InfuSystem (INFU) 10-Q 9 May 24 2024 Q1 Quarterly report Financial data

Cover

Cover - shares	3 Months Ended
	Mar. 31, 2024	May 03, 2024
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2024
Document Transition Report	false
Entity File Number	001-35020
Entity Registrant Name	INFUSYSTEM HOLDINGS, INC
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	20-3341405
Entity Address, Address Line One	3851 West Hamlin Road
Entity Address, City or Town	Rochester Hills
Entity Address, State or Province	MI
Entity Address, Postal Zip Code	48309
City Area Code	248
Local Phone Number	291-1210
Title of Each Class	Common Stock, par value $0.0001 per share
Trading Symbol(s)	INFU
Name of Each Exchange on which Registered	NYSEAMER
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		21,295,254
Entity Central Index Key	0001337013
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Document Fiscal Period Focus	Q1
Document Fiscal Year Focus	2024

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 822	$ 231
Accounts receivable, net	20,543	19,830
Inventories, net	6,249	6,402
Other current assets	4,842	4,157
Total current assets	32,456	30,620
Medical equipment for sale or rental	4,084	3,049
Medical equipment in rental service, net of accumulated depreciation	34,425	34,928
Property & equipment, net of accumulated depreciation	4,231	4,321
Goodwill	3,710	3,710
Intangible assets, net	7,199	7,446
Operating lease right of use assets	6,206	6,703
Deferred income taxes	9,236	9,115
Derivative financial instruments	1,716	1,442
Other assets	1,587	1,581
Total assets	104,850	102,915
Current liabilities:
Accounts payable	9,796	8,009
Other current liabilities	7,516	7,704
Total current liabilities	17,312	15,713
Long-term debt, net of current portion	29,931	29,101
Operating lease liabilities, net of current portion	5,331	5,799
Total liabilities	52,574	50,613
Stockholders’ equity:
Preferred stock, $0.0001 par value: authorized 1,000,000 shares; none issued	0	0
Common stock, $0.0001 par value: authorized 200,000,000 shares; 21,290,254 shares issued and outstanding as of March 31, 2024 and 21,196,851 shares issued and outstanding as of December 31, 2023	2	2
Additional paid-in capital	110,715	109,837
Accumulated other comprehensive income	1,296	1,088
Retained deficit	(59,737)	(58,625)
Total stockholders’ equity	52,276	52,302
Total liabilities and stockholders’ equity	$ 104,850	$ 102,915

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Preferred stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Preferred stock, authorized (in shares)	1,000,000	1,000,000
Preferred stock, issued (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Common stock,, authorized (in shares)	200,000,000	200,000,000
Common stock, issued (in shares)	21,290,254	21,196,851
Common stock, outstanding (in shares)	21,290,254	21,196,851

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Income Statement [Abstract]
Net revenues	$ 31,995	$ 30,370
Cost of revenues	15,521	15,420
Gross profit	16,474	14,950
Selling, general and administrative expenses:
Amortization of intangibles	248	248
Selling and marketing	3,376	3,224
General and administrative	13,695	11,585
Total selling, general and administrative	17,319	15,057
Operating loss	(845)	(107)
Other expense:
Interest expense	(456)	(484)
Other income (expense)	3	(35)
Loss before income taxes	(1,298)	(626)
Benefit from income taxes	186	302
Net loss	$ (1,112)	$ (324)
Net loss per share:
Basic (in dollars per share)	$ (0.05)	$ (0.02)
Diluted (in dollars per share)	$ (0.05)	$ (0.02)
Weighted average shares outstanding:
Basic (in shares)	21,225,768	20,853,018
Diluted (in shares)	21,225,768	20,853,018
Comprehensive loss:
Net loss:	$ (1,112)	$ (324)
Other comprehensive income (loss):
Unrealized gain (loss) on hedges	274	(282)
(Provision for) benefit from income tax on unrealized hedge gain	(66)	63
Net comprehensive loss	$ (904)	$ (543)

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Total	Common Stock	Additional Paid in Capital	Retained Deficit	Accumulated Other Comprehensive Income
Beginning balance (in shares) at Dec. 31, 2022		20,782,000
Beginning balance at Dec. 31, 2022	$ 48,003	$ 2	$ 105,856	$ (59,344)	$ 1,489
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Shares issued upon restricted stock vesting and option exercise (in shares)		167,000
Shares issued upon restricted stock vesting and option exercise	315		315
Stock-based compensation expense	720		720
Employee stock purchase plan (in shares)		41,000
Employee stock purchase plan	243		243
Common stock repurchased as part of share repurchase program (in shares)		(22,000)
Common stock repurchased as part of share repurchase program	(153)			(153)
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation (in shares)		(37,000)
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation	(324)		(324)
Other comprehensive (loss) income	(219)				(219)
Net loss	(324)			(324)
Ending balance (in shares) at Mar. 31, 2023		20,931,000
Ending balance at Mar. 31, 2023	$ 48,261	$ 2	106,810	(59,821)	1,270
Beginning balance (in shares) at Dec. 31, 2023	21,196,851	21,197,000
Beginning balance at Dec. 31, 2023	$ 52,302	$ 2	109,837	(58,625)	1,088
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Shares issued upon restricted stock vesting and option exercise (in shares)		106,000
Shares issued upon restricted stock vesting and option exercise	0
Stock-based compensation expense	1,057		1,057
Employee stock purchase plan (in shares)		26,000
Employee stock purchase plan	186		186
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation (in shares)		(39,000)
Common stock repurchased to satisfy minimum statutory withholding on stock-based compensation	(365)		(365)
Other comprehensive (loss) income	208				208
Net loss	$ (1,112)			(1,112)
Ending balance (in shares) at Mar. 31, 2024	21,290,254	21,290,000
Ending balance at Mar. 31, 2024	$ 52,276	$ 2	$ 110,715	$ (59,737)	$ 1,296

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
OPERATING ACTIVITIES
Net loss:	$ (1,112)	$ (324)
Adjustments to reconcile net loss to net cash provided by operating activities:
Provision for doubtful accounts	(130)	114
Depreciation	2,652	2,955
(Gain) loss on disposal of and reserve adjustments for medical equipment	(43)	450
Gain on sale of medical equipment	(629)	(883)
Amortization of intangible assets	248	248
Amortization of deferred debt issuance costs	19	18
Stock-based compensation	1,057	720
Deferred income taxes	(186)	(302)
Changes in assets - (increase)/decrease:
Accounts receivable	(237)	(961)
Inventories	153	(823)
Other current assets	(685)	(830)
Other assets	376	(846)
Changes in liabilities - (decrease)/increase:
Accounts payable and other liabilities	(1,106)	313
NET CASH PROVIDED BY (USED IN) OPERATING ACTIVITIES	377	(151)
INVESTING ACTIVITIES
Purchase of medical equipment	(1,493)	(3,968)
Purchase of property and equipment	(182)	(317)
Proceeds from sale of medical equipment, property and equipment	1,257	1,234
NET CASH USED IN INVESTING ACTIVITIES	(418)	(3,051)
FINANCING ACTIVITIES
Principal payments on long-term debt	(15,258)	(13,683)
Cash proceeds from long-term debt	16,069	16,894
Common stock repurchased as part of share repurchase program	0	(153)
Common stock repurchased to satisfy statutory withholding on employee stock-based compensation plans	(365)	(324)
Cash proceeds from exercise of options and ESPP	186	559
NET CASH PROVIDED BY FINANCING ACTIVITIES	632	3,293
Net change in cash and cash equivalents	591	91
Cash and cash equivalents, beginning of period	231	165
Cash and cash equivalents, end of period	$ 822	$ 256

Basis of Presentation and Natur

Basis of Presentation and Nature of Operations	3 Months Ended
	Mar. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation and Nature of Operations	Basis of Presentation and Nature of Operations The terms “InfuSystem”, the “Company”, “we”, “our” and “us” are used herein to refer to InfuSystem Holdings, Inc. and its subsidiaries. InfuSystem is a leading provider of infusion pumps and related products and services for patients in the home, oncology clinics, ambulatory surgery centers, and other sites of care. The Company provides products and services to hospitals, oncology practices and facilities and other alternative site health care providers. Headquartered in Rochester Hills, Michigan, the Company delivers local, field-based customer support, and also operates pump service and repair Centers of Excellence in Michigan, Kansas, California, Massachusetts, Texas and Ontario, Canada. The Company operates in two reportable segments, Patient Services and Device Solutions. During the fiscal year ended December 31, 2023, the Company also operated through First Biomedical, Inc., a Kansas Corporation, which was a wholly-owned subsidiary that merged into InfuSystem, Inc. on January 1, 2024. The accompanying unaudited condensed consolidated financial statements have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”) for interim financial information. Accordingly, the unaudited condensed consolidated financial statements do not include all of the information and notes required by U.S. Generally Accepted Accounting Principles (“GAAP”) for complete financial statements. The accompanying unaudited condensed consolidated financial statements include all adjustments, composed of normal recurring adjustments, considered necessary by management to fairly state the Company’s results of operations, financial position and cash flows. The operating results for the interim periods are not necessarily indicative of results that may be expected for any other interim period or for the full year. These unaudited condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023 as filed with the SEC on April 10, 2024. The unaudited condensed consolidated financial statements are prepared in conformity with GAAP, which requires the use of estimates, judgments and assumptions that affect the amounts of assets and liabilities at the reporting date and the amounts of revenue and expenses in the periods presented. The Company believes that the accounting estimates employed are appropriate and the resulting balances are reasonable; however, due to the inherent uncertainties in making estimates, actual results could differ from the original estimates, requiring adjustments to these balances in future periods.

