Core Viewpoint - American Shared Hospital Services (AMS) has received a Certificate of Need (CON) to establish a Proton Beam Radiation Treatment (PBRT) facility in Johnston, Rhode Island, enhancing local cancer care capabilities and reducing the need for patients to travel to other states for treatment [1][2][3]. Company Developments - AMS's subsidiary, ASHS - Rhode Island Proton Beam Radiation Therapy, LLC, will construct and operate the PBRT system, expected to treat its first patients within 36 to 39 months [3]. - The new facility will complement AMS's existing three photon radiation therapy facilities in Rhode Island, where AMS holds a 60% majority ownership [4]. - In April 2024, AMS's subsidiary received another CON for Bristol Radiation Therapy, LLC, further expanding its network of radiation therapy facilities in the region [4]. Market Position and Growth Potential - The establishment of the PBRT facility represents a significant growth opportunity for AMS, as there are currently only two operational Proton Beam Radiation Therapy Systems in the Northeast [5]. - The facility's strategic location between New York City and Boston is expected to improve access to advanced cancer treatment technologies for patients in the Northeast [5]. - AMS has recently strengthened its senior management team with experienced executives to support the development and operation of radiation therapy facilities [5]. Company Background - AMS has been operational for 40 years and has been publicly traded since 1984, providing financial and technological solutions to cancer treatment centers and hospitals globally [5]. - The company collaborates with major global Original Equipment Manufacturers (OEMs) to offer a range of radiation therapy technologies, including Proton Beam Radiation Therapy Systems and Gamma Knife products [5]. - AMS's strategic initiative to acquire majority equity interests in Rhode Island radiation therapy facilities marks a shift from being a technology supplier to a direct provider of cancer care [5].

Revenue and Growth - The Company recognized leasing revenue of approximately $3,312,000 and $11,464,000 for the three and nine-month periods ended September 30, 2024, compared to $3,946,000 and $12,987,000 for the same periods in the prior year, respectively [90]. - Retail revenues for the three and nine-month periods ended September 30, 2024 were approximately $3,687,000 and $7,807,000, compared to $988,000 and $2,440,000 for the same periods in the prior year [93]. - Revenues for the three and nine-month periods ended September 30, 2024 increased by $1,865,000 (36.4%) and $3,644,000 (23.3%) to $6,999,000 and $19,271,000, respectively, compared to the same periods in the prior year [99]. - Retail segment revenues increased by $2,699,000 (273.5%) and $5,367,000 (220.5%) to $3,687,000 and $7,807,000 for the three and nine-month periods ended September 30, 2024, primarily due to the RI Acquisition [99]. - Revenues from the PBRT system increased by $97,000 (4.4%) and $308,000 (4.4%) to $2,316,000 and $7,386,000 for the three and nine-month periods ended September 30, 2024, driven by higher volumes and a shift in payor mix [100]. - Gamma Knife revenue decreased by $895,000 (32.9%) and $1,218,000 (14.6%) to $1,821,000 and $7,131,000 for the three and nine-month periods ended September 30, 2024, due to lower procedure volumes [102]. Acquisitions and Investments - The Company acquired 60% of the equity interests of the RI Companies on May 7, 2024, which operate three radiation therapy facilities in Rhode Island [83]. - The Company recorded a net bargain purchase gain of $3,942,000 related to the RI Acquisition, which closed on May 7, 2024, after acquiring 60% of the equity interests of the RI Companies for $2,850,000 [114]. - As of September 30, 2024, the Company had commitments totaling $13,383,000 for the purchase and installation of four Leksell Gamma Knife Esprit Systems and two Linear Accelerator systems [128]. - The Supplemental Term Loan of $2,700,000 was added to the credit agreement to finance capital expenditures in Puebla, Mexico [122]. Financial Performance and Expenses - Total costs of revenue increased by $2,597,000 (85.6%) and $4,191,000 (46.0%) to $5,629,000 and $13,290,000 for the three and nine-month periods ended September 30, 2024 [106]. - Selling and administrative expenses increased by $188,000 (10.8%) and $436,000 (8.3%) to $1,923,000 and $5,698,000 for the three and nine-month periods ended September 30, 2024, due to higher personnel costs and legal fees [111]. - Interest expense increased by $59,000 (21.3%) and $245,000 (29.7%) to $336,000 and $1,070,000 for the three and nine-month periods ended September 30, 2024, attributed to higher borrowings and interest rates [113]. Cash and Debt Management - The Company had cash, cash equivalents, and restricted cash of $14,077,000 as of September 30, 2024, an increase of $269,000 from December 31, 2023 [119]. - Working capital decreased by $1,518,000 (15.6%) to $8,159,000 as of September 30, 2024, primarily due to increases in accounts payable and accrued liabilities [120]. - The Company has a combined long-term debt of $14,375,000 as of September 30, 2024 [126]. - The Company entered into a $22,000,000 credit agreement with Fifth Third Bank, which includes a $9,500,000 term loan, a $5,500,000 delayed draw term loan, and a $7,000,000 revolving line of credit [121]. - The Company borrowed $4,500,000 under the revolving line of credit as of September 30, 2024 [128]. - The Company is subject to covenants under the credit agreement, including a minimum fixed charge coverage ratio of 1.25 to 1.0 and a total funded debt to EBITDA ratio of 3.0 to 1.0 [123]. - The Company is in compliance with all debt covenants as of September 30, 2024 [125]. Regulatory and Market Conditions - The Centers for Medicare and Medicaid established a 2024 reimbursement rate of approximately $7,420 for a Medicare Gamma Knife treatment, down from $7,691 in 2023 [85]. - The approximate CMS reimbursement rates for PBRT treatments in 2024 are $561 for simple treatments and $1,362 for intermediate and complex treatments, compared to $572 and $1,323 in 2023, respectively [85]. Operational Overview - The Company operates ten domestic Gamma Knife units and one PBRT system in the United States as of September 30, 2024 [89]. - The Company has two international Gamma Knife units in operation in Lima, Peru, and Guayaquil, Ecuador, as part of its retail segment [89]. - The Company’s leasing contracts typically have a ten-year term and are classified as either fee per use or revenue sharing [90]. - The Company’s PBRT system at Orlando Health operates under a revenue share contract within the leasing segment [89]. Related Party Transactions - Total related party transactions for the three months ended September 30, 2024, amounted to $694,000, compared to $2,338,000 for the same period in 2023 [132]. - The Company has cash on hand of $14,077,000 as of September 30, 2024, and is actively seeking financing resources for future projects [128].

