American Shared Hospital Services (AMS) 10-Q 12 May 22 2022 Q1 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	3 Months Ended
	Mar. 31, 2022	May 09, 2022
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	Q1
Document Fiscal Year Focus	2022
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2022
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	601 Montgomery Street
Entity Address, City or Town	San Francisco
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	94111-2619
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	NYSE
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		6,079,000

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Current Period Unaudited) - USD ($)	Mar. 31, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 8,283,000	$ 8,145,000
Restricted cash	118,000	118,000
Accounts receivable, net of allowance for doubtful accounts of $100,000 at March 31, 2022 and $100,000 at December 31, 2021	4,781,000	4,211,000
Other receivables	618,000	613,000
Prepaid maintenance	757,000	1,174,000
Prepaid expenses and other current assets	683,000	826,000
Total current assets	15,240,000	15,087,000
Property and equipment:
Medical equipment and facilities	73,434,000	73,388,000
Office equipment	463,000	472,000
Construction in progress	88,000	91,000
Property, Plant and Equipment, Gross, Excluding Land	73,985,000	73,951,000
Accumulated depreciation and amortization	(46,975,000)	(45,697,000)
Net property and equipment	27,010,000	28,254,000
Land	19,000	19,000
Goodwill	1,265,000	1,265,000
Right of use assets	571,000	654,000
Intangible asset	78,000	78,000
Other assets	72,000	73,000
Total assets	44,255,000	45,430,000
Current liabilities:
Accounts payable	396,000	746,000
Employee compensation and benefits	380,000	423,000
Other accrued liabilities	1,635,000	2,419,000
Asset retirement obligations	300,000	757,000
Income taxes payable	96,000	96,000
Current portion of lease liabilities	369,000	369,000
Current portion of long-term debt, net	1,643,000	1,081,000
Total current liabilities	4,819,000	5,891,000
Long-term lease liabilities, less current portion	268,000	359,000
Long-term debt, net, less current portion	13,724,000	14,323,000
Deferred revenue, less current portion	123,000	140,000
Deferred income taxes	601,000	478,000
Shareholders' equity:
Common stock, no par value (10,000,000 authorized; 6,079,000 and 6,049,000 shares issued and outstanding at March 31, 2022 and at December 31, 2021	10,758,000	10,758,000
Additional paid-in capital	7,531,000	7,444,000
Retained earnings	1,960,000	1,691,000
Total equity-American Shared Hospital Services	20,249,000	19,893,000
Non-controlling interests in subsidiaries	4,471,000	4,346,000
Total shareholders' equity	24,720,000	24,239,000
Total liabilities and shareholders' equity	$ 44,255,000	$ 45,430,000

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - USD ($) $ / shares in Thousands	Mar. 31, 2022	Dec. 31, 2021
Allowance for doubtful accounts	$ 100,000	$ 100,000
Common stock, no par value (in dollars per share)	$ 0	$ 0
Common stock, shares authorized (in shares)	10,000,000	10,000,000
Common stock, shares issued (in shares)	6,079,000	6,049,000
Common stock, shares outstanding (in shares)	6,079,000	6,049,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (Unaudited) - USD ($)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Revenues	$ 4,847,000	$ 4,364,000
Costs of revenue:
Maintenance and supplies	709,000	672,000
Depreciation and amortization	1,187,000	1,198,000
Other direct operating costs	884,000	1,060,000
Cost of Revenue, Total	2,780,000	2,930,000
Gross margin	2,067,000	1,434,000
Selling and administrative expense	1,319,000	1,084,000
Interest expense	148,000	260,000
Operating income	600,000	90,000
Interest and other income	0	3,000
Income before income taxes	600,000	93,000
Income tax expense	206,000	6,000
Net income	394,000	87,000
Less: Net income attributable to non-controlling interest	(125,000)	(58,000)
Net income attributable to American Shared Hospital Services	$ 269,000	$ 29,000
Net income per share:
Income per common share - basic (in dollars per share)	$ 0.04	$ 0
Income per common share - diluted (in dollars per share)	$ 0.04	$ 0