Recent Accounting Pronouncement

Recent Accounting Pronouncements and Developments	3 Months Ended
	Mar. 31, 2024
Accounting Policies [Abstract]
Recent Accounting Pronouncements and Developments	Recent Accounting Pronouncements and Developments In November 2023, the Financial Accounting Standards Board ("FASB") issued Accounting Standards Update ("ASU") No. 2023-07, Segment Reporting (ASC 280): Improvements to Reportable Segment Disclosures. ASU 2023-07 expands the disclosure requirements for reportable segments by requiring enhanced disclosures about significant segment expenses. Under the new standard, entities must disclose an amount for other segment items by reportable segment and a description of its composition. The other segment items category is the difference between segment revenue less the significant expenses disclosed and each reported measure of segment profit or loss. Additionally, entities must disclose at least one measure of assessing segment performance and the title and position of the chief operating decision-maker ("CODM") and an explanation of how the CODM uses the reported measure(s) of segment profit or loss in assessing segment performance. The amendments are effective for annual periods beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. Early adoption is permitted. The amendments are to be applied retrospectively to all prior periods presented in the financial statements. The Company is currently evaluating the impact of ASU 2023-07 on its consolidated financial statements and related disclosures. In December 2023, the FASB issued Accounting Standards Update No. 2023-09, Income Taxes (ASC 740): Improvements to Income Tax Disclosures. ASU 2023-09 enhances existing income tax disclosures primarily through standardization and disaggregation of rate reconciliation categories and income taxes paid by jurisdiction. The amendments in this ASU requires public entities to disclose a tabular tax rate reconciliation, using both percentages and currency, with specific categories. Public entities are also required to provide a qualitative description of the states and local jurisdictions that make up the majority of the effect of the state and local income tax category and the net amount of income taxes paid, disaggregated by federal, state and foreign taxes and also disaggregated by individual jurisdictions. The amendments also remove certain disclosures that are no longer considered cost beneficial. The amendments are effective prospectively for annual periods beginning after December 15, 2024, and early adoption and retrospective application are permitted. The Company is currently evaluating the impact of ASU 2023-09 on its consolidated financial statements and related disclosures. In March 2024, the SEC issued final rules on climate-related disclosures that will require annual disclosure of material climate-related risks and material direct greenhouse gas emissions from operations owned or controlled (Scope 1) and material indirect greenhouse gas emissions from purchased energy consumed in owned or controlled operations (Scope 2). Additionally, the rules require disclosure in the notes to the financial statements of the effects of severe weather events and other natural conditions, subject to certain financial thresholds, as well as amounts related to carbon offsets and renewable energy credits or certificates. These rules also require disclosure of climate risk oversight practices of the Board of Directors and management, and the disclosure of governance, risk management and strategy related to material climate-related risks. In April 2024, the SEC voluntarily stayed the new rules pending the completion of judicial review. The disclosure requirements, if ultimately upheld as adopted, will begin phasing in for reports and registration statements including financial information with respect to annual periods beginning in our fiscal 2027. We are currently evaluating the impact of adoption of these final rules on our disclosures.

Revenue

Revenue	3 Months Ended
	Mar. 31, 2024
Revenue from Contract with Customer [Abstract]
Revenue	Revenue The following table presents the Company’s disaggregated revenue by offering type (in thousands): Three Months Ended 2024 2023 Total Net Revenues Percentage of Total Net Revenues Total Net Revenues Percentage of Total Net Revenues Patient Services revenue recognized at a point in time: Direct products $ 615 1.9 % $ 579 1.9 % Third-Party Payer products 1,872 5.9 % 3,408 11.2 % Patient Services revenue recognized over time: Direct rental services 3,572 11.2 % 1,869 6.2 % Third-Party Payer rental services 10,977 34.3 % 11,020 36.3 % Total Patient Services accounted for under ASC 606 17,036 53.2 % 16,876 55.6 % Device Solutions revenue recognized at a point in time: Products 4,213 13.2 % 3,740 12.3 % Services 2,409 7.5 % 2,576 8.5 % Device Solutions revenue recognized over time: Services 1,969 6.2 % 774 2.5 % Total Device Solutions accounted for under ASC 606 8,591 26.9 % 7,090 23.3 % Total Revenue Accounted for under ASC 606 25,627 80.1 % 23,966 78.9 % Patient Services lease revenue 1,555 4.9 % 1,897 6.2 % Device Solutions lease revenue 4,813 15.0 % 4,507 14.8 % Total Revenue accounted for under ASC 842, Leases 6,368 19.9 % 6,404 21.1 % Total Net Revenue $ 31,995 100.0 % $ 30,370 100.0 % Contract Balances (dollars in thousands) As of March 31, 2024 As of December 31, 2023 $ Change Accounts receivable, net $ 20,543 $ 19,830 $ 713 Contract assets $ 1,332 $ 1,271 $ 61 The change in contract assets during the three months ended March 31, 2024 was mainly due to $2.9 million of revenue recognized for which the payment is subject to conditions other than the passage of time, partially offset by $2.8 million of contract assets reclassified to accounts receivable as our right to consideration for these contract assets became unconditional. Contract assets are included in other current assets on the Company's Condensed Consolidated Balance Sheets.

Medical Equipment

Medical Equipment	3 Months Ended
	Mar. 31, 2024
Medical Equipment [Abstract]
Medical Equipment	Medical Equipment Medical equipment consisted of the following (in thousands): March 31, December 31, 2023 Medical equipment for sale or rental $ 4,113 $ 3,081 Medical equipment for sale or rental - pump reserve (29) (32) Medical equipment for sale or rental - net 4,084 3,049 Medical equipment in rental service 97,480 96,298 Medical equipment in rental service - pump reserve (2,033) (2,126) Accumulated depreciation (61,022) (59,244) Medical equipment in rental service - net 34,425 34,928 Total $ 38,509 $ 37,977 Depreciation expense for medical equipment for the three months ended March 31, 2024 was $2.3 million compared to $2.7 million for the same prior year period, respectively. This expense was recorded in “cost of revenues” for each period. The pump reserve for medical equipment in rental service represents an estimate for medical equipment that is considered to be missing. The reserve calculated is equal to the net book value of assets that have not returned from the field within a certain timeframe. For the three months ended March 31, 2024 and 2023, $2.7 million and $1.1 million of current liabilities related to non-cash purchases of medical equipment and property, respectively, had not been included in investing activities in the Condensed Consolidated Statements of Cash Flows. These amounts will be included as a cash outflow from investing activities when paid.

Property and Equipment

Property and Equipment	3 Months Ended
	Mar. 31, 2024
Property, Plant and Equipment [Abstract]
Property and Equipment	Property and Equipment Property and equipment consisted of the following (in thousands): March 31, 2024 December 31, 2023 Gross Assets Accumulated Depreciation Total Gross Assets Accumulated Depreciation Total Furniture, fixtures, and equipment $ 5,955 $ (4,094) $ 1,861 $ 6,611 $ (3,909) $ 2,702 Automobiles 87 (87) — 87 (87) — Leasehold improvements 4,442 (2,072) 2,370 3,570 (1,951) 1,619 Total $ 10,484 $ (6,253) $ 4,231 $ 10,268 $ (5,947) $ 4,321 Depreciation expense for property and equipment for both the three months ended March 31, 2024 and 2023 was $0.3 million. This expense was recorded in “general and administrative expenses” for each period.

Goodwill & Intangible Assets

Goodwill & Intangible Assets	3 Months Ended
	Mar. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill & Intangible Assets	Goodwill & Intangible Assets The changes in the carrying value of goodwill by segment for the three months ended March 31, 2024 are as follows (in thousands): Device Solutions (a) Balance as of December 31, 2023 $ 3,710 Goodwill acquired — Balance as of March 31, 2024 $ 3,710 (a) The Patient Services segment had no recorded goodwill during the reported periods. The carrying amount and accumulated amortization of intangible assets consisted of the following (in thousands): March 31, 2024 December 31, 2023 Gross Assets Accumulated Amortization Net Gross Assets Accumulated Amortization Net Nonamortizable intangible assets Trade names $ 2,000 $ — $ 2,000 $ 2,000 $ — $ 2,000 Amortizable intangible assets: Trade names 23 (23) — 23 (23) — Physician and customer relationships 38,834 (34,470) 4,364 38,834 (34,295) 4,539 Non-competition agreements 472 (279) 193 472 (255) 217 Unpatented technology 943 (426) 517 943 (393) 550 Software 10,300 (10,175) 125 10,300 (10,160) 140 Total nonamortizable and amortizable intangible assets $ 52,572 $ (45,373) $ 7,199 $ 52,572 $ (45,126) $ 7,446 Amortization expense for both the three months ended March 31, 2024 and 2023 was $0.2 million. This expense was recorded in “amortization of intangibles expenses” for each period. Expected remaining annual amortization expense for the next five years for intangible assets recorded as of March 31, 2024 is as follows (in thousands): 2024 2025 2026 2027 2028 2029 and thereafter Total Amortization expense $ 743 $ 810 $ 525 $ 471 $ 348 $ 2,302 $ 5,199

