American Shared Hospital Services (AMS) 10-Q 14 Aug 24 2024 Q2 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	6 Months Ended
	Jun. 30, 2024	Aug. 09, 2024
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	2024
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2024
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		6,360,000

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Current Period Unaudited) - USD ($)	Jun. 30, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 14,236,000	$ 13,690,000
Restricted cash	250,000	118,000
Accounts receivable, net of allowance for credit losses of $100,000 at June 30, 2024 and at December 31, 2023	8,606,000	4,343,000
Other receivables	991,000	504,000
Due from expired customer contract	500,000	0
Prepaid maintenance	433,000	1,275,000
Prepaid expenses and other current assets	623,000	526,000
Total current assets	25,639,000	20,456,000
Property and equipment, net	32,994,000	25,844,000
Land	19,000	19,000
Goodwill	1,265,000	1,265,000
Intangible asset	78,000	78,000
Right of use assets, net	631,000	57,000
Other assets	199,000	443,000
Total assets	60,825,000	48,162,000
Current liabilities:
Accounts payable	859,000	315,000
Employee compensation and benefits	908,000	757,000
Other accrued liabilities	2,398,000	1,226,000
Asset retirement obligations, related party (includes $271,000 and $250,000 non-related party at June 30, 2024 and December 31, 2023)	1,338,000	650,000
Income taxes payable	0	1,229,000
Current portion of lease liabilities	242,000	57,000
Line of credit	3,950,000	2,500,000
Current portion of long-term debt, net	3,033,000	2,084,000
Total current liabilities	13,336,000	10,779,000
Long-term lease liabilities, less current portion	1,615,000	0
Long-term debt, net, less current portion	12,050,000	11,041,000
Deferred income taxes	1,472,000	63,000
Total liabilities	28,473,000	21,883,000
Commitments (see Note 9)
Shareholders' equity:
Common stock, no par value (10,000,000 authorized shares; Issued and outstanding shares - 6,360,000 at June 30, 2024 and 6,300,000 at December 31, 2023)	10,763,000	10,763,000
Additional paid-in capital	8,429,000	8,232,000
Retained earnings	7,350,000	3,629,000
Total equity-American Shared Hospital Services	26,542,000	22,624,000
Non-controlling interests in subsidiaries	5,810,000	3,655,000
Total shareholders' equity	32,352,000	26,279,000
Total liabilities and shareholders' equity	60,825,000	48,162,000
Related Party [Member]
Current liabilities:
Related party liabilities	$ 608,000	$ 1,961,000

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - USD ($) $ / shares in Thousands	Jun. 30, 2024	Dec. 31, 2023
Allowance for doubtful accounts	$ 100,000	$ 100,000
Asser retirement obligations, non-related party	$ 271,000	$ 250,000
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)	6,360,000	6,300,000
Common stock, shares outstanding (in shares)	6,360,000	6,300,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (Unaudited) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Revenues	$ 7,056,000	$ 5,568,000	$ 12,272,000	$ 10,493,000
Costs of revenue:
Maintenance and supplies	545,000	505,000	1,058,000	991,000
Depreciation and amortization	1,455,000	1,227,000	2,752,000	2,584,000
Other direct operating costs	2,418,000	1,023,000	3,511,000	1,902,000
Other direct operating costs, related party	170,000	295,000	340,000	590,000
Cost of Revenue	4,588,000	3,050,000	7,661,000	6,067,000
Gross margin	2,468,000	2,518,000	4,611,000	4,426,000
Selling and administrative expense	1,896,000	1,988,000	3,775,000	3,527,000
Interest expense	385,000	277,000	734,000	548,000
Loss on write down of impaired assets and associated removal costs, net	188,000	578,000	188,000	578,000
Operating (loss)	(1,000)	(325,000)	(86,000)	(227,000)
Bargain purchase gain RI Acquisition, net of deferred income taxes of $1,226,000	3,679,000	0	3,679,000	0
Interest and other income, net	59,000	113,000	165,000	183,000
Income (loss) before income taxes	3,737,000	(212,000)	3,758,000	(44,000)
Income tax expense (benefit)	(31,000)	(35,000)	(75,000)	33,000
Net income (loss)	3,768,000	(177,000)	3,833,000	(77,000)
Plus (less): net (income) loss attributable to non-controlling interests	(166,000)	66,000	(112,000)	154,000
Net income (loss) attributable to American Shared Hospital Services	$ 3,602,000	$ (111,000)	$ 3,721,000	$ 77,000
Net income (loss) per share:
Basic earnings (loss) per share (in dollars per share)	$ 0.56	$ (0.02)	$ 0.58	$ 0.01
Diluted earnings (loss) per share (in dollars per share)	$ 0.55	$ (0.02)	$ 0.57	$ 0.01
Weighted average common shares for basic earnings (loss) per share (in shares)	6,482,000	6,336,000	6,467,000	6,336,000
Weighted average common shares for diluted earnings per share (in shares)	6,583,000	6,336,000	6,564,000	6,465,000
Rental Income from Medical Services [Member]
Revenues	$ 3,899,000	$ 4,812,000	$ 8,152,000	$ 9,041,000
Patient Income [Member]
Revenues	$ 3,157,000	$ 756,000	$ 4,120,000	$ 1,452,000

