American Shared Hospital Services Reports Third Quarter and Nine-Month 2026 Financial Results

Revenue up 14%, but losses widened and profitability remains elusive.

What the company is saying

American Shared Hospital Services reports strong revenue growth, highlighting a 14% year-over-year increase for both the third quarter and first nine months of 2026. The company emphasizes expansion in its Direct Patient Services segment, particularly in Rhode Island and international Gamma Knife operations in Peru and Ecuador. Executives Craig Tagawa (Interim CEO) and Ray Stachowiak (Executive Chairman) stress ongoing operational improvements, disciplined asset management, and strategic growth initiatives, including a joint venture with Hospital San Javier in Guadalajara, Mexico. Management attributes higher costs to increased operating expenses and legal, banking, and consulting fees tied to a recent credit agreement amendment. The tone is measured, acknowledging both progress and ongoing challenges, and frames the company as focused on long-term shareholder value despite current losses.

What the data suggests

Total revenue for Q3 2026 rose 6.3% to $7.6 million, and nine-month revenue climbed 13.7% to $23.1 million. Direct Patient Services segment revenue grew 13.6% in Q3 to $4.6 million and 27.0% for the nine months to $13.5 million, while Medical Equipment Leasing revenue declined 3.1% in Q3 to $3.0 million and 1.0% year-to-date to $9.6 million. Gross profit for Q3 was $1.5 million, down from $1.6 million, and nine-month gross profit was flat at $4.2 million. Net loss deepened to $620,000 ($0.09 per share) in Q3 and $1.7 million ($0.26 per share) for the nine months, compared to losses of $17,000 and $922,000, respectively, in 2025. Adjusted EBITDA fell to $1.4 million in Q3 and $3.8 million year-to-date. Cash, cash equivalents, and restricted cash increased to $9.5 million, aided by $5.8 million in operating cash flow and $2.0 million in subordinated financing. Costs of revenue and SG&A both increased, driven by higher operating costs and expenses related to a credit agreement amendment. The joint venture in Mexico is at a pre-operational stage, with patient treatments not expected until mid-2027. The data shows revenue momentum but persistent and widening losses, with profitability not yet in sight.

Analysis

The announcement is largely factual, with detailed disclosure of realised financial and operational results, including revenue, gross profit, net loss, and cash flow. However, despite revenue growth, profitability has deteriorated: net loss widened both quarterly and year-to-date, and adjusted EBITDA declined. The only significant forward-looking claim is the joint venture in Mexico, with patient treatments not expected until mid-2027, indicating a long-term execution horizon. The capital intensity flag is triggered by the disclosed financing and planned equipment upgrade, with no immediate earnings impact. The tone is measured and does not overstate progress; most language is descriptive rather than promotional. The gap between narrative and evidence is minimal, as forward-looking statements are clearly separated from realised results and not exaggerated.

Risk flags

• ●Profitability risk remains high as net losses widened to $1.7 million for the nine months despite strong revenue growth, and gross profit did not improve. This suggests that cost control and margin expansion are unresolved challenges.
• ●Execution risk is present in the San Javier joint venture, as patient treatments are not expected to begin until mid-2027. Delays or operational setbacks could push out any revenue contribution from this initiative.
• ●Capital structure risk is evident, with the company relying on $2.0 million in subordinated financing and a recent credit agreement amendment. Ongoing losses may necessitate further financing, which could dilute shareholders or increase leverage.
• ●Operating cost risk is highlighted by rising costs of revenue and SG&A, including legal, banking, and consulting fees tied to financing activities. If these costs persist, they could further erode margins and delay a return to profitability.

Bottom line

American Shared Hospital Services is growing revenue, especially in direct patient services and international operations, but has not translated this into profits. Net losses are increasing, and gross profit remains stagnant despite higher sales. The company has improved its cash position and secured additional financing, but ongoing losses and rising costs pose a risk to sustainability. The joint venture in Mexico offers potential future upside but will not impact results until at least mid-2027. Investors should focus on whether management can control costs, improve margins, and demonstrate a path to profitability before the next round of capital is needed. The most important takeaway is that revenue growth alone is not enough—profitability and cost discipline are now the critical hurdles.

