American Shared Hospital Services (AMS) 10-Q 10 Nov 22 2022 Q3 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	9 Months Ended
	Sep. 30, 2022	Nov. 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	Q3
Document Fiscal Year Focus	2022
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 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		6,153,000

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Current Period Unaudited) - USD ($)	Sep. 30, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 11,546,000	$ 8,145,000
Restricted cash	118,000	118,000
Accounts receivable, net of allowance for doubtful accounts of $100,000 at September 30, 2022 and $100,000 at December 31, 2021	3,550,000	4,211,000
Other receivables	582,000	613,000
Prepaid maintenance	804,000	1,174,000
Prepaid expenses and other current assets	228,000	826,000
Total current assets	16,828,000	15,087,000
Property and equipment, net	24,729,000	28,254,000
Land	19,000	19,000
Goodwill	1,265,000	1,265,000
Right of use assets	402,000	654,000
Intangible asset	78,000	78,000
Other assets	88,000	73,000
Total assets	43,409,000	45,430,000
Current liabilities:
Accounts payable	270,000	318,000
Employee compensation and benefits	411,000	423,000
Other accrued liabilities	1,122,000	1,505,000
Related party liabilities	418,000	1,342,000
Asset retirement obligations, related party (includes $107,000 non-related party at December 31, 2021)	330,000	757,000
Income taxes payable	96,000	96,000
Current portion of lease liabilities	355,000	369,000
Current portion of long-term debt, net	1,262,000	1,081,000
Total current liabilities	4,264,000	5,891,000
Long-term lease liabilities, less current portion	93,000	359,000
Long-term debt, net, less current portion	12,616,000	14,323,000
Deferred revenue, less current portion	88,000	140,000
Deferred income taxes	921,000	478,000
Total liabilities	17,982,000	21,191,000
Commitments (see Note 9)
Shareholders' equity:
Common stock, no par value (10,000,000 shares authorized; 6,153,000 and 6,049,000 shares issued and outstanding at September 30, 2022 and at December 31, 2021)	10,763,000	10,758,000
Additional paid-in capital	7,679,000	7,444,000
Retained earnings	2,773,000	1,691,000
Total equity-American Shared Hospital Services	21,215,000	19,893,000
Non-controlling interests in subsidiaries	4,212,000	4,346,000
Total shareholders' equity	25,427,000	24,239,000
Total liabilities and shareholders' equity	$ 43,409,000	$ 45,430,000

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - USD ($) $ / shares in Thousands	Sep. 30, 2022	Dec. 31, 2021
Allowance for doubtful accounts	$ 100,000	$ 100,000
Asset retirement obligations		$ 107,000
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)	6,153,000	6,049,000
Common stock, shares outstanding (in shares)	6,153,000	6,049,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (Unaudited) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Revenues	$ 4,828,000	$ 4,099,000	$ 14,709,000	$ 12,939,000
Costs of revenue:
Maintenance and supplies	472,000	436,000	1,374,000	1,291,000
Depreciation and amortization	1,171,000	1,224,000	3,514,000	3,666,000
Other direct operating costs	956,000	847,000	2,889,000	2,881,000
Other direct operating costs, related party	272,000	125,000	820,000	593,000
Cost of Revenue, Total	2,871,000	2,632,000	8,597,000	8,431,000
Gross margin	1,957,000	1,467,000	6,112,000	4,508,000
Selling and administrative expense	1,260,000	1,119,000	3,725,000	3,293,000
Interest expense	249,000	162,000	546,000	587,000
Operating income	448,000	186,000	1,841,000	628,000
(Loss) on extinguishment of debt	0	0	0	(401,000)
Interest and other income (loss)	36,000	(1,000)	31,000	0
Income before income taxes	484,000	185,000	1,872,000	227,000
Income tax expense (benefit)	176,000	17,000	630,000	(1,000)
Net income	308,000	168,000	1,242,000	228,000
Less: Net loss (income) attributable to non-controlling interests	8,000	(135,000)	(160,000)	(253,000)
Net income (loss) attributable to American Shared Hospital Services	$ 316,000	$ 33,000	$ 1,082,000	$ (25,000)
Net income (loss) per share:
Income (loss) per common share - basic (in dollars per share)	$ 0.05	$ 0.01	$ 0.17	$ 0
Income (loss) per common share - diluted (in dollars per share)	$ 0.05	$ 0.01	$ 0.17	$ 0
Weighted average common shares for basic earnings (loss) per share (in shares)	6,234,000	6,103,000	6,223,000	5,824,000
Weighted average common shares for diluted earnings (loss) per share (in shares)	6,273,000	6,123,000	6,261,000	5,824,000
Rental Income from Medical Services [Member]
Revenues	$ 4,101,000	$ 3,477,000	$ 12,382,000	$ 10,892,000
Patient Income [Member]
Revenues	$ 727,000	$ 622,000	$ 2,327,000	$ 2,047,000

