National Research (NRC) 10-K 3 Mar 23 2022 FY Annual report Financial data

Document And Entity Information

Document And Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2022	Feb. 23, 2023	Jun. 30, 2022
Document Information [Line Items]
Entity Central Index Key	0000070487
Entity Registrant Name	National Research Corporation
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Document Fiscal Period Focus	FY
Document Fiscal Year Focus	2022
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2022
Document Transition Report	false
Entity File Number	001-35929
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	47-0634000
Entity Address, Address Line One	1245 Q Street
Entity Address, City or Town	Lincoln
Entity Address, State or Province	NE
Entity Address, Postal Zip Code	68508
City Area Code	402
Local Phone Number	475-2525
Title of 12(b) Security	Common Stock, $.001 par value
Trading Symbol	NRC
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Entity Shell Company	false
Entity Public Float			$ 444,018,792
Entity Common Stock, Shares Outstanding		24,594,390
Auditor Name	KPMG LLP
Auditor Firm ID	1997
Auditor Location	Lincoln, Nebraska

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 25,026	$ 54,361
Trade accounts receivable, less allowance for doubtful accounts of $65 and $94, respectively	14,461	13,728
Prepaid expenses	2,386	3,884
Income taxes receivable	733	752
Other current assets	1,110	982
Total current assets	43,716	73,707
Net property and equipment	17,248	12,391
Intangible assets, net	1,611	1,790
Goodwill, Ending Balance	61,614	61,614
Operating lease right-of-use assets	556	975
Deferred contract costs, net	2,441	3,772
Deferred income taxes	14	14
Other	3,261	3,277
Total assets	130,461	157,540
Current liabilities:
Current portion of notes payable, net of unamortized debt issuance costs	4,491	4,278
Accounts payable	1,153	1,943
Accrued wages and bonuses	4,551	7,139
Accrued expenses	3,983	5,450
Dividends payable	2,956	3,044
Deferred revenue	15,198	17,213
Other current liabilities	1,085	1,321
Total current liabilities	33,417	40,388
Notes payable, net of current portion and unamortized debt issuance costs	17,690	22,269
Deferred income taxes	5,274	7,002
Other long-term liabilities	2,047	2,544
Total liabilities	58,428	72,203
Shareholders’ equity:
Preferred stock, $0.01 par value, authorized 2,000,000 shares, none issued	0	0
Common stock, $0.001 par value; authorized 110,000,000 shares, issued 30,922,181 in 2022 and 30,898,600 in 2021, outstanding 24,628,173 in 2022 and 25,361,409 in 2021	31	31
Additional paid-in capital	175,453	173,942
Retained earnings (accumulated deficit)	(25,184)	(36,112)
Accumulated other comprehensive loss, foreign currency translation adjustment		(2,375)
Treasury stock, at cost; 6,294,008 Common shares in 2022 and 5,537,191 Common shares in 2021	(78,267)	(50,149)
Total shareholders’ equity	72,033	85,337
Total liabilities and shareholders’ equity	$ 130,461	$ 157,540

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parentheticals) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Allowance for doubtful accounts	$ 65	$ 94
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	2,000,000	2,000,000
Preferred stock, shares issued (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	110,000,000	110,000,000
Common stock, shares issued (in shares)	30,922,181	30,898,600
Common stock, shares outstanding (in shares)	24,628,173	25,361,409
Treasury stock, shares (in shares)	6,294,008	5,537,191

Consolidated Statements of Inco

Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Revenue	$ 151,568	$ 147,954	$ 133,277
Insurance recoveries			533
Operating expenses:
Direct	57,049	52,350	49,187
Selling, general and administrative	42,699	38,960	34,441
Depreciation, amortization and impairment	5,277	6,374	7,505
Total operating expenses	105,025	97,684	91,133
Operating income	46,543	50,270	42,677
Other income (expense):
Interest income	168	14	18
Interest expense	(1,209)	(1,667)	(1,813)
Reclassification of cumulative foreign currency translation adjustment into earnings	(2,569)
Other, net	(118)	4	585
Total other income (expense)	(3,728)	(1,649)	(1,210)
Income before income taxes	42,815	48,621	41,467
Provision for income taxes	11,015	11,155	4,207
Net income	$ 31,800	$ 37,466	$ 37,260
Earnings per share of common stock:
Basic earnings per share (in dollars per share)	$ 1.28	$ 1.47	$ 1.48
Diluted earnings per share (in dollars per share)	$ 1.27	$ 1.46	$ 1.45
Weighted average shares and share equivalents outstanding
Basic (in shares)	24,922	25,422	25,170
Diluted (in shares)	25,052	25,640	25,696

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Net income	$ 31,800	$ 37,466	$ 37,260
Other comprehensive income (loss):
Other comprehensive loss, foreign currency translation adjustment	(194)	24	(190)
Reclassification of cumulative foreign currency translation adjustment into earnings	2,569	0	0
Other comprehensive income (loss)	2,375	24	(190)
Comprehensive income	$ 34,175	$ 37,490	$ 37,070

Consolidated Statements of Shar

Consolidated Statements of Shareholders' Equity - USD ($) $ in Thousands	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	AOCI Attributable to Parent [Member]	Treasury Stock [Member]	Total
Balances at Dec. 31, 2019	$ 30	$ 162,154	$ (93,357)	$ (2,209)	$ (33,726)	$ 32,892
Purchase of shares treasury stock	0	0	0	0	(10,001)	(10,001)
Issuance of common shares for the exercise of stock options	1	8,951	0	0	0	8,952
Forfeiture of restricted common shares	0	0	0	0	0	0
Non-cash stock compensation expense	0	680	0	0	0	680
Dividends declared	0	0	(5,278)	0	0	(5,278)
Other comprehensive loss, foreign currency translation adjustment	0	0	0	(190)	0	(190)
Net income	0	0	37,260	0	0	37,260
Reclassification of cumulative foreign currency translation adjustment into earnings						0
Balances at Dec. 31, 2020	31	171,785	(61,375)	(2,399)	(43,727)	64,315
Purchase of shares treasury stock	0	0	0	0	(6,422)	(6,422)
Issuance of common shares for the exercise of stock options	0	1,534	0	0	0	1,534
Non-cash stock compensation expense	0	623	0	0	0	623
Dividends declared	0	0	(12,203)	0	0	(12,203)
Other comprehensive loss, foreign currency translation adjustment	0	0	0	24	0	24
Net income	0	0	37,466	0	0	37,466
Reclassification of cumulative foreign currency translation adjustment into earnings						0
Balances at Dec. 31, 2021	31	173,942	(36,112)	(2,375)	(50,149)	85,337
Purchase of shares treasury stock	0	0	0	0	(28,118)	(28,118)
Issuance of common shares for the exercise of stock options	0	311	0	0	0	311
Non-cash stock compensation expense	0	1,200	0	0	0	1,200
Dividends declared	0	0	(20,872)	0	0	(20,872)
Other comprehensive loss, foreign currency translation adjustment	0	0	0	(194)	0	(194)
Net income	0	0	31,800	0	0	31,800
Reclassification of cumulative foreign currency translation adjustment into earnings	0	0	0	$ 2,569	0	2,569
Balances at Dec. 31, 2022	$ 31	$ 175,453	$ (25,184)		$ (78,267)	$ 72,033

Consolidated Statements of Sh_2

Consolidated Statements of Shareholders' Equity (Parentheticals) - $ / shares	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Purchase of shares of treasury stock (in shares)	756,817	153,005	180,112
Shares of common stock for the exercise of stock options (in shares)	23,581	116,753	630,373
Issuance of restricted common shares, net of forfeitures (in shares)			6,793
Dividends declared per common share (in dollars per share)	$ 0.84	$ 0.48	$ 0.21

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Cash flows from operating activities:
Net income	$ 31,800,000	$ 37,466,000	$ 37,260,000
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation, amortization and impairment	5,277,000	6,374,000	7,505,000
Reclassification of cumulative translation adjustment into earnings	2,569,000
Deferred income taxes	(1,729,000)	(277,000)	(134,000)
Reserve for uncertain tax positions	488,000	310,000	185,000
Gain on insurance recoveries for damaged property			(260,000)
Loss on disposal of property and equipment	11,000	7,000	12,000
Non-cash share-based compensation expense	1,200,000	623,000	680,000
Change in assets and liabilities:
Trade accounts receivable	(733,000)	343,000	(2,271,000)
Prepaid expenses and other current and long-term assets	1,634,000	(842,000)	(827,000)
Operating lease assets and liability, net	(39,000)	(34,000)	16,000
Deferred contract costs, net	1,331,000	783,000	(351,000)
Accounts payable	(589,000)	4,000	(247,000)
Accrued expenses, wages and bonuses	(2,947,000)	(285,000)	1,370,000
Income taxes receivable and payable	6,000	484,000	(1,529,000)
Deferred revenue	(2,014,000)	1,388,000	(773,000)
Net cash provided by operating activities	36,265,000	46,344,000	40,636,000
Cash flows from investing activities:
Purchases of property and equipment	(9,835,000)	(5,514,000)	(3,984,000)
Acquisition consideration		(3,000,000)
Insurance proceeds for damaged property			260,000
Net cash used in investing activities	(9,835,000)	(8,514,000)	(3,724,000)
Cash flows from financing activities:
Payments on notes payable	(4,305,000)	(4,093,000)	(3,568,000)
Payment of debt issuance costs	(92,000)		(36,000)
Payments on finance lease obligations	(469,000)	(493,000)	(332,000)
Proceeds from the exercise of stock options	0	446,000	1,734,000
Payment of payroll tax withholdings on share-based awards exercised	(190,000)	(721,000)	(2,784,000)
Payment of deferred acquisition consideration	(1,950,000)
Repurchase of shares for treasury	(27,616,000)	(4,142,000)
Payment of dividends on common stock	(20,961,000)	(9,159,000)	(10,517,000)
Net cash used in financing activities	(55,583,000)	(18,162,000)	(15,503,000)
Effect of exchange rate changes on cash	(182,000)	3,000	(236,000)
Net increase (decrease) in cash and cash equivalents	(29,335,000)	19,671,000	21,173,000
Cash and cash equivalents at beginning of period	54,361,000	34,690,000	13,517,000
Cash and cash equivalents at end of period	25,026,000	54,361,000	34,690,000
Supplemental disclosure of cash paid for:
Interest expense, net of capitalized amounts	1,342,000	1,554,000	1,735,000
Income taxes	12,233,000	10,644,000	5,217,000
Supplemental disclosure of non-cash investing and financing activities:
Finance lease obligations originated for property and equipment		40,000	817,000
Purchase of property and equipment in accounts payable and accrued expenses	1,109,000	979,000	127,000
Stock tendered to the Company for cashless exercise of stock options in connection with equity incentive plans	$ 311,000	1,088,000	$ 7,217,000
Deferred acquisition consideration		$ 1,950,000

