American Shared Hospital Services (AMS) 10-Q 9 Nov 18 2018 Q3 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	9 Months Ended
	Sep. 30, 2018	Nov. 06, 2018
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q3
Entity Registrant Name	AMERICAN SHARED HOSPITAL SERVICES
Entity Central Index Key	744,825
Current Fiscal Year End Date	--12-31
Entity Filer Category	Non-accelerated Filer
Trading Symbol	AMS
Entity Common Stock, Shares Outstanding		5,714,000
Entity Emerging Growth Company	false
Entity Small Business	true

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($)	Sep. 30, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 1,839,000	$ 2,152,000
Restricted cash	350,000	350,000
Accounts receivable, net of allowance for doubtful accounts of $100,000 at September 30, 2018 and $100,000 at December 31, 2017	5,402,000	5,019,000
Other receivables	368,000	216,000
Prepaid expenses and other current assets	1,575,000	1,156,000
Total current assets	9,534,000	8,893,000
Property and equipment:
Medical equipment and facilities	93,966,000	95,923,000
Office equipment	585,000	576,000
Deposits and construction in progress	3,907,000	3,658,000
Property and equipment Gross	98,458,000	100,157,000
Accumulated depreciation and amortization	(52,337,000)	(51,666,000)
Net property and equipment	46,121,000	48,491,000
Other assets	815,000	792,000
Total assets	56,470,000	58,176,000
Current liabilities:
Accounts payable	554,000	359,000
Employee compensation and benefits	255,000	187,000
Other accrued liabilities	1,287,000	1,188,000
Income tax payable	115,000	0
Current portion of long-term debt	2,072,000	2,459,000
Current portion of capital leases	4,499,000	4,814,000
Total current liabilities	8,782,000	9,007,000
Long-term debt, less current portion	2,118,000	3,598,000
Long-term capital leases, less current portion	11,299,000	12,272,000
Deferred revenue, less current portion	408,000	504,000
Deferred income taxes	2,840,000	2,910,000
Shareholders' equity:
Common stock, no par value (10,000,000 authorized; 5,714,000 shares issued and outstanding at September 30, 2018 and 5,710,000 shares at December 31, 2017)	10,711,000	10,711,000
Additional paid-in capital	6,441,000	6,272,000
Retained earnings	7,718,000	6,873,000
Total equity-American Shared Hospital Services	24,870,000	23,856,000
Non-controlling interest in subsidiary	6,153,000	6,029,000
Total shareholders' equity	31,023,000	29,885,000
Total liabilities and shareholders' equity	$ 56,470,000	$ 58,176,000

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS [Parenthetical] - USD ($)	Sep. 30, 2018	Dec. 31, 2017
Allowance for doubtful accounts (in dollars)	$ 100,000	$ 100,000
Common stock, shares authorized	10,000,000	10,000,000
Common stock, shares issued	5,714,000	5,710,000
Common stock, shares outstanding	5,714,000	5,710,000

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Rental income from medical services	$ 4,470,000	$ 4,613,000	$ 14,944,000	$ 14,472,000
Costs of revenue:
Maintenance and supplies	470,000	331,000	1,723,000	811,000
Depreciation and amortization	1,761,000	1,674,000	5,082,000	5,000,000
Other direct operating costs	605,000	726,000	2,218,000	2,182,000
Costs of revenue	2,836,000	2,731,000	9,023,000	7,993,000
Gross Margin	1,634,000	1,882,000	5,921,000	6,479,000
Selling and administrative expense	1,050,000	1,026,000	3,067,000	3,303,000
Interest expense	399,000	417,000	1,230,000	1,314,000
Operating income	185,000	439,000	1,624,000	1,862,000
Proceeds received from investment in equity securities	0	0	22,000	0
Interest and other income (loss)	185,000	0	194,000	(1,000)
Income before income taxes	370,000	439,000	1,840,000	1,861,000
Income tax expense	82,000	164,000	401,000	600,000
Net income	288,000	275,000	1,439,000	1,261,000
Less: Net (income) attributable to non-controlling interests	(120,000)	(176,000)	(594,000)	(756,000)
Net income attributable to American Shared Hospital Services	$ 168,000	$ 99,000	$ 845,000	$ 505,000
Net income per share:
Earnings per common share - basic	$ 0.03	$ 0.02	$ 0.14	$ 0.09
Earnings per common share - diluted	$ 0.03	$ 0.02	$ 0.14	$ 0.09

