American Shared Hospital Services (AMS) 10-Q 12 Aug 21 2021 Q2 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	6 Months Ended
	Jun. 30, 2021	Aug. 10, 2021
Document Information [Line Items]
Entity Central Index Key	0000744825
Entity Registrant Name	AMERICAN SHARED HOSPITAL SERVICES
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Document Fiscal Period Focus	Q2
Document Fiscal Year Focus	2021
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2021
Document Transition Report	false
Entity File Number	001-08789
Entity Incorporation, State or Country Code	CA
Entity Tax Identification Number	94-2918118
Entity Address, Address Line One	Two Embarcadero Center
Entity Address, City or Town	San Francisco
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	94111
City Area Code	415
Local Phone Number	788-5300
Title of 12(b) Security	American Shared Hospital Services Common Stock, No Par Value
Trading Symbol	AMS
Security Exchange Name	NYSEAMER
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		5,868,000

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Current Period Unaudited) - USD ($)	Jun. 30, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 8,319,000	$ 3,961,000
Restricted cash	118,000	364,000
Accounts receivable, net of allowance for doubtful accounts of $100,000 at June 30, 2021 and $100,000 at December 31, 2020	3,633,000	4,303,000
Other receivables	572,000	272,000
Prepaid expenses and other current assets	807,000	1,950,000
Total current assets	13,449,000	10,850,000
Property and equipment:
Medical equipment and facilities	72,035,000	75,657,000
Office equipment	388,000	330,000
Construction in progress	128,000	170,000
Property, Plant and Equipment, Gross, Excluding Land	72,551,000	76,157,000
Accumulated depreciation and amortization	(43,191,000)	(45,739,000)
Net property and equipment	29,360,000	30,418,000
Land	19,000	19,000
Goodwill	1,265,000	1,265,000
Right of use assets	737,000	886,000
Intangible asset	78,000	78,000
Other assets	75,000	137,000
Total assets	44,983,000	43,653,000
Current liabilities:
Accounts payable	584,000	683,000
Employee compensation and benefits	415,000	405,000
Other accrued liabilities	2,018,000	2,045,000
Asset retirement obligations	652,000	1,270,000
Income taxes payable	115,000	373,000
Working capital payment due	178,000	197,000
Current portion of lease liabilities	311,000	305,000
Current portion of long-term debt, net	893,000	1,157,000
Current portion of finance leases	0	5,945,000
Total current liabilities	5,166,000	12,380,000
Long-term lease liabilities, less current portion	426,000	581,000
Long-term debt, net, less current portion	15,148,000	3,440,000
Long-term finance leases, less current portion	0	2,974,000
Deferred revenue, less current portion	175,000	210,000
Deferred income taxes	354,000	418,000
Shareholders' equity:
Common stock, no par value (10,000,000 authorized; 5,868,000 and 5,791,000 shares issued and outstanding at June 30, 2021 and at December 31, 2020	10,758,000	10,753,000
Additional paid-in capital	7,227,000	7,024,000
Retained earnings	1,439,000	1,497,000
Total equity-American Shared Hospital Services	19,424,000	19,274,000
Non-controlling interests in subsidiaries	4,290,000	4,376,000
Total shareholders' equity	23,714,000	23,650,000
Total liabilities and shareholders' equity	$ 44,983,000	$ 43,653,000

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - USD ($) $ / shares in Thousands	Jun. 30, 2021	Dec. 31, 2020
Allowance for doubtful accounts	$ 100,000	$ 100,000
Common Stock, No Par Value	$ 0	$ 0
Common stock, shares authorized (in shares)	10,000,000	10,000,000
Common stock, shares issued (in shares)	5,868,000	5,791,000
Common stock, shares outstanding (in shares)	5,868,000	5,791,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (Unaudited) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Revenues	$ 4,476,000	$ 3,991,000	$ 8,840,000	$ 8,559,000
Costs of revenue:
Maintenance and supplies	651,000	553,000	1,323,000	1,186,000
Depreciation and amortization	1,244,000	1,637,000	2,442,000	3,284,000
Other direct operating costs	974,000	894,000	2,034,000	1,788,000
Cost of Revenue, Total	2,869,000	3,084,000	5,799,000	6,258,000
Gross margin	1,607,000	907,000	3,041,000	2,301,000
Selling and administrative expense	1,090,000	1,210,000	2,174,000	2,421,000
Interest expense	165,000	267,000	425,000	549,000
Operating income (loss)	352,000	(570,000)	442,000	(669,000)
(Loss) on extinguishment of debt	(401,000)	0	(401,000)	0
Interest and other (loss) income	(2,000)	1,000	1,000	4,000
(Loss) income before income taxes	(51,000)	(569,000)	42,000	(665,000)
Income tax (benefit)	(24,000)	(130,000)	(18,000)	(158,000)
Net (loss) income	(27,000)	(439,000)	60,000	(507,000)
Less: Net (income) attributable to non-controlling interest	(60,000)	(44,000)	(118,000)	(111,000)
Net (loss) attributable to American Shared Hospital Services	$ (87,000)	$ (483,000)	$ (58,000)	$ (618,000)
Net (loss) per share:
Basic (loss) per share (in dollars per share)	$ (0.01)	$ (0.08)	$ (0.01)	$ (0.10)
Diluted (loss) per share (in dollars per share)	$ (0.01)	$ (0.08)	$ (0.01)	$ (0.10)