Note 1 - Summary of Significant

Note 1 - Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2022
Notes to Financial Statements
Significant Accounting Policies [Text Block]	( 1 Summary of Significant Accounting Policies Description of Business and Basis of Presentation National Research Corporation, doing business as NRC Health (“NRC Health,” the “Company,” “we,” “our,” “us” or similar terms), is a leading provider of analytics and insights that facilitate measurement and improvement of the patient and employee experience while also increasing patient engagement and customer loyalty for healthcare organizations in the United States. Our purpose is to humanize healthcare and support organizations in their understanding of each person they serve not Principles of Consolidation The consolidated financial statements include the accounts of the Company and our wholly-owned subsidiary, National Research Corporation Canada. All significant intercompany transactions and balances have been eliminated. Use of Estimates The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make certain estimates and assumptions that affect the reported amounts of assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting period. Actual results could differ from those estimates. Translation of Foreign Currencies Gains and losses related to transactions denominated in a currency other than the functional currency of the country in which we operate and short-term intercompany accounts are included in other income (expense) in the consolidated statements of income. Our Canadian subsidiary uses Canadian dollars as its functional currency. We translate its assets and liabilities into U.S. dollars at the exchange rate in effect at the balance sheet date. We translate its revenue and expenses at the average exchange rate during the period. We included foreign currency translation gains and losses in accumulated other comprehensive income (loss), a component of shareholders’ equity. During December 2022, Revenue Recognition We derive a majority of our revenues from our annually renewable subscription-based service agreements with our customers, which include performance measurement and improvement services, healthcare analytics and governance education services. Such agreements are generally cancelable on short or no 3 ● Identify the contract, or contracts, with a customer; ● Identify the performance obligations in the contract; ● Determine the transaction price; ● Allocate the transaction price to the identified performance obligations; and ● Recognize revenue when, or as, we satisfy the performance obligations. Our revenue arrangements with a client may one may one one not not Our arrangements with customers consist principally of four 1 2 one 3 4 Subscription-based services - twelve may One-time services one Fixed, non-subscription services Unit-price services Revenue is presented net of any sales tax charged to our clients that we are required to remit to taxing authorities. We recognize contract assets or unbilled receivables related to revenue recognized for services completed but not Deferred Contract Costs Deferred contract costs, net is stated at gross deferred costs less accumulated amortization. We defer commissions and incentives, including payroll taxes, if they are incremental and recoverable costs of obtaining a renewable customer contract. Deferred contract costs are amortized over the estimated term of the contract, including renewals, which generally ranges from three five one December 31, 2022, 2021 2020, December 31, 2022 2021, 2021 December 31, 2022, 2021 2020 2022 2021 2020 (In thousands) Direct expenses $ 146 $ 157 $ 272 Selling, general and administrative expenses $ 1,625 $ 2,494 $ 2,970 Total amortization $ 1,771 $ 2,651 $ 3,242 Additional expense included in selling, general and administrative expenses for impairment of costs capitalized due to lost clients was $14,000, $31,000 and $63,000 for the years December 31, 2022, 2021 2020, Trade Accounts Receivable The allowance for doubtful accounts is our best estimate of the amount of probable credit losses in our existing accounts receivable, determined based on our historical write-off experience, current economic conditions and reasonable and supportable forecasts about the future. We review the allowance for doubtful accounts monthly. Account balances are charged off against the allowance after all means of collection have been exhausted and the potential for recovery is considered remote. The following table provides the activity in the allowance for doubtful accounts for the years ended December 31, 2022, 2021 2020 Balance at Beginning of Year Bad Debt Expense Write-offs, net of Recoveries Balance at End of Year Year Ended December 31, 2020 $ 144 $ 46 $ 70 $ 120 Year Ended December 31, 2021 $ 120 $ 38 $ 64 $ 94 Year Ended December 31, 2022 $ 94 $ 19 $ 48 $ 65 Property and Equipment Property and equipment is stated at cost. Major expenditures to purchase property or to substantially increase useful lives of property are capitalized. Maintenance, repairs and minor renewals are expensed as incurred. When assets are retired or otherwise disposed of, their costs and related accumulated depreciation are removed from the accounts and resulting gains or losses are included in income. We capitalize 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 projects and external direct costs of materials and services. Capitalization of such costs ceases when the project is substantially complete and ready for its intended purpose. Costs incurred during the preliminary project and post-implementation stages, as well as software maintenance and training costs are expensed as incurred. We capitalized approximately $3.6 million, $2.8 million and $2.7 million of costs incurred for the development of internal-use software for the years ended December 31, 2022, 2021 2020, When a software license is included in a cloud computing arrangement and we have the legal right, ability and feasibility to download the software, it is accounted for as software, included in property and equipment, and amortized. If a software license is not not We provide for depreciation and amortization of property and equipment using annual rates which are sufficient to amortize the cost of depreciable assets over their estimated useful lives. We use the straight-line method of depreciation and amortization over estimated useful lives of two ten three five one five seven forty Impairment of Long-Lived Assets and Amortizing Intangible Assets Long-lived assets, such as property and equipment and purchased intangible assets subject to depreciation or amortization, are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not first not third December 31, 2022, 2021, 2020. Among others, management believes the following circumstances are important indicators of potential impairment of such assets and as a result may ● Significant underperformance in comparison to historical or projected operating results; ● Significant changes in the manner or use of acquired assets or our overall strategy; ● Significant negative trends in our industry or the overall economy; ● A significant decline in the market price for our common stock for a sustained period; and ● Our market capitalization falling below the book value of our net assets. Goodwill and Intangible Assets Intangible assets include customer relationships, trade names, technology, and goodwill. Intangible assets with estimable useful lives are amortized over their respective estimated useful lives to their estimated residual values and reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of the assets may not October 1 may not When performing the impairment assessment, we will first not not 2022, 2021 2020. Goodwill is an asset representing the future economic benefits arising from other assets acquired in a business combination that are not October 1, may not We review goodwill for impairment by first may not October 1, 2022 December 31, 2022 2021. September 2022, December 2020 not September 2022. September 2022. December 31, 2020. In March 2021, six one one no 19 not not not December 31, 2022. Insurance Recoveries We record insurance recoveries when the realization of the claim is probable. In 2020 February 2020 ( “February February not 2020, Income Taxes We use the asset and liability method of accounting for income taxes. Under that method, deferred income tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax basis using enacted tax rates. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. Valuation allowances, if any, are established when necessary to reduce deferred tax assets to the amount that is more likely than not December 31, 2022, 2021, 2020, We recognize the effect of income tax positions only if those positions are more likely than not 50% In 2021, 2019 12, 740 no Share-Based Compensation All of our existing stock option awards and non-vested stock awards have been determined to be equity-classified awards. The compensation expense on share-based payments is recognized based on the grant-date fair value of those awards. We recognize the excess tax benefits and tax deficiencies in the income statement when options are exercised. Amounts recognized in the financial statements with respect to these plans are as follows: 2022 2021 2020 (In thousands) Amounts charged against income, before income tax benefit $ 1,200 $ 623 $ 680 Amount of related income tax benefit (436 ) (919 ) (6,764 ) Net (benefit) expense to net income $ 764 $ (296 ) $ (6,084 ) We refer to our restricted stock awards as “non-vested” stock in these consolidated financial statements. Cash and Cash Equivalents We consider all highly liquid investments with original maturities of three December 31, 2022, 2021, may Leases We determine whether a lease is included in an agreement at inception. We recognize a lease liability and a right-of-use (“ROU”) asset on the balance sheet for our operating leases under which we are lessee. Operating lease ROU assets are included in operating lease right-of-use assets in our consolidated balance sheet. Finance lease assets are included in property and equipment. Operating and finance lease liabilities are included in other current liabilities and other long-term liabilities. Certain lease arrangements may not ROU assets represent our right to use an underlying asset for the lease term and lease liabilities represent our obligation to make lease payments during the lease term. ROU assets and lease liabilities are recorded at lease commencement based on the estimated present value of lease payments. Because the rate of interest implicit in each lease is not Due to remote working arrangements, we reassessed our office needs and subleased our Seattle location under an agreement considered to be an operating lease beginning in May 2021. not 2021 no 2022 2020. Fair Value Measurements Our valuation techniques are based on maximizing observable inputs and minimizing the use of unobservable inputs when measuring fair value. Observable inputs reflect readily obtainable data from independent sources, while unobservable inputs reflect our market assumptions. The inputs are then classified into the following hierarchy: ( 1 1 2 2 1 not 3 3 The following details our financial assets within the fair value hierarchy at December 31, 2022 2021: Level 1 Level 2 Level 3 Total (In thousands) As of December 31, 2022 Money Market Funds $ 24,927 $ — $ — $ 24,927 Total Cash Equivalents $ 24,927 $ — $ — $ 24,927 As of December 31, 2021 Money Market Funds $ 6,306 $ — $ — $ 6,306 Total Cash Equivalents $ 6,306 $ — $ — $ 6,306 There were no December 31, 2022 2021. Our long-term debt described in Note 8 2 The following are the carrying amount and estimated fair values of long-term debt: December 31, 2022 December 31, 2021 (In thousands) Total carrying amount of long-term debt $ 22,315 $ 26,620 Estimated fair value of long-term debt $ 21,668 $ 27,708 The carrying amounts of accounts receivable, accounts payable, and accrued expenses approximate their fair value. All non-financial assets that are not 3 2021. December 31, 2022 2021, December 31, 2020. 3 Commitments and Contingencies not December 31, 2022 We are self-insured for group medical and dental insurance. We carry excess loss coverage in the amount of $150,000 per covered person per year for group medical insurance. We do not not 2022, 2021 2020, not third December 31, 2022 2021, Earnings Per Share Basic net income per share was computed using the weighted-average number of common shares outstanding during the period. Diluted net income per share was computed using the weighted-average number of common shares and, if dilutive, the potential common shares outstanding during the period. Potential common shares consist of the incremental common shares issuable upon the exercise of stock options and vesting of restricted stock. The dilutive effect of outstanding stock options is reflected in diluted earnings per share by application of the treasury stock method. We had 83,070, 127,185 and 65,127 options of Common Stock for the years ended December 31, 2022, 2021 2020, 2022 2021 2020 (In thousands, except per share data) Numerator for net income per share - basic: Net income $ 31,800 $ 37,466 $ 37,260 Allocation of distributed and undistributed income to unvested restricted stock shareholders (16 ) (18 ) (57 ) Net income attributable to common shareholders $ 31,784 $ 37,448 $ 37,203 Denominator for net income per share - basic: Weighted average common shares outstanding – basic 24,922 25,422 25,170 Net income per share – basic $ 1.28 $ 1.47 $ 1.48 Numerator for net income per share - diluted: Net income attributable to common shareholders for basic computation $ 31,784 $ 37,448 $ 37,203 Denominator for net income per share - diluted: Weighted average common s 24,922 25,422 25,170 Weighted average effect of dilutive securities – stock options 130 218 526 Denominator for diluted earnings per share – adjusted weighted average shares 25,052 25,640 25,696 Net income per share – diluted $ 1.27 $ 1.46 $ 1.45

Note 2 - Acquisition

Note 2 - Acquisition	12 Months Ended
	Dec. 31, 2022
Notes to Financial Statements
Business Combination Disclosure [Text Block]	( 2 ACQUISITION On January 4, 2021, January 2022. Amount of Identified Assets Acquired and Liabilities Assumed ($ in thousands) Current Assets $ 184 Property and equipment 10 Customer related 100 Technology 600 Goodwill 4,340 Total assets acquired $ 5,234 Current liabilities 284 Net assets acquired $ 4,950 The identifiable intangible assets are being amortized over their estimated useful lives of 5 years. The goodwill and identifiable intangible assets are deductible for tax purposes. Goodwill related to the acquisition was primarily attributable to anticipated synergies and other intangibles that do not The financial results associated with the PatientWisdom assets we acquired and liabilities we assumed are included in our consolidated financial statements from the date of acquisition, although the amounts are insignificant for 2022 2021. not 2021 December 31, 2021.

Note 3 - Contracts With Custome

Note 3 - Contracts With Customers	12 Months Ended
	Dec. 31, 2022
Notes to Financial Statements
Revenue from Contract with Customer [Text Block]	( 3 Contracts with Customers The following table disaggregates revenue for the years ended December 31, 2022, 2021 2020 2022 2021 2020 Subscription services recognized ratably over time $ 141,981 $ 137,008 $ 122,499 Services recognized at a point in time 4,231 3,216 2,932 Fixed, non-subscription recognized over time 3,134 3,065 2,907 Unit price services recognized over time 2,222 4,665 4,939 Total revenue $ 151,568 $ 147,954 $ 133,277 The following table provides information about receivables, contract assets, and contract liabilities from contracts with customers (In thousands): December 31, 2022 December 31, 2021 Accounts receivables $ 14,461 $ 13,728 Contract assets included in other current assets $ 102 $ 99 Deferred revenue $ 15,198 $ 17,213 Significant changes in contract assets and contract liabilities during the years ended December 31, 2022 2021 2022 2021 Contract Asset Deferred Revenue Contract Asset Deferred Revenue Increase (Decrease) Revenue recognized that was included in deferred revenue at beginning of year due to completion of services $ - $ (17,170 ) $ - $ (15,631 ) Increases due to invoicing of client, net of amounts recognized as revenue - 15,081 - 16,694 Decreases due to completion of services (or portion of services) and transferred to accounts receivable (99 ) - (311 ) - Change due to cumulative catch-up adjustments arising from changes in expected contract consideration - 74 - 326 Increases due to revenue recognized in the period with additional performance obligations before invoicing 102 - 99 - We have elected to apply the practical expedient to not one one December 31, 2022 2023, 2024, 2025,

Note 4 - Equity Investments

Note 4 - Equity Investments	12 Months Ended
	Dec. 31, 2022
Notes to Financial Statements
Investment [Text Block]	( 4 Equity Investments We make equity investments to promote business and strategic objectives. For investments that do not not not not

Note 5 - Property and Equipment

Note 5 - Property and Equipment	12 Months Ended
	Dec. 31, 2022
Notes to Financial Statements
Property, Plant and Equipment Disclosure [Text Block]	( 5 Property and Equipment At December 31, 2022, 2021, 2022 2021 (In thousands) Furniture and equipment $ 4,753 $ 4,901 Computer equipment 2,639 2,672 Computer software 29,876 27,828 Building 12,561 9,271 Leaseholds 502 502 Land 425 425 Property and equipment at cost 50,756 45,599 Less accumulated depreciation and amortization 33,508 33,208 Net property and equipment $ 17,248 $ 12,391 Depreciation and amortization expense related to property and equipment, including assets under capital lease, for the years ended December 31, 2022, 2021, 2020 2022 not 2021 2020. 2022, 2021, 2020.