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Operations (Unaudited) (Parentheticals) - USD ($)	3 Months Ended	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2024
Deferred income taxes	$ 1,226,000	$ 1,226,000

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Shareholders' Equity (Unaudited) - USD ($)	Restricted Stock [Member] Common Stock [Member]	Restricted Stock [Member]	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	Parent [Member]	Noncontrolling Interest [Member]	Total
Balances (in shares) at Dec. 31, 2022			6,184,000
Balances at Dec. 31, 2022			$ 10,763,000	$ 7,843,000	$ 3,019,000	$ 21,625,000	$ 4,000,000	$ 25,625,000
Stock-based compensation expense				96,000		96,000		96,000
Net income (loss)					188,000	188,000	(88,000)	100,000
Balances (in shares) at Mar. 31, 2023			6,184,000
Balances at Mar. 31, 2023			$ 10,763,000	7,939,000	3,207,000	21,909,000	3,912,000	25,821,000
Balances (in shares) at Dec. 31, 2022			6,184,000
Balances at Dec. 31, 2022			$ 10,763,000	7,843,000	3,019,000	21,625,000	4,000,000	25,625,000
Net income (loss)								(77,000)
Non-controlling interest RI Acquisition								0
Balances (in shares) at Jun. 30, 2023			6,214,000
Balances at Jun. 30, 2023			$ 10,763,000	8,036,000	3,096,000	21,895,000	3,846,000	25,741,000
Balances (in shares) at Mar. 31, 2023			6,184,000
Balances at Mar. 31, 2023			$ 10,763,000	7,939,000	3,207,000	21,909,000	3,912,000	25,821,000
Stock-based compensation expense				97,000		97,000		97,000
Net income (loss)			$ 0	0	(111,000)	(111,000)	(66,000)	(177,000)
Vested restricted stock awards (in shares)	30,000
Vested restricted stock awards		$ 0
Balances (in shares) at Jun. 30, 2023			6,214,000
Balances at Jun. 30, 2023			$ 10,763,000	8,036,000	3,096,000	21,895,000	3,846,000	$ 25,741,000
Balances (in shares) at Dec. 31, 2023			6,300,000					6,300,000
Balances at Dec. 31, 2023			$ 10,763,000	8,232,000	3,629,000	22,624,000	3,655,000	$ 26,279,000
Stock-based compensation expense				98,000		98,000		98,000
Net income (loss)					119,000	119,000	(54,000)	65,000
Vested restricted stock awards (in shares)			30,000
Vested restricted stock awards			$ 0	0	0	0	0	0
Capital contribution non-controlling interests			$ 0	0	0	0	38,000	38,000
Cash distributions to non-controlling interests							(95,000)	(95,000)
Balances (in shares) at Mar. 31, 2024			6,330,000
Balances at Mar. 31, 2024			$ 10,763,000	8,330,000	3,748,000	22,841,000	3,544,000	$ 26,385,000
Balances (in shares) at Dec. 31, 2023			6,300,000					6,300,000
Balances at Dec. 31, 2023			$ 10,763,000	8,232,000	3,629,000	22,624,000	3,655,000	$ 26,279,000
Net income (loss)								3,833,000
Non-controlling interest RI Acquisition								$ 2,100,000
Balances (in shares) at Jun. 30, 2024			6,360,000					6,360,000
Balances at Jun. 30, 2024			$ 10,763,000	8,429,000	7,350,000	26,542,000	5,810,000	$ 32,352,000
Balances (in shares) at Mar. 31, 2024			6,330,000
Balances at Mar. 31, 2024			$ 10,763,000	8,330,000	3,748,000	22,841,000	3,544,000	26,385,000
Stock-based compensation expense				99,000		99,000		99,000
Net income (loss)			$ 0	0	3,602,000	3,602,000	166,000	3,768,000
Vested restricted stock awards (in shares)			30,000
Vested restricted stock awards			$ 0	0	0	0	0	0
Non-controlling interest RI Acquisition			$ 0	0	0	0	2,100,000	$ 2,100,000
Balances (in shares) at Jun. 30, 2024			6,360,000					6,360,000
Balances at Jun. 30, 2024			$ 10,763,000	$ 8,429,000	$ 7,350,000	$ 26,542,000	$ 5,810,000	$ 32,352,000

