American Shared Hospital Services (NYSE American: AMS), a leading provider of stereotactic radiosurgery equipment and advanced radiation therapy cancer treatment services, announced financial results for the first quarter ended March 31, 2026, showing a 15.9% increase in total revenue to $7.1 million, compared to $6.1 million in the same period last year. The growth was primarily driven by a 30.2% increase in direct patient services revenue, which reached $4.1 million, up from $3.1 million in the prior year, reflecting higher patient volumes at the company's Rhode Island radiation therapy centers and its facility in Puebla, Mexico.
Gross margin improved significantly, increasing 36.7% to $1.3 million, or 18.2% of revenue, compared to $0.9 million, or 15.4%, in the prior year period. This margin expansion was attributed to higher overall revenue and improved utilization across treatment centers, which offset the higher cost structure associated with the growing direct patient services segment. Operating loss narrowed to $(0.9) million from $(1.3) million in the prior year, and adjusted EBITDA increased 18.4% to $1.1 million, up from $0.9 million.
Key operational highlights included a 10.1% year-over-year increase in Gamma Knife procedures, totaling 229, and a 20.7% rise in proton beam radiation therapy (PBRT) treatments, with 1,003 procedures performed. The company noted that volumes continued to trend higher into the second quarter. Leasing revenue remained flat at $3.0 million, reflecting the impact of prior Gamma Knife agreement expirations, partially offset by improved procedure volumes at upgraded sites.
Craig Tagawa, Interim Chief Executive Officer, stated, "We are encouraged by our performance in the first quarter of 2026, which reflects continued momentum in our direct patient care services segment and improved utilization across our treatment centers. Revenue growth of approximately 16% year-over-year was driven by strong contributions from our Rhode Island and Puebla radiation therapy centers, as well as growth in proton therapy volumes which is continuing into the second quarter." Ray Stachowiak, Executive Chairman, added, "We continue to execute on our strategy of expanding our direct patient care footprint while strengthening our clinical capabilities and partnerships. Growth across our LINAC and proton therapy platforms reflects increasing demand for advanced radiation therapy services."
Total cost of revenue increased to $5.8 million from $5.2 million, primarily due to higher operating costs at the direct patient services segment, including staffing, facility-related expenses, and maintenance costs. Depreciation and amortization expense decreased by $0.2 million, partially offsetting the increase. Selling and administrative expenses rose modestly to $1.9 million from $1.8 million, driven by higher audit, tax, and consulting fees. Interest expense decreased to $0.3 million from $0.4 million due to a lower average outstanding debt balance. Net loss attributable to the company was $(0.6) million, or $(0.09) per diluted share, consistent with the prior year's net loss of $(0.6) million, or $(0.10) per diluted share.
As of March 31, 2026, the company had cash, cash equivalents, and restricted cash of $5.2 million, up from $3.7 million at December 31, 2025, driven by improved operating performance and working capital timing. Current portion of long-term debt decreased to $16.8 million from $17.3 million. Shareholders' equity (excluding non-controlling interests) was $23.5 million, or approximately $3.56 per share. The company continues to engage in discussions with its lender regarding a potential extension of certain debt obligations.
Scott Frech, Chief Financial Officer, stated, "Our first quarter performance highlights the strength of our operating model, as higher treatment volumes translated into improved margins and a significant reduction in operating loss. As utilization continues to ramp up across our network, we expect to drive further margin expansion and increased profitability." A conference call to discuss the results was scheduled for 12:00 PM ET today, accessible via the company's website at www.ashs.com.