Note 6 - Goodwill and Intangibl

Note 6 - Goodwill and Intangible Assets	12 Months Ended
	Dec. 31, 2022
Notes to Financial Statements
Goodwill and Intangible Assets Disclosure [Text Block]	( 6 Goodwill and Intangible Assets Goodwill and intangible assets consisted of the following at December 31, 2022: Gross Accumulated Impairment Net (In thousands) Goodwill $ 62,328 $ (714 ) $ 61,614 Useful Life Gross Accumulated Amortization Net (In years) (In thousands) Non-amortizing intangible assets: Indefinite trade name 1,191 1,191 Amortizing intangible assets: Customer related 5 - 15 9,192 9,132 60 Technology 3 - 7 1,959 1,599 360 Trade names 10 1,572 1,572 — Total amortizing intangible assets 12,723 12,303 420 Total intangible assets other than goodwill $ 13,914 $ 12,303 $ 1,611 Goodwill and intangible assets consisted of the following at December 31, 2021: Gross Accumulated Impairment Net (In thousands) Goodwill $ 62,328 $ (714 ) $ 61,614 Useful Life Gross Accumulated Amortization Net (In years) (In thousands) Non-amortizing intangible assets: Indefinite trade name 1,191 1,191 Amortizing intangible assets: Customer related 5 - 15 9,445 9,325 120 Technology 3 - 7 1,959 1,480 479 Trade names 10 1,572 1,572 — Total amortizing intangible assets 12,976 12,377 599 Total intangible assets other than goodwill $ 14,167 $ 12,377 $ 1,790 The following represents a summary of changes in the carrying amount of goodwill for the years ended December 31, 2022 2021 Balance as of December 31, 2020 $ 57,255 Goodwill acquired 4,340 Foreign currency translation 19 Balance as of December 31, 2021 $ 61,614 There were no changes in goodwill during 2022 December 31, 2021. As discussed in Note 1, December 2020. Aggregate amortization expense for customer related intangibles, trade names, and technology for the years ended December 31, 2022, 2021 2020 2023, 2024, 2025 2025.

Note 7 - Income Taxes

Note 7 - Income Taxes	12 Months Ended
	Dec. 31, 2022
Notes to Financial Statements
Income Tax Disclosure [Text Block]	( 7 Income Taxes For the years ended December 31, 2022, 2021, 2020, 2022 2021 2020 (In thousands) U.S. Operations $ 43,156 $ 48,145 $ 41,357 Foreign Operations (341 ) 476 110 Income before income taxes $ 42,815 $ 48,621 $ 41,467 Income tax expense consisted of the following components: 2022 2021 2020 (In thousands) Federal: Current $ 9,988 $ 9,092 $ 3,546 Deferred (1,427 ) (224 ) (308 ) Total $ 8,561 $ 8,868 $ 3,238 Foreign Current $ (90 ) $ 143 $ 225 Deferred — (17 ) (6 ) Total $ (90 ) $ 126 $ 219 State Current $ 2,846 $ 2,197 $ 578 Deferred (302 ) (36 ) 172 Total $ 2,544 $ 2,161 $ 750 Total $ 11,015 $ 11,155 $ 4,207 As a result of the Tax Cuts and Jobs Act (the “Tax Act”), we determined that we would no 2022 2020, We qualify for tax incentives through the Nebraska Advantage LB312 December 31, 2022, 2021 2020, December 31, 2022, 2021 2020, The differences between income taxes expected at the U.S. federal statutory income tax rate of 21 2022 2021 2020 (In thousands) Expected federal income taxes $ 8,991 $ 10,210 $ 8,708 Foreign tax rate differential (24 ) 26 6 State income taxes, net of federal benefit and state tax credits 2,100 1,531 607 Share-based compensation (120 ) (660 ) (5,713 ) Compensation limit for covered employees — — 463 Federal tax credits (408 ) (272 ) (261 ) Uncertain tax positions 22 254 157 Reclassification of cumulative translation adjustment into earnings 539 — — Goodwill Impairment — — 184 Withholding tax on repatriation of foreign earnings (100 ) 8 18 GILTI — — 10 Other 15 58 28 $ 11,015 $ 11,155 $ 4,207 Deferred tax assets and liabilities at December 31, 2022 2021, 2022 2021 (In thousands) Deferred tax assets: Allowance for doubtful accounts $ 16 $ 24 Accrued expenses 691 687 Share-based compensation 1,072 740 Accrued bonuses 96 267 Employer payroll tax deferral — 200 Uncertain tax positions 256 161 Research & experimental expenditures 856 — Other 78 66 Gross deferred tax assets 3,065 2,145 Less valuation allowance — — Deferred tax assets 3,065 2,145 Deferred tax liabilities: Prepaid expenses 135 89 Deferred contract costs 601 945 Property and equipment 1,066 1,579 Intangible assets 6,523 6,338 Repatriation withholding — 182 Deferred tax liabilities 8,325 9,133 Net deferred tax liabilities $ (5,260 ) $ (6,988 ) In March 27, 2020, December 31, 2020. December 2021, December 2022. no On August 16, 2022, 2022 not In assessing the realizability of deferred tax assets, we consider whether it is more likely than not not not 2020, The Tax Act amended Section 174 174 five 2021. December 31, 2022. We had an unrecognized tax benefit at December 31, 2022 2021, December 31, 2022 2021, December 31, 2022 2021, 2022 2021 (In thousands) Balance of unrecognized tax benefits at December 31, 2020 $ 768 Reductions due to lapse of applicable statute of limitations (38 ) Reductions due to tax positions of prior years — Reductions due to settlement with taxing authorities — Additions based on tax positions related to the current year 345 Balance of unrecognized tax benefits at December 31, 2021 $ 1,075 Reductions due to lapse of applicable statute of limitations (76 ) Additions due to tax positions of prior years — Reductions due to settlement with taxing authorities — Additions based on tax positions related to the current year 558 Balance of unrecognized tax benefits at December 31, 2022 $ 1,557 We file income tax returns in the U.S. federal jurisdiction, various state jurisdictions, and Canada federal and provincial jurisdictions. Tax years 2019 2016 2018

Note 8 - Notes Payable

Note 8 - Notes Payable	12 Months Ended
	Dec. 31, 2022
Notes to Financial Statements
Debt Disclosure [Text Block]	( 8 Notes Payable Our long-term debt consists of the following: 2022 2021 (In thousands) Term Loans $ 22,315 $ 26,620 Less: current portion (4,491 ) (4,278 ) Less: unamortized debt issuance costs (134 ) (73 ) Notes payable, net of current portion $ 17,690 $ 22,269 Our amended and restated credit agreement (the “Credit Agreement”) with First National Bank of Omaha (“FNB”) was amended and restated on September 30, 2022 may The amended Term Loan revised the remaining payments for the then existing outstanding balance at September 30, 2022 May 2027. Borrowings under the Line of Credit and the Delayed Draw Term Loan, if any, bear interest at a floating rate equal to the 30 December 31, 2022). May 2025. December 31, 2022, not 2022. no We are obligated to pay ongoing unused commitment fees quarterly in arrears pursuant to the Line of Credit and the Delayed Draw Term Loan facility at a rate of 0.20% per annum based on the actual daily unused portions of the Line of Credit and the Delayed Draw Term Loan facility, respectively. The Credit Agreement is collateralized by substantially all of our assets, subject to permitted liens and other agreed exceptions, and contains customary representations, warranties, affirmative and negative covenants (including financial covenants) and events of default. The negative covenants include, among other things, restrictions regarding the incurrence of indebtedness and liens, repurchases of our Common Stock and acquisitions, subject in each case to certain exceptions. Pursuant to the Credit Agreement, we are required to maintain a minimum fixed charge coverage ratio of 1.10x 3.00x December 31, 2022, Scheduled maturities of notes payable at December 31, 2022 2023 $ 4,529 2024 4,762 2025 5,011 2026 5,271 2027 2,742

Note 9 - Share-based Compensati

Note 9 - Share-based Compensation	12 Months Ended
	Dec. 31, 2022
Notes to Financial Statements
Share-Based Payment Arrangement [Text Block]	( 9 Share-Based Compensation We measure and recognize compensation expense for all share-based payments based on the grant-date fair value of those awards. All of our existing stock option awards and unvested stock awards have been determined to be equity-classified awards. We account for forfeitures as they occur. Our 2004 “2004 2004 not one ten three December 31, 2022, 2004 2004 Our 2006 “2006 may five ten December 31, 2022, 2006 2006 During 2022, 2021 2020, 2022 2021 2020 Expected dividend yield at date of grant 3.39 % 2.15 % 1.84 % Expected stock price volatility 35.52 % 34.85 % 33.62 % Risk-free interest rate 2.33 % 0.91 % 1.35 % Expected life of options (in years) 6.3 7.01 7.39 The risk-free interest rate assumptions were based on the U.S. Treasury yield curve in effect at the time of the grant. The expected volatility was based on historical monthly price changes of our stock based on the expected life of the options at the date of grant. The expected life of options is the average number of years we estimate that options will be outstanding. We consider groups of associates that have similar historical exercise behavior separately for valuation purposes. The following table summarizes stock option activity under 2006 2004 December 31, 2022: Number of Weighted Average Exercise Price Weighted Average Remaining Contractual Terms (Years) Aggregate Intrinsic Value (In thousands) Common Stock Outstanding at December 31, 2021 477,640 $ 30.88 Granted 127,227 $ 36.67 Exercised 23,581 $ 13.17 Outstanding at December 31, 2022 581,286 $ 32.86 5.44 $ 4,739 Exercisable at December 31, 2022 323,140 $ 26.97 3.55 $ 4,369 The following table summarizes information related to stock options for the years ended December 31, 2022, 2021 2020: 2022 2021 2020 Weighted average grant date fair value of stock options granted $ 9.43 $ 12.55 $ 18.67 Intrinsic value of stock options exercised (in thousands) $ 648 $ 3,535 $ 25,912 Intrinsic value of stock options vested (in thousands) $ 4,369 $ 4,805 $ 1,965 As of December 31, 2022, There was $446,000 and $1.7 million in cash received from stock options exercised for the years ended December 31, 2021 2020, December 31, 2022. December 31, 2022, 2021, 2020, December 31, 2022, 2021, 2020, During 2021 2006 No December 31, 2022 2020. December 31, 2022, 2006 five not December 31, 2022, 2021, 2020, December 31, 2020. December 31, 2022 2021. The following table summarizes information regarding non-vested stock granted to associates under the 2006 December 31, 2022: Common Stock Outstanding Common Stock Weighted Average Grant Date Fair Value Per Share Outstanding at December 31, 2021 12,698 $ 42.92 Granted — $ — Vested — $ — Forfeited — $ — Outstanding at December 31, 2022 12,698 $ 42.92 As of December 31, 2022,

Note 10 - Leases

Note 10 - Leases	12 Months Ended
	Dec. 31, 2022
Notes to Financial Statements
Leases Disclosure [Text Block]	( 10 Leases We lease printing, computer, other equipment and office space in the United States and Canada. The leases remaining terms as of December 31, 2022 one Certain equipment and office lease agreements include provisions for periodic adjustments to rates and charges. The rates and charges are adjusted based on actual usage or actual costs for internet, common area maintenance, taxes or insurance, as determined by the lessor and are considered variable lease costs. The components of lease expense for the years ended December 31, 2022, 2021 2020 2022 2021 2020 Operating leases $ 527 $ 669 $ 600 Finance leases: Asset amortization 462 489 355 Interest on lease liabilities 19 34 37 Variable lease cost 95 99 62 Short-term lease cost 87 59 42 Sublease income (123 ) (81 ) — Total net lease cost $ 1,067 $ 1,269 $ 1,096 In 2020, Supplemental balance sheet information related to leases (in thousands): December 31, 2022 December 31, 2021 Operating leases: Operating ROU assets $ 556 $ 975 Current operating lease liabilities 522 493 Noncurrent operating lease liabilities 333 820 Total operating lease liabilities $ 855 $ 1,313 December 31, 2022 December 31, 2021 Finance leases: Furniture and equipment $ 1,042 $ 1,042 Computer Equipment 659 659 Computer Software 207 207 Property and equipment under finance lease, gross 1,908 1,908 Less accumulated amortization 1,537 1,074 Property and equipment under finance lease, net $ 371 $ 834 Current obligations of finance leases $ 311 $ 470 Noncurrent obligations of finance leases 39 348 Total finance lease liabilities $ 350 $ 818 Weighted average remaining lease term (in years): Operating leases 1.95 2.80 Finance leases 1.15 1.93 Weighted average discount rate: Operating leases 3.97 % 3.85 % Finance leases 3.54 % 3.42 % Supplemental cash flow and other information related to leases were as follows (in thousands): 2022 2021 2020 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 563 $ 680 $ 596 Operating cash flows from finance leases 18 34 36 Financing cash flows from finance leases 469 493 332 ROU assets obtained in exchange for operating lease liabilities 83 560 276 ROU assets obtained in exchange for finance lease liabilities — 40 817 Undiscounted payments under non-cancelable finance and operating leases at December 31, 2022 Finance Leases Operating Leases 2023 $ 315 $ 547 2024 23 227 2025 11 118 2026 10 — 2027 — — Thereafter — — Total minimum lease payments 359 892 Less: Amount representing interest 9 37 Present value of minimum lease payments 350 855 Less: Current portion 311 522 Lease obligations, net of current portion $ 39 $ 333 Undiscounted cash receipts due under the sublease agreement at December 31, 2022 Operating Lease 2023 $ 122 2024 127 2025 65 Total minimum lease receipts $ 314