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Operating activities:
Net income (loss)	$ 3,768,000	$ (177,000)	$ 3,833,000	$ (77,000)
Adjustments to reconcile net income (loss) to net cash from operating activities:
Depreciation, amortization, and other	1,523,000	1,252,000	2,857,000	2,609,000
Loss on write down of impaired assets and associated removal costs, net	188,000	578,000	188,000	578,000
Accretion of debt issuance costs	20,000	19,000	58,000	37,000
Bargain purchase gain RI Acquisition, net of deferred income taxes	(3,679,000)	0	(3,679,000)	0
Non cash lease expense			35,000	171,000
Deferred income taxes			183,000	0
Stock-based compensation expense			197,000	193,000
Changes in operating assets and liabilities:
Receivables			(3,831,000)	(1,187,000)
Prepaid expenses and other assets			977,000	1,230,000
Asset retirement obligations, related party			0	578,000
Related party liabilities			(1,877,000)	656,000
Accounts payable, accrued liabilities, and deferred revenue			1,744,000	627,000
Income taxes payable			(1,229,000)	0
Lease liabilities			(35,000)	(201,000)
Net cash (used in) provided by operating activities			(579,000)	5,214,000
Investing activities:
Payment for RI Acquisition, net of cash received			363,000	0
Payment for purchases of property and equipment			(2,399,000)	(2,561,000)
Net cash used in investing activities			(2,036,000)	(2,561,000)
Financing activities:
Principal payments on long-term debt			(703,000)	(1,160,000)
Payments on line of credit			(4,950,000)	0
Advances on line of credit			6,400,000	0
Long-term debt financing			2,700,000	0
Principal payments on short-term financing			0	(152,000)
Capital contribution non-controlling interests			38,000	0
Distributions to non-controlling interests			(95,000)	0
Debt issuance costs long-term debt			(97,000)	0
Net cash provided by (used in) financing activities			3,293,000	(1,312,000)
Net change in cash, cash equivalents, and restricted cash			678,000	1,341,000
Cash, cash equivalents, and restricted cash at beginning of period			13,808,000	12,453,000
Cash, cash equivalents, and restricted cash at end of period	14,486,000	13,794,000	14,486,000	13,794,000
Supplemental cash flow disclosure
Interest			676,000	507,000
Income taxes			1,339,000	229,000
Schedule of noncash investing and financing activities
Equipment included in accounts payable and accrued liabilities			524,000	0
Non-controlling interest RI Acquisition	2,100,000		2,100,000	0
Changes to asset removal obligations, net			688,000	0
Detail of cash, cash equivalents and restricted cash at end of period
Cash and cash equivalents	14,236,000	13,676,000	14,236,000	13,676,000
Restricted cash	250,000	118,000	250,000	118,000
Cash, cash equivalents, and restricted cash at end of period	$ 14,486,000	$ 13,794,000	$ 14,486,000	$ 13,794,000