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENT OF SHAREHOLDERS' EQUITY - USD ($)	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	Sub-Total ASHS [Member]	Non-controlling Interests in Subsidiaries [Member]
Balances at Dec. 31, 2016	$ 27,173,000	$ 10,596,000	$ 5,949,000	$ 4,950,000	$ 21,495,000	$ 5,678,000
Balances (in shares) at Dec. 31, 2016		5,468,000
Stock-based compensation expense	323,000	$ 0	323,000	0	323,000	0
Stock-based compensation expense (in shares)		4,000
Restricted stock awards	0	$ 0	0	0	0	0
Restricted stock awards (in shares)		162,000
Warrants and options exercised	115,000	$ 115,000	0	0	115,000	0
Warrants and options exercised (in shares)		76,000
Cash distributions to non-controlling interests	(666,000)	$ 0	0	0	0	(666,000)
Net income	2,940,000	0	0	1,923,000	1,923,000	1,017,000
Balances at Dec. 31, 2017	29,885,000	$ 10,711,000	6,272,000	6,873,000	23,856,000	6,029,000
Balances (in shares) at Dec. 31, 2017		5,710,000
Stock-based compensation expense	169,000	$ 0	169,000	0	169,000	0
Stock-based compensation expense (in shares)		4,000
Cash distributions to non-controlling interests	(470,000)	$ 0	0	0	0	(470,000)
Net income	1,439,000	0	0	845,000	845,000	594,000
Balances at Sep. 30, 2018	$ 31,023,000	$ 10,711,000	$ 6,441,000	$ 7,718,000	$ 24,870,000	$ 6,153,000
Balances (in shares) at Sep. 30, 2018		5,714,000

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2017
Operating activities:
Net income	$ 288,000	$ 275,000	$ 1,439,000	$ 1,261,000	$ 2,940,000
Adjustments to reconcile net income to net cash from operating activities:
Depreciation and amortization			5,138,000	5,050,000
Loss on disposal of assets			0	15,000
Deferred income tax			45,000	500,000
Stock-based compensation expense			169,000	158,000
Net accrued interest on lease financing			39,000	(79,000)
Changes in operating assets and liabilities:
Accounts receivable and other receivables			(398,000)	(1,191,000)
Prepaid expenses and other assets			(473,000)	(944,000)
Deferred revenue			(93,000)	(84,000)
Accounts payable and accrued liabilities			359,000	290,000
Net cash from operating activities			6,225,000	4,976,000
Investing activities:
Payment for purchase of property and equipment			(1,187,000)	(760,000)
Proceeds from sale of equipment			0	150,000
Net cash (used in) investing activities			(1,187,000)	(610,000)
Financing activities:
Principal payments on long-term debt			(1,875,000)	(1,595,000)
Principal payments on capital leases			(3,006,000)	(3,823,000)
Distributions to non-controlling interests			(470,000)	(519,000)
Proceeds from warrants and options exercised			0	115,000
Net cash (used in) financing activities			(5,351,000)	(5,822,000)
Net change in cash, cash equivalents, and restricted cash			(313,000)	(1,456,000)
Cash, cash equivalents, and restricted cash at beginning of period			2,502,000	3,121,000	3,121,000
Cash, cash equivalents, and restricted cash at end of period	$ 2,189,000	$ 1,665,000	2,189,000	1,665,000	$ 2,502,000
Supplemental cash flow disclosure:
Cash paid during the period for: Interest			1,307,000	1,424,000
Cash paid during the period for: Income taxes			354,000	104,000
Schedule of non-cash investing and financing activities
Acquisition of equipment with capital lease financing			1,679,000	2,153,000
Acquisition of equipment with long-term debt financing			$ 0	$ 992,000