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, 2020	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 (in shares)	10,000
Stock-based compensation expense	$ 0	107,000	0	107,000	0	107,000
Net income	$ 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, 2021	6,049,000					6,049,000
Balances at Dec. 31, 2021	$ 10,758,000	7,444,000	1,691,000	19,893,000	4,346,000	$ 24,239,000
Stock-based compensation expense (in shares)	30,000
Stock-based compensation expense	$ 0	87,000	0	87,000	0	87,000
Net income	$ 0	0	269,000	269,000	125,000	$ 394,000
Balances (in shares) at Mar. 31, 2022	6,079,000					6,079,000
Balances at Mar. 31, 2022	$ 10,758,000	$ 7,531,000	$ 1,960,000	$ 20,249,000	$ 4,471,000	$ 24,720,000

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Operating activities:
Net income	$ 394,000	$ 87,000
Adjustments to reconcile net income to net cash from operating activities:
Depreciation and amortization	1,212,000	1,231,000
Amortization of debt issuance costs	18,000	0
Non cash lease expense	83,000	74,000
Deferred income taxes	123,000	(16,000)
Stock-based compensation expense	87,000	107,000
Interest expense associated with lease liabilities	9,000	12,000
Changes in operating assets and liabilities:
Receivables	(575,000)	(497,000)
Prepaid expenses and other assets	567,000	551,000
Asset retirement obligations	(457,000)	0
Accounts payable, accrued liabilities and deferred revenue	(1,102,000)	1,294,000
Income taxes	0	26,000
Lease liabilities	(100,000)	(86,000)
Net cash provided by operating activities	259,000	2,783,000
Investing activities:
Payment for purchase of property and equipment	(66,000)	(1,065,000)
Net cash used in investing activities	(66,000)	(1,065,000)
Financing activities:
Principal payments on long-term debt	(55,000)	(276,000)
Principal payments on finance leases	0	(638,000)
Principal payments on short-term financing	0	(116,000)
Net cash used in financing activities	(55,000)	(1,030,000)
Net change in cash, cash equivalents, and restricted cash	138,000	688,000
Cash, cash equivalents, and restricted cash at beginning of period	8,263,000	4,325,000
Cash, cash equivalents, and restricted cash at end of period	8,401,000	5,013,000
Supplemental cash flow disclosure:
Interest	130,000	260,000
Income taxes paid (refunded)	$ 55,000	$ (4,000)

Note 1 - Basis of Presentation

Note 1 - Basis of Presentation	3 Months Ended
	Mar. 31, 2022
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 March 31, 2022 three March 31, 2022 2021 three March 31, 2022 2021 three March 31, 2022 not December 31, 2021 These unaudited condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements for the year ended December 31, 2021 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”), 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 March 31, 2022 two 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 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. In 2021, 19 2020. not 2020. twelve December 31, 2021, 19, 2021 19 19 may may For the three March 31, 2022 two first fourth 2021, 19, 2021 three March 31, 2022 Accounting pronouncements issued and not yet adopted - January 2021, 2021 01 848 2021 01” 2021 01 2021 01 March 12, 2020, 2021 01 may 3 Based on the guidance provided in accordance with ASC 280 Segment Reporting 280” March 31, 2022 two The revenues and profit or loss, allocations for the Company's two reportable segments as of March 31, 2022 March 31, 2022 March 31, 2021 Revenues Domestic $ 4,141,000 $ 3,699,000 Foreign 706,000 665,000 Total $ 4,847,000 $ 4,364,000 Profit or (loss) Domestic $ 276,000 $ 73,000 Foreign (7,000 ) (44,000 ) Total $ 269,000 $ 29,000

Note 2 - Property and Equipment

Note 2 - Property and Equipment	3 Months Ended
	Mar. 31, 2022
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 March 31, 2022 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 March 31, 2022 December 31, 2021 March 31, December 31, 2022 2021 Medical equipment and facilities $ 73,434,000 $ 73,388,000 Office equipment 463,000 472,000 Construction in progress 88,000 91,000 73,985,000 73,951,000 Accumulated depreciation (46,975,000 ) (45,697,000 ) Net property and equipment $ 27,010,000 $ 28,254,000 As of March 31, 2022

