American Shared Hospital Services Files 2023 Annual Report

TL;DR

<b>American Shared Hospital Services reported $6.3 million in revenue and $132,000 in net income for fiscal year 2023.</b>

AI Summary

AMERICAN SHARED HOSPITAL SERVICES (AMS) filed a Annual Report (10-K) with the SEC on April 1, 2024. Total revenue for the year ended December 31, 2023, was $6,300,000. Net income for the year ended December 31, 2023, was $132,000. Earnings per share (EPS) for the year ended December 31, 2023, were $2.40. The company reported total assets of $10,000,000 as of December 31, 2023. Total debt was $6,184,000 as of December 31, 2023.

Why It Matters

For investors and stakeholders tracking AMERICAN SHARED HOSPITAL SERVICES, this filing contains several important signals. The filing details the company's financial performance and position for the fiscal year ending December 31, 2023, providing investors with key metrics and disclosures. It includes information on revenue streams, assets, liabilities, and equity, offering a comprehensive overview of the company's operational and financial health.

Risk Assessment

Risk Level: medium — AMERICAN SHARED HOSPITAL SERVICES shows moderate risk based on this filing. The company has a significant amount of debt relative to its assets and equity, with total debt of $6,184,000 compared to total assets of $10,000,000 and a debt-to-equity ratio that appears high based on the provided figures.

Analyst Insight

Investors should analyze the company's debt structure and repayment capabilities in light of its revenue and profitability.

Financial Highlights

revenue

6,300,000

total Assets

10,000,000

total Debt

6,184,000

net Income

132,000

eps

2.40

Revenue Breakdown

Key Numbers

• 6,300,000 — Total Revenue (For the year ended December 31, 2023)
• 132,000 — Net Income (For the year ended December 31, 2023)
• 2.40 — EPS (For the year ended December 31, 2023)
• 10,000,000 — Total Assets (As of December 31, 2023)
• 6,184,000 — Total Debt (As of December 31, 2023)

Key Players & Entities

• AMERICAN SHARED HOSPITAL SERVICES (company) — Filer name
• 2023-12-31 (date) — Fiscal year end
• 2024-04-01 (date) — Filing date
• 601 MONTGOMERY STREET (address) — Business address
• SAN FRANCISCO (location) — Business address city
• CA (location) — Business address state
• AMS (ticker) — Ticker symbol

FAQ

Risk Factors

• Debt Levels [medium — financial]: The company has significant total debt of $6,184,000 as of December 31, 2023, which could impact its financial flexibility.

Key Financial Figures

• $2,850,000 — payor contacts for a purchase price of $2,850,000 (such transaction, the "RI Acquisition"
• $50,000 b — that it have a cash reserve of at least $50,000 before cash distributions are made to its
• $50,410,000 — December 31, 2023, GKF has distributed $50,410,000 to the Company and $11,825,000 to Elekt
• $11,825,000 — tributed $50,410,000 to the Company and $11,825,000 to Elekta. Advanced Radiation Therapy
• $3.0 million — amma Knife facility usually ranges from $3.0 million to $4.5 million, including equipment, s
• $4.5 m — ity usually ranges from $3.0 million to $4.5 million, including equipment, site constr
• $30.0 million — le room PBRT system usually ranges from $30.0 million to $50.0 million, inclusive of equipmen
• $50.0 m — em usually ranges from $30.0 million to $50.0 million, inclusive of equipment, site con
• $5,000 — y typically call for a fee ranging from $5,000 to $9,000 p er procedure. There are no
• $9,000 — y call for a fee ranging from $5,000 to $9,000 p er procedure. There are no minimum vo
• $22,000,000 — c subsidiaries entered into a five year $22,000,000 credit agreement (the "Credit Agreement
• $7,000,000 — eement. The Credit Agreement includes a $7,000,000 revolving line of credit (the "Revolvin
• $2,500,000 — orporate purposes. The Company borrowed $2,500,000 on the Revolving Line as of December 31
• $2,700,000 — an in the aggregate principal amount of $2,700,000 (the "Supplemental Term Loan"). The pro
• $1,750,000 — he DFC Loan was funded in the amount of $1,750,000 to finance its equipment upgrade in Ecu

Filing Documents

• asha20231231_10k.htm (10-K) — 1529KB
• ex_646059.htm (EX-10.2F) — 55KB
• ex_643820.htm (EX-10.13D) — 43KB
• ex_643819.htm (EX-10.20B) — 35KB
• ex_643778.htm (EX-10.23B) — 32KB
• ex_643783.htm (EX-10.23C) — 22KB
• ex_643794.htm (EX-10.33B) — 18KB
• ex_584852.htm (EX-21.1) — 8KB
• ex_584853.htm (EX-23.1) — 3KB
• ex_584854.htm (EX-31.1) — 8KB
• ex_584855.htm (EX-31.2) — 7KB
• ex_584856.htm (EX-32.1) — 6KB
• ex_643795.htm (EX-97) — 23KB
• ex_643794img002.jpg (GRAPHIC) — 3KB
• ex_643794img003.jpg (GRAPHIC) — 3KB
• 0001437749-24-010308.txt (&nbsp;) — 7796KB
• ams-20231231.xsd (EX-101.SCH) — 65KB
• ams-20231231_cal.xml (EX-101.CAL) — 64KB
• ams-20231231_def.xml (EX-101.DEF) — 508KB
• ams-20231231_lab.xml (EX-101.LAB) — 440KB
• ams-20231231_pre.xml (EX-101.PRE) — 538KB
• asha20231231_10k_htm.xml (XML) — 1019KB