Basis of Presentation

Basis of Presentation	9 Months Ended
	Sep. 30, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization, Consolidation and Presentation of Financial Statements Disclosure [Text Block]	Note 1. Basis of Presentation In the opinion of management, the accompanying unaudited condensed consolidated financial statements contain all adjustments necessary to present fairly American Shared Hospital Services’ consolidated financial position as of September 30, 2018 and the results of its operations for the three and nine-month periods ended September 30, 2018 and 2017, which results are not necessarily indicative of results on an annualized basis. Consolidated balance sheet amounts as of December 31, 2017 have been derived from audited consolidated financial statements. These unaudited condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements for the year ended December 31, 2017 included in American Shared Hospital Services’ Annual Report on Form 10-K filed with the Securities and Exchange Commission. These consolidated financial statements include the accounts of American Shared Hospital Services and its subsidiaries (the “Company”) as follows: the Company wholly-owns the subsidiaries American Shared Radiosurgery Services (“ASRS”), PBRT Orlando, LLC (“Orlando”), OR21, Inc., and MedLeader.com, Inc. (“MedLeader”); the Company is the majority owner of Long Beach Equipment, LLC (“LBE”); ASRS is the majority-owner of GK Financing, LLC (“GKF”) which wholly-owns the subsidiaries Instituto de Gamma Knife del Pacifico S.A.C. (“GKPeru”) and GK Financing U.K., Limited (“GKUK”); GKF is the majority owner of the subsidiaries Albuquerque GK Equipment, LLC (“AGKE”) and Jacksonville GK Equipment, LLC (“JGKE”). The Company (through ASRS) and Elekta AB, the manufacturer of the Gamma Knife (through its wholly-owned United States subsidiary, GKV Investments, Inc.), entered into an operating agreement and formed GKF. As of September 30, 2018, GKF provided Gamma Knife units to fifteen medical centers in the United States in the states of Arkansas, California, Florida, Illinois, Massachusetts, Mississippi, Nebraska, Nevada, New Mexico, New York, Ohio, Oregon, Tennessee, and Texas. GKF also owns and operates a single-unit Gamma Knife facility in Lima, Peru. The Company through its wholly-owned subsidiary, Orlando, provided proton beam radiation therapy (“PBRT”) and related equipment to a customer in the United States. The Company also directly provides radiation therapy and related equipment, including Intensity Modulated Radiation Therapy (“IMRT”), Image Guided Radiation Therapy (“IGRT”) and a CT Simulator to the radiation therapy department at an existing Gamma Knife site in Massachusetts. The Company formed the subsidiaries GKPeru and GKUK for the purposes of expanding its business internationally into Peru and the United Kingdom, respectively; Orlando and LBE to provide proton beam therapy equipment and services in Orlando, Florida and Long Beach, California, respectively; and AGKE and JGKE to provide Gamma Knife equipment and services in Albuquerque, New Mexico and Jacksonville, Florida, respectively. AGKE began operations in the second quarter of 2011 and JGKE began operations in the fourth quarter of 2011. Orlando treated its first patient in April 2016. GKPeru treated its first patient in July 2017. LBE is not expected to generate revenue within the next two years. GKUK will be dissolved in November 2018. The Company continues to develop its design and business model for “The Operating Room for the 21st Century” SM MedLeader was formed to provide continuing medical education online and through videos for doctors, nurses, and other healthcare workers. This subsidiary is not operational at this time. All significant intercompany accounts and transactions have been eliminated in consolidation. Based on the guidance provided in accordance with Accounting Standards Codification (“ASC”) 280 Segment Reporting (“ASC 280”), the Company has analyzed its subsidiaries which are all in the business of leasing radiosurgery and radiation therapy equipment to healthcare providers, and concluded there is one reportable segment, Medical Services. The Company provides Gamma Knife, PBRT, and IGRT equipment to sixteen hospitals in the United States and owns and operates a stand-alone facility in Lima, Peru as of September 30, 2018. These seventeen locations operate under different subsidiaries of the Company but offer the same radiosurgery and radiation therapy service. The operating results of the subsidiaries are reviewed by the Company’s Chief Executive Officer and Chief Financial Officer, who are also deemed the Company’s Chief Operating Decision Makers (“CODMs”) and this is done in conjunction with all of the subsidiaries and locations. In May 2014, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2014-09, Revenue from Contracts with Customers (Topic 606) , ("ASU 2014-09"), which requires an entity to recognize the amount of revenue to which it expects to be entitled for the transfer of promised goods or services to customers. The ASU replaced most existing revenue recognition guidance in United States Generally Accepted Accounting Principles (“GAAP”). In December 2016, the FASB issued ASU 2016-20 Technical Corrections and Improvements to Topic 606 , (“ASU 2016-20”), which affects some narrow aspects of ASU 2014-09. The new standard was