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, 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
Net income						$ 228,000
Options exercised (in shares)						22,000
Balances (in shares) at Sep. 30, 2021	5,868,000
Balances at Sep. 30, 2021	$ 10,758,000	7,336,000	1,472,000	19,566,000	4,387,000	$ 23,953,000
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 (in shares)	62,000
Stock-based compensation expense	$ 0	96,000	0	96,000	0	96,000
Net income	$ 0	0	(87,000)	(87,000)	60,000	(27,000)
Options exercised (in shares)	5,000
Options exercised	$ 5,000	0	0	5,000	0	5,000
Cash distributions to non-controlling interests	$ 0	0	0	0	(204,000)	(204,000)
Balances (in shares) at Jun. 30, 2021	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
Stock-based compensation expense (in shares)	0
Stock-based compensation expense	$ 0	109,000	0	109,000	0	109,000
Net income	0	0	33,000	33,000	135,000	168,000
Cash distributions to non-controlling interests	$ 0	0	0	0	(38,000)	(38,000)
Balances (in shares) at Sep. 30, 2021	5,868,000
Balances at Sep. 30, 2021	$ 10,758,000	7,336,000	1,472,000	19,566,000	4,387,000	$ 23,953,000
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
Balances at Mar. 31, 2022	$ 10,758,000	7,531,000	1,960,000	20,249,000	4,471,000	$ 24,720,000
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
Net income						$ 1,242,000
Options exercised (in shares)						2,000
Balances (in shares) at Sep. 30, 2022	6,153,000					6,153,000
Balances at Sep. 30, 2022	$ 10,763,000	7,679,000	2,773,000	21,215,000	4,212,000	$ 25,427,000
Balances (in shares) at Mar. 31, 2022	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
Stock-based compensation expense (in shares)	31,000
Stock-based compensation expense	$ 0	72,000	0	72,000	0	72,000
Net income	$ 0	0	497,000	497,000	43,000	540,000
Options exercised (in shares)	2,000
Options exercised	$ 5,000	0	0	5,000	0	5,000
Balances (in shares) at Jun. 30, 2022	6,112,000
Balances at Jun. 30, 2022	$ 10,763,000	7,603,000	2,457,000	20,823,000	4,514,000	25,337,000
Stock-based compensation expense (in shares)	30,000
Stock-based compensation expense	$ 0	76,000	0	76,000	0	76,000
Net income	0	0	316,000	316,000	(8,000)	308,000
Cash distributions to non-controlling interests	$ 0	0	0	0	(294,000)	(294,000)
Vested restricted stock awards (in shares)	11,000
Vested restricted stock awards	$ 0	0	0	0	0	$ 0
Balances (in shares) at Sep. 30, 2022	6,153,000					6,153,000
Balances at Sep. 30, 2022	$ 10,763,000	$ 7,679,000	$ 2,773,000	$ 21,215,000	$ 4,212,000	$ 25,427,000

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Operating activities:
Net income	$ 1,242,000	$ 228,000
Adjustments to reconcile net income to net cash from operating activities:
Depreciation, amortization, and other	3,557,000	3,750,000
Amortization of debt issuance costs	65,000	39,000
Loss on extinguishment of debt	0	401,000
Non cash lease expense	252,000	226,000
Deferred income taxes	443,000	(46,000)
Stock-based compensation expense	235,000	312,000
Interest expense associated with lease liabilities	23,000	32,000
Changes in operating assets and liabilities:
Receivables	692,000	(529,000)
Prepaid expenses and other assets	998,000	39,000
Asset retirement obligations, related party	(427,000)	(618,000)
Related party liabilities	(924,000)	485,000
Accounts payable, accrued liabilities, and deferred revenue	(220,000)	(707,000)
Income taxes payable	0	(211,000)
Lease liabilities	(303,000)	(258,000)
Net cash provided by operating activities	5,633,000	3,143,000
Investing activities:
Payment for purchase of property and equipment	(332,000)	(347,000)
Net cash used in investing activities	(332,000)	(347,000)
Financing activities:
Principal payments on long-term debt	(1,602,000)	(3,497,000)
Principal payments on finance leases	0	(8,919,000)
Principal payments on short-term financing	0	(471,000)
Distributions to non-controlling interests	(294,000)	(242,000)
Proceeds from long-term debt financing, net of property and equipment acquired	0	13,897,000
Prepayment penalties	0	(401,000)
Debt issuance costs long-term debt	(9,000)	(325,000)
Proceeds from options exercised	5,000	5,000
Net cash (used in) provided by financing activities	(1,900,000)	47,000
Net change in cash, cash equivalents, and restricted cash	3,401,000	2,843,000
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	11,664,000	7,168,000
Supplemental cash flow disclosure
Interest	481,000	587,000
Income taxes paid	174,000	597,000
Schedule of non-cash investing and financing activities
Acquisition of equipment with long-term debt financing	0	1,103,000
Detail of cash, cash equivalents and restricted cash at end of period
Cash and cash equivalents	11,546,000	7,050,000
Restricted cash	118,000	118,000
Cash, cash equivalents, and restricted cash at end of period	$ 11,664,000	$ 7,168,000