Condensed Consolidated Statem_2

Condensed Consolidated Statement of Shareholders' Equity (Unaudited) - USD ($)	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	Parent [Member]	Noncontrolling Interest [Member]	Total
Balances (in shares) at Dec. 31, 2019	5,817,000
Balances at Dec. 31, 2019	$ 10,753,000	$ 6,725,000	$ 8,555,000	$ 26,033,000	$ 5,778,000	$ 31,811,000
Stock-based compensation expense	$ 0	56,000	0	56,000	0	56,000
Restricted common shares returned to the plan (in shares)	(129,000)
Restricted common shares returned to the plan	$ 0	0	0	0	0	0
Cash distributions to non-controlling interests	0	0	0	0	(326,000)	(326,000)
Net income (loss)	$ 0	0	(135,000)	(135,000)	67,000	(68,000)
Balances (in shares) at Mar. 31, 2020	5,688,000
Balances at Mar. 31, 2020	$ 10,753,000	6,781,000	8,420,000	25,954,000	5,519,000	31,473,000
Balances (in shares) at Dec. 31, 2019	5,817,000
Balances at Dec. 31, 2019	$ 10,753,000	6,725,000	8,555,000	26,033,000	5,778,000	31,811,000
Net income (loss)						(507,000)
Balances (in shares) at Jun. 30, 2020	5,691,000
Balances at Jun. 30, 2020	$ 10,753,000	6,834,000	7,937,000	25,524,000	5,449,000	30,973,000
Balances (in shares) at Mar. 31, 2020	5,688,000
Balances at Mar. 31, 2020	$ 10,753,000	6,781,000	8,420,000	25,954,000	5,519,000	31,473,000
Stock-based compensation expense	0	53,000	0	53,000	0	53,000
Cash distributions to non-controlling interests	0	0	0	0	(114,000)	(114,000)
Net income (loss)	$ 0	0	(483,000)	(483,000)	44,000	(439,000)
Stock-based compensation expense (in shares)	3,000
Balances (in shares) at Jun. 30, 2020	5,691,000
Balances at Jun. 30, 2020	$ 10,753,000	6,834,000	7,937,000	25,524,000	5,449,000	$ 30,973,000
Balances (in shares) at Dec. 31, 2020	5,791,000					5,791,000
Balances at Dec. 31, 2020	$ 10,753,000	7,024,000	1,497,000	19,274,000	4,376,000	$ 23,650,000
Stock-based compensation expense	0	107,000	0	107,000	0	107,000
Net income (loss)	$ 0	0	29,000	29,000	58,000	87,000
Balances (in shares) at Mar. 31, 2021	5,801,000
Balances at Mar. 31, 2021	$ 10,753,000	7,131,000	1,526,000	19,410,000	4,434,000	$ 23,844,000
Balances (in shares) at Dec. 31, 2020	5,791,000					5,791,000
Balances at Dec. 31, 2020	$ 10,753,000	7,024,000	1,497,000	19,274,000	4,376,000	$ 23,650,000
Net income (loss)						$ 60,000
Options exercised (in shares)						22,000
Balances (in shares) at Jun. 30, 2021	5,868,000					5,868,000
Balances at Jun. 30, 2021	$ 10,758,000	7,227,000	1,439,000	19,424,000	4,290,000	$ 23,714,000
Balances (in shares) at Mar. 31, 2021	5,801,000
Balances at Mar. 31, 2021	$ 10,753,000	7,131,000	1,526,000	19,410,000	4,434,000	23,844,000
Stock-based compensation expense	0	96,000	0	96,000	0	96,000
Cash distributions to non-controlling interests	0	0	0	0	(204,000)	(204,000)
Net income (loss)	$ 0	0	(87,000)	(87,000)	60,000	(27,000)
Stock-based compensation expense (in shares)	62,000
Options exercised (in shares)	5,000
Options exercised	$ 5,000	0	0	5,000	0	$ 5,000
Balances (in shares) at Jun. 30, 2021	5,868,000					5,868,000
Balances at Jun. 30, 2021	$ 10,758,000	$ 7,227,000	$ 1,439,000	$ 19,424,000	$ 4,290,000	$ 23,714,000