Note 11 - Related Party

Note 11 - Related Party	12 Months Ended
	Dec. 31, 2022
Notes to Financial Statements
Related Party Transactions Disclosure [Text Block]	( 11 Related Party Mr. Hays, our Chief Executive Officer and director, is an owner of approximately 13% December 31, 2022. December 31, 2022. A director who began serving on our board in May 2021, 2021 not December 31, 2021 A director, who served on our board through October 2021, January 2020 October 2021. 2021 2020 A director, who served on our board through May 2020, 2020 2020. During 2017, 2016 December 31, 2021 2020 no June 30, 2021

Note 12 - Associate Benefits

Note 12 - Associate Benefits	12 Months Ended
	Dec. 31, 2022
Notes to Financial Statements
Compensation and Employee Benefit Plans [Text Block]	( 12 Associate Benefits We sponsor a qualified 401 no 401 first 2022, 2021, 2020, 401

Note 13 - Segment Information

Note 13 - Segment Information	12 Months Ended
	Dec. 31, 2022
Notes to Financial Statements
Segment Reporting Disclosure [Text Block]	( 13 Segment Information In March 2021, six one Our Canada office was closed in 2022. no 2022. 2022 2021 2020 Revenue: United States $ 150,775 $ 144,987 $ 130,305 Canada 793 2,967 2,972 Total $ 151,568 $ 147,954 $ 133,277 Long-lived assets: United States $ 86,718 $ 83,722 $ 77,448 Canada 27 111 1,863 Total $ 86,745 $ 83,833 $ 79,311 Total assets: United States $ 130,151 $ 153,879 $ 128,319 Canada 310 3,661 5,104 Total $ 130,461 $ 157,540 $ 133,423

Significant Accounting Policies

Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2022
Accounting Policies [Abstract]
Consolidation, Policy [Policy Text Block]	Principles of Consolidation The consolidated financial statements include the accounts of the Company and our wholly-owned subsidiary, National Research Corporation Canada. All significant intercompany transactions and balances have been eliminated.
Use of Estimates, Policy [Policy Text Block]	Use of Estimates The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make certain estimates and assumptions that affect the reported amounts of assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting period. Actual results could differ from those estimates.
Foreign Currency Transactions and Translations Policy [Policy Text Block]	Translation of Foreign Currencies Gains and losses related to transactions denominated in a currency other than the functional currency of the country in which we operate and short-term intercompany accounts are included in other income (expense) in the consolidated statements of income. Our Canadian subsidiary uses Canadian dollars as its functional currency. We translate its assets and liabilities into U.S. dollars at the exchange rate in effect at the balance sheet date. We translate its revenue and expenses at the average exchange rate during the period. We included foreign currency translation gains and losses in accumulated other comprehensive income (loss), a component of shareholders’ equity. During December 2022,
Revenue [Policy Text Block]	Revenue Recognition We derive a majority of our revenues from our annually renewable subscription-based service agreements with our customers, which include performance measurement and improvement services, healthcare analytics and governance education services. Such agreements are generally cancelable on short or no 3 ● Identify the contract, or contracts, with a customer; ● Identify the performance obligations in the contract; ● Determine the transaction price; ● Allocate the transaction price to the identified performance obligations; and ● Recognize revenue when, or as, we satisfy the performance obligations. Our revenue arrangements with a client may one may one one not not Our arrangements with customers consist principally of four 1 2 one 3 4 Subscription-based services - twelve may One-time services one Fixed, non-subscription services Unit-price services Revenue is presented net of any sales tax charged to our clients that we are required to remit to taxing authorities. We recognize contract assets or unbilled receivables related to revenue recognized for services completed but not
Deferred Charges, Policy [Policy Text Block]	Deferred Contract Costs Deferred contract costs, net is stated at gross deferred costs less accumulated amortization. We defer commissions and incentives, including payroll taxes, if they are incremental and recoverable costs of obtaining a renewable customer contract. Deferred contract costs are amortized over the estimated term of the contract, including renewals, which generally ranges from three five one December 31, 2022, 2021 2020, December 31, 2022 2021, 2021 December 31, 2022, 2021 2020 2022 2021 2020 (In thousands) Direct expenses $ 146 $ 157 $ 272 Selling, general and administrative expenses $ 1,625 $ 2,494 $ 2,970 Total amortization $ 1,771 $ 2,651 $ 3,242 Additional expense included in selling, general and administrative expenses for impairment of costs capitalized due to lost clients was $14,000, $31,000 and $63,000 for the years December 31, 2022, 2021 2020,
Accounts Receivable [Policy Text Block]	Trade Accounts Receivable The allowance for doubtful accounts is our best estimate of the amount of probable credit losses in our existing accounts receivable, determined based on our historical write-off experience, current economic conditions and reasonable and supportable forecasts about the future. We review the allowance for doubtful accounts monthly. Account balances are charged off against the allowance after all means of collection have been exhausted and the potential for recovery is considered remote. The following table provides the activity in the allowance for doubtful accounts for the years ended December 31, 2022, 2021 2020 Balance at Beginning of Year Bad Debt Expense Write-offs, net of Recoveries Balance at End of Year Year Ended December 31, 2020 $ 144 $ 46 $ 70 $ 120 Year Ended December 31, 2021 $ 120 $ 38 $ 64 $ 94 Year Ended December 31, 2022 $ 94 $ 19 $ 48 $ 65
Property, Plant and Equipment, Policy [Policy Text Block]	Property and Equipment Property and equipment is stated at cost. Major expenditures to purchase property or to substantially increase useful lives of property are capitalized. Maintenance, repairs and minor renewals are expensed as incurred. When assets are retired or otherwise disposed of, their costs and related accumulated depreciation are removed from the accounts and resulting gains or losses are included in income. We capitalize 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 projects and external direct costs of materials and services. Capitalization of such costs ceases when the project is substantially complete and ready for its intended purpose. Costs incurred during the preliminary project and post-implementation stages, as well as software maintenance and training costs are expensed as incurred. We capitalized approximately $3.6 million, $2.8 million and $2.7 million of costs incurred for the development of internal-use software for the years ended December 31, 2022, 2021 2020, When a software license is included in a cloud computing arrangement and we have the legal right, ability and feasibility to download the software, it is accounted for as software, included in property and equipment, and amortized. If a software license is not not We provide for depreciation and amortization of property and equipment using annual rates which are sufficient to amortize the cost of depreciable assets over their estimated useful lives. We use the straight-line method of depreciation and amortization over estimated useful lives of two ten three five one five seven forty
Impairment or Disposal of Long-Lived Assets, Policy [Policy Text Block]	Impairment of Long-Lived Assets and Amortizing Intangible Assets Long-lived assets, such as property and equipment and purchased intangible assets subject to depreciation or amortization, are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not first not third December 31, 2022, 2021, 2020. Among others, management believes the following circumstances are important indicators of potential impairment of such assets and as a result may ● Significant underperformance in comparison to historical or projected operating results; ● Significant changes in the manner or use of acquired assets or our overall strategy; ● Significant negative trends in our industry or the overall economy; ● A significant decline in the market price for our common stock for a sustained period; and ● Our market capitalization falling below the book value of our net assets.
Goodwill and Intangible Assets, Policy [Policy Text Block]	Goodwill and Intangible Assets Intangible assets include customer relationships, trade names, technology, and goodwill. Intangible assets with estimable useful lives are amortized over their respective estimated useful lives to their estimated residual values and reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of the assets may not October 1 may not When performing the impairment assessment, we will first not not 2022, 2021 2020. Goodwill is an asset representing the future economic benefits arising from other assets acquired in a business combination that are not October 1, may not We review goodwill for impairment by first may not October 1, 2022 December 31, 2022 2021. September 2022, December 2020 not September 2022. September 2022. December 31, 2020. In March 2021, six one one no 19 not not not December 31, 2022.
Insurance Recoveries [Policy Text Block]	Insurance Recoveries We record insurance recoveries when the realization of the claim is probable. In 2020 February 2020 ( “February February not 2020,
Income Tax, Policy [Policy Text Block]	Income Taxes We use the asset and liability method of accounting for income taxes. Under that method, deferred income tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax basis using enacted tax rates. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. Valuation allowances, if any, are established when necessary to reduce deferred tax assets to the amount that is more likely than not December 31, 2022, 2021, 2020, We recognize the effect of income tax positions only if those positions are more likely than not 50% In 2021, 2019 12, 740 no
Share-Based Payment Arrangement [Policy Text Block]	Share-Based Compensation All of our existing stock option awards and non-vested stock awards have been determined to be equity-classified awards. The compensation expense on share-based payments is recognized based on the grant-date fair value of those awards. We recognize the excess tax benefits and tax deficiencies in the income statement when options are exercised. Amounts recognized in the financial statements with respect to these plans are as follows: 2022 2021 2020 (In thousands) Amounts charged against income, before income tax benefit $ 1,200 $ 623 $ 680 Amount of related income tax benefit (436 ) (919 ) (6,764 ) Net (benefit) expense to net income $ 764 $ (296 ) $ (6,084 ) We refer to our restricted stock awards as “non-vested” stock in these consolidated financial statements.
Cash and Cash Equivalents, Policy [Policy Text Block]	Cash and Cash Equivalents We consider all highly liquid investments with original maturities of three December 31, 2022, 2021, may
Lessee, Leases [Policy Text Block]	Leases We determine whether a lease is included in an agreement at inception. We recognize a lease liability and a right-of-use (“ROU”) asset on the balance sheet for our operating leases under which we are lessee. Operating lease ROU assets are included in operating lease right-of-use assets in our consolidated balance sheet. Finance lease assets are included in property and equipment. Operating and finance lease liabilities are included in other current liabilities and other long-term liabilities. Certain lease arrangements may not ROU assets represent our right to use an underlying asset for the lease term and lease liabilities represent our obligation to make lease payments during the lease term. ROU assets and lease liabilities are recorded at lease commencement based on the estimated present value of lease payments. Because the rate of interest implicit in each lease is not Due to remote working arrangements, we reassessed our office needs and subleased our Seattle location under an agreement considered to be an operating lease beginning in May 2021. not 2021 no 2022 2020.
Fair Value Measurement, Policy [Policy Text Block]	Fair Value Measurements Our valuation techniques are based on maximizing observable inputs and minimizing the use of unobservable inputs when measuring fair value. Observable inputs reflect readily obtainable data from independent sources, while unobservable inputs reflect our market assumptions. The inputs are then classified into the following hierarchy: ( 1 1 2 2 1 not 3 3 The following details our financial assets within the fair value hierarchy at December 31, 2022 2021: Level 1 Level 2 Level 3 Total (In thousands) As of December 31, 2022 Money Market Funds $ 24,927 $ — $ — $ 24,927 Total Cash Equivalents $ 24,927 $ — $ — $ 24,927 As of December 31, 2021 Money Market Funds $ 6,306 $ — $ — $ 6,306 Total Cash Equivalents $ 6,306 $ — $ — $ 6,306 There were no December 31, 2022 2021. Our long-term debt described in Note 8 2 The following are the carrying amount and estimated fair values of long-term debt: December 31, 2022 December 31, 2021 (In thousands) Total carrying amount of long-term debt $ 22,315 $ 26,620 Estimated fair value of long-term debt $ 21,668 $ 27,708 The carrying amounts of accounts receivable, accounts payable, and accrued expenses approximate their fair value. All non-financial assets that are not 3 2021. December 31, 2022 2021, December 31, 2020. 3
Commitments and Contingencies, Policy [Policy Text Block]	Commitments and Contingencies not December 31, 2022 We are self-insured for group medical and dental insurance. We carry excess loss coverage in the amount of $150,000 per covered person per year for group medical insurance. We do not not 2022, 2021 2020, not third December 31, 2022 2021,
Earnings Per Share, Policy [Policy Text Block]	Earnings Per Share Basic net income per share was computed using the weighted-average number of common shares outstanding during the period. Diluted net income per share was computed using the weighted-average number of common shares and, if dilutive, the potential common shares outstanding during the period. Potential common shares consist of the incremental common shares issuable upon the exercise of stock options and vesting of restricted stock. The dilutive effect of outstanding stock options is reflected in diluted earnings per share by application of the treasury stock method. We had 83,070, 127,185 and 65,127 options of Common Stock for the years ended December 31, 2022, 2021 2020, 2022 2021 2020 (In thousands, except per share data) Numerator for net income per share - basic: Net income $ 31,800 $ 37,466 $ 37,260 Allocation of distributed and undistributed income to unvested restricted stock shareholders (16 ) (18 ) (57 ) Net income attributable to common shareholders $ 31,784 $ 37,448 $ 37,203 Denominator for net income per share - basic: Weighted average common shares outstanding – basic 24,922 25,422 25,170 Net income per share – basic $ 1.28 $ 1.47 $ 1.48 Numerator for net income per share - diluted: Net income attributable to common shareholders for basic computation $ 31,784 $ 37,448 $ 37,203 Denominator for net income per share - diluted: Weighted average common s 24,922 25,422 25,170 Weighted average effect of dilutive securities – stock options 130 218 526 Denominator for diluted earnings per share – adjusted weighted average shares 25,052 25,640 25,696 Net income per share – diluted $ 1.27 $ 1.46 $ 1.45