Note 1 - Basis of Presentation

Note 1 - Basis of Presentation	9 Months Ended
	Sep. 30, 2022
Notes to Financial Statements
Organization, Consolidation and Presentation of Financial Statements Disclosure [Text Block]	Note 1. Basis of Presentation In the opinion of the management of American Shared Hospital Services (“ASHS”), the accompanying unaudited condensed consolidated financial statements contain all adjustments necessary for the fair presentation of ASHS consolidated financial position as of September 30, 2022 three nine September 30, 2022 2021 nine September 30, 2022 2021 three nine September 30, 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 ASHS and its subsidiaries (the “Company”) as follows: ASHS wholly owns the subsidiaries American Shared Radiosurgery Services (“ASRS”), PBRT Orlando, LLC (“Orlando”), OR21, The Company (through ASRS) and Elekta AB (“Elekta”), 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, 2022 twelve 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 On April 27, 2022, y (“Newco”) to 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. Impact of the COVID- 19 2021, 19 2020. not 2020. December 31, 2021, 19, 2021 19 Despite a decrease in volumes for the three nine September 30, 2022 domestic Gamma Knife volumes for existing customers rebounded to pre-pandemic levels. This decrease in volume was due to normal, cyclical fluctuations and the Company does not 19 three nine September 30, 2022 2022. T 19, 2021 three nine September 30, 2022 19 may may 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 Revenue recognition 842 Leases 842” 606 Revenue from Contracts with Customers 606” Rental income from medical services 842 not ten third three nine September 30, 2022 842. Patient income 606, no 30 30 60 not not September 30, 2022 December 31, 2021 September 30, 2022 not December 31, 2021 three nine September 30, 2022 606. Business segment information 280 Segment Reporting 280” two thirteen two September 30, 2022 two two The revenues and profit or loss, allocations for the Company’s two three nine September 30, 2022 2021 Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Revenues Domestic $ 4,101,000 $ 3,477,000 $ 12,382,000 $ 10,892,000 Foreign 727,000 622,000 2,327,000 2,047,000 Total $ 4,828,000 $ 4,099,000 $ 14,709,000 $ 12,939,000 Net income (loss) attributable to American Shared Hospital Services Domestic $ 284,000 $ 34,000 $ 1,093,000 $ (1,000 ) Foreign 32,000 (1,000 ) (11,000 ) (24,000 ) Total $ 316,000 $ 33,000 $ 1,082,000 $ (25,000 ) Reclassification three nine September 30, 2021 December 31, 2021

Note 2 - Property and Equipment

Note 2 - Property and Equipment	9 Months Ended
	Sep. 30, 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 between three ten 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, 2022 December 31, 2021 September 30, December 31, 2022 2021 Medical equipment and facilities $ 73,679,000 $ 73,388,000 Office equipment 442,000 472,000 Construction in progress 92,000 91,000 74,213,000 73,951,000 Accumulated depreciation (49,484,000 ) (45,697,000 ) Net property and equipment $ 24,729,000 $ 28,254,000 As of September 30, 2022

Note 3 - Long-Term Debt Financi

Note 3 - Long-Term Debt Financing	9 Months Ended
	Sep. 30, 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 September 30, 2022 December 31, 2021 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 September 30, 2022 The loan entered into with United States International Development Finance Corporation (“DFC”) in connection with the acquisition of GKCE in June 2020 ( 29 September 30, 2022 September 30, 2022 December 31, 2021 As of September 30, 2022 September 30, 2022 Year ending December 31, Principal 2022 (excluding the nine-months ended September 30, 2022) $ 55,000 2023 1,719,000 2024 2,094,000 2025 2,469,000 2026 7,595,000 Thereafter 164,000 $ 14,096,000

Note 4 - Other Accrued Liabilit

Note 4 - Other Accrued Liabilities	9 Months Ended
	Sep. 30, 2022
Notes to Financial Statements
Other Liabilities Disclosure [Text Block]	N ote 4. Other Accrued Liabilities Other accrued liabilities consist of the following as of September 30, 2022 December 31, 2021 September 30, December 31, 2022 2021 Equipment maintenance and upgrades $ — $ 367,000 Insurance - 340,000 Professional services 116,000 90,000 Operating costs 702,000 397,000 Other 304,000 311,000 Total other accrued liabilities $ 1,122,000 $ 1,505,000

Note 5 - Leases

Note 5 - Leases	9 Months Ended
	Sep. 30, 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, 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 no September 30, 2022 The following table summarizes maturities of lessee operating lease liabilities as of September 30, 2022 Year ending December 31, Operating Leases 2022 (excluding the nine-months ended September 30, 2022) $ 103,000 2023 302,000 2024 58,000 Total lease payments 463,000 Less imputed interest (15,000 ) Total $ 448,000 Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Lease cost Operating lease cost, net of impairment $ 102,000 $ 87,000 $ 303,000 $ 258,000 Sublease income (43,000 ) - (129,000 ) - Total lease cost $ 59,000 $ 87,000 $ 174,000 $ 258,000 Other information Cash paid for amounts included in the measurement of lease liabilities - Operating leases $ 102,000 $ 87,000 $ 303,000 $ 258,000 Weighted-average remaining lease term - Operating leases in years 1.30 1.99 1.30 1.99 Weighted-average discount rate - Operating leases 5.71 % 6.15 % 5.71 % 6.15 %

