Leasing

- Gamma Knife

- PBRT

Retail

- Other Retail Revenue

Equipment Sales

- IGRT

- Patient Income (Lima, Peru)

Radiation Therapy Revenue

Total Revenue

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d8c1747ec76146e4cd48c5bb3c47c30b9bd221e197b232acb86076f9b9113445

Operating income in Q1 2023 was significantly lower, dropping to **$98,000** compared to **$600,000** in Q1 2022—a decline of about **83.7%**. This decrease was due to **higher operating costs**, an increase of **16.7%** in **selling and administrative expenses** (rising from **$1,319,000** to **$1,539,000**), and a **24.3%** increase in **interest expense** (from **$148,000** to **$184,000**), all of which negatively impacted the operating income.  **[0001437749-23-014058_ex_519131.htm:2]** **[AMS_3251277_3]** 

Why was Operating income so low in Q1 2023?

The negative operating income in Q2 2023 was primarily driven by **higher selling and administrative expenses**—which increased by **73.5%** (rising from **$1,146,000** in Q2 2022 to **$1,988,000** in Q2 2023) due to investments in new business opportunities (around **$250,000**) and increased salaries for additional management and sales staff—and by **increased reserves for impaired assets and anticipated removal costs** of **$578,000** associated with potential non-renewals of Gamma Knife agreements. These factors outweighed the benefits from a **20.6% improvement in gross margin**, resulting in a negative operating income for the period.  **[0001437749-23-023719_ex_560295.htm:0]** **[0001437749-23-023719_ex_560295.htm:2]** 

What factors led to a negative Operating income in Q2 2023?

AMS's net income turned negative in **Q2 2023** due to several compounding factors. The company incurred a **$578,000 loss from impaired assets and removal costs**, which represented a major non-recurring charge.  **[AMS_3382930_0]** **[AMS_3382930_3]** **[0001437749-23-023568_asha20230630_10q.htm:21]**  Additionally, **selling and administrative expenses surged by 73.5% to $2 million** (up from $1.1 million) as the company invested in new business opportunities and expanded its management and sales teams.  **[AMS_3382930_3]** **[AMS_3309674_4]**  The effect was compounded by **increased interest expenses** (rising from $149,000 to $167,000) due to higher rates on variable debt, and a **15.4% decline in international revenue** (down to $756,000 from $894,000).  **[AMS_3382930_3]** **[AMS_3309674_4]**  Even though an **income tax benefit of $35,000** was recorded, it was insufficient to counteract these negative impacts, leading to a net loss in Q2 2023.  **[AMS_3382930_3]** **[0001437749-23-023568_asha20230630_10q.htm:21]** 

Why did Net income turn negative in Q2 2023?

The drop in EPS for Q2 2023 was driven by several factors. **Higher selling and administrative expenses** increased by **73.5%** (from **$1.1 million** to **$2 million**), which included additional costs for new business opportunities and higher salaries. There was also a **$578,000 loss on impaired assets and removal costs** and a shift from an **operating income of $793,000** in Q2 2022 to an **operating loss of $325,000** in Q2 2023. Despite an **income tax benefit of $35,000** in Q2 2023 compared to an expense of **$248,000** in Q2 2022, these challenges led to a **net loss of $111,000** in Q2 2023, contributing to the EPS decline.  **[AMS_3382930_3]** **[AMS_3309674_4]** 

What caused the drop in EPS in Q2 2023?

2e3038f4ce27787b64e9b7b81f9f517aea7764a0695f8c662a12491aba036540

Adjustments for Non-Cash Items (USD)

Stock-Based Compensation (USD)

Changes in Working Capital (USD)

Capital Expenditures (CapEx) (USD)

Proceeds from / Repayments of Debt (USD)

Share Repurchases (USD)

Dividend Payments (USD)

Net Change in Cash (USD)

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Cash and cash equivalents (USD, thousands)

Restricted cash (USD, thousands)

Total current assets (USD, thousands)

Total assets (USD, thousands)

Total current liabilities (USD, thousands)

Total equity-American Shared Hospital Services (USD, thousands)

15e532b59585799c9f1890ded30e0c50f83d8196c710601e40317fdd51bd9669

The documents indicate that the **restricted cash** increased by **$132,000** in Q1 2024, from **$118,000 at December 31, 2023** to **$250,000 at March 31, 2024**; however, they do not provide specific details on what drove this jump.  **[0001437749-24-017104_asha20240331_10q.htm:1]** 

What drove the jump in Restricted cash in Q1 2024?

The surge in **Accounts receivable** for Q2 2024 was primarily driven by the **acquisition of a 60% equity interest in three Rhode Island radiation therapy facilities** in May 2024, which generated additional revenue and receivables under AMS's ownership.  **[0001437749-24-026859_ex_714831.htm:0]** **[0001437749-24-026762_asha20240611_10q.htm:26]**  Additionally, there was a significant **increase in retail revenue**—rising from **$756,000 in Q2 2023 to $3,157,000 in Q2 2024**—and **higher procedure volumes at international locations** contributed further to this growth.  **[AMS_3398886_2]** **[0001437749-24-026762_asha20240611_10q.htm:26]** 

Why did Accounts receivable surge in Q2 2024?

The surge in **Total assets** in Q3 2024 was primarily driven by several factors. These include the **acquisition of a 60% equity interest in two Rhode Island entities**, which operate three radiation therapy facilities, a significant **increase in accounts receivable** (from **$4,343,000** to **$8,635,000**), an increase in **property and equipment** (from **$25,844,000** to **$34,807,000**), and a modest rise in **cash and cash equivalents** (from **$13,690,000** to **$13,827,000**).  **[0001437749-24-035251_asha20240930_10q.htm:1]** **[0001437749-24-034762_ex_745759.htm:0]** **[0001437749-24-035251_asha20240930_10q.htm:20]** 

What contributed to the surge in Total assets in Q3 2024?

The increase in the Line of credit in Q3 2024 was primarily driven by **strategic initiatives**, including leveraging the company's resources for additional long-term revenue streams and executing the **Rhode Island acquisition** along with other business opportunities.  **[0001437749-24-035251_asha20240930_10q.htm:32]** 

What led to the increase in the Line of credit in Q3 2024?

The **Total current liabilities** increased sharply in Q3 2024 primarily due to **significant increases** across several areas. Notably, there were marked rises in **Accounts Payable**, **Employee Compensation and Benefits**, **Other Accrued Liabilities**, **Related Party Liabilities**, **Line of Credit**, and the **Current Portion of Long-term Debt, Net**. These changes were largely driven by the company's **recent acquisitions and expansions**, including the **Rhode Island acquisition**, which contributed to higher operational and financial obligations.  **[0001437749-24-035251_asha20240930_10q.htm:1]** 

Why did Total current liabilities rise so sharply in Q3 2024?

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5762e85cf00a669491da4af0300522449a82ea5fae6c921e2803ef45f1da92b9

Domestic (U.S.)

Foreign

- Lima, Peru

- Guayaquil, Ecuador

69e51b18764b5e787bf2561183f34c2a5c76138fc7d8a0056dd49a4880f1a0f2

American Shared Hospital Services (AMS)

Financials