Note 1 - Summary of Significa_2

Note 1 - Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2022
Notes Tables
Amortization of Capitalized Contract Cost [Table Text Block]	2022 2021 2020 (In thousands) Direct expenses $ 146 $ 157 $ 272 Selling, general and administrative expenses $ 1,625 $ 2,494 $ 2,970 Total amortization $ 1,771 $ 2,651 $ 3,242
Financing Receivable, Allowance for Credit Loss [Table Text Block]	Balance at Beginning of Year Bad Debt Expense Write-offs, net of Recoveries Balance at End of Year Year Ended December 31, 2020 $ 144 $ 46 $ 70 $ 120 Year Ended December 31, 2021 $ 120 $ 38 $ 64 $ 94 Year Ended December 31, 2022 $ 94 $ 19 $ 48 $ 65
Share-Based Payment Arrangement, Expensed and Capitalized, Amount [Table Text Block]	2022 2021 2020 (In thousands) Amounts charged against income, before income tax benefit $ 1,200 $ 623 $ 680 Amount of related income tax benefit (436 ) (919 ) (6,764 ) Net (benefit) expense to net income $ 764 $ (296 ) $ (6,084 )
Fair Value, by Balance Sheet Grouping [Table Text Block]	Level 1 Level 2 Level 3 Total (In thousands) As of December 31, 2022 Money Market Funds $ 24,927 $ — $ — $ 24,927 Total Cash Equivalents $ 24,927 $ — $ — $ 24,927 As of December 31, 2021 Money Market Funds $ 6,306 $ — $ — $ 6,306 Total Cash Equivalents $ 6,306 $ — $ — $ 6,306 December 31, 2022 December 31, 2021 (In thousands) Total carrying amount of long-term debt $ 22,315 $ 26,620 Estimated fair value of long-term debt $ 21,668 $ 27,708
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	2022 2021 2020 (In thousands, except per share data) Numerator for net income per share - basic: Net income $ 31,800 $ 37,466 $ 37,260 Allocation of distributed and undistributed income to unvested restricted stock shareholders (16 ) (18 ) (57 ) Net income attributable to common shareholders $ 31,784 $ 37,448 $ 37,203 Denominator for net income per share - basic: Weighted average common shares outstanding – basic 24,922 25,422 25,170 Net income per share – basic $ 1.28 $ 1.47 $ 1.48 Numerator for net income per share - diluted: Net income attributable to common shareholders for basic computation $ 31,784 $ 37,448 $ 37,203 Denominator for net income per share - diluted: Weighted average common s 24,922 25,422 25,170 Weighted average effect of dilutive securities – stock options 130 218 526 Denominator for diluted earnings per share – adjusted weighted average shares 25,052 25,640 25,696 Net income per share – diluted $ 1.27 $ 1.46 $ 1.45

Note 2 - Acquisition (Tables)

Note 2 - Acquisition (Tables)	12 Months Ended
	Dec. 31, 2022
Notes Tables
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed [Table Text Block]	Amount of Identified Assets Acquired and Liabilities Assumed ($ in thousands) Current Assets $ 184 Property and equipment 10 Customer related 100 Technology 600 Goodwill 4,340 Total assets acquired $ 5,234 Current liabilities 284 Net assets acquired $ 4,950

Note 3 - Contracts With Custo_2

Note 3 - Contracts With Customers (Tables)	12 Months Ended
	Dec. 31, 2022
Notes Tables
Disaggregation of Revenue [Table Text Block]	2022 2021 2020 Subscription services recognized ratably over time $ 141,981 $ 137,008 $ 122,499 Services recognized at a point in time 4,231 3,216 2,932 Fixed, non-subscription recognized over time 3,134 3,065 2,907 Unit price services recognized over time 2,222 4,665 4,939 Total revenue $ 151,568 $ 147,954 $ 133,277
Contract with Customer, Contract Asset, Contract Liability, and Receivable [Table Text Block]	December 31, 2022 December 31, 2021 Accounts receivables $ 14,461 $ 13,728 Contract assets included in other current assets $ 102 $ 99 Deferred revenue $ 15,198 $ 17,213 2022 2021 Contract Asset Deferred Revenue Contract Asset Deferred Revenue Increase (Decrease) Revenue recognized that was included in deferred revenue at beginning of year due to completion of services $ - $ (17,170 ) $ - $ (15,631 ) Increases due to invoicing of client, net of amounts recognized as revenue - 15,081 - 16,694 Decreases due to completion of services (or portion of services) and transferred to accounts receivable (99 ) - (311 ) - Change due to cumulative catch-up adjustments arising from changes in expected contract consideration - 74 - 326 Increases due to revenue recognized in the period with additional performance obligations before invoicing 102 - 99 -

Note 5 - Property and Equipme_2

Note 5 - Property and Equipment (Tables)	12 Months Ended
	Dec. 31, 2022
Notes Tables
Property, Plant and Equipment [Table Text Block]	2022 2021 (In thousands) Furniture and equipment $ 4,753 $ 4,901 Computer equipment 2,639 2,672 Computer software 29,876 27,828 Building 12,561 9,271 Leaseholds 502 502 Land 425 425 Property and equipment at cost 50,756 45,599 Less accumulated depreciation and amortization 33,508 33,208 Net property and equipment $ 17,248 $ 12,391

Note 6 - Goodwill and Intangi_2

Note 6 - Goodwill and Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2022
Notes Tables
Schedule of Intangible Assets and Goodwill [Table Text Block]	Gross Accumulated Impairment Net (In thousands) Goodwill $ 62,328 $ (714 ) $ 61,614 Useful Life Gross Accumulated Amortization Net (In years) (In thousands) Non-amortizing intangible assets: Indefinite trade name 1,191 1,191 Amortizing intangible assets: Customer related 5 - 15 9,192 9,132 60 Technology 3 - 7 1,959 1,599 360 Trade names 10 1,572 1,572 — Total amortizing intangible assets 12,723 12,303 420 Total intangible assets other than goodwill $ 13,914 $ 12,303 $ 1,611 Gross Accumulated Impairment Net (In thousands) Goodwill $ 62,328 $ (714 ) $ 61,614 Useful Life Gross Accumulated Amortization Net (In years) (In thousands) Non-amortizing intangible assets: Indefinite trade name 1,191 1,191 Amortizing intangible assets: Customer related 5 - 15 9,445 9,325 120 Technology 3 - 7 1,959 1,480 479 Trade names 10 1,572 1,572 — Total amortizing intangible assets 12,976 12,377 599 Total intangible assets other than goodwill $ 14,167 $ 12,377 $ 1,790
Schedule of Goodwill [Table Text Block]	Balance as of December 31, 2020 $ 57,255 Goodwill acquired 4,340 Foreign currency translation 19 Balance as of December 31, 2021 $ 61,614

Note 7 - Income Taxes (Tables)

Note 7 - Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2022
Notes Tables
Schedule of Income before Income Tax, Domestic and Foreign [Table Text Block]	2022 2021 2020 (In thousands) U.S. Operations $ 43,156 $ 48,145 $ 41,357 Foreign Operations (341 ) 476 110 Income before income taxes $ 42,815 $ 48,621 $ 41,467
Schedule of Components of Income Tax Expense (Benefit) [Table Text Block]	2022 2021 2020 (In thousands) Federal: Current $ 9,988 $ 9,092 $ 3,546 Deferred (1,427 ) (224 ) (308 ) Total $ 8,561 $ 8,868 $ 3,238 Foreign Current $ (90 ) $ 143 $ 225 Deferred — (17 ) (6 ) Total $ (90 ) $ 126 $ 219 State Current $ 2,846 $ 2,197 $ 578 Deferred (302 ) (36 ) 172 Total $ 2,544 $ 2,161 $ 750 Total $ 11,015 $ 11,155 $ 4,207
Schedule of Effective Income Tax Rate Reconciliation [Table Text Block]	2022 2021 2020 (In thousands) Expected federal income taxes $ 8,991 $ 10,210 $ 8,708 Foreign tax rate differential (24 ) 26 6 State income taxes, net of federal benefit and state tax credits 2,100 1,531 607 Share-based compensation (120 ) (660 ) (5,713 ) Compensation limit for covered employees — — 463 Federal tax credits (408 ) (272 ) (261 ) Uncertain tax positions 22 254 157 Reclassification of cumulative translation adjustment into earnings 539 — — Goodwill Impairment — — 184 Withholding tax on repatriation of foreign earnings (100 ) 8 18 GILTI — — 10 Other 15 58 28 $ 11,015 $ 11,155 $ 4,207
Schedule of Deferred Tax Assets and Liabilities [Table Text Block]	2022 2021 (In thousands) Deferred tax assets: Allowance for doubtful accounts $ 16 $ 24 Accrued expenses 691 687 Share-based compensation 1,072 740 Accrued bonuses 96 267 Employer payroll tax deferral — 200 Uncertain tax positions 256 161 Research & experimental expenditures 856 — Other 78 66 Gross deferred tax assets 3,065 2,145 Less valuation allowance — — Deferred tax assets 3,065 2,145 Deferred tax liabilities: Prepaid expenses 135 89 Deferred contract costs 601 945 Property and equipment 1,066 1,579 Intangible assets 6,523 6,338 Repatriation withholding — 182 Deferred tax liabilities 8,325 9,133 Net deferred tax liabilities $ (5,260 ) $ (6,988 )
Schedule of Unrecognized Tax Benefits Roll Forward [Table Text Block]	(In thousands) Balance of unrecognized tax benefits at December 31, 2020 $ 768 Reductions due to lapse of applicable statute of limitations (38 ) Reductions due to tax positions of prior years — Reductions due to settlement with taxing authorities — Additions based on tax positions related to the current year 345 Balance of unrecognized tax benefits at December 31, 2021 $ 1,075 Reductions due to lapse of applicable statute of limitations (76 ) Additions due to tax positions of prior years — Reductions due to settlement with taxing authorities — Additions based on tax positions related to the current year 558 Balance of unrecognized tax benefits at December 31, 2022 $ 1,557

Note 8 - Notes Payable (Tables)

Note 8 - Notes Payable (Tables)	12 Months Ended
	Dec. 31, 2022
Notes Tables
Schedule of Debt [Table Text Block]	2022 2021 (In thousands) Term Loans $ 22,315 $ 26,620 Less: current portion (4,491 ) (4,278 ) Less: unamortized debt issuance costs (134 ) (73 ) Notes payable, net of current portion $ 17,690 $ 22,269
Schedule of Maturities of Long-Term Debt [Table Text Block]	2023 $ 4,529 2024 4,762 2025 5,011 2026 5,271 2027 2,742