effective for the Company for annual reporting periods beginning after December 15, 2017 and interim reporting periods therein. The standard permits the use of either the retrospective or cumulative effect transition method. The Company performed an analysis to determine if its revenue agreements with customers fall under the scope of ASU No. 2016-02 Leases (“ASU 2016-02”) or ASU 2014-09 and concluded that, other than with respect to the Company’s stand-alone facility in Lima, Peru, ASU 2014-09 was not applicable. The Company adopted ASU 2014-09 as of January 1, 2018 using the modified retrospective method. The cumulative effect of adopting ASU 2014-09 did not have a material impact on retained earnings, as reported by the Company, and there was no change to the Company’s IT environment following adoption. Under ASU 2014-09, the Company determined that, as it relates to the stand-alone facility in Lima, Peru, a contract exists between GKPeru and the individual patient treated at the facility. The Company acts as the principal in this transaction and provides, at a point in time, a single performance obligation, in the form of a Gamma Knife treatment. Revenue related to a Gamma Knife treatment is recognized on a gross basis in the month the patient receives treatment. There is no variable consideration present in the Company’s performance obligation and the transaction price is agreed upon per the stated contractual rate. Payment terms are typically prepaid for self-pay patients and insurance provider payments are paid net 30 days. The Company did not capitalize any incremental costs related to the fulfillment of its customer contracts. Accounts receivable and revenues earned by GKPeru were not material for the three and nine-month periods ended September 30, 2018, therefore, no additional disclosures have been made at this time. In February 2016, the FASB issued ASU 2016-02 which requires lessees to recognize, for all leases, at the commencement date, a lease liability, and a right-of-use asset. Under the new guidance, lessor accounting is largely unchanged. In July 2018, the FASB issued ASU No. 2018-10 Leases (Topic 842) Codification Improvements to Topic 842, Leases (“ASU 2018-10”) and ASU No. 2018-11 Leases (Topic 842) Targeted Improvements (“ASU 2018-11”). ASU 2018-11 provides a new transition method in which an entity can initially apply the new lease standards at the adoption date and recognize a cumulative-effect adjustment to the opening balance of retained earnings in the period of adoption. The new guidance is effective for the Company on January 1, 2019. Early adoption is permitted. The Company is evaluating the effect that ill have on its consolidated financial statements and related disclosures. The Company performed an analysis to determine if its revenue agreements with customers fall under the scope of ASU 2016-02 or ASU 2014-09 and concluded that, other than with respect to the Company’s stand-alone facility in Lima, Peru, ASU 2016-02 applied. The Company believes it is following an appropriate timeline to allow for proper recognition, presentation, and disclosure upon adoption of ASU 2016-02. In June 2016, the FASB issued ASU No. 2016-13 Financial Instruments – Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments (“ASU 2016-13”), which requires measurement and recognition of expected credit losses for financial assets held. The new guidance is effective for fiscal periods beginning after December 15, 2018. The Company does not expect ASU 2016-13 to have a significant impact on its consolidated financial statements and related disclosures. In February 2018, the FASB issued ASU No. 2018-03 Recognition and Measurement of Financial Assets and Financial Liabilities (“ASU 2018-03”), which clarifies certain aspects of ASU 2016-01. These are: equity securities without a readily determinable fair value – discontinuation, equity securities without a readily determinable fair value – adjustments, forward contracts and purchased options, presentation requirements for certain fair value option liabilities, fair value option liabilities denominated in a foreign currency, and transition guidance for equity securities without a readily determinable fair value. In August 2018, the FASB issued ASU No. 2018-13 Fair Value Measurement (Topic 820): Disclosure Framework – Changes to the Disclosure Requirements to Fair Value Measurement (“ASU 2018-13”), which amended the effective date and other certain measurement aspects of ASU 2018-03. The new guidance is effective for fiscal years and interim periods within those fiscal years beginning after December 15, 2019. The Company does not expect ASU 2018-03 or ASU 2018-13 to have a significant impact on its consolidated financial statements and related disclosures. In July 2018, the FASB issued ASU No. 2018-09, Codification Improvements (“ASU 2018-09”). This standard does not prescribe any new accounting guidance, but instead makes minor improvements and clarifications of several different FASB Accounting Standards Codification areas based on comments and suggestions made by various stakeholders. Certain updates are applicable immediately while others provide for a transition period to adopt as part of the next fiscal year beginning after December 15, 2018. The Company is currently evaluating this guidance to determine the impact it may have on its consolidated financial statements.