Debt

Debt	3 Months Ended
	Mar. 31, 2024
Debt Disclosure [Abstract]
Debt	Debt On February 5, 2021 , the Company entered into a Credit Agreement (the “ 2021 Credit Agreement”) with JPMorgan Chase Bank, N.A., as administrative agent (the “Agent”), sole bookrunner and sole lead arranger, and the lenders party thereto. The borrowers under the 2021 Credit Agreement are InfuSystem Holdings, Inc. and its subsidiaries (collectively, the “Borrowers”). The 2021 Credit Agreement provides for a revolving credit facility (the “Revolving Facility”) of $75.0 million, that matures on February 5, 2026. The Revolving Facility may be increased by $25.0 million, subject to certain conditions, including the consent of the Agent and obtaining necessary commitments. The lenders under the 2021 Credit Agreement may issue up to $7.0 million in letters of credit subject to the satisfaction of certain conditions. On February 5, 2021, the Borrowers made an initial borrowing of $30.0 million under the Revolving Facility. Proceeds from the loan, along with approximately $8.2 million in cash, were used to repay all amounts due under the Company’s then existing credit facility dated March 23, 2015 (the “2015 Credit Agreement”). The 2021 Credit Agreement has customary representations and warranties. The ability to borrow under the facility is subject to ongoing compliance with a number of customary affirmative and negative covenants, including limitations on indebtedness, liens, mergers, acquisitions, investments, asset sales, affiliate transactions and restricted payments, as well as financial covenants, including the following: • a minimum fixed charge coverage ratio (defined as the ratio of consolidated EBITDA (as defined in the 2021 Credit Agreement) less 50% of depreciation expense), to consolidated fixed charges (as defined in the 2021 Credit Agreement)) for the prior four most recently ended calendar quarters of 1.20 to 1.00; and • a maximum leverage ratio (defined as total indebtedness to EBITDA for the prior four most recently ended calendar quarters) of 3.50 to 1.00. The 2021 Credit Agreement includes customary events of default. The occurrence of an event of default will permit the lenders to terminate commitments to lend under the Revolving Facility and accelerate payment of all amounts outstanding thereunder. Simultaneous with the execution of the 2021 Credit Agreement, the Company entered into a Pledge and Security Agreement to secure repayment of the obligations of the Borrowers. Under the Pledge and Security Agreement, each Borrower has granted to the Agent, for the benefit of various secured parties, a first priority security interest in substantially all of the personal property assets of each of the Borrowers, including the shares of each of Holdings, ISI and First Biomedical and the equity interests of IFC. On April 26, 2023, the Company entered into a First Amendment to the 2021 Credit Agreement (the “First Amendment”) with the Agent and the lenders party thereto, which amended the 2021 Credit Agreement, to provide for, among other things: (i) an extension of the maturity date for the 2021 Credit Agreement to April 26, 2028, (ii) the replacement of London Interbank Offered Rate (“LIBOR”) with Adjusted Term Secured Overnight Financing Rate (“SOFR”) as a benchmark interest rate, and (iii) an increase of the maximum dollar amount of incremental revolving loans from $25 million to $35 million. Incremental revolving loans continue to be subject to certain conditions, including the consent of the Agent and obtaining necessary commitments. The 2021 Credit Agreement and First Amendment were accounted for as debt modifications. As of March 31, 2024, the Company was in compliance with all debt-related covenants under the 2021 Credit Agreement, as amended. The following table illustrates the net availability under the Revolving Facility as of the applicable balance sheet date (in thousands): March 31, December 31, Revolving Facility: Gross availability $ 75,000 $ 75,000 Outstanding draws (30,250) (29,439) Letter of credit (200) (200) Availability on Revolving Facility $ 44,550 $ 45,361 The Company had future maturities of its long-term debt as of March 31, 2024 as follows (in thousands): 2024 2025 2026 2027 2028 Total Revolving Facility $ — $ — $ — $ — $ 30,250 $ 30,250 Total $ — $ — $ — $ — $ 30,250 $ 30,250 The following is a breakdown of the Company’s current and long-term debt (in thousands): March 31, 2024 December 31, 2023 Current Portion Long-Term Portion Total Current Portion Long-Term Portion Total Revolving Facility $ — $ 30,250 $ 30,250 $ — $ 29,439 $ 29,439 Unamortized value of debt issuance costs — (319) (319) — (338) (338) Total $ — $ 29,931 $ 29,931 $ — $ 29,101 $ 29,101 As of March 31, 2024, amounts outstanding under the Revolving Facility provided under the 2021 Credit Agreement, as amended, bear interest at a variable rate equal to, at the Company’s election, Adjusted Term SOFR for Term Benchmark loans or an Alternative Base Rate for ABR loans, as defined by the First Amendment, plus a spread that will vary depending upon the Company’s leverage ratio. The spread ranges from 2.00% to 3.00% for Term Benchmark Loans and 1.00% to 2.00% for base rate loans. The weighted-average Term Benchmark loan rate at March 31, 2024 was 7.42% (Adjusted Term SOFR of 5.42% plus 2.00%). The actual ABR loan rate at March 31, 2024 was 9.50% (lender’s prime rate of 8.50% plus 1.00%).

Derivative Financial Instrument

Derivative Financial Instruments and Hedging Activities	3 Months Ended
	Mar. 31, 2024
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative Financial Instruments and Hedging Activities	Derivative Financial Instruments and Hedging Activities In February 2021, the Company adopted a derivative investment policy, which provides guidelines and objectives related to managing financial and operational exposures arising from market changes in short term interest rates. In accordance with this policy, the Company can enter into interest rate swaps or similar instruments, will endeavor to evaluate all the risks inherent in a transaction before entering into a derivative financial instrument and will not enter into derivative financial instruments for speculative or trading purposes. Hedging relationships are formally documented at the inception of the hedge and hedges must be highly effective in offsetting changes to future cash flows on hedged transactions at the inception of a hedge and on an ongoing basis to be designated for hedge accounting treatment. The Company is exposed to interest rate risk related to its variable rate debt obligations under the 2021 Credit Agreement. In order to manage the volatility in interest rate markets, in February 2021, the Company entered into two interest rate swap agreements to manage exposure arising from this risk. On a combined basis, the agreements had a constant notional amount over a five-year term that would have ended on February 5, 2026. While they were outstanding, each agreement paid the Company 30-day LIBOR on the notional amount and the Company paid a fixed rate of interest equal to 0.73%. These derivative instruments were considered cash flow hedges. On May 11, 2023, these two swaps were settled and a new swap was entered into with different terms that aligned with changes in the 2021 Credit Agreement arising from the First Amendment. The new swap has a constant notional amount over a five-year term that ends on April 26, 2028. The agreement pays the Company 30-day SOFR on the notional amount and the Company pays a fixed rate of interest equal to 1.74%. The Company does not have any other derivative financial instruments. The fair values of the Company’s derivative financial instruments are categorized as Level II of the fair value hierarchy as the values are derived using the market approach based on observable market inputs including quoted prices of similar instruments and interest rate forward curves. The tables below present the location and gross fair value amounts of the Company's derivative financial instruments and the associated notional amounts designated as cash flow hedges as of the applicable balance sheet date (in thousands): March 31, 2024 Balance Sheet Location Notional Fair Value Derivative Assets Derivatives designated as hedges: Cash flow hedges Interest rate swaps Derivative financial instruments $ 20,000 $ 1,716 December 31, 2023 Balance Sheet Location Notional Fair Value Derivative Assets Derivatives designated as hedges: Cash flow hedges Interest rate swaps Derivative financial instruments $ 20,000 $ 1,442 The table below presents the effect of our derivative financial instruments designated as hedging instruments in accumulated other comprehensive income (“AOCI”) (in thousands): Three Months Ended March 31, 2024 2023 Gain on cash flow hedges - interest rate swaps Beginning balance $ 1,088 $ 1,489 Unrealized gain (loss) recognized in AOCI 456 (92) Amounts reclassified to interest expense (a) (b) (182) (190) Tax (provision) benefit (66) 63 Ending balance $ 1,296 $ 1,270 (a) Negative amounts represent interest income and positive amounts represent interest expense. Interest expense as presented in the condensed consolidated statement of operations and comprehensive loss for both the three months ended March 31, 2024 and 2023 was $0.5 million. (b) As of March 31, 2024, $0.6 million of income is expected to be reclassified into earnings within the next 12 months. The Company did not incur any hedge ineffectiveness during the three months ended March 31, 2024.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2024
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes During the three months ended March 31, 2024, the Company recorded a benefit from income taxes totaling $0.2 million on pre-tax losses of $1.3 million, representing an effective tax rate of 14.3%. During the three months ended March 31, 2023, the Company recorded a benefit from income taxes totaling $0.3 million on pre-tax losses of $0.6 million, representing an effective tax rate of 48.2%. These rates differed from the U.S. statutory rate mainly due to the effects of local, state and foreign jurisdiction income taxes, limitations on the deductions of certain expenses including meals and entertainment expense and management compensation and differences between expense recognized for book purposes versus tax purposes associated with equity compensation expense. The impact of permanent differences weighs heavier on the effective tax rate when pre-tax earnings are close to break even.

Commitments, Contingencies and

Commitments, Contingencies and Litigation	3 Months Ended
	Mar. 31, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments, Contingencies and Litigation	Commitments, Contingencies and Litigation From time to time in the ordinary course of its business, the Company may be involved in legal and regulatory proceedings, the outcomes of which may not be determinable. The results of litigation and regulatory proceedings are inherently unpredictable. Any claims against the Company, whether meritorious or not, could be time consuming, result in costly litigation, require significant amounts of management time and result in diversion of significant resources. The Company is not able to estimate an aggregate amount or range of reasonably possible losses for those legal matters for which losses are not probable and estimable, primarily for the following reasons: (i) many of the relevant legal proceedings are in preliminary stages and, until such proceedings develop further, there is often uncertainty regarding the relevant facts and circumstances at issue and potential liability; and (ii) many of these proceedings involve matters of which the outcomes are inherently difficult to predict. The Company has insurance policies covering potential losses where such coverage is cost effective. The Company is not at this time involved in any proceedings that the Company currently believes could have a material effect on the Company’s financial condition, results of operations or cash flows.

Loss Per Share

Loss Per Share	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
Loss Per Share	Loss Per Share Basic loss per share is computed by dividing net loss by the weighted average number of common shares outstanding during the period. Diluted loss per share assumes the issuance of potentially dilutive shares of common stock during the period. The following table reconciles the numerators and denominators of the basic and diluted loss per share computations: Three Months Ended March 31, Numerator (in thousands) : 2024 2023 Net loss: $ (1,112) $ (324) Denominator: Weighted average common shares outstanding: Basic 21,225,768 20,853,018 Dilutive effect of common stock equivalents — — Diluted 21,225,768 20,853,018 Net loss per share: Basic $ (0.05) $ (0.02) Diluted $ (0.05) $ (0.02) For the three months ended March 31, 2024 and 2023, all outstanding options and unvested restricted stock units were anti-dilutive due to the Company's net losses for the periods and therefore not included in the calculations. Share Repurchase Program On June 30, 2021, our Board of Directors approved a stock repurchase program (the “Share Repurchase Program”) that authorizes the Company to repurchase up to $20.0 million of the Company’s outstanding common stock through June 30, 2024. Repurchases under the Share Repurchase Program are subject to market conditions, the periodic capital needs of the Company’s operating activities, and the continued satisfaction of all covenants under the Company’s existing 2021 Credit Agreement, as amended. Repurchases under the Share Repurchase Program may take place in the open market or in privately negotiated transactions and may be made under a Rule 10b5-1 plan. The Share Repurchase Program does not obligate the Company to repurchase shares and may be suspended, terminated, or modified at any time at the discretion of the Board. As of March 31, 2024, the Company had repurchased and retired approximately $6.2 million, or 553,149 shares, of the Company's outstanding common stock under the Share Repurchase Program.