Note 1 - Basis of Presentation

Note 1 - Basis of Presentation	6 Months Ended
	Jun. 30, 2024
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 June 30, 2024 three six June 30, 2024 2023 six June 30, 2024 2023 three six June 30, 2024 not December 31, 2023 These unaudited condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements for the year ended December 31, 2023 10 April 1, 2024. These condensed consolidated financial statements include the accounts of ASHS and its subsidiaries (the “Company”) including as follows: ASHS wholly owns the subsidiaries American Shared Radiosurgery Services (“ASRS”), PBRT Orlando, LLC (“Orlando”), ASHS-Mexico, S.A. de C.V. (“ASHS-Mexico”), ASHS-Rhode Island Proton Beam Radiation Therapy, LLC, ASHS-Bristol Radiation Therapy, LLC, 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 June 30, 2024 ten two On November 10, 2023, three The parties completed the remaining closing conditions pursuant to the IPA and closed the RI Acquisition on May 7, 2024. May 7, 2024 Note 11 to the condensed consolidated financial statements for further information. On June 28, 2024, 50% not first 2025. On April 27, 2022, October 3, 2022 December 15, 2022 July 2024. three six June 30, 2024 The Company formed the subsidiaries GKPeru, Puebla, 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 SM OR21, “OR21 OR21 not two MedLeader was formed to provide continuing medical education online and through videos for doctors, nurses, and other healthcare workers. This subsidiary is not All significant intercompany accounts and transactions have been eliminated in consolidation. Accounting pronouncements issued and not yet adopted - November 2023, 2023 07 Segment Reporting (Topic 280 2023 07” 2023 07 December 15, 2023 December 15, 2024. 2023 07 may In December 2023, 2023 09 Income Taxes (Topic 740 2023 09” 2023 09 December 15, 2024. 2023 09 may Revenue recognition 842 Leases 842” 606 Revenue from Contracts with Customers 606” Rental revenue from medical equipment leasing ( leasing ) 842 not ten three six June 30, 2024 842 three six June 30, 2024 Direct patient services income ( retail 606, no 30 three six not On May 7, 2024, 606, no The Company expects to capitalize customer acquisition costs, incremental costs related to its customer contracts. The Company did not Accounts receivable balances under ASC 606 June 30, 2024 January 1, 2024 606 June 30, 2023 January 1, 2023 $1,118,000 three six June 30, 2024 Business Combinations - 805 Business Combinations 805” not ’ 11 Business segment information 280 Segment Reporting 280” two June 30, 2024 eleven June 30, 2024, two May 7, 2024, three 280 may two For the six June 30, 2024 two June 30, 2024 2023 Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Revenues Leasing $ 3,899,000 $ 4,812,000 $ 8,152,000 $ 9,041,000 Retail 3,157,000 756,000 4,120,000 1,452,000 Total $ 7,056,000 $ 5,568,000 $ 12,272,000 $ 10,493,000 2024 2023 2024 2023 Depreciation expense Leasing $ 1,219,000 $ 1,074,000 $ 2,311,000 $ 2,254,000 Retail 304,000 178,000 546,000 355,000 Total $ 1,523,000 $ 1,252,000 $ 2,857,000 $ 2,609,000 2024 2023 2024 2023 Interest expense Leasing $ 352,000 $ 277,000 $ 668,000 $ 548,000 Retail 33,000 - 66,000 - Total $ 385,000 $ 277,000 $ 734,000 $ 548,000 2024 2023 2024 2023 Interest income Leasing $ 77,000 $ 110,000 $ 189,000 $ 197,000 Retail - - - - Total $ 77,000 $ 110,000 $ 189,000 $ 197,000 2024 2023 2024 2023 Income tax (benefit) expense Leasing $ 71,000 $ (51,000 ) $ 12,000 $ 10,000 Retail (102,000 ) 16,000 (87,000 ) 23,000 Total $ (31,000 ) $ (35,000 ) $ (75,000 ) $ 33,000 2024 2023 2024 2023 Net income (loss) attributable to American Shared Hospital Services Leasing $ (427,000 ) $ (26,000 ) $ (258,000 ) $ 229,000 Retail 4,029,000 (85,000 ) 3,979,000 (152,000 ) Total $ 3,602,000 $ (111,000 ) $ 3,721,000 $ 77,000 Reclassifications

Note 2 - Property and Equipment

Note 2 - Property and Equipment	6 Months Ended
	Jun. 30, 2024
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 equipment, LINAC 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 June 30, 2024 December 31, 2023 June 30, December 31, 2024 2023 Medical equipment and facilities $ 78,688,000 $ 77,150,000 Office equipment 447,000 306,000 Construction in progress 2,674,000 3,771,000 81,809,000 81,227,000 Accumulated depreciation (48,815,000 ) (55,383,000 ) Net property and equipment $ 32,994,000 $ 25,844,000 Net property and equipment held outside of the United States $ 5,760,000 $ 6,174,000 Depreciation expense in the condensed consolidated statements of operations for the three six June 30, 2024 2023 Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Depreciation expense $ 1,523,000 $ 1,252,000 $ 2,857,000 $ 2,609,000

