American Shared Hospital Services

Second-quarter revenue increased 19.2% to approximately $8.4 million from $7.1 million a year ago. First-half 2026 revenue increased 17.7% to approximately $15.5 million from $13.2 million in the first half of 2025. Direct Patient Services revenue increased about 40% to $4.9 million in Q2, and proton beam radiation therapy revenue increased 22% to about $2.3 million. Gross margin was approximately $1.4 million in the quarter, and adjusted EBITDA was approximately $1.3 million versus $1.7 million in the prior-year quarter. Operating activities generated $4.4 million of cash in the first six months, and cash, cash equivalents and restricted cash ended the quarter at $6.8 million compared with $3.7 million at year-end 2025. Management did not provide formal next-quarter or full-year revenue/EPS guidance on the call; instead, it said demand is healthy, utilization is improving, and it expects continued momentum through the rest of the year while it works on refinancing and growth projects.

Raymond Stachowiak emphasized that the quarter validated the company’s shift from a leasing-heavy model to a more diversified radiation oncology platform. He highlighted stronger utilization across Rhode Island, Orlando, Peru, and Pueblo, plus continued investment in future growth opportunities such as Bristol, Johnston, and Guadalajara. His tone was confident, but he repeatedly noted that the balance sheet still needs attention.

Alexis Wallace said revenue growth was driven primarily by Direct Patient Services, with Q2 up 19.2% and first-half revenue up 17.7%. She pointed to gross margin of approximately $1.4 million, adjusted EBITDA of about $1.3 million in Q2, and $4.4 million of operating cash flow for the first half, while also noting $6.8 million in cash, cash equivalents and restricted cash at quarter-end. She said selling and administrative expenses were higher mainly because of $285 thousand of legal and professional costs tied to the credit amendment, and a higher allowance for credit losses of $909 thousand on Rhode Island receivables; she also said interest expense declined as debt balances fell.

Analysts pressed on whether the company can keep driving volume in international facilities the way it has in Rhode Island. Management said yes, pointing to substantial volume growth in Peru after the ESPRIT upgrade, improvement in Pueblo, and the planned Gamma Knife upgrade in Guadalajara with Hospital San Javier. Another analyst challenged the Fifth Third amendment language requiring pursuit of an asset sale and asked about the $909 thousand receivables charge; management said they are evaluating “any and all options” to refinance, expect the amendment to provide time, and said the receivables issue related mostly to insurance carriers, though they did not give more detail.