Share-Based Compensation

Share-Based Compensation	3 Months Ended
	Mar. 31, 2024
Share-Based Payment Arrangement [Abstract]
Share-Based Compensation	Share-Based Compensation The following tables summarize the activity during the period under the Company's 2014 Amended and Restated Stock Incentive Plan (the "2014 Plan") and 2021 Equity Incentive Plan (the "2021 Plan"). Restricted Stock Awards Number of Weighted Unvested at December 31, 2023 529,862 $ 11.42 Granted 88,499 9.09 Vested (67,844) 17.44 Vested shares forgone to satisfy minimum statutory withholding (38,656) 17.44 Forfeitures (3,500) 13.25 Unvested at March 31, 2024 508,361 $ 9.74 Three Months Ended March 31, 2024 2023 0 Weighted average grant date fair value of awards granted $ 9.09 $ — Total fair value of shares vested $ 641,823 $ 273,994 Total fair value of shares forgone to satisfy minimum statutory withholding $ 365,697 $ 167,251 Performance-Based Restricted Stock Units ("PSU") For the three months ended March 31, 2024, there were no grants, vesting, or forfeitures of PSUs. Stock Options 2014 Plan (Options) Number Weighted- Weighted- Aggregate Outstanding at December 31, 2023 657,346 $ 6.69 4.16 $ 2,983,514 Forfeitures and expirations (500) 18.44 Outstanding at March 31, 2024 656,846 $ 6.68 3.91 $ 2,099,944 Exercisable at March 31, 2024 656,846 $ 6.68 3.91 $ 2,099,944 Aggregate Intrinsic Value = Excess of market value over the option exercise price of all in-the-money stock options. 2021 Plan (Options) Number Weighted- Weighted- Aggregate Outstanding at December 31, 2023 1,051,673 $ 11.05 8.79 $ 1,207,118 Granted 152,927 8.97 Forfeitures and expirations (31,291) 9.73 Outstanding at March 31, 2024 (a) 1,173,309 $ 10.81 8.71 $ — Exercisable at March 31, 2024 (a) 309,597 $ 14.31 7.60 $ — (a) Aggregate Intrinsic Value - no exercisable options were in-the-money as of March 31, 2024 Aggregate Intrinsic Value = Excess of market value over the option exercise price of all in-the-money stock options. The following is the average fair value per share estimated on the date of grant and the assumptions used for options granted: Three Months Ended March 31, Stock Options: 2024 Expected volatility 50% to 51% Risk free interest rate 4.25% to 4.28% Expected lives at date of grant (in years) 4.06 Weighted average fair value of options granted $3.97 Total intrinsic value of options exercised $ — For the three months ended March 31, 2023, the Company did not grant any options, and thus that time period is excluded from the table above.

Leases

Leases	3 Months Ended
	Mar. 31, 2024
Leases [Abstract]
Leases	Leases As Lessee The Company’s operating leases are primarily for office space, service facility centers and equipment under operating lease arrangements that expire at various dates over the next seven years. The Company’s leases do not contain any restrictive covenants. The Company’s office leases generally contain renewal options for periods ranging from one 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 consist of sales taxes, property taxes and other fees. The components of lease costs for the three months ended March 31, 2024 and 2023 are as follows (in thousands): Three Months Ended 2024 2023 Operating lease cost $ 473 $ 352 Variable lease cost 75 76 Total lease cost $ 548 $ 428 Supplemental cash flow information and non-cash activity related to the Company’s leases are as follows (in thousands): Three Months Ended 2024 2023 Cash paid for amounts included in the measurement of lease liabilities and right of use assets: Operating cash flow from operating leases $ 530 $ 449 Right of use assets obtained in exchange for lease obligations: Operating leases $ — $ 381 Increases to right of use assets resulting from lease modifications: Operating leases $ — $ 160 Weighted average remaining lease terms and discount rates for the Company’s operating leases are as follows: As of March 31, 2024 2023 Years Years Weighted average remaining lease term: 6.0 6.2 Rate Rate Weighted average discount rate: 7.8% 7.0% Future maturities of lease liabilities as of March 31, 2024 are as follows (in thousands): Operating Leases 2024 $ 1,309 2025 1,837 2026 1,654 2027 1,478 2028 1,429 2029 and thereafter 2,424 Total undiscounted lease payments 10,131 Less: Imputed interest (3,266) Total lease liabilities $ 6,865 The long-term portion of the lease liabilities included in the amounts above is $5.3 million with the remainder included in other current liabilities in the Condensed Consolidated Balance Sheet. As Lessor: We lease medical equipment to customers, often in conjunction with arrangements to provide consumable medical products. Certain of our equipment leases are classified as sales-type leases and the remainder are operating leases. The terms of the related contracts, including the proportion of fixed versus variable payments and any options, varies by customer. The Company elected the “combining lease and non-lease components” practical expedient for all qualifying non-lease components. The components of the Company’s lease revenues consisted of the following (in thousands): Three Months Ended March 31, 2024 2023 Net operating lease revenue $ 6,111 $ 5,910 Sales-type lease revenue 257 494 Total lease revenue $ 6,368 $ 6,404 The components of our net investment in sales-type leases as of March 31, 2024 and December 31, 2023 were (in thousands): March 31, December 31, Lease receivable $ 2,531 $ 2,583 Net investment in leases $ 2,531 $ 2,583 Our net investment in sales-type leases is classified as follows in the accompanying condensed consolidated balance sheets as of March 31, 2024 and December 31, 2023 were (in thousands): March 31, December 31, Accounts receivable, net $ 1,061 $ 1,067 Other assets 1,470 1,516 Total $ 2,531 $ 2,583 Future maturities of sales-type leases as of March 31, 2024 are as follows (in thousands): Sales-Type Leases 2024 $ 985 2025 1,292 2026 614 2027 12 2028 — Thereafter — Total undiscounted lease payments 2,903 Less: Imputed interest (372) Total lease receivables $ 2,531
Leases	Leases As Lessee The Company’s operating leases are primarily for office space, service facility centers and equipment under operating lease arrangements that expire at various dates over the next seven years. The Company’s leases do not contain any restrictive covenants. The Company’s office leases generally contain renewal options for periods ranging from one 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 consist of sales taxes, property taxes and other fees. The components of lease costs for the three months ended March 31, 2024 and 2023 are as follows (in thousands): Three Months Ended 2024 2023 Operating lease cost $ 473 $ 352 Variable lease cost 75 76 Total lease cost $ 548 $ 428 Supplemental cash flow information and non-cash activity related to the Company’s leases are as follows (in thousands): Three Months Ended 2024 2023 Cash paid for amounts included in the measurement of lease liabilities and right of use assets: Operating cash flow from operating leases $ 530 $ 449 Right of use assets obtained in exchange for lease obligations: Operating leases $ — $ 381 Increases to right of use assets resulting from lease modifications: Operating leases $ — $ 160 Weighted average remaining lease terms and discount rates for the Company’s operating leases are as follows: As of March 31, 2024 2023 Years Years Weighted average remaining lease term: 6.0 6.2 Rate Rate Weighted average discount rate: 7.8% 7.0% Future maturities of lease liabilities as of March 31, 2024 are as follows (in thousands): Operating Leases 2024 $ 1,309 2025 1,837 2026 1,654 2027 1,478 2028 1,429 2029 and thereafter 2,424 Total undiscounted lease payments 10,131 Less: Imputed interest (3,266) Total lease liabilities $ 6,865 The long-term portion of the lease liabilities included in the amounts above is $5.3 million with the remainder included in other current liabilities in the Condensed Consolidated Balance Sheet. As Lessor: We lease medical equipment to customers, often in conjunction with arrangements to provide consumable medical products. Certain of our equipment leases are classified as sales-type leases and the remainder are operating leases. The terms of the related contracts, including the proportion of fixed versus variable payments and any options, varies by customer. The Company elected the “combining lease and non-lease components” practical expedient for all qualifying non-lease components. The components of the Company’s lease revenues consisted of the following (in thousands): Three Months Ended March 31, 2024 2023 Net operating lease revenue $ 6,111 $ 5,910 Sales-type lease revenue 257 494 Total lease revenue $ 6,368 $ 6,404 The components of our net investment in sales-type leases as of March 31, 2024 and December 31, 2023 were (in thousands): March 31, December 31, Lease receivable $ 2,531 $ 2,583 Net investment in leases $ 2,531 $ 2,583 Our net investment in sales-type leases is classified as follows in the accompanying condensed consolidated balance sheets as of March 31, 2024 and December 31, 2023 were (in thousands): March 31, December 31, Accounts receivable, net $ 1,061 $ 1,067 Other assets 1,470 1,516 Total $ 2,531 $ 2,583 Future maturities of sales-type leases as of March 31, 2024 are as follows (in thousands): Sales-Type Leases 2024 $ 985 2025 1,292 2026 614 2027 12 2028 — Thereafter — Total undiscounted lease payments 2,903 Less: Imputed interest (372) Total lease receivables $ 2,531
Leases	Leases As Lessee The Company’s operating leases are primarily for office space, service facility centers and equipment under operating lease arrangements that expire at various dates over the next seven years. The Company’s leases do not contain any restrictive covenants. The Company’s office leases generally contain renewal options for periods ranging from one 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 consist of sales taxes, property taxes and other fees. The components of lease costs for the three months ended March 31, 2024 and 2023 are as follows (in thousands): Three Months Ended 2024 2023 Operating lease cost $ 473 $ 352 Variable lease cost 75 76 Total lease cost $ 548 $ 428 Supplemental cash flow information and non-cash activity related to the Company’s leases are as follows (in thousands): Three Months Ended 2024 2023 Cash paid for amounts included in the measurement of lease liabilities and right of use assets: Operating cash flow from operating leases $ 530 $ 449 Right of use assets obtained in exchange for lease obligations: Operating leases $ — $ 381 Increases to right of use assets resulting from lease modifications: Operating leases $ — $ 160 Weighted average remaining lease terms and discount rates for the Company’s operating leases are as follows: As of March 31, 2024 2023 Years Years Weighted average remaining lease term: 6.0 6.2 Rate Rate Weighted average discount rate: 7.8% 7.0% Future maturities of lease liabilities as of March 31, 2024 are as follows (in thousands): Operating Leases 2024 $ 1,309 2025 1,837 2026 1,654 2027 1,478 2028 1,429 2029 and thereafter 2,424 Total undiscounted lease payments 10,131 Less: Imputed interest (3,266) Total lease liabilities $ 6,865 The long-term portion of the lease liabilities included in the amounts above is $5.3 million with the remainder included in other current liabilities in the Condensed Consolidated Balance Sheet. As Lessor: We lease medical equipment to customers, often in conjunction with arrangements to provide consumable medical products. Certain of our equipment leases are classified as sales-type leases and the remainder are operating leases. The terms of the related contracts, including the proportion of fixed versus variable payments and any options, varies by customer. The Company elected the “combining lease and non-lease components” practical expedient for all qualifying non-lease components. The components of the Company’s lease revenues consisted of the following (in thousands): Three Months Ended March 31, 2024 2023 Net operating lease revenue $ 6,111 $ 5,910 Sales-type lease revenue 257 494 Total lease revenue $ 6,368 $ 6,404 The components of our net investment in sales-type leases as of March 31, 2024 and December 31, 2023 were (in thousands): March 31, December 31, Lease receivable $ 2,531 $ 2,583 Net investment in leases $ 2,531 $ 2,583 Our net investment in sales-type leases is classified as follows in the accompanying condensed consolidated balance sheets as of March 31, 2024 and December 31, 2023 were (in thousands): March 31, December 31, Accounts receivable, net $ 1,061 $ 1,067 Other assets 1,470 1,516 Total $ 2,531 $ 2,583 Future maturities of sales-type leases as of March 31, 2024 are as follows (in thousands): Sales-Type Leases 2024 $ 985 2025 1,292 2026 614 2027 12 2028 — Thereafter — Total undiscounted lease payments 2,903 Less: Imputed interest (372) Total lease receivables $ 2,531