Property and Equipment

Property and Equipment	9 Months Ended
	Sep. 30, 2018
Property, Plant and Equipment [Abstract]
Property, Plant and Equipment Disclosure [Text Block]	Note 2. Property and Equipment Property and equipment are stated at cost less accumulated depreciation. Depreciation for Gamma Knife, IGRT, and other equipment is determined using the straight-line method over the estimated useful lives of the assets, which for medical and office equipment is generally 3 – 10 years, and after accounting for salvage value on the equipment where indicated. Salvage value is based on the estimated fair value of the equipment at the end of its useful life. Depreciation for PBRT equipment is determined using the modified units of production method, which is a function of both time and usage of the equipment. This depreciation method allocates costs considering the projected volume of usage through the useful life of the PBRT unit, which has been estimated at 20 years. The estimated useful life of the PBRT unit is consistent with the estimated economic life of 20 years. The following table summarizes property and equipment as of September 30, 2018 and December 31, 2017: September 30, December 31, 2018 2017 Medical equipment and facilities $ 93,966,000 $ 95,923,000 Office equipment 585,000 576,000 Deposits and construction in progress 1,907,000 1,658,000 Deposits towards purchase of proton beam systems 2,000,000 2,000,000 98,458,000 100,157,000 Accumulated depreciation (52,337,000 ) (51,666,000 ) Net property and equipment $ 46,121,000 $ 48,491,000 As of September 30, 2018, the Company has one idle Gamma Knife unit with a cumulative net book value of $729,000. There are currently no plans to place into service or trade this unit in during 2018.

Long-Term Debt

Long-Term Debt	9 Months Ended
	Sep. 30, 2018
Debt Disclosure [Abstract]
Long-term Debt [Text Block]	Note 3. Long-Term Debt Long-term debt consists of seven notes with three financing companies collateralized by the Gamma Knife equipment, the individual customer contracts, and related accounts receivable at September 30, 2018. As of September 30, 2018, long-term debt on the Condensed Consolidated Balance Sheets was $4,190,000.

Obligations Under Capital Lease

Obligations Under Capital Leases	9 Months Ended
	Sep. 30, 2018
Leases, Capital [Abstract]
Capital Leases in Financial Statements of Lessee Disclosure [Text Block]	Note 4. Obligations Under Capital Leases The Company has twelve capital lease obligations with two financing companies, collateralized by Gamma Knife and PBRT equipment, the individual customer contracts, and related accounts receivable at September 30, 2018. As of September 30, 2018, obligations under capital lease on the Condensed Consolidated Balance Sheets were $15,798,000.

Per Share Amounts

Per Share Amounts	9 Months Ended
	Sep. 30, 2018
Earnings Per Share [Abstract]
Earnings Per Share [Text Block]	Note 5. Per Share Amounts Per share information has been computed based on the weighted average number of common shares and dilutive common share equivalents outstanding. The computation for the three and nine-month periods ended September 30, 2018 excluded approximately 176,000 and 519,000 stock options, respectively, because the exercise price of the options was higher than the average market price during those periods. The computation for the three and nine-month periods ended September 30, 2017 excluded approximately 14,000 stock options, because the exercise price of the options or warrants was higher than the average market price during those periods. Based on the guidance provided in accordance with ASC 260 Earnings Per Share (“ASC 260”), the weighted average common shares for basic earnings per share, for the three and nine-month periods ended September 30, 2018 and 2017, excluded the weighted average impact of the unvested performance share awards, discussed below. These awards are legally outstanding but are not deemed participating securities and therefore are excluded from the calculation of basic earnings per share. The unvested shares are also excluded from the denominator for diluted earnings per share because they are considered contingent shares not deemed probable for the three and nine-month periods ended September 30, 2018 and 2017. The following table sets forth the computation of basic and diluted earnings per share for the three and nine-month periods ended September 30, 2018 and 2017: Three Months ended September 30, Nine Months ended September 30, 2018 2017 2018 2017 Net income attributable to American Shared Hospital Services $ 168,000 $ 99,000 $ 845,000 $ 505,000 Weighted average common shares for basic earnings per share 5,841,000 5,947,000 5,831,000 5,745,000 Diluted effect of stock options and restricted stock 50,000 94,000 24,000 167,000 Weighted average common shares for diluted earnings per share 5,891,000 6,041,000 5,855,000 5,912,000 Basic earnings per share $ 0.03 $ 0.02 $ 0.14 $ 0.09 Diluted earnings per share $ 0.03 $ 0.02 $ 0.14 $ 0.09