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020
Operating activities:
Net income (loss)	$ 60,000	$ (507,000)
Adjustments to reconcile net income (loss) to net cash from operating activities (excluding assets acquired and liabilities assumed):
Depreciation and amortization	2,509,000	3,347,000
Amortization of debt issuance costs	14,000	0
Loss on extinguishment of debt	401,000	0
Non cash lease expense	149,000	143,000
Deferred income taxes	(64,000)	(158,000)
Stock-based compensation expense	203,000	109,000
Interest expense associated with lease liabilities	22,000	39,000
Changes in operating assets and liabilities:
Receivables	335,000	2,288,000
Prepaid expenses and other assets	1,086,000	1,206,000
Asset retirement obligations	(562,000)	0
Accounts payable, accrued liabilities and deferred revenue	97,000	638,000
Income taxes	(252,000)	(82,000)
Lease liabilities	(171,000)	(182,000)
Net cash provided by operating activities	3,827,000	6,841,000
Investing activities:
Payment for purchase of property and equipment	(229,000)	(242,000)
Payment for acquisition, net of cash acquired	0	(1,568,000)
Net cash used in investing activities	(229,000)	(1,810,000)
Financing activities:
Principal payments on long-term debt	(3,254,000)	(1,062,000)
Principal payments on finance leases	(8,919,000)	(1,981,000)
Principal payments on short-term financing	(294,000)	(343,000)
Distributions to non-controlling interests	(204,000)	(440,000)
Proceeds from long-term debt financing, net of property and equipment acquired	13,897,000	0
Proceeds from financing for acquisition	0	1,425,000
Prepayment penalties	(401,000)	0
Debt issuance costs long-term debt	(316,000)	0
Proceeds from options exercised	5,000	0
Net cash provided by (used in) financing activities	514,000	(2,401,000)
Net change in cash, cash equivalents, and restricted cash	4,112,000	2,630,000
Cash, cash equivalents, and restricted cash at beginning of period	4,325,000	1,779,000
Cash, cash equivalents, and restricted cash at end of period	8,437,000	4,409,000
Supplemental cash flow disclosure:
Interest	425,000	549,000
Income taxes paid	557,000	71,000
Schedule of non-cash investing and financing activities
Lease reassessment right of use assets and lease liabilities	0	67,000
Right of use assets and lease liabilities	0	135,000
Interest capitalized to property and equipment	0	65,000
Acquisition of equipment with long-term debt financing	1,103,000	1,184,000
Acquisition of insurance with short-term financing	0	45,000
First working capital payment related to acquisition, withholding taxes	0	515,000
Estimated subsequent working capital payment for acquisition	$ 0	$ 354,000

Note 1 - Basis of Presentation

Note 1 - Basis of Presentation	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
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 for the fair presentation of American Shared Hospital Services’ consolidated financial position as of June 30, 2021 three six June 30, 2021 2020 three six June 30, 2021 2020 three six June 30, 2021 not December 31, 2020 These unaudited condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements for the year ended December 31, 2020 10 These condensed 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”), and OR21, June 2020. 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 June 30, 2021 The Company formed the subsidiaries GKPeru and acquired GKCE for the purposes of expanding its business internationally; Orlando and LBE to provide PBRT 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. LBE is not two On June 12, 2020, June 30, 2021 9. The Company continues to develop its design and business model for The Operating Room for the 21st OR21, “OR21 OR21 not two All significant intercompany accounts and transactions have been eliminated in consolidation. The COVID- 19 2020 19 19, 19 19 may may may three June 30, 2021 19 three June 30, 2021 19 19 may not Based on the guidance provided in accordance with ASC 280 Segment Reporting 280” two June 30, 2021 two two June 30, 2020 June 2020, The revenues and profit or loss, allocations for the Company's two June 30, 2021 June 30, 2021 Revenues Domestic $ 7,415,000 Foreign 1,425,000 Total $ 8,840,000 Profit or (loss) Domestic $ (35,000 ) Foreign (23,000 ) Total $ (58,000 )

Note 2 - Property and Equipment

Note 2 - Property and Equipment	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
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 units 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. As of April 1, 2021, nine three June 30, 2021 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 June 30, 2021 December 31, 2020 June 30, December 31, 2021 2020 Medical equipment and facilities $ 72,035,000 $ 75,657,000 Office equipment 388,000 330,000 Construction in progress 128,000 170,000 72,551,000 76,157,000 Accumulated depreciation (43,191,000 ) (45,739,000 ) Net property and equipment $ 29,360,000 $ 30,418,000 As of June 30, 2021

Note 3 - Long-term Debt Financi

Note 3 - Long-term Debt Financing	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Long-term Debt [Text Block]	Note 3. Long-Term Debt Financing On April 9, 2021 five three first two two first 2021 second third five December 31, 2021, three June 30, 2021 three June 30, 2021 The Credit Agreement contains customary covenants and representations, including without limitation, a minimum fixed charge coverage ratio of 1.25 and maximum funded debt to EBITDA ratio of 3.0 to 1.0 twelve The Company’s loan with DFC for the Acquisition was obtained through the Company’s wholly-owned subsidiary, HoldCo and is guaranteed by GKF. As of June 30, 2021 The following are contractual maturities of long-term debt by year as of June 30, 2021 $329,000: Year ending December 31, Principal 2021 (excluding the six-months ended June 30, 2021) $ 485,000 2022 1,344,000 2023 1,719,000 2024 2,094,000 2025 2,469,000 Thereafter 8,259,000 $ 16,370,000

Note 4 - Finance Leases

Note 4 - Finance Leases	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Lessee, Finance Leases [Text Block]	Note 4. Finance Leases The Company's finance lease obligations were refinanced by long-term debt on April 9, 2021. 3