Note 6 - Per Share Amounts

Note 6 - Per Share Amounts	9 Months Ended
	Sep. 30, 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. Based on the guidance provided in accordance with ASC 260 Earnings Per Share 260” not nine September 30, 2021 not The computation for the three nine September 30, 2022 y 91,000 and 91,000, respectively, of the Company’s stock options b three September 30, 2021 y 346,000 of the Company’s stock options b three nine September 30, 2022 three September 30, 2021 The following table sets forth the computation of basic and diluted earnings per share for the three nine September 30, 2022 2021 Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Net income (loss) attributable to American Shared Hospital Services $ 316,000 $ 33,000 $ 1,082,000 $ (25,000 ) Weighted average common shares for basic earnings (loss) per share 6,234,000 6,103,000 6,223,000 5,824,000 Dilutive effect of stock options and restricted stock awards 39,000 20,000 38,000 - Weighted average common shares for diluted earnings (loss) per share 6,273,000 6,123,000 6,261,000 5,824,000 Basic earnings (loss) per share $ 0.05 $ 0.01 $ 0.17 $ (0.00 ) Diluted earnings (loss) per share $ 0.05 $ 0.01 $ 0.17 $ (0.00 )

Note 7 - Stock-based Compensati

Note 7 - Stock-based Compensation	9 Months Ended
	Sep. 30, 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 and $235,000 three nine September 30, 2022 i September 30, 2022 $84,000 o five The following table summarizes stock option activity for the nine September 30, 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 $ - Granted 50,000 $ 2.72 5.00 $ - Exercised (2,000 ) $ 2.70 - $ - Forfeited (7,000 ) $ 2.58 - $ - Outstanding at September 30, 2022 108,000 $ 2.73 4.85 $ 9,000 Exercisable at September 30, 2022 50,000 $ 2.74 2.74 $ - 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 September 30, 2021 394,000 $ 2.80 0.90 $ 17,000 Exercisable at September 30, 2021 383,000 $ 2.80 0.77 $ -

Note 8 - Income Taxes

Note 8 - Income Taxes	9 Months Ended
	Sep. 30, 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 nine September 30, 2022 2021

Note 9 - Commitments and Contin

Note 9 - Commitments and Contingencies	9 Months Ended
	Sep. 30, 2022
Notes to Financial Statements
Commitments and Contingencies Disclosure [Text Block]	Note 9. Commitments On December 20, 2018, two second third second third not second third no 2023. could forfeit its deposits December 31, 2020 September 30, 2022 two S250i As of September 30, 2022 four two three one first 2023, between 2023 2024. first 2023, September 30, 2022 were $13,243,000. It is the Company’s intent to finance these commitments. There are no 12 no and a line of credit of $7,000,000 to fund these projects. On September 4, 2022, September 2022 April 2026. one one As of September 30, 2022 , the Company had commitments to service and maintain its Gamma Knife and PBRT equipment. The service commitments are carried out via contracts with Mevion, Elekta and Mobius Imaging, LLC. In addition, in April 2019, 2023 2024. two September 30, 2022 $17,166,000

Note 10 - Related Party Transac

Note 10 - Related Party Transactions	9 Months Ended
	Sep. 30, 2022
Notes to Financial Statements
Related Party Transactions Disclosure [Text Block]	Note 10. Related Party Transactions The Company’s Gamma Knife business is operated through its 81% indirect interest in its GKF subsidiary. The remaining 19% of GKF is owned by a wholly owned U.S. subsidiary of Elekta, which is the manufacturer of the Gamma Knife. Since the Company purchases its Gamma Knife units from Elekta, there are significant related party transactions with Elekta such as equipment purchases, commitments to purchase and service equipment, and costs to maintain the equipment. The Company believes that all its transactions with Elekta are arm’s-length transactions. The following table summarizes related party activity for the three nine September 30, 2022 2021 Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Equipment purchases and de-install costs $ 231,000 $ 97,000 $ 1,594,000 $ 1,616,000 Costs incurred to maintain equipment 272,000 125,000 820,000 593,000 Total related party transactions $ 503,000 $ 222,000 $ 2,414,000 $ 2,209,000 The Company also had commitments to purchase one four two $10,551,000 as of September 30, 2022 and one four December 31, 2021 September 30, 2022 December 31, 2021 60 fourth 2021, Related party liabilities consist of the following as of September 30, 2022 December 31, 2021 September 30, December 31, 2022 2021 Commitments $ 10,551,000 $ 6,624,000 Accounts payable and other accrued liabilities $ 748,000 $ 1,992,000