Stock-based Compensation

Stock-based Compensation	9 Months Ended
	Sep. 30, 2018
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Disclosure of Compensation Related Costs, Share-based Payments [Text Block]	Note 6. Stock-based Compensation In June 2010, the Company’s shareholders approved an amendment and restatement of the Company’s stock incentive plan, renaming it the Incentive Compensation Plan (the “Plan”), and among other things, increasing the number of shares of the Company’s common stock reserved for issuance under the Plan to 1,630,000. The Plan provides that the shares reserved under the Plan are available for issuance to officers of the Company, other key employees, non-employee directors, and advisors. The Plan is a successor to the Company’s previous plans, and any shares awarded and outstanding under those plans were transferred to the Plan. No further grants or share issuances will be made under the previous plans. On June 27, 2017, the Company’s shareholders approved an amendment and restatement of the Plan in order to extend the term of the Plan by two years to February 22, 2020. Stock-based compensation expense associated with the Company’s stock options to employees is calculated using the Black-Scholes valuation model. The Company’s stock awards have characteristics significantly different from those of traded options, and changes in the subjective input assumptions can materially affect the fair value estimates. The estimated fair value of the Company’s option grants is estimated using assumptions for expected life, volatility, dividend yield, and risk-free interest rate which are specific to each award. The estimated fair value of the Company’s options is amortized over the period during which an employee is required to provide service in exchange for the award (requisite service period), usually the vesting period. Accordingly, stock-based compensation cost before income tax effect for the Company’s options and restricted stock awards, in the amount of $57,000 and $169,000 is reflected in net income for the three and nine-month periods ended September 30, 2018 compared to $58,000 and $158,000 in the same periods of 2017, respectively. At September 30, 2018, there was approximately $214,000 of unrecognized compensation cost related to non-vested share-based compensation arrangements granted under the Plan, excluding the unrecognized compensation cost associated with the Award Agreements, discussed below. This cost is expected to be recognized over a period of approximately four years. As of December 31, 2016, the Company had warrants outstanding representing the right to purchase 100,000 shares of the Company’s common stock at $2.20 per share. These warrants were issued with $1,000,000 of promissory notes to four members of the Company’s Board of Directors in a prior year. During the nine-month period ended September 30, 2017, warrants to purchase all 100,000 shares of the Company’s common stock were exercised. Of the 100,000 outstanding, 50,000 of the warrants exercised were done so through a cashless exercise issuance, totaling approximately 25,000 shares. There are no warrants outstanding as of September 30, 2018. On January 4, 2017, the Company entered into a Performance Share Award Agreement with three executive officers of the Company (the “Award Agreements”) for 161,766 restricted stock awards which vest upon the achievement of certain performance metrics. The Award Agreements expire on March 31, 2020. Based on the guidance in ASC 718 Stock Compensation (“ASC 718”), the Company concluded these were performance-based awards with vesting criteria tied to performance metrics. As of December 31, 2017, the Company achieved one of those certain performance metrics under the Award Agreements and recognized stock compensation expense of approximately $108,000 related to these awards. As of September 30, 2018, it is not probable that any of the remaining required metrics for vesting will be achieved. The unrecognized stock-based compensation expense for these awards was approximately $434,000 and unvested awards were approximately 129,000 shares as of September 30, 2018. If and when the Company determines that the remaining performance metrics’ achievement becomes probable, the Company will record a cumulative catch-up stock-based compensation amount and the remaining unrecognized amount will be recorded over the remaining requisite service period of the awards. The following table summarizes stock option activity for the nine-month period ended September 30, 2018: Stock Options Grant Date Weighted- Average Exercise Price Weighted- Average Remaining Contractual Life (in Years) Intrinsic Value Outstanding at January 1, 2018 615,000 $ 2.87 3.48 $ - Granted 16,000 $ 2.68 6.96 $ - Forfeited (18,000 ) $ 3.15 - $ - Outstanding at September 30, 2018 613,000 $ 2.85 2.93 $ 337,000 Exercisable at September 30, 2018 389,000 $ 2.86 2.83 $ -

