AMERICAN SHARED HOSPITAL SERVICES (AMS) Q2 2025 Earnings Summary

Executive Summary

Q2 2025 revenue was $7.071M (+16% QoQ; +0.2% YoY), with diluted EPS of -$0.04; EPS beat S&P Global consensus (-$0.07*) while revenue was slightly below ($7.29M*), reflecting sequential treatment volume recovery but continued YoY pressure in PBRT and Gamma Knife .
Direct Patient Services revenue rose to $3.500M, leasing revenue was $3.571M, PBRT revenue was $1.921M, and radiation therapy revenue reached $2.541M; management cited strong LINAC momentum and diversification benefits .
Gross margin fell to $1.630M YoY given lower volumes, while adjusted EBITDA improved sequentially to $1.701M; the prior-year quarter included a $3.679M bargain purchase gain that elevated YoY comparables .
Execution catalysts: Esprit installation in Guadalajara expected to start up in late 2025 and new CON approvals for a Bristol RT center and a Rhode Island proton center; management emphasized operational efficiency, cost controls, and tuck-in M&A pipeline as drivers for 2H and medium-term growth .

What Went Well and What Went Wrong

What Went Well

Sequential patient volume recovery and improved momentum with an explicit focus on operational enhancements and efficiency; CFO: “increase in treatment volumes compared to last quarter… expect further recovery into the back half of this year” .
Diversification: LINAC growth underscored the shift beyond leasing; CFO highlighted “linear accelerator business growth… 34% revenue growth quarter over quarter and 7% sequentially” .
Direct patient services expansion: Rhode Island centers and Puebla drove radiation therapy revenue growth; CEO emphasized pipeline strength and balance sheet positioning for next phase of growth .

What Went Wrong

Gross margin fell to $1.630M (vs. $2.468M YoY) due to lower treatment volumes, pressuring profitability .
Leasing segment declined YoY to $3.571M (from $3.899M) on lower Gamma Knife volumes (contract expirations) and lower PBRT volumes; PBRT revenue decreased YoY to $1.921M (from $2.420M) due to cyclical fluctuations .
Net loss of -$0.280M vs. prior-year net income of $3.602M, with the year-ago period benefitting from a $3.679M bargain purchase gain; adjusted EBITDA down YoY to $1.701M (from $2.010M) .

Financial Results

Quarterly P&L Snapshot

Metric	Q4 2024	Q1 2025	Q2 2025
Revenues ($USD)	$9,069,000	$6,112,000	$7,071,000
Gross margin ($USD)	$3,204,000	$942,000	$1,630,000
Operating income (loss) ($USD)	($1,830,000)	($1,299,000)	($544,000)
Net income (loss) attributable to AMS ($USD)	($1,308,000)	($625,000)	($280,000)
Diluted EPS ($USD)	($0.20)	($0.10)	($0.04)

Segment and Revenue Mix (Sequential comparison)

Segment / Category	Q1 2025	Q2 2025
Direct Patient Services Revenue ($USD)	$3,100,000	$3,500,000
Leasing Segment Revenue ($USD)	$3,000,000	$3,571,000
Radiation Therapy Revenue ($USD)	$2,400,000	$2,541,000
PBRT Revenue ($USD)	$1,600,000	$1,921,000

Selected YoY Metrics

Metric	Q2 2024	Q2 2025
Revenues ($USD)	$7,056,000	$7,071,000
Gross margin ($USD)	$2,468,000	$1,630,000
PBRT Revenue ($USD)	$2,420,000	$1,921,000
Radiation Therapy Revenue ($USD)	$1,892,000	$2,541,000
Adjusted EBITDA ($USD)	$2,010,000	$1,701,000

KPIs and Balance Sheet

Metric	Q4 2024	Q1 2025	Q2 2025
Adjusted EBITDA ($USD)	$3,464,000	$949,000	$1,701,000
Cash, cash equivalents & restricted cash ($USD)	$11,275,000	$11,491,000	$11,331,000
Shareholders’ equity (ex-NCI) ($USD)	$25,183,000	$24,647,000	$24,481,000
Current liabilities ($USD)	$10,405,000	$12,710,000	$20,860,000

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Revenue	FY 2025	Not provided	Not provided; management expects long-term growth supported by Guadalajara start-up late 2025 and RI CONs	n/a
Margins	FY 2025	Not provided	Not provided; continued focus on operational efficiencies and cost controls	n/a
OpEx	FY 2025	Not provided	Not provided; efficiency initiatives highlighted	n/a
Tax rate	FY 2025	Not provided	Not provided	n/a
Segment-specific (RI/Puebla/Guadalajara)	Late 2025 and beyond	Not provided	Esprit in Guadalajara expected to start late 2025; RI RT center and RI proton center CONs approved	n/a
Dividend	FY 2025	Not mentioned	Not mentioned	n/a

Note: AMS did not issue formal quantitative guidance in the Q2 materials; commentary focused on growth initiatives, capacity additions, and operational efficiency .

