0001437749-26-015213 | 10-Q | XBRL Viewer

Earnings Per Share [Text Block]

6. EARNINGS PER SHARE

Basic earnings per share is computed by dividing the net income available to common shareholders for the period by the weighted average number of common shares outstanding during the period. Diluted earnings per share is computed by dividing the net income available to common shareholders for the period by the weighted average number of potentially dilutive common and common equivalent shares outstanding during the period. Common equivalent shares are composed of incremental common shares issuable upon the exercise of stock options and RSUs subject to vesting. The dilutive effect of common equivalent shares is included in diluted earnings per share by application of the treasury stock method. The total number of common equivalent shares excluded from the calculations of diluted earnings per share, due to their anti-dilutive effect or contingent performance conditions, was approximately 409,000 and 105,000 for the three months ended March 31, 2026 and 2025, respectively.

The following table sets forth the computation of basic and diluted earnings per share (in thousands, except per share data):

	*Three Months Ended March 31,*
	*2026*		*2025*
Numerator:
Net income	$	5,910	$	4,332
Denominator:
Weighted-average shares outstanding		29,376		30,444
Effect of dilutive shares		48		143
Weighted-average diluted shares		29,424		30,587

Net income per share:
Basic	$	0.20	$	0.14
Diluted	$	0.20	$	0.14

Note 6 - Earnings Per Share - Computation of Basic and Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Net income	$ 5,910	$ 4,332
Weighted-average shares outstanding (in shares)	29,376	30,444
Effect of dilutive shares (in shares)	48	143
Weighted-average diluted shares (in shares)	29,424	30,587
Net income per share:
Basic (in dollars per share)	$ 0.2	$ 0.14
Diluted (in dollars per share)	$ 0.2	$ 0.14

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

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The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.

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The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

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Condensed Consolidated Statements of Shareholders' Equity (Unaudited) - USD ($) shares in Thousands, $ in Thousands	Common Stock Including Additional Paid in Capital [Member]	Retained Earnings [Member]	AOCI Attributable to Parent [Member]	Total
Balance (in shares) at Dec. 31, 2024	30,432
Balance at Dec. 31, 2024	$ 252,432	$ 108,972	$ (2,049)	$ 359,355
Net income	0	4,332	0	4,332
Comprehensive income (loss)	0	0	30	30
Dividends declared on common stock	0	(943)	0	(943)
Stock-based compensation	$ 1,104	0	0	1,104
Common stock issued under stock plans, net of shares withheld for employee taxes (in shares)	93
Common stock issued under stock plans, net of shares withheld for employee taxes	$ (1,070)		0	(1,070)
Balance (in shares) at Mar. 31, 2025	30,525
Balance at Mar. 31, 2025	$ 252,466	112,361	(2,019)	$ 362,808
Balance (in shares) at Dec. 31, 2025	29,579			29,579
Balance at Dec. 31, 2025	$ 231,797	123,587	(1,361)	$ 354,023
Net income	0	5,910	0	5,910
Comprehensive income (loss)	0	0	(205)	(205)
Dividends declared on common stock	0	(1,028)	0	(1,028)
Stock-based compensation	$ 1,309	0	0	1,309
Common stock issued under stock plans, net of shares withheld for employee taxes (in shares)	68
Common stock issued under stock plans, net of shares withheld for employee taxes	$ (582)		0	(582)
Excise tax on repurchases of common stock	$ 72	0	0	72
Repurchases of common stock (in shares)	(342)
Repurchases of common stock	$ (7,507)	0	0	$ (7,507)
Balance (in shares) at Mar. 31, 2026	29,305			29,305
Balance at Mar. 31, 2026	$ 225,089	$ 128,469	$ (1,566)	$ 351,992

Note 9 - Business Combination - Fair Value of the Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Thousands	Mar. 31, 2026	Dec. 31, 2025	Dec. 15, 2025	Oct. 08, 2025
Goodwill	$ 212,701	$ 217,518
Virsys12 [Member]
Cash				$ 741
Accounts and unbilled receivable				72
Prepaid and other current assets				595
Operating lease right-of-use asset				252
Property and equipment				13
Deferred tax assets				529
Goodwill				6,108
Intangible assets				7,050
Accounts payable and accrued liabilities				(926)
Deferred revenue				(2,004)
Net assets acquired				$ 12,430
MissionCare [Member]
Cash			$ 165
Prepaid and other current assets			1,046
Deferred tax assets			1,226
Goodwill			14,993
Intangible assets			18,600
Accounts payable and accrued liabilities			(1,238)
Deferred revenue			(3,830)
Net assets acquired			31,580
Accounts receivable			$ 618

Note 6 - Earnings Per Share (Details Textual) - shares	3 Months Ended
Note 6 - Earnings Per Share (Details Textual) - shares	Mar. 31, 2026	Mar. 31, 2025
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount (in shares)	409,000	105,000

Condensed Consolidated Statements of Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Revenues, net	$ 81,203	$ 73,485
Operating costs and expenses:
Cost of revenues (excluding depreciation and amortization)	27,758	25,487
Product development	13,606	12,047
Sales and marketing	12,960	12,149
General and administrative	8,002	8,669
Depreciation and amortization	11,365	10,755
Total operating costs and expenses	73,691	69,107
Operating income	7,512	4,378
Interest income	414	931
Other expense, net	(106)	(61)
Income before income tax provision	7,820	5,248
Income tax provision	1,910	916
Net income	$ 5,910	$ 4,332
Net income per share:
Basic (in dollars per share)	$ 0.2	$ 0.14
Diluted (in dollars per share)	$ 0.2	$ 0.14
Weighted average shares of common stock outstanding:
Basic (in shares)	29,376	30,444
Diluted (in shares)	29,424	30,587
Dividends declared per share (in dollars per share)	$ 0.035	$ 0.031

Note 3 - Revenue Recognition - Revenues Disaggregated By Revenue Source (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Revenues	$ 81,203	$ 73,485
Subscription Services [Member]
Revenues	78,392	70,789
Professional Services [Member]
Revenues	$ 2,811	$ 2,696

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

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Note 1 - Overview and Basis of Presentation

3 Months Ended

Mar. 31, 2026

Business Description and Basis of Presentation [Text Block]

1. OVERVIEW AND BASIS OF PRESENTATION

Company Overview

HealthStream primarily provides Software-as-a-Service ("SaaS") based applications for healthcare organizations—all designed to improve business and clinical outcomes by supporting the people who deliver patient care. The Company is focused on helping individuals and organizations in healthcare meet their ongoing learning, clinical development, credentialing, and scheduling needs, whether through the Company's enterprise applications or emerging career networks. The Company also provides its solutions to nursing schools and nursing students.

The Company is organized and operated according to its One HealthStream approach, with its hStream technology platform at the center of that approach. Increasingly, SaaS-based applications in the Company's diverse ecosystem of solutions utilize the Company's proprietary hStream technology platform to enhance the value proposition for customers by creating interoperability with and among other applications. We believe that our single platform strategy, as represented by hStream, is the best way to realize our mission of improving the quality of care by developing the people who deliver care and the best way to create value for our shareholders in the process. As used in this Quarterly Report on Form 10-Q (“Form 10-Q”), “HealthStream,” “Company,” “we,” “us,” and “our” mean HealthStream, Inc. and its subsidiaries, unless the context indicates otherwise.