Significant Accounting Policies

Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2022
Accounting Policies [Abstract]
Basis of Accounting, Policy [Policy Text Block]	In the opinion of the management of American Shared Hospital Services (“ASHS”), the accompanying unaudited condensed consolidated financial statements contain all adjustments necessary for the fair presentation of ASHS consolidated financial position as of September 30, 2022 three nine September 30, 2022 2021 nine September 30, 2022 2021 three nine September 30, 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 ASHS and its subsidiaries (the “Company”) as follows: ASHS wholly owns the subsidiaries American Shared Radiosurgery Services (“ASRS”), PBRT Orlando, LLC (“Orlando”), OR21, The Company (through ASRS) and Elekta AB (“Elekta”), 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, 2022 twelve 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 On April 27, 2022, y (“Newco”) to 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. Impact of the COVID- 19 2021, 19 2020. not 2020. December 31, 2021, 19, 2021 19 Despite a decrease in volumes for the three nine September 30, 2022 domestic Gamma Knife volumes for existing customers rebounded to pre-pandemic levels. This decrease in volume was due to normal, cyclical fluctuations and the Company does not 19 three nine September 30, 2022 2022. T 19, 2021 three nine September 30, 2022 19 may may
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
Revenue [Policy Text Block]	Revenue recognition 842 Leases 842” 606 Revenue from Contracts with Customers 606” Rental income from medical services 842 not ten third three nine September 30, 2022 842. Patient income 606, no 30 30 60 not not September 30, 2022 December 31, 2021 September 30, 2022 not December 31, 2021 three nine September 30, 2022 606.
Segment Reporting, Policy [Policy Text Block]	Business segment information 280 Segment Reporting 280” two thirteen two September 30, 2022 two two The revenues and profit or loss, allocations for the Company’s two three nine September 30, 2022 2021 Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Revenues Domestic $ 4,101,000 $ 3,477,000 $ 12,382,000 $ 10,892,000 Foreign 727,000 622,000 2,327,000 2,047,000 Total $ 4,828,000 $ 4,099,000 $ 14,709,000 $ 12,939,000 Net income (loss) attributable to American Shared Hospital Services Domestic $ 284,000 $ 34,000 $ 1,093,000 $ (1,000 ) Foreign 32,000 (1,000 ) (11,000 ) (24,000 ) Total $ 316,000 $ 33,000 $ 1,082,000 $ (25,000 )
Reclassification, Comparability Adjustment [Policy Text Block]	Reclassification three nine September 30, 2021 December 31, 2021

Note 1 - Basis of Presentation

Note 1 - Basis of Presentation (Tables)	9 Months Ended
	Sep. 30, 2022
Notes Tables
Reconciliation of Revenue from Segments to Consolidated [Table Text Block]	Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Revenues Domestic $ 4,101,000 $ 3,477,000 $ 12,382,000 $ 10,892,000 Foreign 727,000 622,000 2,327,000 2,047,000 Total $ 4,828,000 $ 4,099,000 $ 14,709,000 $ 12,939,000 Net income (loss) attributable to American Shared Hospital Services Domestic $ 284,000 $ 34,000 $ 1,093,000 $ (1,000 ) Foreign 32,000 (1,000 ) (11,000 ) (24,000 ) Total $ 316,000 $ 33,000 $ 1,082,000 $ (25,000 )

Note 2 - Property and Equipme_2

Note 2 - Property and Equipment (Tables)	9 Months Ended
	Sep. 30, 2022
Notes Tables
Property, Plant and Equipment [Table Text Block]	September 30, December 31, 2022 2021 Medical equipment and facilities $ 73,679,000 $ 73,388,000 Office equipment 442,000 472,000 Construction in progress 92,000 91,000 74,213,000 73,951,000 Accumulated depreciation (49,484,000 ) (45,697,000 ) Net property and equipment $ 24,729,000 $ 28,254,000

Note 3 - Long-Term Debt Finan_2

Note 3 - Long-Term Debt Financing (Tables)	9 Months Ended
	Sep. 30, 2022
Notes Tables
Schedule of Maturities of Long-Term Debt [Table Text Block]	Year ending December 31, Principal 2022 (excluding the nine-months ended September 30, 2022) $ 55,000 2023 1,719,000 2024 2,094,000 2025 2,469,000 2026 7,595,000 Thereafter 164,000 $ 14,096,000

Note 4 - Other Accrued Liabil_2

Note 4 - Other Accrued Liabilities (Tables)	9 Months Ended
	Sep. 30, 2022
Notes Tables
Other Liabilities [Table Text Block]	September 30, December 31, 2022 2021 Equipment maintenance and upgrades $ — $ 367,000 Insurance - 340,000 Professional services 116,000 90,000 Operating costs 702,000 397,000 Other 304,000 311,000 Total other accrued liabilities $ 1,122,000 $ 1,505,000

Note 5 - Leases (Tables)