Financial Data and Key Metrics Changes - Revenue for Q3 2024 increased by 36% year-over-year to $6.99 million, up from $5.1 million in Q3 2023, driven by the Rhode Island acquisition and the new facility in Puebla, Mexico [14][31] - Gross margin decreased to $1.37 million from $2.10 million in Q3 2023, impacted by lower Gamma Knife treatment volumes and a shift in revenue mix [15][35] - The company reported a net loss of $207,000 or $0.03 per share for Q3 2024, compared to a net income of $118,000 or $0.02 per share in Q3 2023 [15][39] - Cash and equivalents at the end of Q3 2024 stood at over $14.1 million, approximately $2.17 per share [16][43] Business Line Data and Key Metrics Changes - Revenue from the Patient Services or Retail segment surged by 273% to $3.7 million in Q3 2024, primarily due to the Rhode Island acquisition and Puebla operations [32] - Medical Equipment Leasing revenue decreased by 16.1% to $3.31 million, attributed to lower Gamma Knife volumes [33] - Proton therapy revenue increased by 4.4% to $2.3 million, with a 5.4% rise in proton therapy fractions [34] Market Data and Key Metrics Changes - The international business is seen as a significant growth opportunity, with the only Gamma Knife systems in Peru and Ecuador, and a new center in Puebla, Mexico [24] - A joint venture for a Gamma Knife facility in Guadalajara, Mexico was announced, which will be one of only three in the country [25] Company Strategy and Development Direction - The company is focused on integrating the Rhode Island acquisition and optimizing operations, which includes investing in upgraded equipment and improving operational efficiencies [13][19] - Plans to expand geographically and diversify product offerings, including the addition of linear accelerators and a proton beam center in Rhode Island [69][70] Management's Comments on Operating Environment and Future Outlook - Management acknowledged challenges such as seasonality, procedure volume fluctuations, and integration costs from the Rhode Island acquisition [13][26] - There is optimism about future growth, particularly from international operations and new business opportunities [29][73] Other Important Information - The company has incurred additional costs related to the Rhode Island acquisition, expected to decrease in Q4 2024 [26] - The bargain purchase gain from the Rhode Island acquisition was increased by $263,000 in Q3 2024 [38] Q&A Session Summary Question: Follow-up on start-up costs and ramp-up period for new centers - Management confirmed that costs related to the Rhode Island acquisition and integration are impacting results, and acknowledged a ramp-up period for new centers [46][47] Question: Performance of the Puebla facility - Management expressed satisfaction with the revenue growth from the Puebla facility since its opening [51] Question: Impact of outdated equipment on business - Management noted that replacing outdated equipment has led to increased patient referrals and volumes [55][56] Question: Marketing efforts for the Rhode Island centers - Management confirmed ongoing marketing efforts to raise awareness among referring physicians about the upgraded facilities [58][60] Question: Gamma Knife treatment volume issues - Management attributed the decline in Gamma Knife volumes to various factors, including physician vacations and equipment downtime, but expressed confidence in overcoming these challenges [61][62] Question: Concerns about stock performance and transparency - Management acknowledged shareholder frustrations and emphasized the long-term growth strategy, including geographic expansion and product diversification [68][70]