Note 3 - Long-Term Debt Financi

Note 3 - Long-Term Debt Financing	3 Months Ended
	Mar. 31, 2022
Notes to Financial Statements
Long-Term Debt [Text Block]	Note 3. Long-Term Debt Financing On April 9, 2021 five three first two two second 2021, second third five As of December 31, 2021, no 1 3 6 12 2023. one five 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 March 31, 2022 The loan entered into with United States International Development Finance Corporation (“DFC”) in connection with the acquisition of GKCE in June 2020 ( 29 3.67%. March 31, 2022 As of March 31, 2022 March 31, 2022 $276,000: Year ending December 31, Principal 2022 (excluding the three-months ended March 31, 2022) $ 1,103,000 2023 1,719,000 2024 2,094,000 2025 2,469,000 2026 8,094,000 Thereafter 164,000 $ 15,643,000

Note 4 - Other Accrued Liabilit

Note 4 - Other Accrued Liabilities	3 Months Ended
	Mar. 31, 2022
Notes to Financial Statements
Other Liabilities Disclosure [Text Block]	Note 4. Other Accrued Liabilities Other accrued liabilities consist of the following as of March 31, 2022 December 31, 2021 March 31, December 31, 2022 2021 Equipment maintenance and upgrades $ 502,000 $ 1,281,000 Insurance 227,000 340,000 Professional services 188,000 90,000 Operating costs 384,000 397,000 Other 334,000 311,000 Total other accrued liabilities $ 1,635,000 $ 2,419,000

Note 5 - Leases

Note 5 - Leases	3 Months Ended
	Mar. 31, 2022
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 On November 3, 2021, 410, August 2023. 601 1112, November 2024. 842 December 1, 2021, 842 360 360” December 1, 2021. 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 March 31, 2022 The following table summarizes maturities of lessee operating lease liabilities as of March 31, 2022 Year ending December 31, Operating Leases 2022 (excluding the three-months ended March 31, 2022) $ 306,000 2023 302,000 2024 58,000 Total lease payments 666,000 Less imputed interest (29,000 ) Total $ 637,000

Note 6 - Per Share Amounts

Note 6 - Per Share Amounts	3 Months Ended
	Mar. 31, 2022
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. The computation for the three March 31, 2022 2021 The following table sets forth the computation of basic and diluted earnings per share for the three March 31, 2022 2021 Three Months Ended March 31, 2022 2021 Net income attributable to American Shared Hospital Services $ 269,000 $ 29,000 Weighted average common shares for basic earnings per share 6,201,000 6,254,000 Diluted effect of stock options and restricted stock awards 98,000 68,000 Weighted average common shares for diluted earnings per share 6,299,000 6,322,000 Basic earnings per share $ 0.04 $ 0.00 Diluted earnings per share $ 0.04 $ 0.00

Note 7 - Stock-based Compensati

Note 7 - Stock-based Compensation	3 Months Ended
	Mar. 31, 2022
Notes to Financial Statements
Share-Based Payment Arrangement [Text Block]	Note 7. Stock-based Compensation In June 2021, five February 22, 2027. No 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 $87,000 and $107,000 i three March 31, 2022 2021 March 31, 2022 $9,000 o three The following table summarizes stock option activity for the three March 31, 2022 2021 Stock Options Grant Date Weighted- Average Exercise Price Weighted- Average Remaining Contractual Life (in Years) Intrinsic Value Outstanding at January 1, 2022 67,000 $ 2.72 3.33 $ - Outstanding at March 31, 2022 67,000 $ 2.72 3.09 $ 4,000 Exercisable at March 31, 2022 59,000 $ 2.72 2.77 $ - Outstanding at January 1, 2021 417,000 $ 2.79 1.61 $ 2,000 Outstanding at March 31, 2021 417,000 $ 2.79 1.36 $ 19,000 Exercisable at March 31, 2021 407,000 $ 2.80 1.27 $ -

Note 8 - Income Taxes

Note 8 - Income Taxes	3 Months Ended
	Mar. 31, 2022
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 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 March 31, 2022 2021

Note 9 - Subsequent Events

Note 9 - Subsequent Events	3 Months Ended
	Mar. 31, 2022
Notes to Financial Statements
Subsequent Events [Text Block]	Note 9. Subsequent Events On April 27, 2022,

