American Shared Hospital Services (AMS) investor relations material

Executive summary

• Q3 2025 revenue increased 2.5% year-over-year to $7.2M, driven by direct patient care services and new centers in Rhode Island and Puebla, Mexico.

• Direct patient care services revenue rose due to the RI Companies acquisition and Puebla facility opening, offsetting declines in equipment leasing revenue.

• Net loss for Q3 2025 decreased to $17,000, with adjusted EBITDA up 42.3% to $1.94M year-over-year.

• For the first nine months of 2025, revenue grew 5.6% to $20.4M, with direct patient care up 36.5%.

• Management remains focused on operational efficiencies, margin improvement, and long-term shareholder value.

Financial highlights

• Q3 2025 gross margin improved to 22.1%, with gross profit of $1.6M, up from $1.37M in Q3 2024.

• Direct patient care services revenue for Q3 2025 increased 9.4% to $4M, representing 56% of total sales.

• Equipment leasing segment revenue for Q3 2025 declined to $3.1M due to lower PBRT volumes and contract expirations.

• Q3 2025 operating loss narrowed to $344K from $889K in Q3 2024; net loss improved to $17K from $207K.

• Adjusted EBITDA for Q3 2025 increased 41% to $1.9M.

Outlook and guidance

• Anticipates further revenue growth in late 2025 and 2026 from new Gamma Knife center in Guadalajara, Mexico and expansion in Rhode Island.

• New facilities in Bristol and a proton beam center in Rhode Island are under development, representing major growth opportunities.

• Management expects cash, operations, and credit capacity to be sufficient for debt and working capital needs over the next 12 months, but notes the April 2026 credit agreement maturity as a potential risk.

• Commitments to purchase and install new Gamma Knife and LINAC systems total $7.88M, with intent to finance most of these projects.

• Strategic focus on expanding direct patient care services and leveraging economies of scale for profitability.