Revenue Performance - Total revenue for Q3 2024 was $6,999,000, representing a 36.3% increase compared to Q3 2023[2] - Revenue from direct patient services ("retail") segment reached $3,687,000, a significant increase of 273.2% year-over-year[3] - Revenue from medical equipment leasing segment was $3,312,000, reflecting a decrease of 16.1% compared to the prior year[4] - Proton beam radiation therapy revenue increased by 4.4% to $2,316,000, with treatments rising by 5.4%[11] - Gamma Knife revenue decreased by 32.9% to $1,821,000, with procedures down by 31.0%[12] - For the first nine months of 2024, total revenue increased by 23.3% to $19,271,000 compared to $15,627,000 in the same period of 2023[17] - Revenues for the three months ended September 30, 2024, were $6,999,000, a 36.4% increase from $5,134,000 for the same period in 2023[29] Profitability and Loss - Gross margin decreased to $1,370,000, with a gross margin percentage of 19.6%, down from 40.9% in the previous year[5] - Net loss for Q3 2024 was $207,000, or ($0.03) per diluted share, compared to net income of $118,000, or $0.02 per diluted share in Q3 2023[6] - Adjusted EBITDA for Q3 2024 was $1,366,000, down from $1,669,000 in Q3 2023[6] - Gross margin decreased to $1,370,000 for the three months ended September 30, 2024, compared to $2,102,000 in the prior year, reflecting a decline of 34.8%[29] - Adjusted EBITDA for the three months ended September 30, 2024, was $1,366,000, down 18.1% from $1,669,000 in the same period of 2023[30] - Net loss attributable to American Shared Hospital Services was $207,000 for the three months ended September 30, 2024, compared to a net income of $118,000 in the prior year[29] Financial Position - Cash at September 30, 2024, was $14,077,000, compared to $13,808,000 at December 31, 2023[21] - Total assets increased to $63,269,000 as of September 30, 2024, up from $48,162,000 at the end of 2023, representing a growth of 31.4%[29] - Current liabilities rose to $17,561,000 as of September 30, 2024, compared to $10,779,000 at the end of 2023, indicating a 62.5% increase[29] - Cash and cash equivalents increased to $14,077,000 as of September 30, 2024, compared to $13,808,000 at the end of 2023, a growth of 1.9%[29] Expenses - Selling and administrative expenses were $1,923,000 for the three months ended September 30, 2024, compared to $1,735,000 in the same period of 2023, an increase of 10.8%[29] - Interest expense for the three months ended September 30, 2024, was $336,000, up from $277,000 in the prior year, reflecting a rise of 21.3%[29] Other Financial Metrics - The company reported a bargain purchase gain of $263,000 for the three months ended September 30, 2024, compared to a gain of $0 in the same period of 2023[29]