Note 5 - Leases

Note 5 - Leases	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Lessee, Operating Leases [Text Block]	Note 5. Leases The Company determines if a contract is a lease at inception. Under ASC 842 Leases 842” 842 not 842 842 not The Company’s Gamma Knife and PBRT contracts with hospitals are classified as operating leases under ASC 842. not not The Company’s lessee operating leases are accounted for as right-of-use (“ROU”) assets, other current liabilities, and lease liabilities on the condensed consolidated balance sheets. Operating lease ROU assets and liabilities are recognized based on the present value of the future minimum lease payments over the lease term at commencement date. The Company’s operating lease contracts do not June 30, 2021 The following table summarizes maturities of lessee operating lease liabilities as of June 30, 2021 Year ending December 31, Operating Leases 2021 (excluding the six-months ended June 30, 2021) $ 175,000 2022 353,000 2023 248,000 2024 8,000 Total lease payments 784,000 Less imputed interest (47,000 ) Total $ 737,000

Note 6 - Per Share Amounts

Note 6 - Per Share Amounts	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Earnings Per Share [Text Block]	Note 6. Per Share Amounts Per share information has been computed based on the weighted average number of common shares and dilutive common share equivalents outstanding. Based on the guidance provided in accordance with ASC 260 Earnings Per Share 260” not three six June 30, 2021 not The following table sets forth the computation of basic and diluted earnings per share for the three six June 30, 2021 2020 Three Months Ended June 30, Six Months Ended June 30, 2021 2020 2021 2020 Net (loss) attributable to American Shared Hospital Services $ (87,000 ) $ (483,000 ) $ (58,000 ) $ (618,000 ) Weighted average common shares for basic earnings per share 5,802,000 6,008,000 5,801,000 6,066,000 Diluted effect of stock options and restricted stock awards - 69,000 - 69,000 Weighted average common shares for diluted earnings per share 5,802,000 6,077,000 5,801,000 6,135,000 Basic (loss) per share $ (0.01 ) $ (0.08 ) $ (0.01 ) $ (0.10 ) Diluted (loss) per share $ (0.01 ) $ (0.08 ) $ (0.01 ) $ (0.10 )

Note 7 - Stock-based Compensati

Note 7 - Stock-based Compensation	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Share-based Payment Arrangement [Text Block]	Note 7. Stock-based Compensation In June 2021, No June 2021, five February 22, 2027. 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 expensed 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 amo unt of $96,000 and $203,000 i three six June 30, 2021 June 30, 2021 $6,000 o three On January 4, 2017, three March 31, 2020. 718 Stock Compensation 718” December 31, 2019 one March 31, 2020. The following table summarizes stock option activity for the six June 30, 2021 2020 Stock Options Grant Date Weighted- Average Exercise Price Weighted- Average Remaining Contractual Life (in Years) Intrinsic Value Outstanding at January 1, 2021 417,000 $ 2.79 1.61 $ 2,000 Granted 6,000 $ 2.92 7.00 $ - Exercised (22,000 ) $ 2.65 - $ - Forfeited (7,000 ) $ 2.51 - $ - Outstanding at June 30, 2021 394,000 $ 2.80 1.16 $ 15,000 Exercisable at June 30, 2021 383,000 $ 2.80 1.02 $ - Outstanding at January 1, 2020 450,000 $ 2.78 2.44 $ 27,000 Granted 10,000 $ 1.88 7.00 $ - Forfeited (40,000 ) $ 2.58 - $ - Outstanding at June 30, 2020 420,000 $ 2.78 2.12 $ - Exercisable at June 30, 2020 397,000 $ 2.81 1.93 $ -

Note 8 - Income Taxes

Note 8 - Income Taxes	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Income Tax Disclosure [Text Block]	Note 8. 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 pretax income (loss) 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 six June 30, 2021 2020

Note 9 - GKCE Acquisition

Note 9 - GKCE Acquisition	6 Months Ended
	Jun. 30, 2021
Notes to Financial Statements
Business Combination Disclosure [Text Block]	Note 9. On June 18, 2019, 2009 The Acquisition has been accounted for according to ASC 805 Business Combinations 805” June 12, 2021. June 30, 2021 As of June 30, 2021 , accounting for the Closing Date accounts receivable balances, allowance on the uncollected accounts receivable balances, and related liabilities, was complete. The following table summarizes the fair value of assets acquired and liabilities assumed at the date of acquisition: June 12, 2020 Cash and cash equivalents $ 432,000 Accounts receivable 854,000 Prepaid expense and other 22,000 Building 385,000 Land 19,000 Medical equipment 319,000 Purchased intangible assets 78,000 Goodwill 1,265,000 Total assets acquired $ 3,374,000 Accounts payable $ (193,000 ) Income taxes payable (141,000 ) Deferred income taxes (66,000 ) Employee compensation and benefits (91,000 ) Total liabilities assumed (491,000 ) Consideration allocated to assets acquired and liabilities assumed $ 2,883,000 First working capital payment $ (515,000 ) Estimated subsequent working capital payment (368,000 ) Base purchase consideration $ 2,000,000 The Company has allocated the purchase price of GKCE to the tangible assets, liabilities, and intangible asset acquired, based on their estimated fair values. Goodwill represents the excess of the purchase price consideration over the fair value of the identifiable tangible and intangible assets assumed. The Company believes the amount of goodwill resulting from the acquisition is primarily attributable to expected synergies from an assembled and trained workforce and enhanced opportunities for growth and innovation. The goodwill resulting from the acquisition is not The following table summarizes the fair value of the tangible assets acquired at the date of acquisition: Fair Value Useful Life (in Years) Building $ 385,000 20 Land 19,000 Medical equipment 302,000 2 Other fixed assets 17,000 2 Total tangible assets $ 723,000 The Company also acquired intangible assets with a fair value of $78,000. The intangible asset identified was GKCE's trade name and the Company assigned an indefinite useful life