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2018
Income Tax Disclosure [Abstract]
Income Tax Disclosure [Text Block]	Note 7. Income Taxes The Company generally calculates its effective income tax rate at the end of an interim period using an estimate of the annualized effective income tax rate expected to be applicable for the full fiscal year. However, when a reliable estimate of the annualized effective income tax rate cannot be made, the Company computes its provision for income taxes using the actual effective income tax rate for the results of operations reported within the year-to-date periods. The Company’s effective income tax rate is highly influenced by relative income or losses reported and the amount of the nondeductible stock-based compensation associated with grants of its common stock options and from the results of foreign operations. A small change in estimated annual pre-tax income can produce a significant variance in the annualized effective income tax rate given the expected amount of these items. As a result, the Company has computed its provision for income taxes for the three and nine-month periods ended September 30, 2018 by applying the actual effective tax rates to income reported within the condensed consolidated financial statements through those periods. On December 22, 2017, the U.S. government enacted comprehensive tax legislation commonly referred to as the Tax Cuts and Jobs Act (the “Tax Act”). The Tax Act makes broad and complex changes to the U.S. tax code that affect fiscal 2017, including, but not limited to requiring a one-time transition tax on certain unrepatriated earnings of foreign subsidiaries that is payable over eight years. The Tax Act also establishes new tax laws that will affect 2018 and later years, including, but not limited to, a reduction of the U.S. federal corporate tax rate from 34% to 21%, a general elimination of U.S. federal income taxes on dividends from foreign subsidiaries, net operating loss deduction limitations, a base erosion, anti-tax abuse tax and a deduction for foreign-derived intangible income and a new provision designed to tax global intangible low-taxed income. As a result of the Tax Act, the Company revalued its federal and state deferred tax liabilities based on a 21% tax rate as opposed to a 34% tax rate for the year ended December 31, 2017.

Property and Equipment (Tables)

Property and Equipment (Tables)	9 Months Ended
	Sep. 30, 2018
Property, Plant and Equipment [Abstract]
Property, Plant and Equipment [Table Text Block]	The following table summarizes property and equipment as of September 30, 2018 and December 31, 2017: September 30, December 31, 2018 2017 Medical equipment and facilities $ 93,966,000 $ 95,923,000 Office equipment 585,000 576,000 Deposits and construction in progress 1,907,000 1,658,000 Deposits towards purchase of proton beam systems 2,000,000 2,000,000 98,458,000 100,157,000 Accumulated depreciation (52,337,000 ) (51,666,000 ) Net property and equipment $ 46,121,000 $ 48,491,000

Per Share Amounts (Tables)

Per Share Amounts (Tables)	9 Months Ended
	Sep. 30, 2018
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	The following table sets forth the computation of basic and diluted earnings per share for the three and nine-month periods ended September 30, 2018 and 2017: Three Months ended September 30, Nine Months ended September 30, 2018 2017 2018 2017 Net income attributable to American Shared Hospital Services $ 168,000 $ 99,000 $ 845,000 $ 505,000 Weighted average common shares for basic earnings per share 5,841,000 5,947,000 5,831,000 5,745,000 Diluted effect of stock options and restricted stock 50,000 94,000 24,000 167,000 Weighted average common shares for diluted earnings per share 5,891,000 6,041,000 5,855,000 5,912,000 Basic earnings per share $ 0.03 $ 0.02 $ 0.14 $ 0.09 Diluted earnings per share $ 0.03 $ 0.02 $ 0.14 $ 0.09

Stock-based Compensation (Table

Stock-based Compensation (Tables)	9 Months Ended
	Sep. 30, 2018
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Share-based Compensation, Stock Options, Activity [Table Text Block]	The following table summarizes stock option activity for the nine-month period ended September 30, 2018: Stock Options Grant Date Weighted- Average Exercise Price Weighted- Average Remaining Contractual Life (in Years) Intrinsic Value Outstanding at January 1, 2018 615,000 $ 2.87 3.48 $ - Granted 16,000 $ 2.68 6.96 $ - Forfeited (18,000 ) $ 3.15 - $ - Outstanding at September 30, 2018 613,000 $ 2.85 2.93 $ 337,000 Exercisable at September 30, 2018 389,000 $ 2.86 2.83 $ -

Basis of Presentation (Details

Basis of Presentation (Details Textual)	Sep. 30, 2018
OR21 LLC [Member]
Basis Of Presentation [Line Items]
Equity Method Investment, Ownership Percentage	50.00%
Architectural Design Company [Member]
Basis Of Presentation [Line Items]
Equity Method Investment, Ownership Percentage	50.00%

Property and Equipment (Details

Property and Equipment (Details) - USD ($)	Sep. 30, 2018	Dec. 31, 2017
Property, Plant and Equipment, Gross	$ 98,458,000	$ 100,157,000
Accumulated depreciation	(52,337,000)	(51,666,000)
Net property and equipment	46,121,000	48,491,000
Medical equipment and facilities [Member]
Property, Plant and Equipment, Gross	93,966,000	95,923,000
Office equipment [Member]
Property, Plant and Equipment, Gross	585,000	576,000
Deposits and construction in progress [Member]
Property, Plant and Equipment, Gross	1,907,000	1,658,000
Deposits towards purchase of proton beam systems [Member]
Property, Plant and Equipment, Gross	$ 2,000,000	$ 2,000,000