Core Insights - American Shared Hospital Services reported a revenue increase of 36.3% year-over-year for Q3 2024, reaching $6,999,000, driven by the acquisition of Rhode Island radiation therapy facilities and a new facility in Puebla, Mexico [2][4][6] Financial Performance - Total revenue for Q3 2024 was $6,999,000, up from $5,134,000 in Q3 2023 [6] - Revenue from direct patient services ("retail") surged 273.2% to $3,687,000, primarily due to the new Rhode Island and Puebla facilities [2][7] - Medical equipment leasing revenue decreased by 16.1% to $3,312,000, attributed to lower Gamma Knife treatment volumes [2][8] - Proton beam radiation therapy revenue increased by 4.4% to $2,316,000, with treatment volumes rising by 5.4% [9] - Gamma Knife operations revenue fell by 32.9% to $1,821,000, with procedures down 31.0% due to contract expirations and equipment downtime [10] - Gross margin decreased to $1,370,000, representing 19.6% of revenue, down from 40.9% in the previous year [2][4] - Operating income turned to a loss of $889,000 compared to an income of $90,000 in Q3 2023, mainly due to increased operating costs [12] - Net loss for Q3 2024 was $207,000, or ($0.03) per diluted share, compared to a net income of $118,000, or $0.02 per diluted share, in Q3 2023 [14] - Adjusted EBITDA for Q3 2024 was $1,366,000, down from $1,669,000 in Q3 2023 [15] Balance Sheet Highlights - Cash and cash equivalents as of September 30, 2024, were $14,077,000, an increase from $13,808,000 at the end of 2023 [3][21] - Shareholders' equity increased to $26,423,000 as of September 30, 2024, compared to $22,624,000 at the end of 2023 [21] Strategic Outlook - The company is focused on long-term growth strategies, including improving operational efficiencies and expanding its product portfolio [4][5] - The CEO expressed confidence in the company's growth trajectory, supported by a strong balance sheet and increasing sales pipeline [5]

Core Points - American Shared Hospital Services (AMS) will hold a conference call to discuss its third quarter 2024 financial results on November 13, 2024, at 1:00 PM ET [1] - The financial results press release will be issued before the market opens on the same day [1] Company Overview - AMS is a leading provider of turnkey technology solutions for stereotactic radiosurgery and advanced radiation therapy equipment and services [1] - The company collaborates with major global Original Equipment Manufacturers (OEMs) to provide clinical treatment systems and software for cancer treatment [4] - AMS offers a range of products including MR Guided Radiation Therapy Linacs, Advanced Digital Linear Accelerators, Proton Beam Radiation Therapy Systems, and Brachytherapy systems [4]

Hires Gary Delanois, Seasoned Radiation Oncology Services Executive, as Chief Operating Officer Promotes Ranjit Pradhan to Senior Vice President of Sales and Marketing SAN FRANCISCO, Oct. 18, 2024 (GLOBE NEWSWIRE) -- American Shared Hospital Services (NYSE American: AMS) (the "Company"), a leading provider of turnkey technology solutions for stereotactic radiosurgery and advanced radiation therapy cancer treatment systems and services, today announced the appointment of Gary Delanois as Executive Vice Presi ...

Financial Data and Key Metrics Changes - Total revenue for Q2 2024 was $7.1 million, a year-over-year increase of 27% from $5.7 million in Q2 2023 [11][14] - Net income attributable to the company was $3.6 million or $0.55 per diluted share, compared to a net loss of $111,000 or $0.02 per diluted share in Q2 2023 [17] - Adjusted EBITDA for Q2 2024 was $2 million, slightly up from $1.9 million in Q2 2023 [18] Business Line Data and Key Metrics Changes - Revenue from the leasing segment was $3.9 million, a decrease of 19% compared to $4.81 million in the prior year [14] - Revenue from the retail segment surged to $3.16 million, marking a 318% increase from $756,000 in the year-ago quarter, driven by the Rhode Island acquisition and increased volumes [14] - Proton therapy revenue decreased by 5% to $2.42 million, while total proton therapy fractions fell by 10% [15] Market Data and Key Metrics Changes - International retail results showed growth, particularly in Ecuador and Peru, with the upgrade of equipment contributing to increased volumes [9] - The Gamma Knife procedures revenue decreased by 9% to $2.74 million, but excluding expired contracts, procedures increased by 24% [15] Company Strategy and Development Direction - The company is focusing on expanding its retail segment, as evidenced by the Rhode Island acquisition and new centers in Mexico [9][23] - Plans include building a proton beam radiation therapy center in Rhode Island, which would be the only system between New York City and Boston [10] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the future, highlighting the strong performance in Q2 and the strategic acquisition in Rhode Island [7][32] - The company anticipates stronger international growth and additional revenue streams from new centers and acquisitions [12][32] Other Important Information - The company ended Q2 2024 with over $14.5 million in cash, approximately $2.24 per share [12] - Shareholders' equity increased to $26.5 million or $4.17 per share at the end of Q2 2024, up from $22.6 million or $3.59 per share at the end of 2023 [20] Q&A Session Summary Question: Confirmation on growth opportunities in direct business and potential service interruptions at Sacred Heart - Management confirmed focus on both leasing and retail segments, with a stronger emphasis on retail opportunities [23] Question: Clarification on the timing of the Rhode Island acquisition - Management confirmed that the acquisition concluded in early May, thus not reflecting a full three months in the reported quarter [25] Question: Insights from the direct relationship and updates on the proton beam project - Management noted delays in the CON application process but expressed confidence in the outcome and highlighted ongoing learning from the new operations [27][28] Question: Marketing strategies for Rhode Island centers and sales pipeline updates - Management indicated a robust sales pipeline and ongoing market engagement to identify new opportunities [30]