Note 9 - Share-based Compensa_2

Note 9 - Share-based Compensation (Tables)	12 Months Ended
	Dec. 31, 2022
Notes Tables
Schedule of Share-Based Payment Award, Stock Options, Valuation Assumptions [Table Text Block]	2022 2021 2020 Expected dividend yield at date of grant 3.39 % 2.15 % 1.84 % Expected stock price volatility 35.52 % 34.85 % 33.62 % Risk-free interest rate 2.33 % 0.91 % 1.35 % Expected life of options (in years) 6.3 7.01 7.39
Share-Based Payment Arrangement, Activity [Table Text Block]	Number of Weighted Average Exercise Price Weighted Average Remaining Contractual Terms (Years) Aggregate Intrinsic Value (In thousands) Common Stock Outstanding at December 31, 2021 477,640 $ 30.88 Granted 127,227 $ 36.67 Exercised 23,581 $ 13.17 Outstanding at December 31, 2022 581,286 $ 32.86 5.44 $ 4,739 Exercisable at December 31, 2022 323,140 $ 26.97 3.55 $ 4,369
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Weighted Average Grant Date Fair Value, Intrinsic Value of Exercised and Vested in Period, and Fair Value of Vested in Period [Table Text Block]	2022 2021 2020 Weighted average grant date fair value of stock options granted $ 9.43 $ 12.55 $ 18.67 Intrinsic value of stock options exercised (in thousands) $ 648 $ 3,535 $ 25,912 Intrinsic value of stock options vested (in thousands) $ 4,369 $ 4,805 $ 1,965
Schedule of Nonvested Share Activity [Table Text Block]	Common Stock Outstanding Common Stock Weighted Average Grant Date Fair Value Per Share Outstanding at December 31, 2021 12,698 $ 42.92 Granted — $ — Vested — $ — Forfeited — $ — Outstanding at December 31, 2022 12,698 $ 42.92

Note 10 - Leases (Tables)

Note 10 - Leases (Tables)	12 Months Ended
	Dec. 31, 2022
Notes Tables
Lease, Cost [Table Text Block]	2022 2021 2020 Operating leases $ 527 $ 669 $ 600 Finance leases: Asset amortization 462 489 355 Interest on lease liabilities 19 34 37 Variable lease cost 95 99 62 Short-term lease cost 87 59 42 Sublease income (123 ) (81 ) — Total net lease cost $ 1,067 $ 1,269 $ 1,096
Lessee, Lease, Balance Sheet Information [Table Text Block]	December 31, 2022 December 31, 2021 Operating leases: Operating ROU assets $ 556 $ 975 Current operating lease liabilities 522 493 Noncurrent operating lease liabilities 333 820 Total operating lease liabilities $ 855 $ 1,313 December 31, 2022 December 31, 2021 Finance leases: Furniture and equipment $ 1,042 $ 1,042 Computer Equipment 659 659 Computer Software 207 207 Property and equipment under finance lease, gross 1,908 1,908 Less accumulated amortization 1,537 1,074 Property and equipment under finance lease, net $ 371 $ 834 Current obligations of finance leases $ 311 $ 470 Noncurrent obligations of finance leases 39 348 Total finance lease liabilities $ 350 $ 818 Weighted average remaining lease term (in years): Operating leases 1.95 2.80 Finance leases 1.15 1.93 Weighted average discount rate: Operating leases 3.97 % 3.85 % Finance leases 3.54 % 3.42 %
Lease, Cash flow [Table Text Block]	2022 2021 2020 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 563 $ 680 $ 596 Operating cash flows from finance leases 18 34 36 Financing cash flows from finance leases 469 493 332 ROU assets obtained in exchange for operating lease liabilities 83 560 276 ROU assets obtained in exchange for finance lease liabilities — 40 817
Lessee, Operating and Finance Lease, Liability, Maturity [Table Text Block]	Finance Leases Operating Leases 2023 $ 315 $ 547 2024 23 227 2025 11 118 2026 10 — 2027 — — Thereafter — — Total minimum lease payments 359 892 Less: Amount representing interest 9 37 Present value of minimum lease payments 350 855 Less: Current portion 311 522 Lease obligations, net of current portion $ 39 $ 333
Lessor, Operating Lease, Payment to be Received, Fiscal Year Maturity [Table Text Block]	Operating Lease 2023 $ 122 2024 127 2025 65 Total minimum lease receipts $ 314

Note 13 - Segment Information (

Note 13 - Segment Information (Tables)	12 Months Ended
	Dec. 31, 2022
Notes Tables
Schedule of Revenue from External Customers and Long-Lived Assets, by Geographical Areas [Table Text Block]	2022 2021 2020 Revenue: United States $ 150,775 $ 144,987 $ 130,305 Canada 793 2,967 2,972 Total $ 151,568 $ 147,954 $ 133,277 Long-lived assets: United States $ 86,718 $ 83,722 $ 77,448 Canada 27 111 1,863 Total $ 86,745 $ 83,833 $ 79,311 Total assets: United States $ 130,151 $ 153,879 $ 128,319 Canada 310 3,661 5,104 Total $ 130,461 $ 157,540 $ 133,423

Note 1 - Summary of Significa_3

Note 1 - Summary of Significant Accounting Policies (Details Textual)	1 Months Ended	12 Months Ended
	Mar. 31, 2021	Dec. 31, 2022 USD ($) shares	Dec. 31, 2021 USD ($) shares	Dec. 31, 2020 USD ($) shares
Other Comprehensive Income (Loss), Foreign Currency Transaction and Translation Reclassification Adjustment from AOCI, Realized upon Sale or Liquidation, Net of Tax		$ (2,569,000)	$ 0	$ 0
Incremental Costs of Obtaining a Contract, Deferred During Period		454,000	1,900,000	3,700,000
Capitalized Contract Cost, Net, Noncurrent		2,441,000	3,772,000
Capitalized Contract Cost, Impairment Loss		14,000	31,000	63,000
Capitalized Computer Software, Additions		3,600,000	2,800,000	2,700,000
Asset Impairment Charges, Total		0	0
Impairment of Intangible Assets (Excluding Goodwill), Total		0	0	$ 0
Goodwill, Impairment Loss		0	$ 0
Number of Operating Segments	1		1	6
Number of Reporting Units	1
Income Tax Credits and Adjustments		36,000	$ 10,000	$ 45,000
Cash Equivalents, at Carrying Value, Total		24,900,000	6,300,000
Operating Lease, Impairment Loss			324,000
Excess Loss Coverage Per Person		150,000
Claims Loss Coverage, Minimum Aggregate Deductible		4,700,000	3,200,000	$ 2,800,000
Self Insurance Reserve, Current		$ 424,000	$ 406,000
Common Class A [Member]
Stock Options Excluded from Computation of Earnings Per Share, Amount (in shares) | shares		83,070	127,185	65,127
Cyber Attack [Member] | Recoveries Received Direct by the Company [Member]
Proceeds from Insurance Settlement, Operating Activities				$ 3,300,000
Cyber Attack [Member] | Recoveries Paid Directly by Insurer to Outside Vendor [Member]
Proceeds from Insurance Settlement, Operating Activities				447,000
Cyber Attack [Member] | Reimbursement for Lost Revenue [Member]
Insurance Recoveries				533,000
Property Damage Excluding Cyber Attack [Member] | Other Income [Member]
Insurance Recoveries				260,000
Canadian Subsidiary [Member]
Goodwill, Impairment Loss				$ 714,000
Number of Customers		1
Minimum [Member]
Capitalized Contract Cost, Amortization Period (Year)			3 years
Minimum [Member] | Furniture and Fixtures [Member]
Property, Plant and Equipment, Useful Life (Year)		2 years
Minimum [Member] | Computer Equipment [Member]
Property, Plant and Equipment, Useful Life (Year)		3 years
Minimum [Member] | Software and Software Development Costs [Member]
Property, Plant and Equipment, Useful Life (Year)		1 year
Minimum [Member] | Building and Building Improvements [Member]
Property, Plant and Equipment, Useful Life (Year)		7 years
Maximum [Member]
Capitalized Contract Cost, Amortization Period (Year)			5 years
Maximum [Member] | Furniture and Fixtures [Member]
Property, Plant and Equipment, Useful Life (Year)		10 years
Maximum [Member] | Computer Equipment [Member]
Property, Plant and Equipment, Useful Life (Year)		5 years
Maximum [Member] | Software and Software Development Costs [Member]
Property, Plant and Equipment, Useful Life (Year)		5 years
Maximum [Member] | Building and Building Improvements [Member]
Property, Plant and Equipment, Useful Life (Year)		40 years

Note 1 - Summary of Significa_4

Note 1 - Summary of Significant Accounting Policies - Amortization Expense Classification (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Capitalized contract cost	$ 1,771	$ 2,651	$ 3,242
Direct Expenses [Member]
Capitalized contract cost	146	157	272
Selling, General and Administrative Expenses [Member]
Capitalized contract cost	$ 1,625	$ 2,494	$ 2,970

Note 1 - Summary of Significa_5

Note 1 - Summary of Significant Accounting Policies - Allowance for Doubtful Accounts (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Balance	$ 94	$ 120	$ 144
Bad debt expense	19	38	46
Write-offs	48	64	70
Balance	$ 65	$ 94	$ 120

Note 1 - Summary of Significa_6

Note 1 - Summary of Significant Accounting Policies - Share-based Compensation Amounts Recognized in Financial Statements (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Non-cash share-based compensation expense	$ 1,200	$ 623	$ 680
Amount of related income tax benefit	(436)	(919)	(6,764)
Net (benefit) expense to net income	$ 764	$ (296)	$ (6,084)

Note 1 - Summary of Significa_7

Note 1 - Summary of Significant Accounting Policies - Fair Value of Financial Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Total carrying amount of long-term debt	$ 22,315	$ 26,620
Estimated fair value of long-term debt	21,668	27,708
Fair Value, Recurring [Member]
Assets, fair value	24,927	6,306
Money Market Funds [Member] | Fair Value, Recurring [Member]
Assets, fair value	24,927	6,306
Fair Value, Inputs, Level 1 [Member] | Fair Value, Recurring [Member]
Assets, fair value	24,927	6,306
Fair Value, Inputs, Level 1 [Member] | Money Market Funds [Member] | Fair Value, Recurring [Member]
Assets, fair value	$ 24,927	$ 6,306

Note 1 - Summary of Significa_8

Note 1 - Summary of Significant Accounting Policies - Net Income Per Share Computation (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Numerator for net income per share - basic:
Net income	$ 31,800	$ 37,466	$ 37,260
Allocation of distributed and undistributed income to unvested restricted stock shareholders	(16)	(18)	(57)
Net income attributable to common shareholders	$ 31,784	$ 37,448	$ 37,203
Denominator for net income per share - basic:
Weighted average common shares outstanding – basic (in shares)	24,922	25,422	25,170
Net income per share – basic (in dollars per share)	$ 1.28	$ 1.47	$ 1.48
Numerator for net income per share - diluted:
Net income attributable to common shareholders	$ 31,784	$ 37,448	$ 37,203
Weighted average common shares outstanding – basic (in shares)	24,922	25,422	25,170
Weighted average effect of dilutive securities – stock options (in shares)	130	218	526
Denominator for diluted earnings per share – adjusted weighted average shares (in shares)	25,052	25,640	25,696
Net income per share – diluted (in dollars per share)	$ 1.27	$ 1.46	$ 1.45

Note 2 - Acquisition (Details T

Note 2 - Acquisition (Details Textual) - USD ($)		1 Months Ended	12 Months Ended
	Jan. 04, 2021	Jan. 31, 2022	Dec. 31, 2022	Dec. 31, 2021
Payments to Acquire Businesses, Gross				$ 3,000,000
Payment for Contingent Consideration Liability, Financing Activities			$ 1,950,000
Selling, General and Administrative Expenses [Member]
Business Combination, Acquisition Related Costs				$ 119,000
PatientWisdom, Inc. [Member]
Payments to Acquire Businesses, Gross	$ 3,000,000
Business Combination, Consideration Transferred, Total	$ 5,000,000
Payment for Contingent Consideration Liability, Financing Activities		$ 2,000,000
Finite-Lived Intangible Asset, Useful Life (Year)	5 years

Note 2 - Acquisition - Fair Val

Note 2 - Acquisition - Fair Value of Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021	Jan. 04, 2021	Dec. 31, 2020
Goodwill	$ 61,614	$ 61,614		$ 57,255
PatientWisdom, Inc. [Member]
Current Assets			$ 184
Property and equipment			10
Goodwill			4,340
Total assets acquired			5,234
Current liabilities			284
Net assets acquired			4,950
PatientWisdom, Inc. [Member] | Customer Relationships [Member]
Intangible assets			100
PatientWisdom, Inc. [Member] | Technology-Based Intangible Assets [Member]
Intangible assets			$ 600