Note 5 - Leases (Tables)	9 Months Ended
	Sep. 30, 2022
Notes Tables
Lessee, Operating Lease, Liability, Maturity [Table Text Block]	Year ending December 31, Operating Leases 2022 (excluding the nine-months ended September 30, 2022) $ 103,000 2023 302,000 2024 58,000 Total lease payments 463,000 Less imputed interest (15,000 ) Total $ 448,000
Lease, Cost [Table Text Block]	Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Lease cost Operating lease cost, net of impairment $ 102,000 $ 87,000 $ 303,000 $ 258,000 Sublease income (43,000 ) - (129,000 ) - Total lease cost $ 59,000 $ 87,000 $ 174,000 $ 258,000 Other information Cash paid for amounts included in the measurement of lease liabilities - Operating leases $ 102,000 $ 87,000 $ 303,000 $ 258,000 Weighted-average remaining lease term - Operating leases in years 1.30 1.99 1.30 1.99 Weighted-average discount rate - Operating leases 5.71 % 6.15 % 5.71 % 6.15 %

Note 6 - Per Share Amounts (Tab

Note 6 - Per Share Amounts (Tables)	9 Months Ended
	Sep. 30, 2022
Notes Tables
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Net income (loss) attributable to American Shared Hospital Services $ 316,000 $ 33,000 $ 1,082,000 $ (25,000 ) Weighted average common shares for basic earnings (loss) per share 6,234,000 6,103,000 6,223,000 5,824,000 Dilutive effect of stock options and restricted stock awards 39,000 20,000 38,000 - Weighted average common shares for diluted earnings (loss) per share 6,273,000 6,123,000 6,261,000 5,824,000 Basic earnings (loss) per share $ 0.05 $ 0.01 $ 0.17 $ (0.00 ) Diluted earnings (loss) per share $ 0.05 $ 0.01 $ 0.17 $ (0.00 )

Note 7 - Stock-based Compensa_2

Note 7 - Stock-based Compensation (Tables)	9 Months Ended
	Sep. 30, 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 $ - Granted 50,000 $ 2.72 5.00 $ - Exercised (2,000 ) $ 2.70 - $ - Forfeited (7,000 ) $ 2.58 - $ - Outstanding at September 30, 2022 108,000 $ 2.73 4.85 $ 9,000 Exercisable at September 30, 2022 50,000 $ 2.74 2.74 $ - 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 September 30, 2021 394,000 $ 2.80 0.90 $ 17,000 Exercisable at September 30, 2021 383,000 $ 2.80 0.77 $ -

Note 10 - Related Party Trans_2

Note 10 - Related Party Transactions (Tables)	9 Months Ended
	Sep. 30, 2022
Notes Tables
Schedule of Related Party Transactions [Table Text Block]	Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Equipment purchases and de-install costs $ 231,000 $ 97,000 $ 1,594,000 $ 1,616,000 Costs incurred to maintain equipment 272,000 125,000 820,000 593,000 Total related party transactions $ 503,000 $ 222,000 $ 2,414,000 $ 2,209,000 September 30, December 31, 2022 2021 Commitments $ 10,551,000 $ 6,624,000 Accounts payable and other accrued liabilities $ 748,000 $ 1,992,000

Note 1 - Basis of Presentatio_2

Note 1 - Basis of Presentation (Details Textual)	3 Months Ended		9 Months Ended
	Sep. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Apr. 27, 2022	Dec. 31, 2021 USD ($)
Number of Reportable Segments			2
GK Peru [Member]
Accounts Receivable, Related Parties	$ 1,046,000		$ 1,046,000			$ 0
Newco [Member]
Equity Method Investment, Ownership Percentage					85%
OR21, LLC [Member]
Equity Method Investment, Ownership Percentage	50%		50%
Guadalupe [Member] | Newco [Member]
Equity Method Investment, Ownership Percentage					15%
Architectural Design Company [Member] | OR21, LLC [Member]
Equity Method Investment, Ownership Percentage	50%		50%
Gamma Knife Center Ecuador S.A. (GKCE) [Member] | Gamma Knife Units [Member]
Number of Medical Centers	12		12
Rental Income from Medical Services [Member]
Revenue from Contract with Customer, Including Assessed Tax	$ 4,101,000	$ 3,477,000	$ 12,382,000	$ 10,892,000
Patient Income [Member]
Revenue from Contract with Customer, Including Assessed Tax	$ 727,000	$ 622,000	$ 2,327,000	$ 2,047,000
Gamma Knife and PBRT Equipment [Member]
Number of Medical Centers	13		13
Lima, Peru and Guayaquil, Ecuador [Member]
Number of Single-unit Facilities	2		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		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Revenues	$ 4,828,000	$ 4,099,000	$ 14,709,000	$ 12,939,000
Net income (loss)	316,000	33,000	1,082,000	(25,000)
Domestic Segment [Member]
Revenues	4,101,000	3,477,000	12,382,000	10,892,000
Net income (loss)	284,000	34,000	1,093,000	(1,000)
Foreign Segment [Member]
Revenues	727,000	622,000	2,327,000	2,047,000
Net income (loss)	$ 32,000	$ (1,000)	$ (11,000)	$ (24,000)