Business Segment Information

Business Segment Information	3 Months Ended
	Mar. 31, 2024
Segment Reporting [Abstract]
Business Segment Information	Business Segment Information The Company’s reportable segments are organized based on service platforms, with the Patient Services segment reflecting higher margin rental revenues that generally include payments made by third-party and direct payers and the Device Solutions segment reflecting lower margin product sales, direct payer rental and service revenues. Resources are allocated and performance is assessed for these segments by the Company’s Chief Executive Officer, whom the Company has determined to be its chief operating decision-maker. The Company believes that reporting performance at the gross profit level is the best indicator of segment performance. The financial information summarized below is presented by reportable segment for the three months ended March 31, 2024 and 2023: 2024 (in thousands) Patient Services Device Solutions Corporate/ Eliminations Total Net revenues - external $ 18,591 $ 13,404 $ — $ 31,995 Net revenues - internal — 1,713 (1,713) — Total net revenues 18,591 15,117 (1,713) 31,995 Gross profit 12,274 4,200 — 16,474 Selling, general and administrative expenses 17,319 Interest expense (456) Other income 3 Loss before income taxes $ (1,298) Total assets $ 57,996 $ 44,854 $ 2,000 $ 104,850 Purchases of medical equipment $ 350 $ 1,143 $ — $ 1,493 Depreciation and amortization of intangible assets $ 1,856 $ 1,044 $ — $ 2,900 2023 (in thousands) Patient Services Device Solutions Corporate/ Eliminations Total Net revenues - external $ 18,774 $ 11,596 $ — $ 30,370 Net revenues - internal — 1,630 (1,630) — Total net revenues 18,774 13,226 (1,630) 30,370 Gross profit 11,541 3,409 — 14,950 Selling, general and administrative expenses 15,057 Interest expense (484) Other expense (35) Loss before income taxes $ (626) Total assets $ 62,769 $ 37,492 $ 2,000 $ 102,261 Purchases of medical equipment $ 2,673 $ 1,295 $ — $ 3,968 Depreciation and amortization of intangible assets $ 2,178 $ 1,025 $ — $ 3,203

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ (1,112)	$ (324)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Mar. 31, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Revenue (Tables)

Revenue (Tables)	3 Months Ended
	Mar. 31, 2024
Revenue from Contract with Customer [Abstract]
Schedule of the Company’s Disaggregated Revenue	The following table presents the Company’s disaggregated revenue by offering type (in thousands): Three Months Ended 2024 2023 Total Net Revenues Percentage of Total Net Revenues Total Net Revenues Percentage of Total Net Revenues Patient Services revenue recognized at a point in time: Direct products $ 615 1.9 % $ 579 1.9 % Third-Party Payer products 1,872 5.9 % 3,408 11.2 % Patient Services revenue recognized over time: Direct rental services 3,572 11.2 % 1,869 6.2 % Third-Party Payer rental services 10,977 34.3 % 11,020 36.3 % Total Patient Services accounted for under ASC 606 17,036 53.2 % 16,876 55.6 % Device Solutions revenue recognized at a point in time: Products 4,213 13.2 % 3,740 12.3 % Services 2,409 7.5 % 2,576 8.5 % Device Solutions revenue recognized over time: Services 1,969 6.2 % 774 2.5 % Total Device Solutions accounted for under ASC 606 8,591 26.9 % 7,090 23.3 % Total Revenue Accounted for under ASC 606 25,627 80.1 % 23,966 78.9 % Patient Services lease revenue 1,555 4.9 % 1,897 6.2 % Device Solutions lease revenue 4,813 15.0 % 4,507 14.8 % Total Revenue accounted for under ASC 842, Leases 6,368 19.9 % 6,404 21.1 % Total Net Revenue $ 31,995 100.0 % $ 30,370 100.0 %
Schedule of Accounts, Notes, Loans and Financing Receivable	(dollars in thousands) As of March 31, 2024 As of December 31, 2023 $ Change Accounts receivable, net $ 20,543 $ 19,830 $ 713 Contract assets $ 1,332 $ 1,271 $ 61

Medical Equipment (Tables)

Medical Equipment (Tables)	3 Months Ended
	Mar. 31, 2024
Medical Equipment [Abstract]
Schedule of Medical Equipment	Medical equipment consisted of the following (in thousands): March 31, December 31, 2023 Medical equipment for sale or rental $ 4,113 $ 3,081 Medical equipment for sale or rental - pump reserve (29) (32) Medical equipment for sale or rental - net 4,084 3,049 Medical equipment in rental service 97,480 96,298 Medical equipment in rental service - pump reserve (2,033) (2,126) Accumulated depreciation (61,022) (59,244) Medical equipment in rental service - net 34,425 34,928 Total $ 38,509 $ 37,977

Property and Equipment (Tables)

Property and Equipment (Tables)	3 Months Ended
	Mar. 31, 2024
Property, Plant and Equipment [Abstract]
Schedule of Property, Plant and Equipment	Property and equipment consisted of the following (in thousands): March 31, 2024 December 31, 2023 Gross Assets Accumulated Depreciation Total Gross Assets Accumulated Depreciation Total Furniture, fixtures, and equipment $ 5,955 $ (4,094) $ 1,861 $ 6,611 $ (3,909) $ 2,702 Automobiles 87 (87) — 87 (87) — Leasehold improvements 4,442 (2,072) 2,370 3,570 (1,951) 1,619 Total $ 10,484 $ (6,253) $ 4,231 $ 10,268 $ (5,947) $ 4,321

Goodwill & Intangible Assets (T

Goodwill & Intangible Assets (Tables)	3 Months Ended
	Mar. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Goodwill	The changes in the carrying value of goodwill by segment for the three months ended March 31, 2024 are as follows (in thousands): Device Solutions (a) Balance as of December 31, 2023 $ 3,710 Goodwill acquired — Balance as of March 31, 2024 $ 3,710 (a) The Patient Services segment had no recorded goodwill during the reported periods.
Schedule of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets	The carrying amount and accumulated amortization of intangible assets consisted of the following (in thousands): March 31, 2024 December 31, 2023 Gross Assets Accumulated Amortization Net Gross Assets Accumulated Amortization Net Nonamortizable intangible assets Trade names $ 2,000 $ — $ 2,000 $ 2,000 $ — $ 2,000 Amortizable intangible assets: Trade names 23 (23) — 23 (23) — Physician and customer relationships 38,834 (34,470) 4,364 38,834 (34,295) 4,539 Non-competition agreements 472 (279) 193 472 (255) 217 Unpatented technology 943 (426) 517 943 (393) 550 Software 10,300 (10,175) 125 10,300 (10,160) 140 Total nonamortizable and amortizable intangible assets $ 52,572 $ (45,373) $ 7,199 $ 52,572 $ (45,126) $ 7,446
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense	Expected remaining annual amortization expense for the next five years for intangible assets recorded as of March 31, 2024 is as follows (in thousands): 2024 2025 2026 2027 2028 2029 and thereafter Total Amortization expense $ 743 $ 810 $ 525 $ 471 $ 348 $ 2,302 $ 5,199

Debt (Tables)

Debt (Tables)	3 Months Ended
	Mar. 31, 2024
Debt Disclosure [Abstract]
Schedule of Line of Credit Facilities	The following table illustrates the net availability under the Revolving Facility as of the applicable balance sheet date (in thousands): March 31, December 31, Revolving Facility: Gross availability $ 75,000 $ 75,000 Outstanding draws (30,250) (29,439) Letter of credit (200) (200) Availability on Revolving Facility $ 44,550 $ 45,361
Schedule of Maturities of Long-term Debt	The Company had future maturities of its long-term debt as of March 31, 2024 as follows (in thousands): 2024 2025 2026 2027 2028 Total Revolving Facility $ — $ — $ — $ — $ 30,250 $ 30,250 Total $ — $ — $ — $ — $ 30,250 $ 30,250
Schedule of Debt	The following is a breakdown of the Company’s current and long-term debt (in thousands): March 31, 2024 December 31, 2023 Current Portion Long-Term Portion Total Current Portion Long-Term Portion Total Revolving Facility $ — $ 30,250 $ 30,250 $ — $ 29,439 $ 29,439 Unamortized value of debt issuance costs — (319) (319) — (338) (338) Total $ — $ 29,931 $ 29,931 $ — $ 29,101 $ 29,101

Derivative Financial Instrume_2

Derivative Financial Instruments and Hedging Activities (Tables)	3 Months Ended
	Mar. 31, 2024
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Derivative Instruments in Statement of Financial Position, Fair Value	The tables below present the location and gross fair value amounts of the Company's derivative financial instruments and the associated notional amounts designated as cash flow hedges as of the applicable balance sheet date (in thousands): March 31, 2024 Balance Sheet Location Notional Fair Value Derivative Assets Derivatives designated as hedges: Cash flow hedges Interest rate swaps Derivative financial instruments $ 20,000 $ 1,716 December 31, 2023 Balance Sheet Location Notional Fair Value Derivative Assets Derivatives designated as hedges: Cash flow hedges Interest rate swaps Derivative financial instruments $ 20,000 $ 1,442
Schedule of Derivative Instruments, Effect on AOCI	The table below presents the effect of our derivative financial instruments designated as hedging instruments in accumulated other comprehensive income (“AOCI”) (in thousands): Three Months Ended March 31, 2024 2023 Gain on cash flow hedges - interest rate swaps Beginning balance $ 1,088 $ 1,489 Unrealized gain (loss) recognized in AOCI 456 (92) Amounts reclassified to interest expense (a) (b) (182) (190) Tax (provision) benefit (66) 63 Ending balance $ 1,296 $ 1,270 (a) Negative amounts represent interest income and positive amounts represent interest expense. Interest expense as presented in the condensed consolidated statement of operations and comprehensive loss for both the three months ended March 31, 2024 and 2023 was $0.5 million. (b) As of March 31, 2024, $0.6 million of income is expected to be reclassified into earnings within the next 12 months.