Note 3 - Contracts With Custo_3

Note 3 - Contracts With Customers 1 (Details Textual) $ in Millions	Dec. 31, 2022 USD ($)
Long-Term Contract with Customer [Member]
Revenue, Remaining Performance Obligation, Amount	$ 1.6

Note 3 - Contracts With Custo_4

Note 3 - Contracts With Customers 2 (Details Textual) - Long-Term Contract with Customer [Member]	Dec. 31, 2022 USD ($)
Revenue, Remaining Performance Obligation, Amount	$ 1,600,000
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2023-01-01
Revenue, Remaining Performance Obligation, Amount	$ 972,000
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Period (Year)	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2024-01-01
Revenue, Remaining Performance Obligation, Amount	$ 621,000
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Period (Year)	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2025-01-01
Revenue, Remaining Performance Obligation, Amount	$ 15,000
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Period (Year)	1 year

Note 3 - Contracts With Custo_5

Note 3 - Contracts With Customers - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Revenue	$ 151,568	$ 147,954	$ 133,277
Transferred over Time [Member] | Subscription Services [Member]
Revenue	141,981	137,008	122,499
Transferred over Time [Member] | Fixed, Non-subscription Services [Member]
Revenue	3,134	3,065	2,907
Transferred over Time [Member] | Unit Price Services [Member]
Revenue	2,222	4,665	4,939
Transferred at Point in Time [Member] | Service [Member]
Revenue	$ 4,231	$ 3,216	$ 2,932

Note 3 - Contracts With Custo_6

Note 3 - Contracts With Customers - Information About Receivables, Contract Assets, and Contract Liabilities From Contracts With Customers (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Accounts receivables	$ 14,461	$ 13,728
Deferred revenue	15,198	17,213
Revenue recognized that was included in deferred revenue at beginning of year due to completion of services	(17,170)	(15,631)
Increases due to invoicing of client, net of amounts recognized as revenue	15,081	16,694
Decreases due to completion of services (or portion of services) and transferred to accounts receivable	(99)	(311)
Change due to cumulative catch-up adjustments arising from changes in expected contract consideration	74	326
Increases due to revenue recognized in the period with additional performance obligations before invoicing	102	99
Other Current Assets [Member]
Contract assets included in other current assets	$ 102	$ 99

Note 4 - Equity Investments (De

Note 4 - Equity Investments (Details Textual) $ in Millions	Dec. 31, 2022 USD ($)
Equity Securities without Readily Determinable Fair Value, Amount	$ 1.3
Cost Method Investment, Ownership Percentage	13.80%

Note 5 - Property and Equipme_3

Note 5 - Property and Equipment (Details Textual) - USD ($)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Interest Costs Capitalized	$ 216,000	$ 0	$ 0
Impairment, Long-Lived Asset, Held-for-Use, Total	0	0	0
Including Assets Held under Capital Lease [Member]
Depreciation, Depletion and Amortization, Nonproduction, Total	$ 5,100,000	$ 5,700,000	$ 6,500,000

Note 5 - Property and Equipme_4

Note 5 - Property and Equipment - Summary of Property and Equipment (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Property and equipment at cost	$ 50,756	$ 45,599
Less accumulated depreciation and amortization	33,508	33,208
Net property and equipment	17,248	12,391
Furniture and Fixtures [Member]
Property and equipment at cost	4,753	4,901
Computer Equipment [Member]
Property and equipment at cost	2,639	2,672
Software and Software Development Costs [Member]
Property and equipment at cost	29,876	27,828
Building and Building Improvements [Member]
Property and equipment at cost	12,561	9,271
Leasehold Improvements [Member]
Property and equipment at cost	502	502
Land [Member]
Property and equipment at cost	$ 425	$ 425

Note 6 - Goodwill and Intangi_3

Note 6 - Goodwill and Intangible Assets (Details Textual) - USD ($)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Goodwill, Period Increase (Decrease), Total	$ 0
Goodwill, Ending Balance	61,614,000	$ 61,614,000	$ 57,255,000
Goodwill, Impairment Loss	0	0
Amortization of Intangible Assets	180,000	$ 320,000	318,000
Finite-Lived Intangible Asset, Expected Amortization, Year Two	140,000
Finite-Lived Intangible Asset, Expected Amortization, Year Three	140,000
Finite-Lived Intangible Asset, Expected Amortization, Year Four	140,000
Finite-Lived Intangible Asset, Expected Amortization, after Year Five	$ 0
Canadian Subsidiary [Member]
Goodwill, Impairment Loss			$ 714,000

Note 6 - Goodwill and Intangi_4

Note 6 - Goodwill and Intangible Assets - Summary of Goodwill and Intangible Assets (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Goodwill	$ 62,328	$ 62,328
Goodwill, Accumulated Depreciation	(714)	(714)
Goodwill, Ending Balance	61,614	61,614	$ 57,255
Finite-lived intangible assets, gross	12,723	12,976
Finite-lived intangible assets, accumulated amortization	12,303	12,377
Finite-lived intangible assets, net	420	599
Total intangible assets other than goodwill	13,914	14,167
Total intangible assets other than goodwill	1,611	1,790
Customer Relationships [Member]
Finite-lived intangible assets, gross	9,192	9,445
Finite-lived intangible assets, accumulated amortization	9,132	9,325
Finite-lived intangible assets, net	$ 60	$ 120
Customer Relationships [Member] | Minimum [Member]
Finite-Lived Intangible Asset, Useful Life (Year)	5 years	5 years
Customer Relationships [Member] | Maximum [Member]
Finite-Lived Intangible Asset, Useful Life (Year)	15 years	15 years
Technology-Based Intangible Assets [Member]
Finite-lived intangible assets, gross	$ 1,959	$ 1,959
Finite-lived intangible assets, accumulated amortization	1,599	1,480
Finite-lived intangible assets, net	$ 360	$ 479
Technology-Based Intangible Assets [Member] | Minimum [Member]
Finite-Lived Intangible Asset, Useful Life (Year)	3 years	3 years
Technology-Based Intangible Assets [Member] | Maximum [Member]
Finite-Lived Intangible Asset, Useful Life (Year)	7 years	7 years
Trade Names [Member]
Finite-Lived Intangible Asset, Useful Life (Year)	10 years	10 years
Finite-lived intangible assets, gross	$ 1,572	$ 1,572
Finite-lived intangible assets, accumulated amortization	1,572	1,572
Finite-lived intangible assets, net	0	0
Trade Names 1 [Member]
Indefinite trade name	$ 1,191	$ 1,191

Note 6 - Goodwill and Intangi_5

Note 6 - Goodwill and Intangible Assets - Summary of Changes in the Carrying Amount of Goodwill (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2021 USD ($)
Goodwill	$ 57,255
Goodwill acquired	4,340
Foreign currency translation	19
Goodwill	$ 61,614

Note 7 - Income Taxes (Details

Note 7 - Income Taxes (Details Textual) - USD ($)	1 Months Ended	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Deemed Dividend Paid by Foreign Subsidiary		$ 1,400,000		$ 9,600,000
Withholding Tax on Dividend Distribution, Percent	5%	5%
Cumulative Tax Incentives		$ 510,000	$ 473,000	435,000
Income Tax Credits and Adjustments		36,000	10,000	45,000
Social Security Tax Payable, Current			656,000	1,300,000
Deferred Social Security Tax Paid	$ 656,000
Deferred Tax Asset, Prior Year Foreign Tax Credit Carryforwards, Write Off				535,000
Reserach and Experimentation Costs Deferred	3,500,000	3,500,000
Deferred Tax Assets, Research and Expenditures	856,000	856,000	0
Deferred Tax Assets, Software Development Costs	52,000	52,000
Unrecognized Tax Benefits, Ending Balance	1,557,000	1,557,000	1,075,000	$ 768,000
Unrecognized Tax Benefits, Interest on Income Taxes Accrued	25,000	25,000	19,000
Unrecognized Tax Benefits that Would Impact Effective Tax Rate	$ 1,300,000	$ 1,300,000	$ 918,000
Domestic Tax Authority [Member]
Open Tax Year		2019 2020 2021 2022
State and Local Jurisdiction [Member]
Open Tax Year		2016 2017 2018 2019 2020 2021 2022
Foreign Tax Authority [Member] | Canada Revenue Agency [Member]
Open Tax Year		2018 2019 2020 2021 2022
Domestic Research [Member]
Tax Amortization Period (Year)		5 years
Foreign Research [Member]
Tax Amortization Period (Year)		15 years
Canadian Subsidiary [Member]
Capital Returns from Subsidiary		$ 1,200,000

Note 7 - Income Taxes - Income

Note 7 - Income Taxes - Income Before Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
U.S. Operations	$ 43,156	$ 48,145	$ 41,357
Foreign Operations	(341)	476	110
Income before income taxes	$ 42,815	$ 48,621	$ 41,467

Note 7 - Income Taxes - Incom_2

Note 7 - Income Taxes - Income Tax Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Current	$ 9,988	$ 9,092	$ 3,546
Deferred	(1,427)	(224)	(308)
Total	8,561	8,868	3,238
Current	(90)	143	225
Deferred	0	(17)	(6)
Total	(90)	126	219
Current	2,846	2,197	578
Deferred	(302)	(36)	172
Total	2,544	2,161	750
Income Tax Expense (Benefit), Total	$ 11,015	$ 11,155	$ 4,207

Note 7 - Income Taxes - Incom_3

Note 7 - Income Taxes - Income Tax Reconciliation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Expected federal income taxes	$ 8,991	$ 10,210	$ 8,708
Foreign tax rate differential	(24)	26	6
State income taxes, net of federal benefit and state tax credits	2,100	1,531	607
Share-based compensation	(120)	(660)	(5,713)
Compensation limit for covered employees	0	0	463
Federal tax credits	(408)	(272)	(261)
Uncertain tax positions	22	254	157
Reclassification of cumulative translation adjustment into earnings	539	0	0
Goodwill Impairment	0	0	184
Withholding tax on repatriation of foreign earnings	(100)	8	18
GILTI	0	0	10
Other	15	58	28
Income Tax Expense (Benefit), Total	$ 11,015	$ 11,155	$ 4,207

Note 7 - Income Taxes - Deferre

Note 7 - Income Taxes - Deferred Tax Assets and Liabilities (Details) - USD ($)	Dec. 31, 2022	Dec. 31, 2021
Deferred tax assets:
Allowance for doubtful accounts	$ 16,000	$ 24,000
Accrued expenses	691,000	687,000
Share-based compensation	1,072,000	740,000
Accrued bonuses	96,000	267,000
Employer payroll tax deferral	0	200,000
Uncertain tax positions	256,000	161,000
Deferred Tax Assets, Research and Expenditures	856,000	0
Other	78,000	66,000
Gross deferred tax assets	3,065,000	2,145,000
Deferred tax assets	3,065,000	2,145,000
Deferred tax liabilities:
Prepaid expenses	135,000	89,000
Deferred contract costs	601,000	945,000
Property and equipment	1,066,000	1,579,000
Intangible assets	6,523,000	6,338,000
Repatriation withholding	0	182,000
Deferred tax liabilities	8,325,000	9,133,000
Net deferred tax liabilities	$ (5,260,000)	$ (6,988,000)

Note 7 - Income Taxes - Change

Note 7 - Income Taxes - Change in Unrecognized Tax Benefits (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Balance of unrecognized tax benefits	$ 1,075	$ 768
Reductions due to lapse of applicable statute of limitations	(76)	(38)
Reductions due to tax positions of prior years		0
Additions based on tax positions related to the current year	558	345
Balance of unrecognized tax benefits	$ 1,557	$ 1,075

Note 8 - Notes Payable (Details

Note 8 - Notes Payable (Details Textual) - Credit Agreement [Member] - First National Bank of Omaha [Member]	9 Months Ended	12 Months Ended
	Sep. 30, 2022 USD ($)	Dec. 31, 2022 USD ($)
Debt Instrument, Covenant, Minimum Fixed Charge Coverage Ratio		1.10
Debt Instrument, Covenant, Exception, Fixed Charge Coverage Ratio, Dividend Threshold		$ 5,500,000
Debt Instrument, Covenant, Maximum Cash Flow Leverage Ratio		3
Secured Overnight Financing Rate (SOFR) [Member]
Debt Instrument, Basis Spread on Variable Rate		2.35%
Term Loan [Member]
Debt Instrument, Face Amount	$ 23,412,383
Debt Instrument, Periodic Payment, Total	$ 462,988
Debt Instrument, Interest Rate, Stated Percentage	5%
Delayed Draw Term Loan [Member]
Line of Credit Facility, Maximum Borrowing Capacity	$ 75,000,000
Revolving Credit Facility [Member]
Line of Credit Facility, Maximum Borrowing Capacity	$ 30,000,000
Debt Instrument, Percentage Bearing Variable Interest, Percentage Rate		6.10%
Long-Term Line of Credit, Total		$ 0
Line of Credit Facility, Unused Capacity, Commitment Fee Percentage		0.20%