Significant Accounting Policies

Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2021
Accounting Policies [Abstract]
Basis of Accounting, Policy [Policy Text Block]	In the opinion of management, the accompanying unaudited condensed consolidated financial statements contain all adjustments necessary for the fair presentation of American Shared Hospital Services’ consolidated financial position as of June 30, 2021 three six June 30, 2021 2020 three six June 30, 2021 2020 three six June 30, 2021 not December 31, 2020 These unaudited condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements for the year ended December 31, 2020 10 These condensed 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”), and OR21, June 2020. 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 June 30, 2021 The Company formed the subsidiaries GKPeru and acquired GKCE for the purposes of expanding its business internationally; Orlando and LBE to provide PBRT 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. LBE is not two On June 12, 2020, June 30, 2021 9. The Company continues to develop its design and business model for The Operating Room for the 21st OR21, “OR21 OR21 not two All significant intercompany accounts and transactions have been eliminated in consolidation. The COVID- 19 2020 19 19, 19 19 may may may three June 30, 2021 19 three June 30, 2021 19 19 may not
Segment Reporting, Policy [Policy Text Block]	Based on the guidance provided in accordance with ASC 280 Segment Reporting 280” two June 30, 2021 two two June 30, 2020 June 2020, The revenues and profit or loss, allocations for the Company's two June 30, 2021 June 30, 2021 Revenues Domestic $ 7,415,000 Foreign 1,425,000 Total $ 8,840,000 Profit or (loss) Domestic $ (35,000 ) Foreign (23,000 ) Total $ (58,000 )

Note 1 - Basis of Presentation

Note 1 - Basis of Presentation (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Reconciliation of Revenue from Segments to Consolidated [Table Text Block]	June 30, 2021 Revenues Domestic $ 7,415,000 Foreign 1,425,000 Total $ 8,840,000 Profit or (loss) Domestic $ (35,000 ) Foreign (23,000 ) Total $ (58,000 )

Note 2 - Property and Equipme_2

Note 2 - Property and Equipment (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Property, Plant and Equipment [Table Text Block]	June 30, December 31, 2021 2020 Medical equipment and facilities $ 72,035,000 $ 75,657,000 Office equipment 388,000 330,000 Construction in progress 128,000 170,000 72,551,000 76,157,000 Accumulated depreciation (43,191,000 ) (45,739,000 ) Net property and equipment $ 29,360,000 $ 30,418,000

Note 3 - Long-term Debt Finan_2

Note 3 - Long-term Debt Financing (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Schedule of Maturities of Long-term Debt [Table Text Block]	Year ending December 31, Principal 2021 (excluding the six-months ended June 30, 2021) $ 485,000 2022 1,344,000 2023 1,719,000 2024 2,094,000 2025 2,469,000 Thereafter 8,259,000 $ 16,370,000

Note 5 - Leases (Tables)

Note 5 - Leases (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Lessee, Operating Lease, Liability, Maturity [Table Text Block]	Year ending December 31, Operating Leases 2021 (excluding the six-months ended June 30, 2021) $ 175,000 2022 353,000 2023 248,000 2024 8,000 Total lease payments 784,000 Less imputed interest (47,000 ) Total $ 737,000

Note 6 - Per Share Amounts (Tab

Note 6 - Per Share Amounts (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	Three Months Ended June 30, Six Months Ended June 30, 2021 2020 2021 2020 Net (loss) attributable to American Shared Hospital Services $ (87,000 ) $ (483,000 ) $ (58,000 ) $ (618,000 ) Weighted average common shares for basic earnings per share 5,802,000 6,008,000 5,801,000 6,066,000 Diluted effect of stock options and restricted stock awards - 69,000 - 69,000 Weighted average common shares for diluted earnings per share 5,802,000 6,077,000 5,801,000 6,135,000 Basic (loss) per share $ (0.01 ) $ (0.08 ) $ (0.01 ) $ (0.10 ) Diluted (loss) per share $ (0.01 ) $ (0.08 ) $ (0.01 ) $ (0.10 )