Financial Performance - Total revenue for Q2 2024 was $7.1 million, a 27% increase year-over-year, driven by the acquisition of Rhode Island facilities which contributed $1.9 million to the revenue growth[1][5] - Net income for Q2 2024 was $3.6 million, or $0.55 per diluted share, compared to a net loss of $111,000, or $0.02 per diluted share in Q2 2023, primarily due to a $3.7 million bargain purchase gain from the Rhode Island acquisition[2][9] - Adjusted EBITDA for Q2 2024 was $2,010,000, up from $1,938,000 in Q2 2023, reflecting contributions from the newly acquired Rhode Island facilities[3][9] - Revenues for the three months ended June 30, 2024, increased to $7,056,000, up 27% from $5,568,000 in the same period last year[21] - Net income attributable to American Shared Hospital Services for the three months ended June 30, 2024, was $3,602,000, compared to a net loss of $111,000 in the same period last year[21] - Basic earnings per share for the three months ended June 30, 2024, was $0.56, compared to a loss of $0.02 in the same period last year[21] Cash and Assets - Cash and cash equivalents at June 30, 2024, were $14.5 million, an increase from $13.8 million at December 31, 2023[3][12] - Total assets as of June 30, 2024, increased to $60,825,000, up from $48,162,000 as of December 31, 2023[22] - Cash and cash equivalents as of June 30, 2024, were $14,486,000, compared to $13,808,000 as of December 31, 2023[22] Revenue Segments - Revenue from the retail segment increased by 318% to $3,157,000 in Q2 2024, compared to $756,000 in the same period last year, attributed to the Rhode Island acquisition and increased patient volumes[5][6] - Proton beam radiation therapy revenue decreased by 5% to $2.4 million in Q2 2024, with a 10% decline in therapy fractions compared to the same period last year[6][8] Operational Metrics - Total Gamma Knife procedures increased by 10% to 340 in Q2 2024, compared to 309 in Q2 2023, despite a 9% decrease in overall Gamma Knife revenue due to contract expirations[6][7] - Gross margin for Q2 2024 was $2.5 million, or 35% of revenue, down from 45% in the prior year, reflecting the expansion in the retail segment[2][7] - Gross margin for the six months ended June 30, 2024, was $4,611,000, representing a 4% increase compared to $4,426,000 for the same period in 2023[21] Liabilities and Expenses - Current liabilities as of June 30, 2024, were $13,336,000, compared to $10,779,000 as of December 31, 2023[22] - Interest expense for the three months ended June 30, 2024, was $385,000, an increase from $277,000 in the same period last year[21] Strategic Developments - The company signed a joint venture agreement for a Gamma Knife facility in Guadalajara, Mexico, marking its fourth international center[4] - The company reported a bargain purchase gain of $3,679,000 for the three months ended June 30, 2024[21]

Revenue increases 27% year over yearReports gain of $3.7 million from strategic acquisition of Rhode Island Radiation Therapy Cancer Centers Now treating patients at the new Puebla, Mexico center Conference Call on August 14th at 6:30 pm ET SAN FRANCISCO, Aug. 14, 2024 (GLOBE NEWSWIRE) -- American Shared Hospital Services (NYSE American: AMS) (the "Company"), a leading provider of turnkey technology solutions for stereotactic radiosurgery and advanced radiation therapy cancer treatment systems and services ...