Loss Per Share (Tables)

Loss Per Share (Tables)	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
Schedule of Loss Per Share, Basic and Diluted	The following table reconciles the numerators and denominators of the basic and diluted loss per share computations: Three Months Ended March 31, Numerator (in thousands) : 2024 2023 Net loss: $ (1,112) $ (324) Denominator: Weighted average common shares outstanding: Basic 21,225,768 20,853,018 Dilutive effect of common stock equivalents — — Diluted 21,225,768 20,853,018 Net loss per share: Basic $ (0.05) $ (0.02) Diluted $ (0.05) $ (0.02)

Share-Based Compensation (Table

Share-Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2024
Share-Based Payment Arrangement [Abstract]
Schedule of Restricted Share Activity, Excluding Company's Employee Stock Purchase Plan	Number of Weighted Unvested at December 31, 2023 529,862 $ 11.42 Granted 88,499 9.09 Vested (67,844) 17.44 Vested shares forgone to satisfy minimum statutory withholding (38,656) 17.44 Forfeitures (3,500) 13.25 Unvested at March 31, 2024 508,361 $ 9.74 Three Months Ended March 31, 2024 2023 0 Weighted average grant date fair value of awards granted $ 9.09 $ — Total fair value of shares vested $ 641,823 $ 273,994 Total fair value of shares forgone to satisfy minimum statutory withholding $ 365,697 $ 167,251
Schedule of Share-based Payment Arrangement, Option, Activity	2014 Plan (Options) Number Weighted- Weighted- Aggregate Outstanding at December 31, 2023 657,346 $ 6.69 4.16 $ 2,983,514 Forfeitures and expirations (500) 18.44 Outstanding at March 31, 2024 656,846 $ 6.68 3.91 $ 2,099,944 Exercisable at March 31, 2024 656,846 $ 6.68 3.91 $ 2,099,944 Aggregate Intrinsic Value = Excess of market value over the option exercise price of all in-the-money stock options. 2021 Plan (Options) Number Weighted- Weighted- Aggregate Outstanding at December 31, 2023 1,051,673 $ 11.05 8.79 $ 1,207,118 Granted 152,927 8.97 Forfeitures and expirations (31,291) 9.73 Outstanding at March 31, 2024 (a) 1,173,309 $ 10.81 8.71 $ — Exercisable at March 31, 2024 (a) 309,597 $ 14.31 7.60 $ — (a) Aggregate Intrinsic Value - no exercisable options were in-the-money as of March 31, 2024
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions	The following is the average fair value per share estimated on the date of grant and the assumptions used for options granted: Three Months Ended March 31, Stock Options: 2024 Expected volatility 50% to 51% Risk free interest rate 4.25% to 4.28% Expected lives at date of grant (in years) 4.06 Weighted average fair value of options granted $3.97 Total intrinsic value of options exercised $ —

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2024
Leases [Abstract]
Schedule of the Components of Lease Costs	The components of lease costs for the three months ended March 31, 2024 and 2023 are as follows (in thousands): Three Months Ended 2024 2023 Operating lease cost $ 473 $ 352 Variable lease cost 75 76 Total lease cost $ 548 $ 428 Supplemental cash flow information and non-cash activity related to the Company’s leases are as follows (in thousands): Three Months Ended 2024 2023 Cash paid for amounts included in the measurement of lease liabilities and right of use assets: Operating cash flow from operating leases $ 530 $ 449 Right of use assets obtained in exchange for lease obligations: Operating leases $ — $ 381 Increases to right of use assets resulting from lease modifications: Operating leases $ — $ 160 Weighted average remaining lease terms and discount rates for the Company’s operating leases are as follows: As of March 31, 2024 2023 Years Years Weighted average remaining lease term: 6.0 6.2 Rate Rate Weighted average discount rate: 7.8% 7.0%
Schedule of Future Maturities of Lease Liabilities	Future maturities of lease liabilities as of March 31, 2024 are as follows (in thousands): Operating Leases 2024 $ 1,309 2025 1,837 2026 1,654 2027 1,478 2028 1,429 2029 and thereafter 2,424 Total undiscounted lease payments 10,131 Less: Imputed interest (3,266) Total lease liabilities $ 6,865
Schedule of Leases Revenues	The components of the Company’s lease revenues consisted of the following (in thousands): Three Months Ended March 31, 2024 2023 Net operating lease revenue $ 6,111 $ 5,910 Sales-type lease revenue 257 494 Total lease revenue $ 6,368 $ 6,404
Schedule of Net Investment in Sales-Type Leases	The components of our net investment in sales-type leases as of March 31, 2024 and December 31, 2023 were (in thousands): March 31, December 31, Lease receivable $ 2,531 $ 2,583 Net investment in leases $ 2,531 $ 2,583 Our net investment in sales-type leases is classified as follows in the accompanying condensed consolidated balance sheets as of March 31, 2024 and December 31, 2023 were (in thousands): March 31, December 31, Accounts receivable, net $ 1,061 $ 1,067 Other assets 1,470 1,516 Total $ 2,531 $ 2,583
Schedule of Future Maturities of Sales-Type Leases	Future maturities of sales-type leases as of March 31, 2024 are as follows (in thousands): Sales-Type Leases 2024 $ 985 2025 1,292 2026 614 2027 12 2028 — Thereafter — Total undiscounted lease payments 2,903 Less: Imputed interest (372) Total lease receivables $ 2,531

Business Segment Information (T

Business Segment Information (Tables)	3 Months Ended
	Mar. 31, 2024
Segment Reporting [Abstract]
Schedule of Segment Reporting Information, by Segment	The financial information summarized below is presented by reportable segment for the three months ended March 31, 2024 and 2023: 2024 (in thousands) Patient Services Device Solutions Corporate/ Eliminations Total Net revenues - external $ 18,591 $ 13,404 $ — $ 31,995 Net revenues - internal — 1,713 (1,713) — Total net revenues 18,591 15,117 (1,713) 31,995 Gross profit 12,274 4,200 — 16,474 Selling, general and administrative expenses 17,319 Interest expense (456) Other income 3 Loss before income taxes $ (1,298) Total assets $ 57,996 $ 44,854 $ 2,000 $ 104,850 Purchases of medical equipment $ 350 $ 1,143 $ — $ 1,493 Depreciation and amortization of intangible assets $ 1,856 $ 1,044 $ — $ 2,900 2023 (in thousands) Patient Services Device Solutions Corporate/ Eliminations Total Net revenues - external $ 18,774 $ 11,596 $ — $ 30,370 Net revenues - internal — 1,630 (1,630) — Total net revenues 18,774 13,226 (1,630) 30,370 Gross profit 11,541 3,409 — 14,950 Selling, general and administrative expenses 15,057 Interest expense (484) Other expense (35) Loss before income taxes $ (626) Total assets $ 62,769 $ 37,492 $ 2,000 $ 102,261 Purchases of medical equipment $ 2,673 $ 1,295 $ — $ 3,968 Depreciation and amortization of intangible assets $ 2,178 $ 1,025 $ — $ 3,203

Basis of Presentation and Nat_2

Basis of Presentation and Nature of Operations (Details)	3 Months Ended
	Mar. 31, 2024 segment
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of reportable segments	2
Number of operating segments	2

Revenue - Disaggregated Revenue

Revenue - Disaggregated Revenue by Revenue Stream (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Disaggregation of Revenue [Line Items]
Lease revenue	$ 6,368	$ 6,404
Total net revenues	31,995	30,370
Patient Services
Disaggregation of Revenue [Line Items]
Revenues	17,036	16,876
Lease revenue	1,555	1,897
Device Solutions
Disaggregation of Revenue [Line Items]
Lease revenue	4,813	4,507
Device Solutions | Transferred over Time
Disaggregation of Revenue [Line Items]
Revenues	8,591	7,090
Patient Services And Device Solutions
Disaggregation of Revenue [Line Items]
Revenues	25,627	23,966
Lease revenue	6,368	6,404
Product Sales | Patient Services | Transferred at Point in Time
Disaggregation of Revenue [Line Items]
Revenues	615	579
Product Sales | Device Solutions | Transferred at Point in Time
Disaggregation of Revenue [Line Items]
Revenues	4,213	3,740
Third-Party Payer Rentals | Patient Services | Transferred at Point in Time
Disaggregation of Revenue [Line Items]
Revenues	1,872	3,408
Third-Party Payer Rentals | Patient Services | Transferred over Time
Disaggregation of Revenue [Line Items]
Revenues	10,977	11,020
Direct Payer Rentals | Patient Services | Transferred over Time
Disaggregation of Revenue [Line Items]
Revenues	3,572	1,869
Service | Device Solutions | Transferred at Point in Time
Disaggregation of Revenue [Line Items]
Revenues	2,409	2,576
Service | Device Solutions | Transferred over Time
Disaggregation of Revenue [Line Items]
Revenues	$ 1,969	$ 774
Revenue from Contract with Customer Benchmark | Customer Concentration Risk | Patient Services
Disaggregation of Revenue [Line Items]
Percentage of total net revenues	53.20%	55.60%
Revenue from Contract with Customer Benchmark | Customer Concentration Risk | Device Solutions | Transferred over Time
Disaggregation of Revenue [Line Items]
Percentage of total net revenues	26.90%	23.30%
Revenue from Contract with Customer Benchmark | Customer Concentration Risk | Patient Services And Device Solutions
Disaggregation of Revenue [Line Items]
Percentage of total net revenues	80.10%	78.90%
Revenue from Contract with Customer Benchmark | Customer Concentration Risk | Product Sales | Patient Services | Transferred at Point in Time
Disaggregation of Revenue [Line Items]
Percentage of total net revenues	1.90%	1.90%
Revenue from Contract with Customer Benchmark | Customer Concentration Risk | Product Sales | Device Solutions | Transferred at Point in Time
Disaggregation of Revenue [Line Items]
Percentage of total net revenues	13.20%	12.30%
Revenue from Contract with Customer Benchmark | Customer Concentration Risk | Third-Party Payer Rentals | Patient Services | Transferred at Point in Time
Disaggregation of Revenue [Line Items]
Percentage of total net revenues	5.90%	11.20%
Revenue from Contract with Customer Benchmark | Customer Concentration Risk | Third-Party Payer Rentals | Patient Services | Transferred over Time
Disaggregation of Revenue [Line Items]
Percentage of total net revenues	34.30%	36.30%
Revenue from Contract with Customer Benchmark | Customer Concentration Risk | Direct Payer Rentals | Patient Services | Transferred over Time
Disaggregation of Revenue [Line Items]
Percentage of total net revenues	11.20%	6.20%
Revenue from Contract with Customer Benchmark | Customer Concentration Risk | Service | Device Solutions | Transferred at Point in Time
Disaggregation of Revenue [Line Items]
Percentage of total net revenues	7.50%	8.50%
Revenue from Contract with Customer Benchmark | Customer Concentration Risk | Service | Device Solutions | Transferred over Time
Disaggregation of Revenue [Line Items]
Percentage of total net revenues	6.20%	2.50%
Revenue Benchmark | Customer Concentration Risk
Disaggregation of Revenue [Line Items]
Percentage of total net revenues	100%	100%
Revenue Benchmark | Customer Concentration Risk | Patient Services
Disaggregation of Revenue [Line Items]
Percentage of total net revenues	4.90%	6.20%
Revenue Benchmark | Customer Concentration Risk | Device Solutions
Disaggregation of Revenue [Line Items]
Percentage of total net revenues	15%	14.80%
Revenue Benchmark | Customer Concentration Risk | Patient Services And Device Solutions
Disaggregation of Revenue [Line Items]
Percentage of total net revenues	19.90%	21.10%