Property and Equipment (Detai_2

Property and Equipment (Details Textual) - USD ($)	9 Months Ended
	Sep. 30, 2018	Dec. 31, 2017
Property, Plant and Equipment, Net	$ 46,121,000	$ 48,491,000
Medical Equipment And Facilities [Member] | Maximum [Member]
Property, Plant and Equipment, Useful Life	10 years
Medical Equipment And Facilities [Member] | Minimum [Member]
Property, Plant and Equipment, Useful Life	3 years
PBRT Equipment [Member]
Property, Plant and Equipment, Useful Life	20 years
Gamma Knife [Member]
Property, Plant and Equipment, Net	$ 729,000

Long-Term Debt (Details Textual

Long-Term Debt (Details Textual)	Sep. 30, 2018USD ($)
Long-term Debt	$ 4,190,000

Obligations Under Capital Lea_2

Obligations Under Capital Leases (Details Textual)	Sep. 30, 2018USD ($)
Capital Lease Obligations	$ 15,798,000

Per Share Amounts (Details)

Per Share Amounts (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Schedule Of Earnings Per Share Basic And Diluted [Line Items]
Net income attributable to American Shared Hospital Services	$ 168,000	$ 99,000	$ 845,000	$ 505,000
Weighted average common shares for basic earnings per share	5,841,000	5,947,000	5,831,000	5,745,000
Diluted effect of stock options and restricted stock	50,000	94,000	24,000	167,000
Weighted average common shares for diluted earnings per share	5,891,000	6,041,000	5,855,000	5,912,000
Basic earnings per share	$ 0.03	$ 0.02	$ 0.14	$ 0.09
Diluted earnings per share	$ 0.03	$ 0.02	$ 0.14	$ 0.09

Per Share Amounts (Details Text

Per Share Amounts (Details Textual) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Warrant [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	176,000	14,000	519,000	14,000
Employee Stock Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	0	0	0	0

Stock-based Compensation (Detai

Stock-based Compensation (Details) - Employee Stock Option [Member] - USD ($)	9 Months Ended	12 Months Ended
	Sep. 30, 2018	Dec. 31, 2017
Schedule Of Share Based Compensation Stock Options Activity [Line Items]
Stock Options, Outstanding Beginning balance	615,000
Stock Options, Granted	16,000
Stock Options, Forfeited	(18,000)
Stock Options, Outstanding Ending balance	613,000	615,000
Stock Options, Exercisable	389,000
Grant Date Weighted-Average Exercise Price, Beginning balance	$ 2.87
Grant Date Weighted-Average Exercise Price, Granted	2.68
Grant Date Weighted-Average Exercise Price, Forfeited	3.15
Grant Date Weighted-Average Exercise Price, Ending balance	2.85	$ 2.87
Grant Date Weighted Average Exercise Price, Exercisable	$ 2.86
Weighted Average Remaining Contractual Life (Years), Balance	2 years 11 months 5 days	3 years 5 months 23 days
Weighted Average Remaining Contractual Life (Years), Granted	6 years 11 months 16 days
Weighted Average Remaining Contractual Life (Years), Exercisable	2 years 9 months 29 days
Intrinsic Value, Outstanding	$ 337,000	$ 0
Intrinsic Value, Exercisable at September 30, 2018	$ 0

Stock-based Compensation (Det_2

Stock-based Compensation (Details Textual) - USD ($)	Jan. 04, 2017	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2017	Dec. 31, 2016	Jun. 30, 2010
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Allocated Share Based Compensation Expense		$ 57,000	$ 58,000	$ 169,000	$ 158,000	$ 108,000
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized		434,000		434,000
Class of Warrant or Right, Outstanding							100,000
Class of Warrant or Right, Exercise Price of Warrants or Rights							$ 2.20
Notes Payable							$ 1,000,000
Class Of Warrant Or Right Exercised					100,000
Noncash Warrants Exercised					50,000
Stock Issued During Period, Shares, Warrants Exercised					25,000
Incentive Compensation Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Common Stock, Capital Shares Reserved for Future Issuance								1,630,000
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized		$ 214,000		$ 214,000
Performance Share Award Agreement [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period	161,766
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Number		129,000		129,000

Income Taxes (Details Textual)

Income Taxes (Details Textual)	9 Months Ended	12 Months Ended
	Sep. 30, 2018	Dec. 31, 2017
Income Tax Disclosure [Line Items]
Effective Income Tax Rate Reconciliation, at Federal Statutory Income Tax Rate, Percent	21.00%	34.00%