Basis of Presentation

The accompanying unaudited Condensed Consolidated Financial Statements have been prepared in accordance with accounting principles generally accepted in the United States (“US GAAP”) for interim financial information and with the instructions to Form 10‑Q and Article 10 of Regulation S‑X. Accordingly, condensed consolidated financial statements do not include all of the information and footnotes required by US GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair presentation have been included. All intercompany transactions have been eliminated in consolidation and certain prior period amounts have been reclassified to conform to the current period presentation. Operating results for the three months ended March 31, 2026 are not necessarily indicative of the results that may be expected for the year ending December 31, 2026.

The Condensed Consolidated Balance Sheet at December 31, 2025 was derived from the audited Consolidated Financial Statements at that date but does not include all of the information and footnotes required by US GAAP for a complete set of financial statements. For further information, refer to the Consolidated Financial Statements and Notes thereto for the year ended December 31, 2025 (included in the Company's Annual Report on Form 10-K, filed with the Securities and Exchange Commission on February 26, 2026).

Business Segment

The Company’s chief operating decision maker ("CODM") is its Chief Executive Officer. The Company’s business is organized and managed around a consolidated, enterprise approach, including with regard to technology, operations, accounting, internal reporting (including the nature of information reviewed by the CODM), organization structure, compensation, performance assessment, and resource allocation. The Company’s CODM uses consolidated net income to make operating decisions, assess financial performance, and allocate resources. Further, the CODM reviews and utilizes functional expenses (cost of revenues, product development, sales and marketing, general and administrative, and depreciation and amortization) at the consolidated level to manage the Company's operations. Other segment items included in consolidated net income are interest income, other expense, net, and income tax provision, which are reflected in the Condensed Consolidated Statements of Income. Expenditures for additions to long-lived assets for the consolidated entity were $12.2 million and $10.7 million for the three months ended March 31, 2026 and 2025, respectively.

Non-Marketable Equity Investments

The aggregate carrying amounts of non-marketable equity investments accounted for using the measurement alternative for equity investments that do not have readily determinable fair values were $3.0 million and $1.5 million as of March 31, 2026 and December 31, 2025, respectively, which the Company evaluates for impairment at each reporting period. Cumulatively, there have been no adjustments recorded due to changes in the fair value of the non-marketable equity investments the Company held as of March 31, 2026. The fair value of non-marketable equity investments is not estimated if there are no identified events or changes in circumstances that may have a significant adverse effect on the fair value of the investment.

Fair Value Measurement

During the three months ended March 31, 2026, the Company recorded a purchase accounting adjustment to reduce the fair value of contingent consideration by $2.3 million related to the MissionCare Collective acquisition from the original estimate recorded based on updated information received from valuation specialists (see Note 9 to the Condensed Consolidated Financial Statements).

	March 31,			December 31,
Contingent Consideration:	2026			2025
Beginning balance	$	6,450		$	535
Purchases/Initial recognition		(2,300	)		6,000
Total (gains) losses:
Included in earnings		—			(85	)
Included in other comprehensive income		—			—
Payments		—			—
Ending balance	$	4,150		$	6,450

Note 1 - Overview and Basis of Presentation - Schedule of Unobservable Input Reconciliation (Details) - Fair Value of Contingent Consideration [Member] - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2026	Dec. 31, 2025
Beginning balance	$ 6,450	$ 535
Purchases/Initial recognition	(2,300)	6,000
Included in earnings	0	(85)
Included in other comprehensive income	0	0
Payments	0	0
Ending balance	$ 4,150	$ 6,450

Note 9 - Business Combinations (Tables) - Virsys12 [Member]

3 Months Ended

Mar. 31, 2026

Business Combination [Table Text Block]

Cash	$	11,430
Fair value of contingent consideration		1,000
Total consideration	$	12,430

Cash	$	24,880
Common stock issued		4,000
Fair value of contingent consideration		2,700
Total consideration	$	31,580

Business Combination, Recognized Asset Acquired and Liability Assumed [Table Text Block]

Cash	$	741
Accounts and unbilled receivable		72
Prepaid and other current assets		595
Operating lease right-of-use asset		252
Property and equipment		13
Deferred tax assets		529
Goodwill		6,108
Intangible assets		7,050
Accounts payable and accrued liabilities		(926	)
Deferred revenue		(2,004	)
Net assets acquired	$	12,430

Cash	$	165
Accounts receivable		618
Prepaid and other current assets		1,046
Deferred tax assets		1,226
Goodwill		14,993
Intangible assets		18,600
Accounts payable and accrued liabilities		(1,238	)
Deferred revenue		(3,830	)
Net assets acquired	$	31,580

Business Combination, Intangible Asset, Acquired, Finite-Lived [Table Text Block]

	Fair value		Useful life
Customer relationships	$	700	10 years
Developed technology		5,900	5 years
Non-compete		250	5 years
Trade name		200	3 years
Total intangible assets subject to amortization	$	7,050

	*Fair value*		*Useful life*
Customer relationships	$	9,000	7 years
Developed technology		8,800	5 years
Trade name		800	8 years
Total intangible assets subject to amortization	$	18,600

Business Combination, Pro Forma Information [Table Text Block]

	Three Months Ended March 31,
	2025
Total revenues	$	75,236
Net income	$	4,139
Net income per share - basic	$	0.14
Net income per share - diluted	$	0.14

	Three Months Ended March 31,
	2025
Total revenues	$	75,711
Net income	$	4,486
Net income per share - basic	$	0.15
Net income per share - diluted	$	0.15

Tabular disclosure of business combination. Includes, but is not limited to, recognized asset and liability.

Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Net income	$ 5,910	$ 4,332
Other comprehensive (loss) income, net of taxes:
Foreign currency translation adjustments	(188)	49
Unrealized loss on marketable securities	(17)	(19)
Total other comprehensive (loss) income	(205)	30
Comprehensive income	$ 5,705	$ 4,362

Amount after tax of increase (decrease) in equity from transactions and other events and circumstances from net income and other comprehensive income, attributable to parent entity. Excludes changes in equity resulting from investments by owners and distributions to owners.

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

Condensed Consolidated Balance Sheets (Unaudited) (Parentheticals) - $ / shares shares in Thousands, $ / shares in Thousands	Mar. 31, 2026	Dec. 31, 2025
Preferred stock, par value (in dollars per share)	$ 0	$ 0
Preferred stock, authorized (in shares)	10,000	10,000
Preferred stock, issued (in shares)	0	0
Preferred stock, outstanding (in shares)	0	0
Common stock, shares authorized (in shares)	75,000	75,000
Common stock, shares issued (in shares)	29,305	29,579
Common stock, shares outstanding (in shares)	29,305	29,579
Common stock, par value (in dollars per share)	$ 0	$ 0

Number of shares of common stock outstanding. Common stock represent the ownership interest in a corporation.

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The maximum number of nonredeemable preferred shares (or preferred stock redeemable solely at the option of the issuer) permitted to be issued by an entity's charter and bylaws.