Revenue - Contract Balances (De

Revenue - Contract Balances (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Disaggregation of Revenue [Line Items]
Accounts receivable, net	$ 20,543	$ 19,830
Contract assets	1,332	$ 1,271
Revision of Prior Period, Adjustment
Disaggregation of Revenue [Line Items]
Accounts receivable, net	713
Contract assets	$ 61

Revenue - Narrative (Details)

Revenue - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Disaggregation of Revenue [Line Items]
Contract assets	$ 1,332	$ 1,271
Other Current Assets
Disaggregation of Revenue [Line Items]
Contract assets partially offset amount	2,800
Revision of Prior Period, Adjustment
Disaggregation of Revenue [Line Items]
Contract assets	61
Revision of Prior Period, Adjustment | Other Current Assets
Disaggregation of Revenue [Line Items]
Contract assets	$ 2,900

Medical Equipment - Summary of

Medical Equipment - Summary of Medical Equipment (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Medical Equipment [Abstract]
Medical equipment for sale or rental	$ 4,113	$ 3,081
Medical equipment for sale or rental - pump reserve	(29)	(32)
Medical equipment for sale or rental - net	4,084	3,049
Medical equipment in rental service	97,480	96,298
Medical equipment in rental service - pump reserve	(2,033)	(2,126)
Accumulated depreciation	(61,022)	(59,244)
Medical equipment in rental service - net	34,425	34,928
Total	$ 38,509	$ 37,977

Medical Equipment - Narrative (

Medical Equipment - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Medical Equipment [Abstract]
Depreciation expense related to medical equipment	$ 2.3	$ 2.7
Non-cash purchases of medical equipment	$ 2.7	$ 1.1

Property and Equipment - Schedu

Property and Equipment - Schedule of Property and Equipment (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Property, Plant and Equipment [Line Items]
Gross Assets	$ 10,484	$ 10,268
Accumulated Depreciation	(6,253)	(5,947)
Total	4,231	4,321
Furniture, fixtures, and equipment
Property, Plant and Equipment [Line Items]
Gross Assets	5,955	6,611
Accumulated Depreciation	(4,094)	(3,909)
Total	1,861	2,702
Automobiles
Property, Plant and Equipment [Line Items]
Gross Assets	87	87
Accumulated Depreciation	(87)	(87)
Total	0	0
Leasehold improvements
Property, Plant and Equipment [Line Items]
Gross Assets	4,442	3,570
Accumulated Depreciation	(2,072)	(1,951)
Total	$ 2,370	$ 1,619

Property and Equipment - Narrat

Property and Equipment - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Property, Plant and Equipment [Abstract]
Depreciation	$ 0.3	$ 0.3

Goodwill & Intangible Assets -

Goodwill & Intangible Assets - Goodwill (Details)	3 Months Ended
	Mar. 31, 2024 USD ($)
Goodwill [Roll Forward]
Goodwill, beginning balance	$ 3,710,000
Goodwill, ending balance	3,710,000
Device Solutions
Goodwill [Roll Forward]
Goodwill, beginning balance	3,710,000
Goodwill acquired	0
Goodwill, ending balance	3,710,000
Patient Services
Goodwill [Roll Forward]
Goodwill, ending balance	$ 0

Goodwill & Intangible Assets _2

Goodwill & Intangible Assets - Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Goodwill [Line Items]
Trade names	$ 2,000	$ 2,000
Accumulated Amortization	(45,373)	(45,126)
Total	5,199
Total nonamortizable and amortizable intangible assets	52,572	52,572
Net	7,199	7,446
Trade names
Goodwill [Line Items]
Gross Assets	23	23
Accumulated Amortization	(23)	(23)
Total	0	0
Physician and customer relationships
Goodwill [Line Items]
Gross Assets	38,834	38,834
Accumulated Amortization	(34,470)	(34,295)
Total	4,364	4,539
Non-competition agreements
Goodwill [Line Items]
Gross Assets	472	472
Accumulated Amortization	(279)	(255)
Total	193	217
Unpatented technology
Goodwill [Line Items]
Gross Assets	943	943
Accumulated Amortization	(426)	(393)
Total	517	550
Software
Goodwill [Line Items]
Gross Assets	10,300	10,300
Accumulated Amortization	(10,175)	(10,160)
Total	$ 125	$ 140

Goodwill & Intangible Assets _3

Goodwill & Intangible Assets - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization of intangible assets	$ 248	$ 248

Goodwill & Intangible Assets _4

Goodwill & Intangible Assets - Expected Annual Amortization Expense for Intangible Assets (Details) $ in Thousands	Mar. 31, 2024 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
2024	$ 743
2025	810
2026	525
2027	471
2028	348
2029 and thereafter	2,302
Total	$ 5,199

Debt - Narrative (Details)

Debt - Narrative (Details)		3 Months Ended
	Feb. 05, 2021 USD ($)	Mar. 31, 2024	Apr. 26, 2023 USD ($)	Apr. 25, 2023 USD ($)
The 2021 Credit Agreement
Debt Instrument [Line Items]
Percentage of total depreciation expense	50%
Debt instrument, covenant, minimum fixed coverage ratio	1.20
Debt instrument, covenant, maximum leverage ratio	3.50
The 2021 Credit Agreement | Term Benchmark Loans
Debt Instrument [Line Items]
Effective percentage		7.42%
LIBOR rate		5.42%
The 2021 Credit Agreement | ABR Loans
Debt Instrument [Line Items]
Effective percentage		9.50%
The 2021 Credit Agreement | Secured Overnight Financing Rate (SOFR) | Term Benchmark Loans
Debt Instrument [Line Items]
Basis spread on variable rate		2%
The 2021 Credit Agreement | Base Rate | ABR Loans
Debt Instrument [Line Items]
Basis spread on variable rate		1%
The 2021 Credit Agreement | Minimum | Secured Overnight Financing Rate (SOFR) | Term Benchmark Loans
Debt Instrument [Line Items]
Basis spread on variable rate		2%
The 2021 Credit Agreement | Minimum | Base Rate | ABR Loans
Debt Instrument [Line Items]
Basis spread on variable rate		1%
Lender prime rate		8.50%
The 2021 Credit Agreement | Maximum | Secured Overnight Financing Rate (SOFR) | Term Benchmark Loans
Debt Instrument [Line Items]
Basis spread on variable rate		3%
The 2021 Credit Agreement | Maximum | Base Rate | ABR Loans
Debt Instrument [Line Items]
Basis spread on variable rate		2%
The 2021 Credit Agreement | Revolving Facility
Debt Instrument [Line Items]
Line of credit facility	$ 75,000,000
Revolving credit facility	25,000,000		$ 35,000,000	$ 25,000,000
Borrowings under revolving credit facility	30,000,000
The 2021 Credit Agreement | Letter of credit
Debt Instrument [Line Items]
Line of credit facility	7,000,000
The 2015 Credit Agreement | Revolving Facility
Debt Instrument [Line Items]
Repayments	$ 8,200,000

Debt - Summary of Revolver Base

Debt - Summary of Revolver Based Upon Borrowers' Eligible Accounts Receivable and Inventory (Details) - Revolving Facility - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Gross availability	$ 75,000	$ 75,000
Outstanding draws	(30,250)	(29,439)
Letter of credit	(200)	(200)
Availability on Revolving Facility	$ 44,550	$ 45,361

Debt - Summary of Future Maturi

Debt - Summary of Future Maturities of Loans (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
2024	$ 0
2025	0
2026	0
2027	0
2028	30,250
Total	30,250
Revolving Facility
Debt Instrument [Line Items]
2024	0
2025	0
2026	0
2027	0
2028	30,250
Total	$ 30,250	$ 29,439

Debt - Summary of Company's Cur

Debt - Summary of Company's Current and Long-term Debt (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Total	$ 30,250
Unamortized value of the debt issuance costs, current portion of long-term debt	0	$ 0
Unamortized value of the debt issuance costs, long-term debt	(319)	(338)
Unamortized value of the debt issuance costs, total	(319)	(338)
Current portion of long-term debt	0	0
Long-term debt	29,931	29,101
Total	29,931	29,101
Revolving Facility
Debt Instrument [Line Items]
Current Portion	0	0
Long-Term Portion	30,250	29,439
Total	$ 30,250	$ 29,439

Derivative Financial Instrume_3

Derivative Financial Instruments and Hedging Activities - Narrative (Details) - Interest rate swaps - Derivatives designated as hedges: - Cash flow hedges			3 Months Ended
	May 11, 2023 agreement	Feb. 05, 2021 agreement	Mar. 31, 2024 USD ($)
Derivative [Line Items]
Interest rate swap | agreement	2	2
Term of contract (year)	5 years	5 years
Fixed interest rate	1.74%	0.73%
Net hedge effectiveness | $			$ 0

Derivative Financial Instrume_4

Derivative Financial Instruments and Hedging Activities - Fair Value and Notional Amounts of Cash Flow Hedges (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Derivative [Line Items]
Fair Value Derivative Assets	$ 1,716	$ 1,442
Cash flow hedges | Interest rate swaps | Derivatives designated as hedges:
Derivative [Line Items]
Notional	20,000	20,000
Fair Value Derivative Assets	$ 1,716	$ 1,442