Note 3 - Long Term Debt Financi

Note 3 - Long Term Debt Financing	6 Months Ended
	Jun. 30, 2024
Notes to Financial Statements
Long-Term Debt [Text Block]	Note 3. Long-Term Debt Financing On April 9, 2021 five three first second third June 30, 2024 July 2024. five On January 25, 2024 ( January 25, 2024, January 25, 2030 ( twelve twelve June 30, 2024 December 31, 2023 June 30, 2024 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 June 30, 2024 The loan entered into with United States International Development Finance Corporation (“DFC”) in connection with the acquisition of GKCE in June 2020 ( first June 2020. fourth 2023, second first 29 second 16 June 30, 2024 December 31, 2023 June 30, 2024 December 31, 2023 The DFC Loan contains customary covenants including without limitation, requirements that HoldCo maintain certain financial ratios related to liquidity and cash flow as well as depository requirements. On March 28, 2024 December 31, 2023 December 31, 2024 June 30, 2024 The accretion of debt issuance costs for the three six June 30, 2024 June 30, 2024 December 31, 2023 As of June 30, 2024 June 30, 2024 Year ending December 31, Principal 2024 (excluding the six-months ended June 30, 2024) $ 1,453,000 2025 3,402,000 2026 8,272,000 2027 1,033,000 2028 540,000 Thereafter 585,000 $ 15,285,000

Note 4 - Other Accrued Liabilit

Note 4 - Other Accrued Liabilities	6 Months Ended
	Jun. 30, 2024
Notes to Financial Statements
Other Liabilities Disclosure [Text Block]	N ote 4. Other Accrued Liabilities Other accrued liabilities consist of the following as of June 30, 2024 December 31, 2023 June 30, December 31, 2024 2023 Professional services $ 714,000 $ 472,000 Operating costs 667,000 450,000 Other 1,017,000 304,000 Total other accrued liabilities $ 2,398,000 $ 1,226,000

Note 5 - Leases

Note 5 - Leases	6 Months Ended
	Jun. 30, 2024
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 not 12 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. On May 7, 2024, 842 two three three six June 30, 2024 . The operating lease in Woonsocket is with a related party and contains a sublease for a 1,950 square feet of the clinic space. The sublease is also with a related party. Sublease income, related party, for the three six June 30, 2024 was $9,000. Rent payable to related parties was approximately $50,000 June 30, 2024 The Company’s lessee operating leases are accounted for as ROU assets, current portion of lease 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 June 30, 2024 The following table summarizes the maturities of the Company's lessee operating lease liabilities as of June 30, 2024 Year ending December 31, Operating Leases 2024 (excluding the six-months ended June 30, 2024) $ 267,000 2025 346,000 2026 347,000 2027 347,000 2028 348,000 Thereafter 958,000 Total lease payments 2,613,000 Less imputed interest (756,000 ) Total $ 1,857,000 Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Lease cost Operating lease cost $ 14,000 $ 103,000 $ 35,000 $ 206,000 Sublease income, related party (9,000 ) (49,000 ) (9,000 ) (99,000 ) Total lease cost $ 5,000 $ 54,000 $ 26,000 $ 107,000 Other information Cash paid for amounts included in the measurement of lease liabilities - Operating leases $ 14,000 $ 103,000 $ 35,000 $ 206,000 Weighted-average remaining lease term - Operating leases in years 8.38 0.92 8.38 0.92 Weighted-average discount rate - Operating leases 7.92 % 5.28 % 7.92 % 5.28 %

Note 6 - Per Share Amounts

Note 6 - Per Share Amounts	6 Months Ended
	Jun. 30, 2024
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 Company calculates diluted shares using the treasury stock method. The computation for the three six June 30, 2024 y 20,000 of the Company’s stock options b six June 30, 2023 three June 30, 2023, not three six June 30, 2024 2023 The following table sets forth the computation of basic and diluted earnings per share for the three six June 30, 2024 2023 Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Net income (loss) attributable to American Shared Hospital Services $ 3,602,000 $ (111,000 ) $ 3,721,000 $ 77,000 Weighted average common shares for basic earnings (loss) per share 6,482,000 6,336,000 6,467,000 6,336,000 Dilutive effect of stock options and restricted stock awards 101,000 - 97,000 129,000 Weighted average common shares for diluted earnings (loss) per share 6,583,000 6,336,000 6,564,000 6,465,000 Basic earnings (loss) per share $ 0.56 $ (0.02 ) $ 0.58 $ 0.01 Diluted earnings (loss) per share $ 0.55 $ (0.02 ) $ 0.57 $ 0.01