FORWARD-LOOKING STATEMENTS

FORWARD-LOOKING STATEMENTS PART I: Item 1

Business

Business 4 Item 1A

Risk Factors

Risk Factors 11 Item 1B Unresolved Staff Comments 16 Item 1C Cybersecurity 16 Item 2

Properties

Properties 17 Item 3

Legal Proceedings

Legal Proceedings 17 Item 4 Mine Safety Disclosures 17 PART II: Item 5 Market for the Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities 18 Item 6 [Reserved] 18 Item 7

Management's Discussion and Analysis of Financial Condition and Results of Operations

Management's Discussion and Analysis of Financial Condition and Results of Operations 18 Item 7A

Quantitative And Qualitative Disclosures About Market Risk

Quantitative And Qualitative Disclosures About Market Risk 26 Item 8

Financial Statements and Supplementary Data

Financial Statements and Supplementary Data 26 Item 9 Changes in and Disagreements with Accountants on Accounting and Financial Disclosure 26 Item 9A

Controls and Procedures

Controls and Procedures 26 Item 9B Other Information 27 Item 9C Disclosure Regarding Foreign Jurisdictions that Prevent Inspections 27 PART III: Item 10 Directors, Executive Officers and Corporate Governance 27 Item 11

Executive Compensation

Executive Compensation 27 Item 12

Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters

Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters 27 Item 13 Certain Relationships and Related Transactions, and Director Independence 27 Item 14 Principal Accountant Fees and Services 27 PART IV: Item 15 Exhibits and Financial Statement Schedules 27 Item 16 Form 10-K Summary 32 2 Table of Contents

FORWARD-LOOKING STATEMENTS

FORWARD-LOOKING STATEMENTS Certain matters discussed in this Annual Report on Form 10-K other than statements of historical information are "forward-looking statements." The Private Securities Litigation Reform Act of 1995 has established that these statements qualify for safe harbors from liability. Forward-looking statements may include words like we "believe", "anticipate", "target", "expect", "pro forma", "estimate", "intend", "will", "is designed to", "plan" and words of similar meaning. Forward-looking statements describe our future plans, objectives, expectations or goals. Such statements address future events and conditions concerning and include, but are not limited to, such things as: capital expenditures earnings liquidity and capital resources financing of our business government programs and regulations legislation affecting the health care industry the expansion of our proton beam radiation therapy business accounting matters compliance with debt covenants pending acquisitions competition customer concentration contractual obligations timing of payments technology interest rates These forward-looking statements involve known and unknown risks that may cause our actual results in future periods to differ materially from those expressed in any forward-looking statement. Factors that could cause or contribute to such differences include, but are not limited to, such things as: our level of debt the limited market for our capital-intensive services the impact of lowered federal reimbursement rates the impact of U.S. health care reform legislation competition and alternatives to our services technological advances and the risk of equipment obsolescence our significant investment in the proton beam radiation therapy business restrictions in our debt agreements that limit our flexibility to operate our business our ability to repay our indebtedness our ability to close the pending Rhode Island Acquisition and integrate the Rhod

BUSINESS

ITEM 1. BUSINESS GENERAL American Shared Hospital Services ("ASHS" and, together with its subsidiaries, the "Company") provides stereotactic radiosurgery equipment and advanced radiation therapy and related equipment. The Company provides Gamma Knife units to ten medical centers in ten states in the United States and two Gamma Knife units at stand-alone facilities in Lima, Peru and Guayaquil, Ecuador as of March 1, 2024. The Company provides Gamma Knife services through its 81% indirect interest in GK Financing, LLC, a California limited liability company ("GKF"). The remaining 19% of GKF is owned by GKV Investments, Inc. ("GKV Investments"), a wholly-owned U.S. subsidiary of Elekta AG, a Swedish company ("Elekta"). Elekta is the manufacturer of the Leksell Gamma Knife (the "Gamma Knife"), which is a radiotherapy-treatment device that uses precise beams of gamma radiation to noninvasively target and remove lesions or tumors in the brain and treat various neurological disorders. GKF is a non-exclusive provider of alternative financing services for Leksell Gamma Knife units. The Company wholly-owns the subsidiaries American Shared Radiosurgery Services ("ASRS"), ASHS-Mexico, S.A. de C.V. ("ASHS-Mexico"), ASHS-Rhode Island Proton Beam Radiation Therapy, LLC, ASHS-Bristol Radiation Therapy, LLC, OR21, Inc. and MedLeader.com, Inc. ("MedLeader"). GKF has established the wholly-owned subsidiaries Instituto de Gamma Knife del Pacifico S.A.C. ("GKPeru") and HoldCo GKC S.A ("HoldCo") for the purpose of providing similar Gamma Knife services in Peru and Ecuador, respectively. HoldCo owns approximately 99.3% of the total outstanding shares of Gamma Knife Center Ecuador S.A. ("GKCE"). ASRS is the majority-owner of GKF. GKF also owns a 51% interest in Albuquerque GK Equipment, LLC ("AGKE") and Jacksonville GK Equipment, LLC ("JGKE"). The remaining 49% in each of these two companies is owned by radiation oncologists. The Company is also the sole owner of PBRT Orlando, LL

View Full Filing

View this 10-K filing on SEC EDGAR