Earnings Call Themes & Trends

The Q2 2025 call transcript was not available in the document set; themes below track Q4 2024 (Q-2) and Q1 2025 (Q-1) vs current-period commentary.

Topic	Previous Mentions (Q-2: Q4 2024; Q-1: Q1 2025)	Current Period (Q2 2025)	Trend
Shift to direct patient services	Strong pivot beyond leasing; integrating RI centers; expanding Puebla; staffing and uptime improvements	Continued emphasis; DPS revenue $3.500M; operational efficiencies and cost controls	Positive momentum
International expansion	JV for Guadalajara Esprit; only Gamma Knife centers in Peru/Ecuador; Puebla launch	Guadalajara expected late 2025 start; continued international growth focus	Building pipeline
Volumes and utilization	Gamma Knife/PBRT volumes impacted by contract expirations and cyclical factors; April volumes trending up	Sequential volume recovery vs Q1; PBRT down YoY due to cyclical fluctuations	Mixed (sequential up, YoY down in PBRT)
Regulatory/reimbursement	Q&A: Low Medicaid exposure; limited reimbursement risk	No specific update; focus on operational drivers	Stable / low risk cited
Rhode Island footprint & CONs	Brown University staffing agreement; RI centers with CNE and Prospect; CONs for Bristol RT and RI proton	Reaffirmed CON approvals and expansion plans	Execution underway
Cost controls & efficiency	Emphasis on staffing optimization, maintenance agreements, efficiency	Explicit focus to position for profitability	Ongoing improvement

Management Commentary

CEO (Gary Delanois): “We expect further long-term growth from the new Esprit being installed in Guadalajara, Mexico that is expected to startup in late 2025… Certificate of Need approvals… put us on track to further expand our Rhode Island footprint and growth potential” .
CFO (Scott Frech): “Our second quarter of 2025 was highlighted by an increase in treatment volumes compared to last quarter… our linear accelerator business growth is a shining example of the strength of our diversification strategy” .
Executive Chairman (Ray Stachowiak): “Past four years of consecutive revenue growth and the past three years of sustained profitability… successful acquisition of a majority interest in three Rhode Island radiation therapy treatment centers and the opening of our new Puebla, Mexico center” .

Q&A Highlights

No Q2 2025 transcript was available; Q&A insights below are from Q1 2025:

Reimbursement risk: Management sees limited risk from potential Medicaid changes; revenue mix is primarily private insurers and Medicare .
Fixed-cost absorption and RI expansion: Greater control under DPS model; synergies expected as footprint grows (additional center) .
State-level synergies: Brown University staffing agreement and health-system partnerships (CNE and Prospect) expected to support coordinated cancer care and growth .

Estimates Context

Q2 2025 vs S&P Global consensus:

EPS: Actual -$0.04 vs -$0.07* → Bold beat; management linked sequential improvement to volume recovery and cost control .
Revenue: Actual $7.071M vs $7.29M* → Slight miss; headwinds from PBRT cyclical volume and leasing contract expirations partially offset by radiation therapy growth .

Metric	Q2 2025 Estimate*	Q2 2025 Actual
Primary EPS ($)	-0.07	-0.04
Revenue ($USD)	$7,290,000	$7,071,000

Values retrieved from S&P Global.*

Implications:

EPS beat driven by sequential volume recovery and operating discipline; revenue slight miss reflects lingering PBRT/Gamma Knife volume softness .
Only one covering estimate (EPS and revenue # of estimates = 1*), limiting inference strength for consensus surprise sizing.*

Key Takeaways for Investors

Sequential recovery: Revenue +16% QoQ and adjusted EBITDA improved to $1.701M as volumes rebounded; watch sustainability into 2H 2025 .
Mix shift to DPS: Direct patient services reached $3.500M, supporting the strategic transition beyond leasing; LINAC growth underscores diversification .
PBRT/Gamma Knife headwinds: PBRT revenue fell YoY; leasing segment declined on contract expirations—track contract pipeline and volume normalization .
Strategic capacity adds: Guadalajara Esprit startup late 2025 and RI CON approvals (Bristol RT center, RI proton center) are tangible catalysts for medium-term volume and revenue growth .
Operational discipline: Management is focused on efficiency and cost controls to improve profitability amid lower-margin DPS mix .
Balance sheet positioning: Cash ~$11.331M and equity ~$24.481M provide flexibility for tuck-in M&A and buildout execution .
Trading angles: Near-term moves likely driven by evidence of sustained sequential volume growth and progress on RI/Guadalajara milestones; medium-term thesis hinges on DPS scaling, international volume ramp, and margin stabilization .