Note 7 - Stock-based Compensati

Note 7 - Stock-based Compensation	6 Months Ended
	Jun. 30, 2024
Notes to Financial Statements
Share-Based Payment Arrangement [Text Block]	Note 7. Stock-based Compensation In 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 $99,000 three six June 30, 2024 three six June 30, 2023 six June 30, 2024 o four The following table summarizes stock option activity for the six June 30, 2024 2023 Stock Options Grant Date Weighted- Average Exercise Price Weighted- Average Remaining Contractual Life (in Years) Intrinsic Value Outstanding at January 1, 2024 146,000 $ 2.83 5.44 $ - Forfeited (84,000 ) $ 2.87 - $ - Outstanding at June 30, 2024 62,000 $ 2.76 2.81 $ 28,000 Exercisable at June 30, 2024 42,000 $ 2.76 1.57 $ - Outstanding at January 1, 2023 95,000 $ 2.76 4.83 $ 25,000 Granted 70,000 $ 2.82 7.00 $ - Forfeited (19,000 ) $ 2.69 - $ - Outstanding at June 30, 2023 146,000 $ 2.80 5.76 $ - Exercisable at June 30, 2023 20,000 $ 2.92 2.67 $ -

Note 8 - Income Taxes

Note 8 - Income Taxes	6 Months Ended
	Jun. 30, 2024
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 international 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 six June 30, 2024 2023 six June 30, 2024

Note 9 - Commitments

Note 9 - Commitments	6 Months Ended
	Jun. 30, 2024
Notes to Financial Statements
Commitments and Contingencies Disclosure [Text Block]	Note 9. Commitments As of June 30, 2024 five one three one 2024 2025 Total Gamma Knife and LINAC commitments as of June 30, 2024 were $15,651,000. There are no June 30, 2024 . It is the Company’s intent to finance substantially all of these commitments. There can be no and its Revolving Line of $7,000,000 and is actively engaged with financing resources to fund these projects. June 30, 2024 July 2024. On September 4, 2022, September 2022 April 2026. one one As of June 30, 2024 one June 30, 2024

Note 10 - Related Party Transac

Note 10 - Related Party Transactions and Balances	6 Months Ended
	Jun. 30, 2024
Notes to Financial Statements
Related Party Transactions Disclosure [Text Block]	Note 10. Related Party Transactions and Balances 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’s operating lease in Woonsocket, Rhode Island is with a related party. See Note 5 The following table summarizes related party activity for the three six June 30, 2024 2023 Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Equipment purchases and de-install costs $ 521,000 $ 1,217,000 $ 2,937,000 $ 1,418,000 Costs incurred to maintain equipment 170,000 295,000 340,000 590,000 Total related party transactions $ 691,000 $ 1,512,000 $ 3,277,000 $ 2,008,000 The Company also had commitments to purchase and install five two June 30, 2024 Related party liabilities on the condensed consolidated balance sheets consist of the following as of June 30, 2024 December 31, 2023 June 30, December 31, 2024 2023 Accounts payable, asset retirement obligation and other accrued liabilities $ 1,675,000 $ 2,361,000