Note 8 - Notes Payable - Summar

Note 8 - Notes Payable - Summary of Notes Payable (Details) - Term Loan [Member] - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Term Loans	$ 22,315	$ 26,620
Less: current portion	(4,491)	(4,278)
Less: unamortized debt issuance costs	(134)	(73)
Notes payable, net of current portion	$ 17,690	$ 22,269

Note 8 - Notes Payable - Schedu

Note 8 - Notes Payable - Scheduled Maturities of Notes Payable (Details) $ in Thousands	Dec. 31, 2022 USD ($)
2023	$ 4,529
2024	4,762
2025	5,011
2026	5,271
2027	$ 2,742

Note 9 - Share-based Compensa_3

Note 9 - Share-based Compensation (Details Textual) - USD ($)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Proceeds from Stock Options Exercised	$ 0	$ 446,000	$ 1,734,000
Share-Based Payment Arrangement, Exercise of Option, Tax Benefit	$ 160,000	$ 862,000	$ 6,300,000
Common Stock Options [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Grants in Period, Gross (in shares)	127,227	101,091	70,471
Share-Based Payment Arrangement, Option [Member]
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount, Total	$ 1,200,000
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year)	2 years 7 months 17 days
Share-Based Payment Arrangement, Option [Member] | Direct, Selling, General and Administrative Expenses [Member]
Share-Based Payment Arrangement, Expense	$ 1,100,000	$ 607,000	$ 680,000
Nonvested [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period (Year)	5 years
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount, Total	$ 327,000
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year)	3 years
Nonvested [Member] | Direct, Selling, General and Administrative Expenses [Member]
Share-Based Payment Arrangement, Expense	$ 109,000	17,000	23,000
Restricted Stock [Member]
Share-Based Payment Arrangement, Expense	$ 0	$ 0
Tax Benefit Realized Restricted Stock Vested			$ 235,000
Director Plan 2004 [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award, Number of Shares Available for Grant (in shares)	707,862
Share-based Compensation Arrangement by Share-based Payment Award, Options Grants Cumulative (in shares)	2,292,138
Director Plan 2004 [Member] | Nonqualified Stock Options [Member] | Director [Member]
Share Based Compensation, Arrangement By Share Based Payment Award, Options Grant, Amount	$ 100,000
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period (Year)	1 year
Director Plan 2004 [Member] | Nonqualified Stock Options [Member] | Director [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period (Year)	10 years
Director Plan 2004 [Member] | Nonqualified Stock Options [Member] | Director [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period (Year)	3 years
Director Plan 2004 [Member] | Common Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Authorized (in shares)	3,000,000
The 2006 Equity Incentive Plan [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award, Number of Shares Available for Grant (in shares)	751,778
Share-based Compensation Arrangement by Share-based Payment Award, Options Grants Cumulative (in shares)	1,048,222
The 2006 Equity Incentive Plan [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period (Year)	10 years
The 2006 Equity Incentive Plan [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period (Year)	5 years
The 2006 Equity Incentive Plan [Member] | Nonvested [Member]
Stock Issued During Period, Shares, Restricted Stock Award, Gross (in shares)		12,698
Share-based Compensation Arrangement by Share-based Payment Award, Nonvested Restricted Stock, Outstanding Number (in shares)	12,698
The 2006 Equity Incentive Plan [Member] | Common Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Authorized (in shares)	1,800,000

Note 9 - Share-based Compensa_4

Note 9 - Share-based Compensation - Stock Options Valuation Assumptions (Details) - Common Stock [Member]	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Expected dividend yield at date of grant	3.39%	2.15%	1.84%
Expected stock price volatility	35.52%	34.85%	33.62%
Risk-free interest rate	2.33%	0.91%	1.35%
Expected life of options (in years) (Year)	6 years 3 months 18 days	7 years 3 days	7 years 4 months 20 days

Note 9 - Share-based Compensa_5

Note 9 - Share-based Compensation - Stock Option Activity Under Equity Incentive Plans and Director Plan (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Exercised, number of options (in shares)	23,581	116,753	630,373
Common Stock Options [Member]
Beginning balance, outstanding, number of options (in shares)	477,640
Beginning balance, outstanding, weighted average exercise price (in dollars per share)	$ 30.88
Granted, number of options (in shares)	127,227	101,091	70,471
Granted, weighted average exercise price (in dollars per share)	$ 36.67
Exercised, number of options (in shares)	23,581
Exercised, weighted average exercise price (in dollars per share)	$ 13.17
Ending balance, outstanding, number of options (in shares)	581,286	477,640
Ending balance, outstanding, weighted average exercise price (in dollars per share)	$ 32.86	$ 30.88
Outstanding, weighted average remaining contractual term (Year)	5 years 5 months 8 days
Outstanding, aggregate intrinsic value	$ 4,739
Exercisable, number of options (in shares)	323,140
Weighted average exercise price (in dollars per share)	$ 26.97
Exercisable, weighted average remaining contractual term (Year)	3 years 6 months 18 days
Exercisable, aggregate intrinsic value	$ 4,369

Note 9 - Share-based compensa_6

Note 9 - Share-based compensation - Stock Option Activity (Details) - Common Stock [Member] - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Weighted average grant date fair value of stock options granted (in dollars per share)	$ 9.43	$ 12.55	$ 18.67
Intrinsic value of stock options exercised (in thousands)	$ 648	$ 3,535	$ 25,912
Intrinsic value of stock options vested (in thousands)	$ 4,369	$ 4,805	$ 1,965

Note 9 - Share-based Compensa_7

Note 9 - Share-based Compensation - Non-vested Stock (Details) - Common Stock [Member]	12 Months Ended
	Dec. 31, 2022 $ / shares shares
Outstanding (in shares) | shares	12,698
Outstanding (in dollars per share) | $ / shares	$ 42.92
Granted (in shares) | shares	0
Granted (in dollars per share) | $ / shares	$ 0
Vested (in shares) | shares	0
Vested (in dollars per share) | $ / shares	$ 0
Forfeited (in shares) | shares	0
Forfeited (in dollars per share) | $ / shares	$ 0
Outstanding (in shares) | shares	12,698
Outstanding (in dollars per share) | $ / shares	$ 42.92

Note 10 - Leases (Details Textu

Note 10 - Leases (Details Textual)	Dec. 31, 2022
Minimum [Member]
Lessee, Operating Lease, Remaining Lease Term (Year)	1 year
Maximum [Member]
Lessee, Operating Lease, Remaining Lease Term (Year)	3 years 11 months 4 days

Note 10 - Leases - Lease Expens

Note 10 - Leases - Lease Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Operating leases	$ 527	$ 669	$ 600
Asset amortization	462	489	355
Interest on lease liabilities	19	34	37
Variable lease cost	95	99	62
Short-term lease cost	87	59	42
Sublease income	(123)	(81)	0
Total net lease cost	$ 1,067	$ 1,269	$ 1,096

Note 10 - Leases - Supplemental

Note 10 - Leases - Supplemental Balance Sheet Information Related to Leases (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Operating lease right-of-use assets	$ 556	$ 975
Property and equipment at cost	50,756	45,599
Less accumulated depreciation and amortization	33,508	33,208
Property and equipment under finance lease, net	$ 17,248	$ 12,391
Operating leases (Year)	1 year 11 months 12 days	2 years 9 months 18 days
Finance leases (Year)	1 year 1 month 24 days	1 year 11 months 4 days
Operating leases	3.97%	3.85%
Finance leases	3.54%	3.42%
Other Current Liabilities [Member]
Current portion, operating leases	$ 522	$ 493
Current portion, finance leases	311
Other Noncurrent Liabilities [Member]
Operating lease obligations, net of current portion	333	820
Noncurrent obligations of finance leases	39
Other Current Liabilities and Other Noncurrent Liabilities [Member]
Total operating lease liabilities	855	1,313
Total finance lease liabilities	350
Property and Equipment [Member]
Current portion, finance leases	311	470
Noncurrent obligations of finance leases	39	348
Total finance lease liabilities	350	818
Furniture and Equipment Held under Finance Leases [Member]
Property and equipment at cost	1,042	1,042
Computer Equipment Held under Finance Leases [Member]
Property and equipment at cost	659	659
Computer Software Held under Finance Leases [Member]
Property and equipment at cost	207	207
Assets Held under Finance Leases [Member]
Property and equipment at cost	1,908	1,908
Less accumulated depreciation and amortization	1,537	1,074
Property and equipment under finance lease, net	$ 371	$ 834

Note 10 - Leases - Supplement_2

Note 10 - Leases - Supplemental Cash Flow and Other Information Related to Leases (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Operating cash flows from operating leases	$ 563	$ 680	$ 596
Operating cash flows from finance leases	18	34	36
Financing cash flows from finance leases	469	493	332
ROU assets obtained in exchange for operating lease liabilities	83	560	276
ROU assets obtained in exchange for finance lease liabilities	$ 0	$ 40	$ 817

Note 10 - Leases - Undiscounted

Note 10 - Leases - Undiscounted Payments Under Non-cancelable Leases (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
2023, finance leases	$ 315
2023, operating leases	547
2024, finance leases	23
2024, operating leases	227
2025, finance leases	11
2025, operating leases	118
2026, finance leases	10
2027, finance leases	0
Finance leases, total minimum lease payments	359
Operating leases, total minimum lease payments	892
Finance leases, less: Amount representing interest	9
Operating leases, less: Amount representing interest	37
Other Current Liabilities and Other Noncurrent Liabilities [Member]
Present value of minimum finance lease payments	350
Present value of minimum operating lease payments	855	$ 1,313
Other Current Liabilities [Member]
Current portion, finance leases	311
Current portion, operating leases	522	493
Other Noncurrent Liabilities [Member]
Finance leases obligations, net of current portion	39
Operating lease obligations, net of current portion	$ 333	$ 820

Note 10 - Leases - Undiscount_2

Note 10 - Leases - Undiscounted Payments Under Sublease (Details) $ in Thousands	Dec. 31, 2022 USD ($)
2023	$ 122
2024	127
2025	65
Total minimum lease receipts	$ 314

Note 11 - Related Party (Detail

Note 11 - Related Party (Details Textual) - USD ($)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Chief Executive Officer [Member] | Nebraska Global Investment Company LLC [Member]
Officer Ownership Percentage in Vendor	13%
Don’t Panic Labs, LLC [Member]
Related Party Transaction, Amounts of Transaction	$ 196,000
Allina Health [Member]
Revenue from Related Parties		$ 1,700,000
Ameritas Life Insurance Corp [Member]
Related Party Transaction, Amounts of Transaction		278,000	$ 248,000
IMA Financial Group [Member] | Purchasing Directors and Officers and Employment Practices Liability Insurance [Member]
Related Party Transaction, Amounts of Transaction			1,100,000
PracticingExcellence.com [Member]
Revenue from Related Parties		$ 35,000	$ 294,000

Note 12 - Associate Benefits (D

Note 12 - Associate Benefits (Details Textual) - USD ($)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Defined Contribution Plan, Employer Matching Contribution, Percent of Employees' Gross Pay	25%
Defined Contribution Plan, Maximum Percentage of Annual Contribution Employee Subject to Match	6%
Defined Contribution Plan, Employers Matching Contribution, Annual Vesting Percentage	20%
Defined Contribution Plan, Employer Discretionary Contribution Amount	$ 588,000	$ 531,000	$ 521,000

Note 13 - Segment Information_2

Note 13 - Segment Information (Details Textual)	1 Months Ended	12 Months Ended
	Mar. 31, 2021	Dec. 31, 2021	Dec. 31, 2020
Number of Operating Segments	1	1	6

Note 13 - Segment Information -

Note 13 - Segment Information - Assets by Geographic Area (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Revenue	$ 151,568	$ 147,954	$ 133,277
Long-lived assets	86,745	83,833	79,311
Total assets	130,461	157,540	133,423
UNITED STATES
Revenue	150,775	144,987	130,305
Long-lived assets	86,718	83,722	77,448
Total assets	130,151	153,879	128,319
CANADA
Revenue	793	2,967	2,972
Long-lived assets	27	111	1,863
Total assets	$ 310	$ 3,661	$ 5,104