Number of shares issued for nonredeemable preferred shares and preferred shares redeemable solely at option of issuer. Includes, but is not limited to, preferred shares issued, repurchased, and held as treasury shares. Excludes preferred shares classified as debt.

Aggregate share number for all nonredeemable preferred stock (or preferred stock redeemable solely at the option of the issuer) held by stockholders. Does not include preferred shares that have been repurchased.

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Note 8 - Debt

3 Months Ended

Mar. 31, 2026

Debt Disclosure [Text Block]

8. DEBT

Revolving Credit Facility

On March 13, 2026, the Company entered into the First Amendment (the "First Amendment") to Amended and Restated Revolving Credit Agreement, amending the Amended and Restated Revolving Credit Agreement dated October 6, 2023 (the “Revolving Credit Facility"; the Revolving Credit Facility, as amended by the First Amendment, the "Amended Revolving Credit Facility"). The First Amendment made certain revisions to the restricted payments provision in the Revolving Credit Facility (including to broaden the scope of certain parameters restricting dividends and share repurchases by the Company), and did not otherwise change the terms of the Revolving Credit Facility.

The Revolving Credit Facility amended and restated the revolving credit facility dated as of November 24, 2014, as amended, with certain lenders party thereto from time to time, and Truist, as Administrative Agent for the lenders. Under the Amended Revolving Credit Facility, the Company may borrow up to $50.0 million, which includes a $5.0 million swingline sub-facility and a $5.0 million letter of credit sub-facility, as well as an accordion feature that allows the Company to increase the Amended Revolving Credit Facility by a total of up to $25.0 million, subject to securing additional commitments from existing lenders or new lending institutions. The Amended Revolving Credit Facility has a maturity date of October 6, 2026.

The Company's obligations under the Amended Revolving Credit Facility are unsecured. In addition, if the Company forms or acquires any domestic subsidiaries, the loans and other obligations under the Amended Revolving Credit Facility will be guaranteed by such domestic subsidiaries.

At the Company’s election, the borrowings under the Amended Revolving Credit Facility, other than the swingline loans, bear interest at either (1) a base rate defined as the highest of (a) the rate which the Administrative Agent announces from time to time as its prime lending rate, as in effect from time to time, or (b) the Federal Funds Rate, as in effect from time to time, plus one-half of one percent (0.50%) per annum (any changes in such rates to be effective as of the date of any change in such rate), plus in each case an applicable margin that varies with the company’s funded debt leverage ratio; or (2) a term secured overnight financing rate (“SOFR”) defined as the greater of (a)(i) the forward-looking term rate based on SOFR determined as of the reference time for such interest period with a term equivalent to such interest period plus (ii) a term SOFR adjustment equal to 0.10% per annum and (b) zero, plus, in each case, an applicable margin that varies with the Company’s consolidated total leverage ratio. The Company’s borrowings under the swingline loans bear interest at the base rate plus the applicable margin. The initial applicable margin for base rate loans is 0.50% and the initial applicable margin SOFR loans is 1.50%. The applicable margins will be adjusted quarterly, in each case two (2) business days after the Administrative Agent's receipt of the Company's quarterly financial statements. The Company is also required to pay a commitment fee accruing on the unused revolving commitment, which fee initially is 20 basis points per annum and a letter of credit fee, accruing at a rate per annum equal to the applicable margin for SOFR loans then in effect on the daily average amount of such lender’s letter of credit exposure.

Principal is payable in full at maturity on October 6, 2026, and there are no scheduled principal payments prior to maturity. Interest on base rate loans and swingline loans is payable quarterly in arrears, and interest on SOFR loans is payable at the end of each interest period, and in the case of interest periods longer than three months, on each day which occurs every three months after the initial date of such interest period.

The purpose of the Amended Revolving Credit Facility is for general working capital needs, permitted acquisitions (as defined in the Amended and Restated Revolving Credit Agreement), and for stock repurchase and/or redemption transactions that the Company may authorize.

In addition, the Amended Revolving Credit Facility required the Company to meet certain financial tests, including, without limitation:

•	a funded debt leverage ratio (consolidated debt/consolidated EBITDA) of not greater than 3.0 to 1.0; and

•	an interest coverage ratio (consolidated EBITDA/consolidated interest expense) of not less than 3.0 to 1.0.

In addition, the Amended Revolving Credit Facility contains certain customary affirmative and negative covenants that, among other things, restrict additional indebtedness, liens and encumbrances, changes to the character of the Company’s business, acquisitions, asset dispositions, mergers and consolidations, sale or discount of receivables, creation or acquisitions of additional subsidiaries, and other matters customarily restricted in such agreements.

As of March 31, 2026, the Company was in compliance with all covenants of the Amended Revolving Credit Facility. There were no balances outstanding on the Amended Revolving Credit Facility as of or during the three months ended March 31, 2026.

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

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Note 5 - Shareholders' Equity and Stock-Based Compensation - RSUs Activities (Details) - Restricted Stock Units (RSUs) [Member] $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2026 USD ($) $ / shares shares
Outstanding, shares (in shares) \| shares	518
Outstanding, Weighted average grant date fair value (in dollars per share) \| $ / shares	$ 26.57
Granted, shares (in shares) \| shares	57
Granted, Weighted average grant date fair value (in dollars per share) \| $ / shares	$ 20.61
Vested, shares (in shares) \| shares	(95)
Vested, Weighted average grant date fair value (in dollars per share) \| $ / shares	$ 24.13
Forfeited, shares (in shares) \| shares	0
Forfeited, Weighted average grant date fair value (in dollars per share) \| $ / shares	$ 0
Outstanding, shares (in shares) \| shares	480
Outstanding, Weighted average grant date fair value (in dollars per share) \| $ / shares	$ 26.34
Outstanding, aggregate intrinsic value \| $	$ 9,935

Note 1 - Overview and Basis of Presentation (Tables)

3 Months Ended

Mar. 31, 2026

Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Table Text Block]

	March 31,			December 31,
Contingent Consideration:	2026			2025
Beginning balance	$	6,450		$	535
Purchases/Initial recognition		(2,300	)		6,000
Total (gains) losses:
Included in earnings		—			(85	)
Included in other comprehensive income		—			—
Payments		—			—
Ending balance	$	4,150		$	6,450

Note 3 - Revenue Recognition (Tables)

3 Months Ended

Mar. 31, 2026

Disaggregation of Revenue [Table Text Block]

	*Three Months Ended March 31,*
	*2026*		*2025*
Subscription services	$	78,392	$	70,789
Professional services		2,811		2,696
Total revenues, net	$	81,203	$	73,485

Note 5 - Shareholders' Equity and Stock-Based Compensation (Tables)

3 Months Ended

Mar. 31, 2026

Schedule of Dividends Payable [Table Text Block]

Dividend Payment Date		Dividend Declaration Date		Dividend Per Share			Record Date		Cash Outlay
March 20, 2026		February 23, 2026		$	0.035		March 9, 2026		$	1,028

Share-Based Payment Arrangement, Option, Activity [Table Text Block]