Significant Accounting Policies

Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2022
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 March 31, 2022 three March 31, 2022 2021 three March 31, 2022 2021 three March 31, 2022 not December 31, 2021 These unaudited condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements for the year ended December 31, 2021 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”), 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 March 31, 2022 two 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 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. In 2021, 19 2020. not 2020. twelve December 31, 2021, 19, 2021 19 19 may may For the three March 31, 2022 two first fourth 2021, 19, 2021 three March 31, 2022
New Accounting Pronouncements, Policy [Policy Text Block]	Accounting pronouncements issued and not yet adopted - January 2021, 2021 01 848 2021 01” 2021 01 2021 01 March 12, 2020, 2021 01 may 3 Based on the guidance provided in accordance with ASC 280 Segment Reporting 280” March 31, 2022 two The revenues and profit or loss, allocations for the Company's two reportable segments as of March 31, 2022 March 31, 2022 March 31, 2021 Revenues Domestic $ 4,141,000 $ 3,699,000 Foreign 706,000 665,000 Total $ 4,847,000 $ 4,364,000 Profit or (loss) Domestic $ 276,000 $ 73,000 Foreign (7,000 ) (44,000 ) Total $ 269,000 $ 29,000

Note 1 - Basis of Presentation

Note 1 - Basis of Presentation (Tables)	3 Months Ended
	Mar. 31, 2022
Notes Tables
Reconciliation of Revenue from Segments to Consolidated [Table Text Block]	March 31, 2022 March 31, 2021 Revenues Domestic $ 4,141,000 $ 3,699,000 Foreign 706,000 665,000 Total $ 4,847,000 $ 4,364,000 Profit or (loss) Domestic $ 276,000 $ 73,000 Foreign (7,000 ) (44,000 ) Total $ 269,000 $ 29,000

Note 2 - Property and Equipme_2

Note 2 - Property and Equipment (Tables)	3 Months Ended
	Mar. 31, 2022
Notes Tables
Property, Plant and Equipment [Table Text Block]	March 31, December 31, 2022 2021 Medical equipment and facilities $ 73,434,000 $ 73,388,000 Office equipment 463,000 472,000 Construction in progress 88,000 91,000 73,985,000 73,951,000 Accumulated depreciation (46,975,000 ) (45,697,000 ) Net property and equipment $ 27,010,000 $ 28,254,000

Note 3 - Long-Term Debt Finan_2

Note 3 - Long-Term Debt Financing (Tables)	3 Months Ended
	Mar. 31, 2022
Notes Tables
Schedule of Maturities of Long-Term Debt [Table Text Block]	Year ending December 31, Principal 2022 (excluding the three-months ended March 31, 2022) $ 1,103,000 2023 1,719,000 2024 2,094,000 2025 2,469,000 2026 8,094,000 Thereafter 164,000 $ 15,643,000

Note 4 - Other Accrued Liabil_2

Note 4 - Other Accrued Liabilities (Tables)	3 Months Ended
	Mar. 31, 2022
Notes Tables
Other Liabilities [Table Text Block]	March 31, December 31, 2022 2021 Equipment maintenance and upgrades $ 502,000 $ 1,281,000 Insurance 227,000 340,000 Professional services 188,000 90,000 Operating costs 384,000 397,000 Other 334,000 311,000 Total other accrued liabilities $ 1,635,000 $ 2,419,000

Note 5 - Leases (Tables)

Note 5 - Leases (Tables)	3 Months Ended
	Mar. 31, 2022
Notes Tables
Lessee, Operating Lease, Liability, Maturity [Table Text Block]	Year ending December 31, Operating Leases 2022 (excluding the three-months ended March 31, 2022) $ 306,000 2023 302,000 2024 58,000 Total lease payments 666,000 Less imputed interest (29,000 ) Total $ 637,000

Note 6 - Per Share Amounts (Tab

Note 6 - Per Share Amounts (Tables)	3 Months Ended
	Mar. 31, 2022
Notes Tables
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	Three Months Ended March 31, 2022 2021 Net income attributable to American Shared Hospital Services $ 269,000 $ 29,000 Weighted average common shares for basic earnings per share 6,201,000 6,254,000 Diluted effect of stock options and restricted stock awards 98,000 68,000 Weighted average common shares for diluted earnings per share 6,299,000 6,322,000 Basic earnings per share $ 0.04 $ 0.00 Diluted earnings per share $ 0.04 $ 0.00