Announcement summary

(NYSE:AMS) American Shared Hospital Services announced financial results for the third quarter and nine months ended September 30, 2026. Cash, cash equivalents and restricted cash increased to approximately $9.5 million at September 30, 2026, compared with $3.7 million at December 31, 2025. For the first nine months of 2026, the Company generated $5.8 million in cash from operating activities, compared with $3.8 million in the same period of 2025. Total revenue for the third quarter of 2026 increased 6.3% to $7.6 million, compared with $7.2 million in the third quarter of 2025. Direct Patient Services segment revenue increased 13.6% to $4.6 million, compared with $4.0 million in the prior-year period. Revenue from the Company's three Rhode Island radiation therapy facilities and its Puebla, Mexico facility increased 13.5% to $3.3 million, compared with $2.9 million in the third quarter of 2025. Radiation therapy procedures at these facilities totaled 7,143, compared with 7,355 in the prior-year quarter. International Gamma Knife operations in Peru and Ecuador saw procedure volume increase 8.9% period over period. Medical Equipment Leasing segment revenue was $3.0 million, compared with $3.1 million in the third quarter of 2025, a decrease of 3.1%. PBRT system revenue was $2.0 million, compared with $2.1 million in the prior-year quarter, with PBRT treatment fractions totaling 960, compared with 1,150 in the third quarter of 2025. Domestic Gamma Knife procedure volume increased 13.1% compared with the prior-year quarter. Gross profit for the third quarter was $1.5 million, compared with $1.6 million in the prior-year period. Total costs of revenue increased to $6.1 million from $5.6 million. Selling and administrative expenses increased to $1.8 million from $1.5 million in the third quarter of 2025. The Company reported a net loss attributable to American Shared Hospital Services of $620,000, or $0.09 per diluted share, compared with a net loss of $17,000, or $0.00 per diluted share, in the third quarter of 2025. Third quarter adjusted EBITDA was $1.4 million compared to $1.9 million in the prior year quarter. For the first nine months of 2026, total revenue increased 13.7% to $23.1 million, compared with $20.4 million in the first nine months of 2025. Direct Patient Services segment revenue increased 27.0% to $13.5 million, compared with $10.7 million in the prior-year period. Revenue from the Company's three Rhode Island radiation therapy facilities and its Puebla, Mexico facility increased to approximately $9.6 million, compared with $7.8 million in the first nine months of 2025. Radiation therapy procedures at these facilities totaled 19,788, compared with 20,401 in the prior-year period. International Gamma Knife facilities in Peru and Ecuador saw procedure volume increase 30.7% compared with the first nine months of 2025. Medical Equipment Leasing segment revenue was $9.6 million, compared with $9.7 million in the first nine months of 2025, a decrease of approximately 1.0%. PBRT revenue increased to $6.3 million from $5.7 million in the prior-year period, with PBRT treatment fractions totaling 3,184, compared with 3,095 in the first nine months of 2025. Gross profit for the first nine months of 2026 was $4.2 million. Total costs of revenue increased to $18.9 million from $16.2 million. Selling, general and administrative expenses increased to $5.8 million from $5.1 million in the first nine months of 2025. The Company reported a net loss attributable to American Shared Hospital Services of $1.7 million, or $0.26 per diluted share, compared with a net loss of $922,000, or $0.14 per diluted share, in the first nine months of 2025. Adjusted EBITDA for the nine-month period was $3.8 million compared to $4.6 million in the prior year period. The current portion of long-term debt, net was $15.7 million as of September 30, 2026, representing a decrease from $17.3 million at December 31, 2025. Shareholders’ equity attributable to American Shared Hospital Services, excluding non-controlling interests, was $22.6 million, or approximately $3.40 per share, based on 6.65 million shares outstanding at September 30, 2026. In July 2026, the Company executed a Third Amendment to its Credit Agreement with Fifth Third Bank and secured $2.0 million of subordinated financing from RCS/TIG Holdings LLC, controlled by the Executive Chairman. The Company is advancing its joint venture with Hospital San Javier, S.A. de C.V. in Guadalajara, Mexico, and expects to upgrade the hospital's Gamma Knife Perfexion system to a Gamma Knife Esprit system, with patient treatments expected to begin in mid-2027. The Company held a conference call to discuss these results on November 12, 2026.

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