			*Weighted-*
	*Common*		*Average*		*Aggregate*
	*Shares*		*Exercise Price*		*Intrinsic Value*
Outstanding at beginning of period		233	$	22.54
Granted		—		—
Exercised		—		—
Expired		—		—
Forfeited		—		—
Outstanding at end of period		233	$	22.54	$	33
Exercisable at end of period		90	$	20.34	$	33

Share-Based Payment Arrangement, Restricted Stock Unit, Activity [Table Text Block]

				*Weighted-*
	*Number of*			*Average Grant Date*		*Aggregate*
	*RSU’s*			*Fair Value*		*Intrinsic Value*
Outstanding at beginning of period		518		$	26.57
Granted		57			20.61
Vested		(95	)		24.13
Forfeited		—			—
Outstanding at end of period		480		$	26.34	$	9,935

Share-Based Payment Arrangement, Expensed and Capitalized, Amount [Table Text Block]

	*Three Months Ended March 31,*
	*2026*		*2025*
Cost of revenues (excluding depreciation and amortization)	$	56	$	53
Product development		273		229
Sales and marketing		168		145
General and administrative		812		677
Total stock-based compensation expense	$	1,309	$	1,104

Note 6 - Earnings Per Share (Tables)

3 Months Ended

Mar. 31, 2026

Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]

	*Three Months Ended March 31,*
	*2026*		*2025*
Numerator:
Net income	$	5,910	$	4,332
Denominator:
Weighted-average shares outstanding		29,376		30,444
Effect of dilutive shares		48		143
Weighted-average diluted shares		29,424		30,587

Net income per share:
Basic	$	0.20	$	0.14
Diluted	$	0.20	$	0.14

Note 9 - Business Combinations

3 Months Ended

Mar. 31, 2026

Business Combination [Text Block]

9. BUSINESS COMBINATIONS

Virsys12

On October 8, 2025, the Company acquired all of the outstanding equity of Virsys12, LLC ("Virsys12"), a Brentwood, Tennessee-based healthcare technology company that offers payers and health plans an innovative provider data management suite used for onboarding, credentialing, and network management. The consideration paid at closing for Virsys12 consisted of approximately $11.4 million payable in cash, after giving effect to customary purchase price adjustments and a post-closing working capital adjustment. In addition, up to an additional $4.0 million in cash may be paid over a three-year period following closing, contingent upon the achievement of certain financial targets. This acquisition expanded the Company's existing provider data management and credentialing solution for payers and health plan enterprises, called Network by HealthStream^TM, which is a part of its broader, market-leading Credentialing application suite. The acquisition was accounted for using the acquisition method of business combination under ASC 805. The results of operations for Virsys12 have been included in the Company’s Condensed Consolidated Financial Statements from the date of acquisition.

A summary of the purchase price is as follows (in thousands):

Cash	$	11,430
Fair value of contingent consideration		1,000
Total consideration	$	12,430

The following table summarizes the preliminary fair value of the assets acquired and liabilities assumed as of the date of acquisition (in thousands):

Cash	$	741
Accounts and unbilled receivable		72
Prepaid and other current assets		595
Operating lease right-of-use asset		252
Property and equipment		13
Deferred tax assets		529
Goodwill		6,108
Intangible assets		7,050
Accounts payable and accrued liabilities		(926	)
Deferred revenue		(2,004	)
Net assets acquired	$	12,430

The following table sets forth the preliminary components of identifiable intangible assets and their estimated useful lives as of the acquisition date (in thousands):

	Fair value		Useful life
Customer relationships	$	700	10 years
Developed technology		5,900	5 years
Non-compete		250	5 years
Trade name		200	3 years
Total intangible assets subject to amortization	$	7,050

The following unaudited pro forma financial information summarizes the results of operations of the Company and Virsys12 as though the companies were combined as of January 1, 2024 (in thousands, except per share data):

	Three Months Ended March 31,
	2025
Total revenues	$	75,236
Net income	$	4,139
Net income per share - basic	$	0.14
Net income per share - diluted	$	0.14

These unaudited pro forma combined results of operations include certain adjustments arising from the acquisition, such as amortization of intangible assets, depreciation of property and equipment, and interest expense related to Virsys12's previously outstanding debt. The unaudited pro forma combined results of operations is for informational purposes only and is not indicative of what the Company’s results of operations would have been had the transaction occurred as of January 1, 2024 or to project the Company’s results of operations in any future period.

MissionCare Collective

On December 15, 2025, the Company acquired all of the outstanding equity of MissionCare Collective, LLC ("MissionCare"), a healthcare workforce company that includes the largest caregiver network in the United States. The consideration paid at closing for MissionCare consisted of approximately $24.9 million payable in cash at closing, after giving effect to customary purchase price adjustments and a post-closing working capital adjustment. In addition, 165,684 shares of HealthStream common stock valued at $4.0 million were issued at closing through a private placement, and up to an additional $10.0 million in cash may be paid over a three-year period following closing, contingent upon the achievement of certain financial targets. The acquisition will be accounted for using the acquisition method of business combination under ASC 805. The results of operations for MissionCare have been included in the Company’s Condensed Consolidated Financial Statements from the date of acquisition.

A summary of the purchase price is as follows (in thousands):

Cash	$	24,880
Common stock issued		4,000
Fair value of contingent consideration		2,700
Total consideration	$	31,580

The following table summarizes the preliminary fair value of the assets acquired and liabilities assumed as of the date of acquisition (in thousands):

Cash	$	165
Accounts receivable		618
Prepaid and other current assets		1,046
Deferred tax assets		1,226
Goodwill		14,993
Intangible assets		18,600
Accounts payable and accrued liabilities		(1,238	)
Deferred revenue		(3,830	)
Net assets acquired	$	31,580

The excess of preliminary purchase price over the preliminary fair values of net tangible and intangible assets is recorded as goodwill. The preliminary fair values of tangible and identifiable intangible assets and liabilities are based on management’s estimates and assumptions. The preliminary fair values of assets acquired and liabilities assumed continue to be subject to change during the measurement period (up to one year from the acquisition date) as the Company finalizes the valuation of these items. During the three months ended March 31, 2026, the Company recorded adjustments to intangible assets and contingent consideration based on information received during the period from valuation specialists, as well as recorded the post-closing working capital adjustment, which resulted in the Company recording a measurement period adjustment which decreased goodwill by $4.6 million. The measurement period adjustment had an immaterial effect on current or prior period earnings. The primary areas of the preliminary purchase price allocation that are not finalized include the composition and valuation of an indemnification asset and liability related to sales tax attributes, which is preliminarily valued at $1.0 million. The primary intangible assets acquired were customer relationships and developed technology. The fair value estimate for customer relationships intangible asset included significant assumptions regarding prospective financial information with respect to the acquisition, including with respect to revenue growth, customer attrition, EBITDA margin, and the discount rate. The fair value estimate for developed technology intangible asset included significant assumptions, including the estimate of employee hours that would be needed to recreate the technology. Additionally, these assumptions are forward looking and could be affected by future economic and market conditions. The goodwill balance is primarily attributed to the assembled workforce, additional market opportunities arising from offering MissionCare products, and expected synergies from integrating MissionCare with other products or other combined functional areas within the Company. The goodwill balance is deductible for U.S. income tax purposes.

