American Shared Hospital Services (NYSEAMERICAN:AMS) reported improved first-quarter 2026 results, citing higher treatment volumes across its direct patient care network, stronger utilization at newer facilities and growth in proton therapy and Gamma Knife services.
On the company’s earnings call, Executive Chairman Ray Stachowiak said American Shared is seeing “continued progress across our network,” particularly in treatment volumes and center-level performance. He said volumes were trending positively into the second quarter, with contributions from the Orlando proton beam radiation therapy facility, Rhode Island centers and international Gamma Knife centers.
Leadership Transition Announced
Stachowiak began the call by addressing a recent management change. In late April, the company announced that Gary Delanois had stepped down as chief executive officer for personal reasons, and the board appointed Craig Tagawa as interim CEO.
Stachowiak said Tagawa brings more than 35 years of experience with the company, including prior leadership roles as president, chief operating officer and chief financial officer. He said Tagawa’s operational and financial experience positions him to lead the company through its next phase.
Tagawa said he is focused on maintaining continuity in the company’s strategy while emphasizing execution, operational discipline and long-term shareholder value.
Revenue Rises on Direct Patient Care Growth
Chief Financial Officer Scott Frech said total revenue for the first quarter increased 15.9% to $7.1 million, compared with $6.1 million in the prior-year period. The gain was driven primarily by the company’s direct patient care services segment, which generated about $4.1 million in revenue, up 30.2% from $3.1 million a year earlier.
Frech said the increase reflected higher procedure volumes at American Shared’s Rhode Island facilities and its radiation therapy center in Puebla, Mexico, as those sites continued to ramp up utilization and patient throughput.
Leasing revenue was approximately $3 million, which Frech described as relatively consistent with the prior-year period. He said higher procedure volumes in some areas were largely offset by the impact of a Gamma Knife customer contract that expired in April 2025.
From a modality standpoint, Frech said proton beam radiation therapy revenue increased on higher volumes, with total fractions rising more than 20% year over year. Gamma Knife revenue also increased, supported by strength in direct patient services, particularly at international locations in Peru and Ecuador, where volumes benefited from equipment upgrades and improved operating conditions.
Margins Improve, Net Loss Narrows
Gross margin improved to $1.3 million, or 18.2% of revenue, from $0.9 million, or 15.4%, in the prior-year quarter. Frech attributed the improvement to higher revenue and better utilization across the treatment network, which more than offset the higher cost structure associated with the company’s expanding direct patient services segment.
Total cost of revenue rose to $5.8 million from $5.2 million a year earlier, reflecting higher operating costs tied to staffing, facility expenses and maintenance at the Rhode Island and Puebla locations. Frech also noted higher maintenance expenses as certain LINAC systems came out of warranty and as maintenance contract costs for the Orlando proton beam radiation therapy facility continued to increase.
Selling and administrative expenses rose modestly to $1.9 million, primarily due to higher audit, tax and consulting fees, partially offset by lower legal expenses.
The company reported an operating loss of $0.9 million, improved from a $1.3 million loss in the prior-year period. Net loss attributable to the company improved to $0.6 million, or $0.09 per diluted share, compared with $0.10 per diluted share a year earlier. Adjusted EBITDA increased 18.4% to $1.1 million from $949,000 in the same period last year.
Tagawa said the results showed continued momentum in direct patient care services and improving utilization across treatment centers. He said the company is seeing early benefits from operational initiatives implemented over the past year, including better cost alignment and improved coordination across centers.
Rhode Island and International Expansion Remain Key Priorities
Management highlighted several growth initiatives, including expansion in Rhode Island and Mexico. Stachowiak said the company has Certificate of Need approvals for a new radiation therapy center in Bristol, Rhode Island, and a proton beam radiation therapy center in Johnston, Rhode Island.
In response to an analyst question, Stachowiak said both projects remain on schedule, but emphasized that they are long-term developments. He said the Bristol radiation therapy center, which would be the company’s fourth center in Rhode Island, is expected to open in 18 to 24 months. The Johnston proton beam facility is “about 24 to 30 months out,” he said.
Stachowiak also said American Shared expects its Guadalajara center to begin operations late this year. He described the Puebla center as continuing to demonstrate strong growth, while Tagawa said Puebla benefited from improved reimbursement dynamics and ongoing operational ramp-up.
Stachowiak said he remains “bullish” on the company’s growth prospects and believes the current valuation does not reflect the true value of the business or its opportunities.
Balance Sheet and Contract Updates
Frech said American Shared ended the quarter with approximately $5.2 million in cash equivalents and restricted cash, up from $3.7 million at year-end. The current portion of long-term debt was $16.8 million as of March 31, down from $17.3 million as of Dec. 31.
Frech said the company continues to manage its capital structure and is having productive conversations with its lender regarding a potential extension. During the question-and-answer session, he said discussions with Fifth Third Bank are “proceeding” and “going well,” but declined to provide additional detail. He added that some of the company’s cash is held in international operations, and that American Shared has recently been successful in repatriating some funds back to the United States.
Asked about a contract referenced in an April Zacks report as potentially expiring in the second quarter of 2026, Stachowiak said he did not expect a material impact because the company signed a two-year extension for that agreement.
In closing, the company said its priorities remain increasing utilization across centers, improving operational efficiency and strengthening its financial position. Management said the foundation built by the company positions it for continued progress in 2026.
About American Shared Hospital Services (NYSEAMERICAN:AMS)
American Shared Hospital Services operates as a specialized healthcare services company focused on delivering diagnostic imaging solutions to community and rural hospitals across the United States. Through strategic joint ventures and management agreements, the company collaborates with hospital partners to develop and operate outpatient imaging centers that provide advanced modalities while sharing the capital and operating costs. By partnering directly with hospitals, American Shared Hospital Services enables facility owners to offer in-house diagnostic capabilities without the burden of full operational oversight and significant equipment investment.
The company’s service portfolio encompasses a wide range of imaging technologies, including magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography/computed tomography (PET/CT), mammography, ultrasound, bone densitometry (DEXA) and nuclear medicine.
