American Shared Hospital Services — Third Quarter and Nine-Month 2026 Earnings Summary

Financial Performance:

• Total revenue for the third quarter of 2026 increased 6.3% to $7.6 million, compared to $7.2 million in the third quarter of 2025.
• Total revenue for the first nine months of 2026 increased 13.7% to $23.1 million, compared to $20.4 million in the same period of 2025.
• Direct Patient Services revenue increased 13.6% to $4.6 million in Q3 2026 (vs. $4.0 million in Q3 2025) and 27.0% to $13.5 million for the nine months ended September 30, 2026 (vs. $10.7 million).
• Medical Equipment Leasing revenue decreased 3.1% to $3.0 million in Q3 2026 (vs. $3.1 million) and 1.0% to $9.6 million for the nine months ended September 30, 2026 (vs. $9.7 million).
• Gross profit for Q3 2026 was $1.5 million, down from $1.6 million in Q3 2025; costs of revenue increased to $6.1 million from $5.6 million.
• Gross profit for the nine months ended September 30, 2026, was $4.2 million, consistent with the prior-year period; costs of revenue increased to $18.9 million from $16.2 million.
• Selling and administrative expenses increased to $1.8 million in Q3 2026 (vs. $1.5 million) and $5.8 million for the nine months (vs. $5.1 million), driven by legal, banking, and consulting expenses related to a credit agreement amendment.
• The Company reported a net loss of $620,000 ($0.09 per diluted share) for Q3 2026, compared to a net loss of $17,000 ($0.00 per diluted share) in Q3 2025.
• The Company reported a net loss of $1.7 million ($0.26 per diluted share) for the nine months ended September 30, 2026, compared to a net loss of $922,000 ($0.14 per diluted share) in the prior-year period.
• Adjusted EBITDA was $1.4 million for Q3 2026, down from $1.9 million in Q3 2025.
• Adjusted EBITDA was $3.8 million for the nine months ended September 30, 2026, down from $4.6 million in the prior-year period.
• Cash flow from operating activities for the first nine months of 2026 was $5.8 million, compared to $3.8 million in the same period of 2025.
• Cash, cash equivalents, and restricted cash increased to approximately $9.5 million as of September 30, 2026, from $3.7 million at December 31, 2025.
• Current portion of long-term debt, net, was $15.7 million as of September 30, 2026, a decrease from $17.3 million at December 31, 2025.
• Shareholders' equity attributable to American Shared Hospital Services was $22.6 million ($3.40 per share) based on 6.65 million shares outstanding as of September 30, 2026.

Business Segments and Product Lines:

• Revenue from Rhode Island and Puebla, Mexico radiation therapy facilities increased 13.5% to $3.3 million in Q3 2026 and to approximately $9.6 million for the nine months ended September 30, 2026.
• Radiation therapy procedures at Rhode Island and Puebla facilities totaled 7,143 in Q3 2026 (down from 7,355) and 19,788 for the nine months (down from 20,401).
• International Gamma Knife procedure volume in Peru and Ecuador increased 8.9% in Q3 2026 and 30.7% for the nine months ended September 30, 2026.
• The Peru facility was upgraded to a Gamma Knife Esprit system in June 2025, resulting in shorter treatment times and increased capacity.
• PBRT revenue was $2.0 million in Q3 2026 (down from $2.1 million) and $6.3 million for the nine months (up from $5.7 million).
• PBRT treatment fractions totaled 960 in Q3 2026 (down from 1,150) and 3,184 for the nine months (up from 3,095).
• Domestic Gamma Knife procedure volume increased 13.1% in Q3 2026 but was lower than the prior-year period for the nine months due to the expiration of one customer contract in April 2025.

Market and Competitive Landscape:

• The Company continues to expand its international Direct Patient Services platform through joint ventures and facility upgrades.
• The Company believes fluctuations in PBRT treatment volume reflect normal cyclical changes in patient activity.

Risks and Challenges:

• Higher operating costs at Rhode Island and international Gamma Knife facilities contributed to increased costs of revenue.
• The expiration of a domestic Gamma Knife customer contract in April 2025 negatively impacted procedure volume for the nine-month period.
• The Safe Harbor statement notes risks including economic and market conditions, compliance with debt covenants, variability in financial results, changes to CMS reimbursement rates, and risks associated with expanding into new markets or operating acquired businesses.

Management Commentary and Tone:

• Interim CEO Craig Tagawa stated the Company is pleased with progress in growing Direct Patient Services, optimizing cost structure, and maximizing the contribution of existing facilities.
• Executive Chairman Ray Stachowiak emphasized a focus on long-term success, disciplined asset management, and strengthening the financial foundation.
• Management expressed confidence in the Company's diversified platform of Gamma Knife, Proton Beam Radiation Therapy, and direct patient services to drive long-term growth.
• Management noted that the third quarter financing and credit agreement actions provide additional flexibility while exploring longer-term capital structure alternatives.

Other Key Points:

• The Company entered into a Third Amendment to its Credit Agreement and Forbearance Agreement with Fifth Third Bank in July 2026.
• In conjunction with the credit amendment, the Company secured $2.0 million of subordinated financing from RCS/TIG Holdings LLC, an entity controlled by Executive Chairman Ray Stachowiak.
• The Company is advancing a joint venture with Hospital San Javier in Guadalajara, Mexico, expecting to upgrade the facility's Gamma Knife Perfexion system to a Gamma Knife Esprit system, with patient treatments expected to begin in mid-2027.
• A conference call to discuss results was scheduled for November 12, 2026, at 12:00 PM ET.