Note 2 - Property and Equipme_3

Note 2 - Property and Equipment (Details Textual)	9 Months Ended
	Sep. 30, 2022 USD ($)
Non-US [Member]
Property, Plant, and Equipment and Finance Lease Right-of-Use Asset, after Accumulated Depreciation and Amortization, Total	$ 2,320,000
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 ($)	Sep. 30, 2022	Dec. 31, 2021
Property and equipment, gross	$ 74,213,000	$ 73,951,000
Accumulated depreciation	(49,484,000)	(45,697,000)
Net property and equipment	24,729,000	28,254,000
Medical Equipment and Facilities [Member]
Property and equipment, gross	73,679,000	73,388,000
Office Equipment [Member]
Property and equipment, gross	442,000	472,000
Construction in Progress [Member]
Property and equipment, gross	$ 92,000	$ 91,000

Note 3 - Long-Term Debt Finan_3

Note 3 - Long-Term Debt Financing (Details Textual)		3 Months Ended	9 Months Ended		12 Months Ended
	Apr. 09, 2021 USD ($)	Mar. 31, 2021 USD ($)	Sep. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Dec. 31, 2021 USD ($)	Dec. 31, 2022
Finance Lease, Principal Payments			$ 0	$ 8,919,000
Long-Term Debt, Total			13,878,000
Debt Issuance Costs, Net, Total			218,000
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
Long-Term Debt, Total			13,000,000		$ 14,437,000
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%
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%
DFC Loan [Member]
Long-Term Debt, Total			$ 1,096,000		$ 1,261,000
Debt Instrument, Interest Rate, Stated Percentage			3.67%

Note 3 - Long-Term Debt Finan_4

Note 3 - Long-Term Debt Financing - Long-term Debt Maturities (Details)	Sep. 30, 2022 USD ($)
2022 (excluding the nine-months ended September 30, 2022)	$ 55,000
2023	1,719,000
2024	2,094,000
2025	2,469,000
2026	7,595,000
Thereafter	164,000
Long-Term Debt, Gross	$ 14,096,000

Note 4 - Other Accrued Liabil_3

Note 4 - Other Accrued Liabilities - Other Accrued Liabilities (Details) - USD ($)	Sep. 30, 2022	Dec. 31, 2021
Equipment maintenance and upgrades	$ 0	$ 367,000
Insurance	0	340,000
Professional services	116,000	90,000
Operating costs	702,000	397,000
Other	304,000	311,000
Total other accrued liabilities	$ 1,122,000	$ 1,505,000

Note 5 - Leases (Details Textua

Note 5 - Leases (Details Textual)		1 Months Ended
	Nov. 03, 2021 USD ($) ft²	Dec. 01, 2021 USD ($)	Sep. 30, 2022 USD ($)	Dec. 31, 2021 USD ($)
Operating Lease, Right-of-Use Asset			$ 402,000	$ 654,000
Operating Lease, Liability, Total			$ 448,000
Minimum [Member]
Lessee, Operating Lease, Discount Rate			4%
Lessee, Operating Lease, Remaining Lease Term (Year)			2 years
Maximum [Member]
Lessee, Operating Lease, Discount Rate			6%
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	$ 22,011
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)	Sep. 30, 2022 USD ($)
2022 (excluding the nine-months ended September 30, 2022)	$ 103,000
2023	302,000
2024	58,000
Total lease payments	463,000
Less imputed interest	(15,000)
Total	$ 448,000

Note 5 - Leases - Lease Cost an

Note 5 - Leases - Lease Cost and Information (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Operating lease cost, net of impairment	$ 102,000	$ 87,000	$ 303,000	$ 258,000
Sublease income	(43,000)	0	(129,000)	0
Total lease cost	59,000	87,000	174,000	258,000
Cash paid for amounts included in the measurement of lease liabilities - Operating leases	$ 102,000	$ 87,000	$ 303,000	$ 258,000
Weighted-average remaining lease term - Operating leases in years (Year)	1 year 3 months 18 days	1 year 11 months 26 days	1 year 3 months 18 days	1 year 11 months 26 days
Weighted-average discount rate - Operating leases	5.71%	6.15%	5.71%	6.15%

Note 6 - Per Share Amounts (Det

Note 6 - Per Share Amounts (Details Textual) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Incremental Common Shares Attributable to Dilutive Effect of Share-Based Payment Arrangements (in shares)	39,000	20,000	38,000	0
Share-Based Payment Arrangement, Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount (in shares)	91,000	346,000	91,000	48,000
Restricted Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount (in shares)				13,000
Incremental Common Shares Attributable to Dilutive Effect of Share-Based Payment Arrangements (in shares)	123,000	235,000	123,000

