USD ($)	Feb. 04, 2020USD ($)	Dec. 31, 2019USD ($)
Revolving Credit Facility [Member]
Long-term Line of Credit, Total
The 2015 Credit Agreement [Member] | Letter of Credit [Member]
Long-term Line of Credit, Total				$ 0.8
Subsequent Event [Member] | The 2021 Credit Agreement [Member]
Percentage of Total Depreciation Expense	50.00%
Debt Instrument, Covenant, Minimum Fixed Coverage Ratio	1.2
Debt Instrument, Covenant, Maximum Leverage Ratio	3.5
Subsequent Event [Member] | The 2021 Credit Agreement [Member] | Eurodollar Loan [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate	2.00%
Subsequent Event [Member] | The 2021 Credit Agreement [Member] | Eurodollar Loan [Member] | Minimum [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate	2.00%
Subsequent Event [Member] | The 2021 Credit Agreement [Member] | Eurodollar Loan [Member] | Maximum [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate	3.00%
Subsequent Event [Member] | The 2021 Credit Agreement [Member] | ABR Loans [Member] | Base Rate [Member]
Debt Instrument, Basis Spread on Variable Rate	1.00%
Subsequent Event [Member] | The 2021 Credit Agreement [Member] | ABR Loans [Member] | Minimum [Member] | Base Rate [Member]
Debt Instrument, Basis Spread on Variable Rate	1.00%
Subsequent Event [Member] | The 2021 Credit Agreement [Member] | ABR Loans [Member] | Maximum [Member] | Base Rate [Member]
Debt Instrument, Basis Spread on Variable Rate	2.00%
Subsequent Event [Member] | The 2021 Credit Agreement [Member] | Revolving Credit Facility [Member]
Line of Credit Facility, Maximum Borrowing Capacity	$ 75
Line of Credit Facility, Additional Borrowing Capacity Subject to Certain Conditions	25
Proceeds from Long-term Lines of Credit	30
Subsequent Event [Member] | The 2021 Credit Agreement [Member] | Letter of Credit [Member]
Line of Credit Facility, Maximum Borrowing Capacity	7
Subsequent Event [Member] | The 2015 Credit Agreement [Member] | Revolving Credit Facility [Member]
Repayments of Long-term Lines of Credit	$ 8.2
FilAMed [Member] | Subsequent Event [Member]
Business Combination, Consideration Transferred, Total		$ 1.4