Derivative Financial Instrume_5

Derivative Financial Instruments and Hedging Activities - Derivative Financial Instruments Designated as Hedging Instruments in AOCI (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Derivatives used in Net Investment Hedge, Net of Tax [Roll Forward]
Beginning balance	$ 52,302	$ 48,003
Ending balance	52,276	48,261
Interest expense	456	484
Interest rate swaps | Cash flow hedges | Derivatives designated as hedges:
Derivatives used in Net Investment Hedge, Net of Tax [Roll Forward]
Reclassified within twelve months	600
Gain/(loss) on cash flow hedges
Derivatives used in Net Investment Hedge, Net of Tax [Roll Forward]
Beginning balance	1,088	1,489
Unrealized gain (loss) recognized in AOCI	456	(92)
Amounts reclassified to interest expense	(182)	(190)
Tax (provision) benefit	(66)	63
Ending balance	$ 1,296	$ 1,270

Income Taxes - Narrative (Detai

Income Taxes - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Income Tax Disclosure [Abstract]
Income tax expense (benefit)	$ (186)	$ (302)
Loss before income taxes	$ (1,298)	$ (626)
Effective income tax rate reconciliation, percent	14.30%	48.20%

Loss Per Share - Calculation of

Loss Per Share - Calculation of Basic and Diluted EPS (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Earnings Per Share [Abstract]
Net loss:	$ (1,112)	$ (324)
Weighted average common shares outstanding:
Basic (in shares)	21,225,768	20,853,018
Dilutive effect of common stock equivalents (in shares)	0	0
Diluted (in shares)	21,225,768	20,853,018
Basic (in dollars per share)	$ (0.05)	$ (0.02)
Diluted (in dollars per share)	$ (0.05)	$ (0.02)

Loss Per Share - Narrative (Det

Loss Per Share - Narrative (Details) - USD ($)	Mar. 31, 2024	Jun. 30, 2021
Earnings Per Share [Abstract]
Stock repurchase program, authorized amount		$ 20,000,000
Cumulative shares purchased	$ 6,200,000
Cumulative shares purchased (in shares)	553,149

Share-Based Compensation - Summ

Share-Based Compensation - Summary of Restricted Share Activity, Excluding Company's Employee Stock Purchase Plan (Details) - Restricted Stock - USD ($)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Number of shares
Unvested, number of shares (in shares)	529,862
Granted, number of shares (in shares)	88,499
Vested, number of shares (in shares)	(67,844)
Vested shares forgone to satisfy minimum statutory withholding, number of shares (in shares)	(38,656)
Forfeitures, number of shares (in shares)	(3,500)
Unvested, number of shares (in shares)	508,361
Weighted average grant date fair value
Unvested, weighted average grant date fair value (usd per share)	$ 11.42
Granted, weighted average grant date fair value (usd per share)	9.09	$ 0
Vested, weighted average grant date fair value (usd per share)	17.44
Vested shares forgone to satisfy minimum statutory withholding, weighted average grant date fair value (usd per share)	17.44
Forfeitures, weighted average grant date fair value (usd per share)	13.25
Unvested, weighted average grant date fair value (usd per share)	$ 9.74
Total fair value of shares vested	$ 641,823	$ 273,994
Total fair value of shares forgone to satisfy minimum statutory withholding	$ 365,697	$ 167,251

Share-Based Compensation - Sche

Share-Based Compensation - Schedule of Share-based Payment Arrangement, Option, Activity (Details) - USD ($)	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
2014 Equity Incentive Plan
Number of Authorized Shares
Outstanding, number of authorized shares (in shares)	657,346
Forfeitures and expirations (in shares)	(500)
Outstanding, number of authorized shares (in shares)	656,846	657,346
Exercisable, number of authorized shares (in shares)	656,846
Weighted- Average Exercise Price
Outstanding, weighted average exercise price (usd per share)	$ 6.69
Forfeitures and expirations (usd per share)	18.44
Outstanding, weighted average exercise price (usd per share)	6.68	$ 6.69
Exercisable, weighted average exercise price (usd per share)	$ 6.68
Options, Additional Disclosures
Outstanding, Weighted average remaining contractual term	3 years 10 months 28 days	4 years 1 month 28 days
Exercisable, Weighted average remaining contractual term	3 years 10 months 28 days
Outstanding, Aggregate Intrinsic Value	$ 2,099,944	$ 2,983,514
Exercisable, Aggregate Intrinsic Value	$ 2,099,944
2021 Equity Incentive Plan
Number of Authorized Shares
Outstanding, number of authorized shares (in shares)	1,051,673
Granted (in shares)	152,927
Forfeitures and expirations (in shares)	(31,291)
Outstanding, number of authorized shares (in shares)	1,173,309	1,051,673
Exercisable, number of authorized shares (in shares)	309,597
Weighted- Average Exercise Price
Outstanding, weighted average exercise price (usd per share)	$ 11.05
Granted (usd per share)	8.97
Forfeitures and expirations (usd per share)	9.73
Outstanding, weighted average exercise price (usd per share)	10.81	$ 11.05
Exercisable, weighted average exercise price (usd per share)	$ 14.31
Options, Additional Disclosures
Outstanding, Weighted average remaining contractual term	8 years 8 months 15 days	8 years 9 months 14 days
Exercisable, Weighted average remaining contractual term	7 years 7 months 6 days
Outstanding, Aggregate Intrinsic Value	$ 0	$ 1,207,118
Exercisable, Aggregate Intrinsic Value	$ 0

Share-Based Compensation - Sc_2

Share-Based Compensation - Schedule of Share-based Compensation Expense Based on Fair Value of Options (Details) - Stock Options	3 Months Ended
	Mar. 31, 2024 USD ($) $ / shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected volatility rate, minimum	50%
Expected volatility rate, maximum	51%
Risk free interest rate, minimum	4.25%
Risk free interest rate, maximum	4.28%
Expected lives at date of grant (in years)	4 years 21 days
Weighted average fair value of options granted (usd per share) | $ / shares	$ 3.97
Total intrinsic value of options exercised | $	$ 0

Leases - Narrative (Details)

Leases - Narrative (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Lessee, Lease, Description [Line Items]
Operating lease, term of contract	7 years
Operating lease liabilities, net of current portion	$ 5,331	$ 5,799
Minimum | Office Leases With Renewal Options Not Reasonably Certain to Exercise
Lessee, Lease, Description [Line Items]
Lessee, operating lease, renewal term (year)	1 year
Maximum | Office Leases With Renewal Options Not Reasonably Certain to Exercise
Lessee, Lease, Description [Line Items]
Lessee, operating lease, renewal term (year)	5 years

Leases - Lease Cost (Details)

Leases - Lease Cost (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Leases [Abstract]
Operating lease cost	$ 473	$ 352
Variable lease cost	75	76
Total lease cost	548	428
Operating cash flow from operating leases	530	449
Operating leases	0	381
Increases to right of use assets resulting from lease modifications, operating lease	$ 0	$ 160
Weighted average remaining lease term:	6 years	6 years 2 months 12 days
Weighted average discount rate:	7.80%	7%

Leases - Maturities of Lease Li

Leases - Maturities of Lease Liabilities (Details) $ in Thousands	Mar. 31, 2024 USD ($)
Leases [Abstract]
2024	$ 1,309
2025	1,837
2026	1,654
2027	1,478
2028	1,429
2029 and thereafter	2,424
Total undiscounted lease payments	10,131
Less: Imputed interest	(3,266)
Total lease liabilities	$ 6,865

Leases - Lease Revenue (Details

Leases - Lease Revenue (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Leases [Abstract]
Net operating lease revenue	$ 6,111	$ 5,910
Sales-type lease revenue	257	494
Total lease revenue	$ 6,368	$ 6,404

Leases - Net Investment in Sale

Leases - Net Investment in Sales-Type Leases (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Leases [Abstract]
Lease receivable	$ 2,531	$ 2,583
Net investment in leases	$ 2,531	$ 2,583

Leases - Net Investment in Sa_2

Leases - Net Investment in Sales-Type Leases in Balance Sheet (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023	Mar. 31, 2023
Sales-Type Lease, Net Investment In Lease [Line Items]
Total assets	$ 104,850	$ 102,915	$ 102,261
Sales-Type Lease, Net Investment
Sales-Type Lease, Net Investment In Lease [Line Items]
Accounts receivable, net	1,061	1,067
Other assets	1,470	1,516
Total assets	$ 2,531	$ 2,583

Leases - Maturities of Sale-Typ

Leases - Maturities of Sale-Type Leases (Details) $ in Thousands	Mar. 31, 2024 USD ($)
Leases [Abstract]
2024	$ 985
2025	1,292
2026	614
2027	12
2028	0
Thereafter	0
Total undiscounted lease payments	2,903
Less: Imputed interest	(372)
Total lease receivables	$ 2,531

Business Segment Information -

Business Segment Information - Segment Reporting Information, by Segment (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Segment Reporting Information [Line Items]
Net revenues - external	$ 31,995	$ 30,370
Net revenues - internal	0	0
Total net revenues	31,995	30,370
Gross profit	16,474	14,950
Selling, general and administrative expenses	17,319	15,057
Interest expense	(456)	(484)
Other income (expense)	3	(35)
Loss before income taxes	(1,298)	(626)
Total assets	104,850	102,261	$ 102,915
Purchases of medical equipment	1,493	3,968
Depreciation and amortization of intangible assets	2,900	3,203
Corporate and Eliminations
Segment Reporting Information [Line Items]
Net revenues - external	0	0
Net revenues - internal	(1,713)	(1,630)
Total net revenues	(1,713)	(1,630)
Gross profit	0	0
Total assets	2,000	2,000
Purchases of medical equipment	0	0
Depreciation and amortization of intangible assets	0	0
Patient Services | Operating Segments
Segment Reporting Information [Line Items]
Net revenues - external	18,591	18,774
Net revenues - internal	0	0
Total net revenues	18,591	18,774
Gross profit	12,274	11,541
Total assets	57,996	62,769
Purchases of medical equipment	350	2,673
Depreciation and amortization of intangible assets	1,856	2,178
Device Solutions | Operating Segments
Segment Reporting Information [Line Items]
Net revenues - external	13,404	11,596
Net revenues - internal	1,713	1,630
Total net revenues	15,117	13,226
Gross profit	4,200	3,409
Total assets	44,854	37,492
Purchases of medical equipment	1,143	1,295
Depreciation and amortization of intangible assets	$ 1,044	$ 1,025