The following table sets forth the preliminary components of identifiable intangible assets and their estimated useful lives as of the acquisition date (in thousands):

	*Fair value*		*Useful life*
Customer relationships	$	9,000	7 years
Developed technology		8,800	5 years
Trade name		800	8 years
Total intangible assets subject to amortization	$	18,600

The following unaudited pro forma financial information summarizes the results of operations of the Company and MissionCare as though the companies were combined as of January 1, 2024 (in thousands, except per share data):

	Three Months Ended March 31,
	2025
Total revenues	$	75,711
Net income	$	4,486
Net income per share - basic	$	0.15
Net income per share - diluted	$	0.15

These unaudited pro forma combined results of operations include certain adjustments arising from the acquisition, such as amortization of intangible assets. The unaudited pro forma combined results of operations is for informational purposes only and is not indicative of what the Company’s results of operations would have been had the transaction occurred as of January 1, 2024 or to project the Company’s results of operations in any future period.

The entire disclosure for business combination.

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Note 4 - Income Taxes

3 Months Ended

Mar. 31, 2026

Income Tax Disclosure [Text Block]

4. INCOME TAXES

Income taxes are accounted for using the asset and liability method, whereby deferred tax assets and liabilities are determined based on the temporary differences between the financial statement and tax bases of assets and liabilities measured at tax rates that will be in effect for the year in which the differences are expected to affect taxable income. The Company computes its interim period provision for income taxes by applying the estimated annual effective tax rate to year-to-date pretax income or loss and adjusts the provision for discrete tax items recorded in the period. The Company’s effective tax rate was 24% and 17% for the three months ended March 31, 2026 and 2025, respectively. The Company’s effective tax rate primarily reflects the statutory corporate income tax rate, the net effect of state taxes, foreign income taxes, the effect of various permanent tax differences, and recognition of discrete tax items. During the three months ended March 31, 2026, the Company recorded discrete tax expense of $0.2 million, which consisted of discrete tax expense associated with stock-based awards and reserves for uncertain tax positions. During the three months ended March 31, 2025, the Company recorded discrete tax benefits of $0.2 million, which consisted of a tax benefit associated with stock-based awards partially offset by discrete tax expense related to reserves for uncertain tax positions.

The entire disclosure for income tax.

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Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Mar. 31, 2026	Dec. 31, 2025
ASSETS
Cash and cash equivalents	$ 48,711	$ 36,161
Marketable securities	17,787	20,843
Accounts receivable, net	38,435	32,153
Accounts receivable - unbilled	5,009	6,845
Prepaid and other current assets	23,081	23,654
Total current assets	133,023	119,656
Property and equipment, net	10,203	10,661
Capitalized software development, net	45,621	45,581
Operating lease right of use assets, net	14,445	15,272
Goodwill	212,701	217,518
Intangibles, net	63,657	64,930
Other assets	47,791	46,756
Total assets	527,441	520,374
LIABILITIES AND SHAREHOLDERS’ EQUITY
Accounts payable	5,086	7,769
Accrued royalties	6,588	5,595
Accrued liabilities	14,409	11,166
Accrued compensation	4,029	11,199
Deferred revenue	106,402	88,417
Total current liabilities	136,514	124,146
Deferred tax liabilities	17,977	18,246
Deferred revenue, noncurrent	1,320	1,344
Operating lease liability, noncurrent	14,067	14,684
Other long-term liabilities	5,571	7,931
Commitments and contingencies
Shareholders’ equity:
Preferred Stock, no par value, 10,000 shares authorized, no shares issued or outstanding	0	0
Common stock, no par value, 75,000 shares authorized; 29,305 and 29,579 shares issued and outstanding at March 31, 2026 and December 31, 2025, respectively	225,089	231,797
Retained earnings	128,469	123,587
Accumulated other comprehensive loss	(1,566)	(1,361)
Total shareholders’ equity	351,992	354,023
Total liabilities and shareholders’ equity	$ 527,441	$ 520,374

Note 7 - Marketable Securities (Tables)

3 Months Ended

Mar. 31, 2026

Debt Securities, Available-for-Sale [Table Text Block]

	*March 31, 2026*
	*Adjusted Cost*		*Unrealized Gains*		*Unrealized Losses*			*Fair Value*
Level 2:
U.S. treasury securities	$	17,778	$	10	$	(1	)	$	17,787
Total	$	17,778	$	10	$	(1	)	$	17,787

	*December 31, 2025*
	*Adjusted Cost*		*Unrealized Gains*		*Unrealized Losses*		*Fair Value*
Level 2:
U.S. treasury securities	$	20,817	$	26	$	—	$	20,843
Total	$	20,817	$	26	$	—	$	20,843

Tabular disclosure of investment in debt security measured at fair value with change in fair value recognized in other comprehensive income (available-for-sale).

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 5: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 6: http://www.xbrl.org/2009/role/commonPracticeRef
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Note 1 - Overview and Basis of Presentation (Details Textual) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025	Dec. 31, 2025
Segment Reporting, Long-Lived Asset, Expenditure for Addition	$ 12.2	$ 10.7
Equity Securities without Readily Determinable Fair Value, Amount	3.0		$ 1.5
Business Combination, Contingent Consideration, Change in Contingent Consideration, Liability, Increase (Decrease)	$ (2.3)

Note 9 - Business Combination - Pro Forma Financial Information, Business Acquisition (Details) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2026 USD ($) $ / shares
Virsys12 [Member]
Total revenues \| $	$ 75,236
Net income \| $	$ 4,139
Net income per share - basic (in dollars per share) \| $ / shares	$ 0.14
Net income per share - diluted (in dollars per share) \| $ / shares	$ 0.14
MissionCare [Member]
Total revenues \| $	$ 75,711
Net income \| $	$ 4,486
Net income per share - basic (in dollars per share) \| $ / shares	$ 0.15
Net income per share - diluted (in dollars per share) \| $ / shares	$ 0.15

Note 5 - Shareholders' Equity and Stock-Based Compensation (Details Textual) $ / shares in Units, $ in Thousands		1 Months Ended	3 Months Ended
	May 04, 2026 $ / shares	Apr. 30, 2026 USD ($) shares	Mar. 31, 2026 USD ($) $ / shares shares	Mar. 31, 2025 USD ($) $ / shares	Mar. 13, 2026 USD ($)	Nov. 11, 2025 USD ($)
Common Stock, Dividends, Per Share, Declared (in dollars per share) \| $ / shares			$ 0.035	$ 0.031
Stock Repurchased During Period, Value			$ 7,507
The November 2025 Share Repurchase Program [Member]
Share Repurchase Program, Authorized, Amount						$ 10,000
Stock Repurchased and Retired During Period, Shares (in shares) \| shares			222,978
Stock Repurchased and Retired During Period, Value			$ 5,000
Stock Repurchased Average Price per Share (in dollars per share) \| $ / shares			$ 22.42
The May 2025 Share Repurchase Program [Member]
Share Repurchase Program, Excise Tax Rate			0.01
The March 2026 Share Repurchase Program [Member]
Share Repurchase Program, Authorized, Amount					$ 10,000
Stock Repurchased and Retired During Period, Shares (in shares) \| shares			119,367
Stock Repurchased and Retired During Period, Value			$ 2,500
Stock Repurchased Average Price per Share (in dollars per share) \| $ / shares			$ 20.94
Share Repurchase Program, Excise Tax Rate			0.01
Share-Based Payment Arrangement, Option [Member]
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year)			7 years 9 months 18 days
Restricted Stock [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award, Equity Instruments Other than Options, Vested in Period, Fair Value			$ 2,300	$ 2,900
Stock Options And Restricted Stock Units [Member]
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year)			2 years 8 months 12 days
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount			$ 8,600
Subsequent Event [Member] \| The March 2026 Share Repurchase Program [Member]
Stock Repurchased During Period, Shares (in shares) \| shares		90,131
Stock Repurchased During Period, Value		$ 1,800
Subsequent Event [Member] \| O 2026 Q2 Dividends [Member]
Common Stock, Dividends, Per Share, Declared (in dollars per share) \| $ / shares	$ 0.035
Dividends Payable, Date to be Paid	May 29, 2026
Dividends Payable, Date of Record	May 18, 2026