Note 7 - Stock-based Compensa_2

Note 7 - Stock-based Compensation (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Share-based Payment Arrangement, Option, Activity [Table Text Block]	Stock Options Grant Date Weighted- Average Exercise Price Weighted- Average Remaining Contractual Life (in Years) Intrinsic Value Outstanding at January 1, 2021 417,000 $ 2.79 1.61 $ 2,000 Granted 6,000 $ 2.92 7.00 $ - Exercised (22,000 ) $ 2.65 - $ - Forfeited (7,000 ) $ 2.51 - $ - Outstanding at June 30, 2021 394,000 $ 2.80 1.16 $ 15,000 Exercisable at June 30, 2021 383,000 $ 2.80 1.02 $ - Outstanding at January 1, 2020 450,000 $ 2.78 2.44 $ 27,000 Granted 10,000 $ 1.88 7.00 $ - Forfeited (40,000 ) $ 2.58 - $ - Outstanding at June 30, 2020 420,000 $ 2.78 2.12 $ - Exercisable at June 30, 2020 397,000 $ 2.81 1.93 $ -

Note 9 - GKCE Acquisition (Tabl

Note 9 - GKCE Acquisition (Tables)	6 Months Ended
	Jun. 30, 2021
Notes Tables
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed [Table Text Block]	June 12, 2020 Cash and cash equivalents $ 432,000 Accounts receivable 854,000 Prepaid expense and other 22,000 Building 385,000 Land 19,000 Medical equipment 319,000 Purchased intangible assets 78,000 Goodwill 1,265,000 Total assets acquired $ 3,374,000 Accounts payable $ (193,000 ) Income taxes payable (141,000 ) Deferred income taxes (66,000 ) Employee compensation and benefits (91,000 ) Total liabilities assumed (491,000 ) Consideration allocated to assets acquired and liabilities assumed $ 2,883,000 First working capital payment $ (515,000 ) Estimated subsequent working capital payment (368,000 ) Base purchase consideration $ 2,000,000
Tangible Assets Acquired as Part of Business Combination [Table Text Block]	Fair Value Useful Life (in Years) Building $ 385,000 20 Land 19,000 Medical equipment 302,000 2 Other fixed assets 17,000 2 Total tangible assets $ 723,000

Note 1 - Basis of Presentatio_2

Note 1 - Basis of Presentation (Details Textual)	Jun. 12, 2020USD ($)	Jun. 30, 2021	Jun. 30, 2020
Number of Reportable Segments		2	1
Lima, Peru and Guayaquil, Ecuador [Member]
Number of Single-unit Facilities		2
OR21, LLC [Member]
Equity Method Investment, Ownership Percentage		50.00%
Gamma Knife Center Ecuador S.A. (GKCE) [Member]
Noncontrolling Interest, Ownership Percentage by Parent		99.30%
Gamma Knife Center Ecuador S.A. (GKCE) [Member]
Business Combination, Consideration Transferred, Total	$ 2,000,000
Payments to Acquire Businesses, Gross	575,000
Business Combination, Consideration Transferred, Liabilities Incurred	1,425,000
Business Combination, Provisional Information, Initial Accounting Incomplete, Adjustment, Consideration Transferred	$ 883,000
Gamma Knife and PBRT Equipment [Member]
Number of Medical Centers		14
GK Financing, LLC (GKF) [Member] | Gamma Knife Center Ecuador S.A. (GKCE) [Member]
Business Acquisition, Percentage of Voting Interests Acquired	98.00%
GK Financing, LLC (GKF) [Member] | Gamma Knife Units [Member]
Number of Medical Centers		13
Architectural Design Company [Member] | OR21, LLC [Member]
Equity Method Investment, Ownership Percentage		50.00%

Note 1 - Basis of Presentatio_3

Note 1 - Basis of Presentation - Revenues and Profit (Loss) Allocations to Reportable Segments (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Revenues	$ 4,476,000	$ 3,991,000	$ 8,840,000	$ 8,559,000
Net Income (Loss) Attributable to Parent, Total	$ (87,000)	$ (483,000)	(58,000)	$ (618,000)
Domestic Segment [Member]
Revenues			7,415,000
Net Income (Loss) Attributable to Parent, Total			(35,000)
Foreign Segment [Member]
Revenues			1,425,000
Net Income (Loss) Attributable to Parent, Total			$ (23,000)

Note 2 - Property and Equipme_3

Note 2 - Property and Equipment (Details Textual) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Net Income (Loss) Attributable to Parent, Total	$ (87,000)	$ (483,000)	$ (58,000)	$ (618,000)
Earnings Per Share, Diluted, Total (in dollars per share)	$ (0.01)	$ (0.08)	$ (0.01)	$ (0.10)
Non-US [Member]
Property, Plant and Equipment, Net, Ending Balance	$ 2,937,000		$ 2,937,000
Salvage Value [Member]
Net Income (Loss) Attributable to Parent, Total	$ 114,000
Earnings Per Share, Diluted, Total (in dollars per share)	$ 0.02
Medical and Office Equipment [Member] | Minimum [Member]
Property, Plant and Equipment, Useful Life (Year)			3 years
Medical and Office Equipment [Member] | Maximum [Member]
Property, Plant and Equipment, Useful Life (Year)			10 years
PBRT Equipment [Member]
Property, Plant and Equipment, Useful Life (Year)			20 years