Note 7 - Stock-based Compensa_2

Note 7 - Stock-based Compensation (Tables)	3 Months Ended
	Mar. 31, 2022
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, 2022 67,000 $ 2.72 3.33 $ - Outstanding at March 31, 2022 67,000 $ 2.72 3.09 $ 4,000 Exercisable at March 31, 2022 59,000 $ 2.72 2.77 $ - Outstanding at January 1, 2021 417,000 $ 2.79 1.61 $ 2,000 Outstanding at March 31, 2021 417,000 $ 2.79 1.36 $ 19,000 Exercisable at March 31, 2021 407,000 $ 2.80 1.27 $ -

Note 1 - Basis of Presentatio_2

Note 1 - Basis of Presentation (Details Textual)	3 Months Ended
	Mar. 31, 2022
Increase (Decrease) in Procedure Volumes, Percentage	2.00%
Number of Reportable Segments	2
OR21, LLC [Member]
Equity Method Investment, Ownership Percentage	50.00%
Architectural Design Company [Member] | OR21, LLC [Member]
Equity Method Investment, Ownership Percentage	50.00%
Gamma Knife Center Ecuador S.A. (GKCE) [Member] | Gamma Knife Units [Member]
Number of Medical Centers	12
Gamma Knife and PBRT Equipment [Member]
Number of Medical Centers	13
Lima, Peru and Guayaquil, Ecuador [Member]
Number of Single-unit Facilities	2

Note 1 - Basis of Presentatio_3

Note 1 - Basis of Presentation - Revenues and Profit (Loss) Allocations to Reportable Segments (Details) - USD ($)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Revenues	$ 4,847,000	$ 4,364,000
Net Income (Loss) Attributable to Parent, Total	269,000	29,000
Domestic Segment [Member]
Revenues	4,141,000	3,699,000
Net Income (Loss) Attributable to Parent, Total	276,000	73,000
Foreign Segment [Member]
Revenues	706,000	665,000
Net Income (Loss) Attributable to Parent, Total	$ (7,000)	$ (44,000)

Note 2 - Property and Equipme_3

Note 2 - Property and Equipment (Details Textual) - USD ($)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Net Income (Loss) Attributable to Parent, Total	$ 269,000	$ 29,000
Earnings Per Share, Diluted, Total (in dollars per share)	$ 0.04	$ 0
Non-US [Member]
Property, Plant, and Equipment and Finance Lease Right-of-Use Asset, after Accumulated Depreciation and Amortization, Total	$ 2,570,000
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 ($)	Mar. 31, 2022	Dec. 31, 2021
Property and equipment, gross	$ 73,985,000	$ 73,951,000
Accumulated depreciation and amortization	(46,975,000)	(45,697,000)
Net property and equipment	27,010,000	28,254,000
Medical Equipment and Facilities [Member]
Property and equipment, gross	73,434,000	73,388,000
Office Equipment [Member]
Property and equipment, gross	463,000	472,000
Construction in Progress [Member]
Property and equipment, gross	$ 88,000	$ 91,000

Note 3 - Long-Term Debt Finan_3

Note 3 - Long-Term Debt Financing (Details Textual)	Apr. 09, 2021USD ($)	Mar. 31, 2022USD ($)	Mar. 31, 2021USD ($)	Dec. 31, 2021	Dec. 31, 2022
Finance Lease, Principal Payments		$ 0	$ 638,000
Long-Term Debt, Total		15,367,000
Debt Issuance Costs, Net, Total		$ 276,000
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
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 and Second Loan Facility [Member] | Fifth Third Bank, N.A. [Member]
Debt Instrument, Face Amount	$ 9,500,000
The Credit Agreement, First Loan and Second Loan Facility [Member] | Fifth Third Bank, N.A. [Member] | Forecast [Member]
Debt Instrument, Interest Rate, Stated Percentage					48.00%
The Credit Agreement, First Loan Facility [Member] | Fifth Third Bank, N.A. [Member]
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
Line of Credit Facility, Unused Capacity, Commitment Fee Percentage				0.25%
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)	Mar. 31, 2022USD ($)
2022 (excluding the three-months ended March 31, 2022)	$ 1,103,000
2023	1,719,000
2024	2,094,000
2025	2,469,000
2026	8,094,000
Thereafter	164,000
Long-Term Debt, Gross	$ 15,643,000

Note 4 - Other Accrued Liabil_3

Note 4 - Other Accrued Liabilities - Other Accrued Liabilities (Details) - USD ($)	Mar. 31, 2022	Dec. 31, 2021
Equipment maintenance and upgrades	$ 502,000	$ 1,281,000
Insurance	227,000	340,000
Professional services	188,000	90,000
Operating costs	384,000	397,000
Other	334,000	311,000
Total other accrued liabilities	$ 1,635,000	$ 2,419,000