Note 9 - Business Combinations (Details Textual) - USD ($) $ in Thousands			3 Months Ended
	Dec. 15, 2025	Oct. 08, 2025	Mar. 31, 2026	Dec. 31, 2025
Virsys12 [Member]
Payments to Acquire Businesses, Gross		$ 11,430
Business Combination, Contingency Recognized at Acquisition Date, Liability Assumed, Fair Value		$ 4,000
Business Combination Indemnification Assets and Liability Related to Tax Liabilities Amount as of Acquisition Date				$ 400
MissionCare [Member]
Payments to Acquire Businesses, Gross	$ 24,880
Business Combination, Contingency Recognized at Acquisition Date, Liability Assumed, Fair Value	$ 10,000
Business Combination Indemnification Assets and Liability Related to Tax Liabilities Amount as of Acquisition Date			$ 1,000
Business Combination, Consideration Transferred, Equity Interest, Share Issued, Number of Shares (in shares)	165,684
Business Combination, Consideration Transferred, Equity Interest	$ 4,000
Goodwill, Measurement Period Adjustment			$ (4,600)

Condensed Consolidated Statements of Shareholders' Equity (Unaudited) (Parentheticals) - $ / shares	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Dividends declared per share (in dollars per share)	$ 0.035	$ 0.031

Note 9 - Business Combination - Identifiable Intangible Assets and Their Estimated Useful Lives (Details) - USD ($) $ in Thousands	Dec. 15, 2025	Oct. 08, 2025
Virsys12 [Member]
Finite-Lived Intangible Assets Acquired		$ 7,050
Virsys12 [Member] \| Customer Relationships [Member]
Finite-Lived Intangible Assets Acquired		$ 700
Useful Life (Year)		10 years
Virsys12 [Member] \| Developed Technology Rights [Member]
Finite-Lived Intangible Assets Acquired		$ 5,900
Useful Life (Year)		5 years
Virsys12 [Member] \| Noncompete Agreements [Member]
Finite-Lived Intangible Assets Acquired		$ 250
Useful Life (Year)		5 years
Virsys12 [Member] \| Trade Names [Member]
Finite-Lived Intangible Assets Acquired		$ 200
Useful Life (Year)		3 years
MissionCare [Member]
Finite-Lived Intangible Assets Acquired	$ 18,600
MissionCare [Member] \| Customer Relationships [Member]
Finite-Lived Intangible Assets Acquired	$ 9,000
Useful Life (Year)	7 years
MissionCare [Member] \| Developed Technology Rights [Member]
Finite-Lived Intangible Assets Acquired	$ 8,800
Useful Life (Year)	5 years
MissionCare [Member] \| Trade Names [Member]
Finite-Lived Intangible Assets Acquired	$ 800
Useful Life (Year)	8 years

Document And Entity Information - shares	3 Months Ended
Document And Entity Information - shares	Mar. 31, 2026	May 04, 2026
Document Information [Line Items]
Entity Central Index Key	0001095565
Entity Registrant Name	HEALTHSTREAM INC
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Document Fiscal Period Focus	Q1
Document Fiscal Year Focus	2026
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2026
Document Transition Report	false
Entity File Number	000-27701
Entity Incorporation, State or Country Code	TN
Entity Tax Identification Number	62-1443555
Entity Address, Address Line One	500 11th Avenue North, Suite 850
Entity Address, City or Town	Nashville
Entity Address, State or Province	TN
Entity Address, Postal Zip Code	37203
City Area Code	615
Local Phone Number	301-3100
Title of 12(b) Security	Common Stock (Par Value $0.00)
Trading Symbol	HSTM
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		29,215,188

Note 5 - Shareholders' Equity and Stock-Based Compensation

3 Months Ended

Mar. 31, 2026

Equity [Text Block]

5. SHAREHOLDERS' EQUITY AND STOCK-BASED COMPENSATION

Dividends on Common Stock

During the three months ended March 31, 2026, the Company's Board of Directors (“Board”) declared the following quarterly dividend under the Company's dividend policy (in thousands, except per share data):

Dividend Payment Date		Dividend Declaration Date		Dividend Per Share			Record Date		Cash Outlay
March 20, 2026		February 23, 2026		$	0.035		March 9, 2026		$	1,028

Additionally, on May 4, 2026, the Board declared a quarterly cash dividend of $0.035 per share, payable on May 29, 2026 to holders of record on May 18, 2026.

Stock Option Activity

A summary of stock option activity for the three months ended March 31, 2026 is as follows (in thousands, except weighted-average exercise price).

			*Weighted-*
	*Common*		*Average*		*Aggregate*
	*Shares*		*Exercise Price*		*Intrinsic Value*
Outstanding at beginning of period		233	$	22.54
Granted		—		—
Exercised		—		—
Expired		—		—
Forfeited		—		—
Outstanding at end of period		233	$	22.54	$	33
Exercisable at end of period		90	$	20.34	$	33

The weighted average remaining contractual term of options outstanding at March 31, 2026 was 7.8 years.

Restricted Share Unit Activity

A summary of Restricted Share Unit ("RSU") activity for the three months ended March 31, 2026 is as follows (in thousands, except weighted-average grant date fair value):

				*Weighted-*
	*Number of*			*Average Grant Date*		*Aggregate*
	*RSU’s*			*Fair Value*		*Intrinsic Value*
Outstanding at beginning of period		518		$	26.57
Granted		57			20.61
Vested		(95	)		24.13
Forfeited		—			—
Outstanding at end of period		480		$	26.34	$	9,935

The aggregate fair value of RSUs that vested during the three months ended March 31, 2026 and 2025, as of the respective vesting dates, was $2.3 million and $2.9 million, respectively.

Stock-Based Compensation

Total stock-based compensation expense recognized in the Condensed Consolidated Statements of Income is as follows (in thousands):

	*Three Months Ended March 31,*
	*2026*		*2025*
Cost of revenues (excluding depreciation and amortization)	$	56	$	53
Product development		273		229
Sales and marketing		168		145
General and administrative		812		677
Total stock-based compensation expense	$	1,309	$	1,104

As of March 31, 2026, total unrecognized compensation expense related to non-vested stock options, RSUs, and performance-based RSUs where the performance criteria has been established was $8.6 million, net of estimated forfeitures, with a weighted average expense recognition period remaining of 2.7 years.