Note 2 - Property and Equipme_4

Note 2 - Property and Equipment - Summary of Property and Equipment (Details) - USD ($)	Jun. 30, 2021	Dec. 31, 2020
Property and equipment, gross	$ 72,551,000	$ 76,157,000
Accumulated depreciation and amortization	(43,191,000)	(45,739,000)
Net property and equipment	29,360,000	30,418,000
Medical Equipment and Facilities [Member]
Property and equipment, gross	72,035,000	75,657,000
Office Equipment [Member]
Property and equipment, gross	388,000	330,000
Construction in Progress [Member]
Property and equipment, gross	$ 128,000	$ 170,000

Note 3 - Long-term Debt Finan_3

Note 3 - Long-term Debt Financing (Details Textual)	Apr. 09, 2021USD ($)	Jun. 30, 2021USD ($)	Mar. 31, 2021USD ($)	Jun. 30, 2020USD ($)	Jun. 30, 2021USD ($)	Jun. 30, 2020USD ($)
Finance Lease, Principal Payments					$ 8,919,000	$ 1,981,000
Gain (Loss) on Extinguishment of Debt, Total		$ (401,000)		$ 0	(401,000)	$ 0
Long-term Debt, Total		16,041,000			16,041,000
Gamma Knife Debt and Finance Leases [Member]
Short-term Debt, Refinanced, Amount	$ 6,774,000
The Credit Agreement [Member] | Fifth Third Bank, N.A. [Member]
Debt Instrument, Term (Year)	5 years
Line of Credit Facility, Maximum Borrowing Capacity	$ 22,000,000
Number of Debt Instruments	3
Gain (Loss) on Extinguishment of Debt, Total		(401,000)
Debt Issuance Costs, Net, Total		$ 310,000			$ 310,000
Debt Instrument, Covenant, Minimum Fixed Charge Coverage Ratio	1.25
Debt Instrument, Covenant, Maximum Funded Debt to EDITDA Ratio	3
The Credit Agreement, First Loan Facility [Member] | Fifth Third Bank, N.A. [Member]
Debt Instrument, Face Amount	$ 9,500,000
Finance Lease, Principal Payments			$ 1,665,000
Cash, Ending Balance	1,061,000
The Credit Agreement, Second Loan Facility [Member] | Fifth Third Bank, N.A. [Member]
Debt Instrument, Face Amount	5,500,000
Finance Lease, Principal Payments	$ 5,026,000
The Credit Agreement, Third Loan Facility [Member] | Fifth Third Bank, N.A. [Member] | Revolving Credit Facility [Member]
Debt Instrument, Term (Year)	5 years
Line of Credit Facility, Maximum Borrowing Capacity	$ 7,000,000
The Credit Agreement, Third Loan Facility [Member] | Fifth Third Bank, N.A. [Member] | Revolving Credit Facility [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate	3.00%

Note 3 - Long-term Debt Finan_4

Note 3 - Long-term Debt Financing - Long-term Debt Maturities (Details)	Jun. 30, 2021USD ($)
2021 (excluding the six-months ended June 30, 2021)	$ 485,000
2022	1,344,000
2023	1,719,000
2024	2,094,000
2025	2,469,000
Thereafter	8,259,000
Long-term Debt, Gross	$ 16,370,000

Note 5 - Leases (Details Textua

Note 5 - Leases (Details Textual)	Jun. 30, 2021USD ($)
Operating Lease, Liability, Total	$ 737,000
Minimum [Member]
Lessee, Operating Lease, Discount Rate	4.00%
Lessee, Operating Lease, Remaining Lease Term (Year)	2 years
Maximum [Member]
Lessee, Operating Lease, Discount Rate	6.00%
Lessee, Operating Lease, Remaining Lease Term (Year)	3 years

Note 5 - Leases - Summary of Ma

Note 5 - Leases - Summary of Maturities of Lessee Operating Lease Liabilities (Details)	Jun. 30, 2021USD ($)
2021 (excluding the six-months ended June 30, 2021)	$ 175,000
2022	353,000
2023	248,000
2024	8,000
Total lease payments	784,000
Less imputed interest	(47,000)
Total	$ 737,000

Note 6 - Per Share Amounts (Det

Note 6 - Per Share Amounts (Details Textual) - shares	3 Months Ended	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2021
Share-based Payment Arrangement, Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount (in shares)	48,000	42,000
Restricted Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount (in shares)	21,000	21,000

Note 6 - Per Share Amounts - Co

Note 6 - Per Share Amounts - Computation of Basic and Diluted Earnings Per Share (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Net (loss) attributable to American Shared Hospital Services	$ (87,000)	$ (483,000)	$ (58,000)	$ (618,000)
Weighted average common shares for basic earnings per share (in shares)	5,802,000	6,008,000	5,801,000	6,066,000
Diluted effect of stock options and restricted stock awards (in shares)	0	69,000	0	69,000
Weighted average common shares for diluted earnings per share (in shares)	5,802,000	6,077,000	5,801,000	6,135,000
Basic (loss) per share (in dollars per share)	$ (0.01)	$ (0.08)	$ (0.01)	$ (0.10)
Diluted (loss) per share (in dollars per share)	$ (0.01)	$ (0.08)	$ (0.01)	$ (0.10)