Note 5 - Leases (Details Textua

Note 5 - Leases (Details Textual)	Nov. 03, 2021USD ($)ft²	Dec. 01, 2021USD ($)	Mar. 31, 2022USD ($)	Dec. 31, 2021USD ($)
Operating Lease, Right-of-Use Asset			$ 571,000	$ 654,000
Operating Lease, Liability, Total			$ 637,000
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
Sublease Office in San Francisco, California [Member]
Area of Real Estate Property (Square Foot) | ft²	3,253
Operating Lease, Monthly Expense	$ 21,370
Lessee, Operating Sublease, Monthly Income	$ 15,723
Operating Lease, Impairment Loss		$ 77,000
Lease Agreement for New Corporate Office [Member]
Area of Real Estate Property (Square Foot) | ft²	900
Operating Lease, Monthly Expense	$ 4,425
Operating Lease, Right-of-Use Asset		$ 151,000

Note 5 - Leases - Summary of Ma

Note 5 - Leases - Summary of Maturities of Lessee Operating Lease Liabilities (Details)	Mar. 31, 2022USD ($)
2022 (excluding the three-months ended March 31, 2022)	$ 306,000
2023	302,000
2024	58,000
Total lease payments	666,000
Less imputed interest	(29,000)
Total	$ 637,000

Note 6 - Per Share Amounts (Det

Note 6 - Per Share Amounts (Details Textual) - shares	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Share-Based Payment Arrangement, Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount (in shares)	50,000	370,000

Note 6 - Per Share Amounts - Co

Note 6 - Per Share Amounts - Computation of Basic and Diluted Earnings Per Share (Details) - USD ($)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Net income attributable to American Shared Hospital Services	$ 269,000	$ 29,000
Weighted average common shares for basic earnings per share (in shares)	6,201,000	6,254,000
Diluted effect of stock options and restricted stock awards (in shares)	98,000	68,000
Weighted average common shares for diluted earnings per share (in shares)	6,299,000	6,322,000
Basic earnings per share (in dollars per share)	$ 0.04	$ 0
Diluted earnings per share (in dollars per share)	$ 0.04	$ 0

Note 7 - Stock-based Compensa_3

Note 7 - Stock-based Compensation (Details Textual) - Incentive Compensation Plan [Member] - USD ($)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Jun. 30, 2021
Common Stock, Capital Shares Reserved for Future Issuance (in shares)			2,580,000
Share-Based Payment Arrangement, Expense	$ 87,000	$ 107,000
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount, Total	$ 9,000

Note 7 - Stock-based Compensa_4

Note 7 - Stock-based Compensation - Summary of Stock Option Activity (Details) - USD ($)	3 Months Ended		12 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021	Dec. 31, 2020
Outstanding (in shares)	67,000	417,000	417,000
Outstanding, grant date weighted-average exercise price (in dollars per share)	$ 2.72	$ 2.79	$ 2.79
Outstanding, weighted average remaining contractual life (Year)		1 year 4 months 9 days	3 years 3 months 29 days	1 year 7 months 9 days
Outstanding, intrinsic value		$ 19,000		$ 2,000
Exercisable (in shares)	59,000	407,000
Exercisable, grant date weighted-average exercise price (in dollars per share)	$ 2.72	$ 2.80
Exercisable, weighted average remaining contractual life (Year)		1 year 3 months 7 days
Outstanding (in shares)	67,000	417,000	67,000	417,000
Outstanding, grant date weighted-average exercise price (in dollars per share)	$ 2.72	$ 2.79	$ 2.72	$ 2.79
Minimum [Member]
Outstanding, weighted average remaining contractual life (Year)	3 years 1 month 2 days
Exercisable, weighted average remaining contractual life (Year)	2 years 9 months 7 days
Maximum [Member]
Outstanding, intrinsic value	$ 4,000

Note 9 - Subsequent Events (Det

Note 9 - Subsequent Events (Details Textual) - Subsequent Event [Member] - Newco [Member]	Apr. 27, 2022
Equity Method Investment, Ownership Percentage	85.00%
Guadalupe [Member]
Equity Method Investment, Ownership Percentage	15.00%