Share Repurchase Plan

On November 11, 2025, the Board approved a share repurchase program under which the Company was authorized to repurchase up to $10.0 million of its outstanding shares of common stock. Pursuant to this authorization, the Company was authorized to make repurchases in the open market, including under Rule 10b5-1 plans, through privately negotiated transactions, or otherwise. The terms of this program provided that it would terminate on the earlier of February 26, 2026 or when the maximum dollar amount had been expended. During the three months ended March 31, 2026, the Company repurchased and subsequently retired 222,978 shares of common stock at an aggregate fair value of $5.0 million, reflecting an average price per share of $22.42 (excluding the cost of broker commissions and the 1% share repurchase excise tax imposed by the Inflation Reduction Act of 2022). This share repurchase program terminated in January 2026 when the maximum dollar amount under this program was expended.

On March 13, 2026, the Company announced the adoption of a new share repurchase program approved by the Board under which the Company is authorized to repurchase up to $10.0 million of its outstanding shares of common stock. Pursuant to this authorization, the Company is authorized to make repurchases in the open market, including under Rule 10b5-1 plans, through privately negotiated transactions, or otherwise. This share repurchase program terminates on the earlier of September 12, 2026 or when the maximum dollar amount under the plan has been expended. During the three months ended March 31, 2026, the Company repurchased and subsequently retired 119,367 shares of common stock at an aggregate fair value of $2.5 million under this authorization, reflecting an average price per share of $20.94 (excluding the cost of broker commissions and the 1% share repurchase excise tax imposed by the Inflation Reduction Act of 2022), and the Company continued to repurchase shares pursuant to this authorization during the second quarter of 2026, repurchasing 90,131 additional shares valued at $1.8 million through April 30, 2026.

The entire disclosure for equity.

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-URI https://asc.fasb.org/1943274/2147481112/505-10-50-14

Reference 35: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 16
-Subparagraph (b)
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-URI https://asc.fasb.org/1943274/2147481112/505-10-50-16

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
OPERATING ACTIVITIES:
Net income	$ 5,910	$ 4,332
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	11,365	10,755
Stock-based compensation	1,309	1,104
Amortization of deferred commissions	3,286	3,150
Provision for credit losses	92	237
Deferred income taxes	0	751
Loss on equity method investments	40	72
Other	(160)	(399)
Changes in operating assets and liabilities:
Accounts and unbilled receivables	4,550	1,002
Prepaid royalties	(1,695)	(1,200)
Other prepaid expenses and other current assets	2,300	1,469
Other assets	(2,611)	(2,781)
Accounts payable and accrued expenses	(7,044)	(7,296)
Accrued royalties	994	425
Deferred revenue	17,900	17,457
Net cash provided by operating activities	27,136	27,074
INVESTING ACTIVITIES:
Cash paid for acquisitions	(302)	0
Proceeds from maturities of marketable securities	13,400	11,268
Purchases of marketable securities	(10,197)	(9,171)
Purchases of other investments	(1,750)	(500)
Payments associated with capitalized software development	(6,727)	(7,790)
Purchases of property and equipment	(740)	(1,055)
Net cash used in investing activities	(6,316)	(7,248)
FINANCING ACTIVITIES:
Taxes paid related to net settlement of equity awards	(582)	(1,070)
Payment of cash dividends	(1,028)	(943)
Repurchases of common stock	(6,723)	0
Net cash used in financing activities	(8,333)	(2,013)
Net increase in cash and cash equivalents	12,550	17,820
Cash and cash equivalents at beginning of period	36,161	59,469
Cash and cash equivalents at end of period	48,711	77,289
Effect of exchange rate changes on cash and cash equivalents	63	7
NONCASH INVESTING AND FINANCING ACTIVITIES:
Purchases of property and equipment, accrued but not paid	262	197
Capitalized software development, accrued but not paid	$ 741	$ 330

Note 7 - Marketable Securities

3 Months Ended

Mar. 31, 2026

Investment in Debt and Equity Securities and Other Trading Assets [Text Block]

7. MARKETABLE SECURITIES

The fair value of marketable securities, which were all classified as available for sale and which the Company does not intend to sell nor will the Company be required to sell prior to recovery of their amortized cost basis, included the following (in thousands):

	*March 31, 2026*
	*Adjusted Cost*		*Unrealized Gains*		*Unrealized Losses*			*Fair Value*
Level 2:
U.S. treasury securities	$	17,778	$	10	$	(1	)	$	17,787
Total	$	17,778	$	10	$	(1	)	$	17,787

	*December 31, 2025*
	*Adjusted Cost*		*Unrealized Gains*		*Unrealized Losses*		*Fair Value*
Level 2:
U.S. treasury securities	$	20,817	$	26	$	—	$	20,843
Total	$	20,817	$	26	$	—	$	20,843

The carrying amounts reported in the Condensed Consolidated Balance Sheets approximate fair value based on quoted market prices or alternative pricing sources and models utilizing market observable inputs. As of March 31, 2026 and December 31, 2025, the Company did not recognize any allowance for credit impairments on its available for sale securities. All investments in marketable securities are classified as current assets on the Condensed Consolidated Balance Sheets because the underlying securities mature within one year from the balance sheet date.

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Mar. 31, 2026 shares
Trading Arrangements, by Individual [Table]
Material Terms of Trading Arrangement [Text Block]	Item 5. Other Information None. Without limiting the generality of the foregoing, during the three months ended March 31, 2026, no director or officer of the Company adopted or terminated any “Rule 10b5-1 trading arrangement,” or any “non-Rule 10b-5 trading arrangement,” as such terms are defined in Item 408 of Regulation S-K. In addition, on November 21, 2025, Linda Rebrovick, a member of the Company’s Board of Directors, adopted a trading arrangement that was intended to satisfy the affirmative defense conditions of Rule 10b5‑1(c) under the Securities Exchange Act of 1934, as amended. The trading arrangement, which became effective on March 4, 2026, and has an expiration date of December 31, 2026, provides for the sale of up to an aggregate of 22,000 shares of the Company’s common stock pursuant to pre‑established instructions regarding the timing and amount of shares to be sold. No sales to date have occurred under the plan. Disclosure of the adoption of this trading arrangement was inadvertently omitted from the Company’s Annual Report on Form 10‑K for the year ended December 31, 2025, filed on February 26, 2026.
Non-Rule 10b5-1 Arrangement Adopted [Flag]	false
Rule 10b5-1 Arrangement Terminated [Flag]	false
Non-Rule 10b5-1 Arrangement Terminated [Flag]	false
Trading Arrangement Adoption Date	November 21, 2025
Trading Arrangement, Individual Name	Linda Rebrovick
Trading Arrangement, Individual Title	member of the Company’s Board of Directors
Rule 10b5-1 Arrangement Adopted [Flag]	true
Trading Arrangement Expiration Date	December 31, 2026
Trading Arrangement, Securities Aggregate Available Amount	22,000