Note 7 - Stock-based Compensa_3

Note 7 - Stock-based Compensation (Details Textual) - USD ($)	Jan. 04, 2017	Jun. 30, 2021	Jun. 30, 2020	Mar. 31, 2020	Jun. 30, 2021	Jun. 30, 2020	Dec. 31, 2019
Incentive Compensation Plan [Member]
Common Stock, Capital Shares Reserved for Future Issuance (in shares)		2,580,000			2,580,000
Share-based Payment Arrangement, Expense		$ 96,000	$ 53,000		$ 203,000	$ 109,000
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount, Total		$ 6,000			$ 6,000
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year)					3 years
Performance Share Award Agreement [Member] | Performance Shares [Member]
Share-based Payment Arrangement, Expense							$ 108,000
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount, Total				$ 434,000
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period (in shares)	161,766
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Forfeited in Period (in shares)				129,000

Note 7 - Stock-based Compensa_4

Note 7 - Stock-based Compensation - Summary of Stock Option Activity (Details) - USD ($)	6 Months Ended		12 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Dec. 31, 2020	Dec. 31, 2019
Outstanding (in shares)	417,000	450,000	450,000
Outstanding, grant date weighted-average exercise price (in dollars per share)	$ 2.79	$ 2.78	$ 2.78
Outstanding, weighted average remaining contractual life (Year)		2 years 1 month 13 days	1 year 7 months 9 days	2 years 5 months 8 days
Outstanding, intrinsic value		$ 0	$ 2,000	$ 27,000
Granted (in shares)	6,000	10,000
Granted, grant date weighted-average exercise price (in dollars per share)	$ 2.92	$ 1.88
Granted, weighted average remaining contractual life (Year)	7 years	7 years
Exercised (in shares)	(22,000)
Exercised, grant date weighted-average exercise price (in dollars per share)	$ 2.65
Forfeited (in shares)	(7,000)	(40,000)
Forfeited, grant date weighted-average exercise price (in dollars per share)	$ 2.51	$ 2.58
Exercisable (in shares)	383,000	397,000
Exercisable, grant date weighted-average exercise price (in dollars per share)	$ 2.80	$ 2.81
Exercisable, weighted average remaining contractual life (Year)		1 year 11 months 4 days
Outstanding (in shares)	394,000	420,000	417,000	450,000
Outstanding, grant date weighted-average exercise price (in dollars per share)	$ 2.80	$ 2.78	$ 2.79	$ 2.78
Minimum [Member]
Outstanding, weighted average remaining contractual life (Year)	1 year 1 month 28 days
Exercisable, weighted average remaining contractual life (Year)	1 year 7 days
Maximum [Member]
Outstanding, intrinsic value	$ 15,000

Note 9 - GKCE Acquisition (Deta

Note 9 - GKCE Acquisition (Details Textual)	Jun. 12, 2020USD ($)
Gamma Knife Center Ecuador S.A. (GKCE) [Member] | Trade Names [Member]
Indefinite-lived Intangible Assets Acquired	$ 78,000

Note 9 - GKCE Acquisition - Ass

Note 9 - GKCE Acquisition - Assets Acquired and Liabilities Assumed (Details) - USD ($)	Jun. 12, 2020	Jun. 30, 2021	Jun. 30, 2020	Dec. 31, 2020
Goodwill		$ 1,265,000		$ 1,265,000
First working capital payment		0	$ (515,000)
Estimated subsequent working capital payment		$ 0	$ (354,000)
Gamma Knife Center Ecuador S.A. (GKCE) [Member]
Cash and cash equivalents	$ 432,000
Accounts receivable	854,000
Prepaid expense and other	22,000
Purchased intangible assets	78,000
Goodwill	1,265,000
Total assets acquired	3,374,000
Accounts payable	(193,000)
Income taxes payable	(141,000)
Deferred income taxes	(66,000)
Employee compensation and benefits	(91,000)
Total liabilities assumed	(491,000)
Consideration allocated to assets acquired and liabilities assumed	2,883,000
First working capital payment	(515,000)
Estimated subsequent working capital payment	(368,000)
Base purchase consideration	2,000,000
Gamma Knife Center Ecuador S.A. (GKCE) [Member] | Building [Member]
Tangible assets	385,000
Gamma Knife Center Ecuador S.A. (GKCE) [Member] | Land [Member]
Tangible assets	19,000
Gamma Knife Center Ecuador S.A. (GKCE) [Member] | Medical Equipment [Member]
Tangible assets	$ 319,000

Note 9 - GKCE Acquisition - Tan

Note 9 - GKCE Acquisition - Tangible Assets Acquired (Details) - Gamma Knife Center Ecuador S.A. (GKCE) [Member]	Jun. 12, 2020USD ($)
Tangible assets	$ 723,000
Building [Member]
Tangible assets	$ 385,000
Useful life (Year)	20 years
Land [Member]
Tangible assets	$ 19,000
Medical Equipment [Member]
Tangible assets	$ 302,000
Useful life (Year)	2 years
Property, Plant and Equipment, Other Types [Member]
Tangible assets	$ 17,000
Useful life (Year)	2 years