Company Summary: American Shared Hospital Services (ASHS)

Business Overview

• Type of Business: Provider of turn-key technology solutions for stereotactic radiosurgery and advanced radiation therapy equipment and services.
• Main Revenue Drivers:
  • Number of sites
  • Procedure volume
  • Reimbursement rates

Segments

• Medical Equipment Leasing:
  • Operates through fee-per-use and revenue sharing contracts
  • Shares in revenue and operating costs with hospital/healthcare facilities
  • Provides equipment such as Gamma Knife units, LINACs, and PBRT systems
  • Leases 9 Gamma Knife systems and 1 PBRT system as of December 31, 2024
  • Total leasing sites include U.S. and international locations
• Direct Patient Services ("Retail"):
  • Operates facilities directly treating patients in Rhode Island, Peru, Ecuador, and Mexico
  • Owns and manages stand-alone Gamma Knife centers in Lima, Peru and Guayaquil, Ecuador
  • Owns and operates multiple radiation therapy centers in Rhode Island and Puebla, Mexico
  • Started operating a LINAC facility in Puebla, Mexico in July 2024
  • Owns 60% in three Rhode Island cancer centers acquired in May 2024

Key Operations & Locations

• Gamma Knife:
  • 8 units in the U.S. and 2 units in South America
  • Conducted approximately 48,490 procedures through December 31, 2024
  • Procedures in 2024: 1,084 (a 9.3% decrease from 2023)
  • Revenue from Gamma Knife in 2024: approximately $9.7 million (34.3% of total revenue)
• Proton Beam Radiation Therapy (PBRT):
  • 1 PBRT system (located in Orlando, Florida)
  • Procedures in 2024: 5,139 (a 4.3% decrease from 2023)
  • Revenue in 2024: approximately $9.95 million (about 35% of total revenue)
• Radiation Therapy (LINAC):
  • 4 facilities owned and operated as of December 31, 2024
  • Began operations at a new LINAC site in Puebla, Mexico in July 2024
  • Procedures in 2024: 14,662
• International Operations:
  • Facilities in Peru, Ecuador, and Mexico
  • Focus on providing Gamma Knife and radiation therapy services

Revenue & Financials (2024)

• Total Revenue: ~$28.34 million (up 32.9% from 2023)
  • Leasing segment: $15.6 million (decreased from prior year)
  • Retail segment: $12.56 million (significantly increased due to new acquisitions and facilities)
  • Gamma Knife services: $9.7 million (34.3% of total revenue)
  • PBRT: $9.95 million (35% of total revenue)
  • LINAC: $8.5 million (about 30% of total revenue)
  • Equipment sales contributed a small amount (~$155,000)
• Net Income (2024): approximately $2.2 million
• Employees: 43 full-time US staff, 15 full-time in Peru, 4 in Ecuador, and 19 in Puebla, Mexico

Customer & Contracts

• Gamma Knife Customers:
  • US facilities organized under leasing and revenue-sharing models with hospital and clinic clients
  • Top customers accounted for a substantial portion of revenue (two customers 35% and 27% in 2024, and one customer 48% in 2023)
  • Leasing contracts typically last 10 years, with no minimum volume guarantees
• International and Domestic Facilities:
  • Facilities in Rhode Island, Peru, Ecuador, Mexico
  • Owned, leased, or operated directly for patient treatments

Additional Details

• Employees: 43 full-time employees in the US, with additional teams in Peru, Ecuador, and Mexico
• Market & Competition:
  • Competes with traditional neurosurgery, radiation, and other radiosurgery devices
  • Gamma Knife has a limited market, with a mature US market
  • Proton therapy and LINAC are competitive segments with several manufacturers
• Revenue Concentration:
  • Significant reliance on a few large customers in both Gamma Knife and leasing segments
  • Two customers represented 35% and 27% of revenue in 2024

This summary is based solely on the provided Form 10-K excerpt, including operations, segmentation, revenue, assets, and employee information.