Note 8 - Debt (Details Textual) - Revolving Credit Facility [Member] - Truist Bank [Member] - USD ($) $ in Thousands	Oct. 06, 2023	Mar. 31, 2026
Debt Instrument, Covenant, Maximum Funded Debt Leverage Ratio	3
Debt Instrument, Covenant, Interest Coverage Ratio	3
Long-Term Line of Credit		$ 0
Minimum [Member]
Line of Credit Facility, Unused Capacity, Commitment Fee Percentage	0.20%
Third Amendment [Member]
Line of Credit Facility, Maximum Borrowing Capacity	$ 50,000
Line of Credit Facility, Increased Facility Size Due to Accordion Feature	$ 25,000
Third Amendment [Member] \| Fed Funds Effective Rate Overnight Index Swap Rate [Member]
Debt Instrument, Basis Spread on Variable Rate	0.50%
Third Amendment [Member] \| Base Rate [Member]
Debt Instrument, Basis Spread on Variable Rate	0.10%
Third Amendment [Member] \| Base Rate [Member] \| Minimum [Member]
Line of Credit Facility, Percentage of Applicable Margin for Borrowings	0.50%
Third Amendment [Member] \| Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate [Member] \| Maximum [Member]
Line of Credit Facility, Percentage of Applicable Margin for Borrowings	1.50%
Third Amendment [Member] \| Swing Line Subfacility [Member]
Line of Credit Facility, Maximum Borrowing Capacity	$ 5,000
Third Amendment [Member] \| Letter of Credit Subfacility [Member]
Line of Credit Facility, Maximum Borrowing Capacity	$ 5,000

Note 9 - Business Combination - Summary of Purchase Price (Details) - USD ($) $ in Thousands	Dec. 15, 2025	Oct. 08, 2025
Virsys12 [Member]
Payments to Acquire Businesses, Gross		$ 11,430
Fair value of contingent consideration		1,000
Total consideration		$ 12,430
MissionCare [Member]
Payments to Acquire Businesses, Gross	$ 24,880
Fair value of contingent consideration	2,700
Total consideration	31,580
Business Combination, Consideration Transferred, Equity Interest	$ 4,000

Note 5 - Shareholders' Equity and Stock-Based Compensation - Stock Based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Cost of revenues (excluding depreciation and amortization)	$ 56	$ 53
Product development	273	229
Sales and marketing	168	145
General and administrative	812	677
Stock-based compensation expense	$ 1,309	$ 1,104

Note 3 - Revenue Recognition

3 Months Ended

Mar. 31, 2026

Revenue from Contract with Customer [Text Block]

3. REVENUE RECOGNITION

Revenues are recognized when control of the promised goods or services is transferred to the customer in an amount that reflects the consideration the Company expects to be entitled to in exchange for transferring those goods or services. Revenue is recognized based on the following five step model:

•

Identification of the contract with a customer

•

Identification of the performance obligations in the contract

•

Determination of the transaction price

•

Allocation of the transaction price to the performance obligations in the contract

•

Recognition of revenue when, or as, the Company satisfies a performance obligation

The following table represents revenues disaggregated by revenue source (in thousands). Sales taxes are excluded from revenues.

	*Three Months Ended March 31,*
	*2026*		*2025*
Subscription services	$	78,392	$	70,789
Professional services		2,811		2,696
Total revenues, net	$	81,203	$	73,485

For the three months ended March 31, 2026 and 2025, the Company recognized $0.1 million and $0.2 million in impairment losses on receivables and contract assets arising from the Company's contracts with customers, respectively.

During the three months ended March 31, 2026 and 2025, the Company recognized revenues of $42.7 million and $44.3 million, respectively, from amounts included in deferred revenue at the beginning of the respective periods. As of March 31, 2026, approximately $687 million of revenue is expected to be recognized from remaining performance obligations under contracts with customers. The Company expects to recognize revenue related to approximately 39% of these remaining performance obligations over the next 12 months, 67% over the next 24 months, and 83% over the next 36 months, with the remaining amounts recognized thereafter.

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

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Note 2 - Recent Accounting Pronouncements

3 Months Ended

Mar. 31, 2026

Accounting Standards Update and Change in Accounting Principle [Text Block]

2. RECENT ACCOUNTING PRONOUNCEMENTS

In November 2024, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2024-03, Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures: Disaggregation of Income Statement Expenses, which requires disclosure of disaggregated information about specific categories underlying certain income statement expense line items in the footnotes to the financial statements for both annual and interim periods. This ASU is effective for fiscal years beginning after December 15, 2026, and interim reporting periods beginning after December 15, 2027. Early adoption is permitted. The Company is currently evaluating the impact of the adoption of this standard.

In July 2025, the FASB issued ASU 2025-05, Measurement of Credit Loss for Accounts Receivable and Contract Assets. The ASU provides a practical expedient for the calculation of current expected credit losses for current accounts receivable and contract assets, allowing entities to assume that current conditions as of the balance sheet date will persist through the forecast period. The Company adopted the ASU effective January 1, 2026 on a prospective basis and elected the practical expedient for the calculation of current expected credit losses. The adoption did not have a material impact on the Company’s allowance for doubtful accounts.

In September 2025, the FASB issued ASU 2025-06, Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software, to modernize the accounting guidance for the costs to develop software for internal use. The standard applies to costs incurred to develop or obtain software for internal use. ASU 2025-06 amends the existing standard that refers to various stages of a software development project to align better with current software development methods, such as agile development. Under the new standard, entities will commence capitalizing eligible costs when (i) management has authorized and committed to funding the software project, and (ii) it is probable that the project will be completed and the software will be used to perform the function intended. The new standard also supersedes the guidance related to costs incurred to develop a website. ASU 2025-06 is effective for annual periods beginning after December 15, 2027. The guidance can be applied on a prospective basis, a modified basis for in-process projects, or on a retrospective basis. The Company is currently evaluating the impact of this accounting standard on its consolidated financial statements.

In December 2025, the FASB issued ASU 2025-11, Interim Reporting (Topic 270): Narrow-Scope Improvements, which clarifies the guidance in Topic 270 to improve the consistency of interim financial reporting. The standard provides a comprehensive list of required interim disclosures and introduces a disclosure principle requiring entities to disclose events since the end of the last annual reporting period that have a material impact on the entity. ASU 2025-11 is effective for fiscal years beginning after December 15, 2027, including interim periods within those fiscal years, with early adoption permitted. The Company is currently evaluating the impact of adopting ASU 2025-11.

The entire disclosure for change in accounting principle. Includes, but is not limited to, nature, reason, and method of adopting amendment to accounting standards or other change in accounting principle.

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Note 7 - Marketable Securities - Fair Value of Available for Sale Marketable Securities (Details) - USD ($) $ in Thousands	Mar. 31, 2026	Dec. 31, 2025
Adjusted Cost	$ 17,778	$ 20,817
Unrealized Gains	10	26
Unrealized Losses	(1)	0
Fair Value	17,787	20,843
US Treasury Securities [Member] \| Fair Value, Inputs, Level 2 [Member]
Adjusted Cost	17,778	20,817
Unrealized Gains	10	26
Unrealized Losses	(1)	0
Fair Value	$ 17,787	$ 20,843

Amortized cost of investment in debt security measured at fair value with change in fair value recognized in other comprehensive income (available-for-sale).

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