Note 6 - Per Share Amounts - Co

Note 6 - Per Share Amounts - Computation of Basic and Diluted Earnings Per Share (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Net income (loss) attributable to American Shared Hospital Services	$ 316,000	$ 33,000	$ 1,082,000	$ (25,000)
Weighted average common shares for basic earnings (loss) per share (in shares)	6,234,000	6,103,000	6,223,000	5,824,000
Dilutive effect of stock options and restricted stock awards (in shares)	39,000	20,000	38,000	0
Weighted average common shares for diluted earnings (loss) per share (in shares)	6,273,000	6,123,000	6,261,000	5,824,000
Basic earnings (loss) per share (in dollars per share)	$ 0.05	$ 0.01	$ 0.17	$ 0
Diluted earnings (loss) per share (in dollars per share)	$ 0.05	$ 0.01	$ 0.17	$ 0

Note 7 - Stock-based Compensa_3

Note 7 - Stock-based Compensation (Details Textual) - Incentive Compensation Plan [Member] - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Jun. 30, 2021
Common Stock, Capital Shares Reserved for Future Issuance (in shares)					2,580,000
Share-Based Payment Arrangement, Expense	$ 76,000	$ 109,000	$ 235,000	$ 312,000
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount, Total	$ 84,000		$ 84,000
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year)			5 years

Note 7 - Stock-based Compensa_4

Note 7 - Stock-based Compensation - Summary of Stock Option Activity (Details) - USD ($)	9 Months Ended		12 Months Ended
	Sep. 30, 2022	Sep. 30, 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)		10 months 24 days	3 years 3 months 29 days	1 year 7 months 9 days
Granted (in shares)	50,000	6,000
Granted (in dollars per share)	$ 2.72	$ 2.92
Granted (Year)	5 years	7 years
Exercised (in shares)	(2,000)	(22,000)
Exercised (in dollars per share)	$ 2.70	$ 2.65
Forfeited (in shares)	(7,000)	(7,000)
Forfeited (in dollars per share)	$ 2.58	$ 2.51
Outstanding, intrinsic value		$ 17,000		$ 2,000
Exercisable (in shares)	50,000	383,000
Exercisable, grant date weighted-average exercise price (in dollars per share)	$ 2.74	$ 2.80
Exercisable, weighted average remaining contractual life (Year)		9 months 7 days
Outstanding (in shares)	108,000	394,000	67,000	417,000
Outstanding, grant date weighted-average exercise price (in dollars per share)	$ 2.73	$ 2.80	$ 2.72	$ 2.79
Minimum [Member]
Outstanding, weighted average remaining contractual life (Year)	4 years 10 months 6 days
Exercisable, weighted average remaining contractual life (Year)	2 years 8 months 26 days
Maximum [Member]
Outstanding, intrinsic value	$ 9,000

Note 9 - Commitments and Cont_2

Note 9 - Commitments and Contingencies (Details Textual)		9 Months Ended	12 Months Ended
	Sep. 04, 2022 USD ($)	Sep. 30, 2022 USD ($)	Dec. 31, 2021 USD ($)
Number Of Purchase Commitments			2
Leksell Gamma Knife Icon Systems and Linear Accelerator System [Member]
Long-term Install Service and Purchase Commitment, Amount		$ 13,243,000
Long-term Commitment, Cash on Hand to Fund		11,664,000
Long-term Commitment, Line of Credit to Fund		7,000,000
LINAC System [Member]
Long-Term Service Commitment, Amount		$ 17,166,000
LINAC System [Member] | Maximum [Member]
Long-Term Service Commitment, Period (Year)		9 years
LINAC System [Member] | Minimum [Member]
Long-Term Service Commitment, Period (Year)		5 years
Mevion PBRT Units [Member] | Upgrade and Purchase MEVION Systems [Member]
Long-term Purchase Commitment, Amount			$ 34,000,000
Mevion Medical Systems Inc [Member] | Maintenance And Support Agreement, Mevion Service Agreement [Member]
Purchase Agreement Annual Prepayment	$ 1,800,000
Long-term Purchase Commitment, Period (Year)	1 year

Note 10 - Related Party Trans_3

Note 10 - Related Party Transactions (Details Textual) - USD ($)	Sep. 30, 2022	Dec. 31, 2021
US Subsidiary Of Elekta Member
Purchase Obligation, Total	$ 10,551,000	$ 6,624,000
Due to Related Parties, Total	$ 748,000	$ 1,992,000
GKF Subsidiary [Member]
Noncontrolling Interest, Ownership Percentage by Parent	81%
US Subsidiary Of Elekta Member
Noncontrolling Interest, Ownership Percentage by Parent	19%

Note 10 - Related Party Trans_4

Note 10 - Related Party Transactions - Schedule of Related Party Transactions (Details) - US Subsidiary Of Elekta Member - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Equipment purchases and de-install costs	$ 231,000	$ 97,000	$ 1,594,000	$ 1,616,000
Costs incurred to maintain equipment	272,000	125,000	820,000	593,000
Total related party transactions	503,000	$ 222,000	2,414,000	$ 2,209,000
Commitments	10,551,000		10,551,000		$ 6,624,000
Accounts payable and other accrued liabilities	$ 748,000		$ 748,000		$ 1,992,000