Note 11 - Rhode Island Acquisit

Note 11 - Rhode Island Acquisition	6 Months Ended
	Jun. 30, 2024
Notes to Financial Statements
Business Combination Disclosure [Text Block]	Note 11. On November 10, 2023, three On March 1, 2024, not March 10, 2024 April 30, 2024. April 18, 2024, 5 April 24 2024, May 31, 2024. May 7, 2024, May 7, 2024 ( The RI acquisition has been accounted for as a business combination under ASC 805 Business Combinations 805” no one no one The Company recorded medical equipment, facilities and non-controlling interest at fair value as of the Closing date. Sales comparison and cost approaches were used to value the medical equipment, including assumptions of estimated direct costs associated with acquiring the equipment. Where appropriate, adjustments were made to the direct replacement cost to reflect depreciation and obsolescence. The sales comparison approach was also utilized to value certain assets, involving secondary market research. The cost approach was also used to value the facilities acquired and the unfavorable leasehold interest. The non-controlling interest was recorded at fair value based on the purchase price paid for the acquisition, after any premium or discount derived from the operating agreement with the minority owners. The major classes of assets and liabilities to which the Company has preliminarily allocated the fair value of the purchase price consideration were as follows: May 7, 2024 Cash and cash equivalents $ 3,388,000 Accounts receivable 919,000 Medical equipment 2,403,000 Facilities 4,697,000 ROU assets 1,835,000 Unfavorable leasehold interest (1,227,000 ) Total assets acquired 12,015,000 Accounts payable (150,000 ) Deferred income taxes (1,226,000 ) Gain on bargain purchase (3,679,000 ) Lease liabilities (1,835,000 ) Base purchase consideration 5,125,000 Non-controlling interest (2,100,000 ) CT Sim (175,000 ) Cash paid by the Company $ 2,850,000 The Company recognized a bargain purchase, as defined by ASC 805, three six June 30, 2024 None none The preliminary value of the acquired tangible assets acquired were as follows: Fair Value Average Useful Life (in Years) Facilities $ 4,697,000 15 Medical equipment 2,403,000 4 Total medical equipment and facilities acquired $ 7,100,000 Costs related to legal, financial and due diligence services performed in connection with the RI Acquisition recorded in selling and administrative expense in the condensed consolidated statement of operations were $341,000 six June 30, 2024 The net impact of the RI Acquisition on the consolidated results of operations, since the date of acquisition, are as follows: Three Months Ended June 30, 2024 Revenue $ 1,892,000 Operating income $ 612,000 Per the guidance in ASC 805, January 1, 2024. not not 805 not not Following are the supplemental consolidated financial results of the Company on an unaudited, pro forma basis, as if the acquisition occurred on January 1, 2024. Six Months Ended June 30, 2024 Revenue $ 13,396,000 Operating income $ 1,045,000 Diluted earnings per share $ 0.21

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2024
Insider Trading Arr Line Items
Material Terms of Trading Arrangement [Text Block]		Item 5. Other Information. (a) On May 7, 2024, 8 60% 1 02 X 8 04 8 05 X, June 30, 2023 “8 04 “8 05 8 04 X June 2023. not X not 10 not three one hundred fifty one not not not X not 8 04 8 05 X. X not twelve X, not 144 1933, not (c) During the three June 30, 2024 none 10b5 1 10b5 1 408
Rule 10b5-1 Arrangement Terminated [Flag]	false
Rule 10b5-1 Arrangement Adopted [Flag]	false
Non-Rule 10b5-1 Arrangement Terminated [Flag]	false
Non-Rule 10b5-1 Arrangement Adopted [Flag]	false

Note 1 - Basis of Presentation

Note 1 - Basis of Presentation (Tables)	6 Months Ended
	Jun. 30, 2024
Notes Tables
Reconciliation of Revenue from Segments to Consolidated [Table Text Block]	Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Revenues Leasing $ 3,899,000 $ 4,812,000 $ 8,152,000 $ 9,041,000 Retail 3,157,000 756,000 4,120,000 1,452,000 Total $ 7,056,000 $ 5,568,000 $ 12,272,000 $ 10,493,000
Segment, Reconciliation of Other Items from Segments to Consolidated [Table Text Block]	2024 2023 2024 2023 Depreciation expense Leasing $ 1,219,000 $ 1,074,000 $ 2,311,000 $ 2,254,000 Retail 304,000 178,000 546,000 355,000 Total $ 1,523,000 $ 1,252,000 $ 2,857,000 $ 2,609,000 2024 2023 2024 2023 Interest expense Leasing $ 352,000 $ 277,000 $ 668,000 $ 548,000 Retail 33,000 - 66,000 - Total $ 385,000 $ 277,000 $ 734,000 $ 548,000 2024 2023 2024 2023 Interest income Leasing $ 77,000 $ 110,000 $ 189,000 $ 197,000 Retail - - - - Total $ 77,000 $ 110,000 $ 189,000 $ 197,000 2024 2023 2024 2023 Income tax (benefit) expense Leasing $ 71,000 $ (51,000 ) $ 12,000 $ 10,000 Retail (102,000 ) 16,000 (87,000 ) 23,000 Total $ (31,000 ) $ (35,000 ) $ (75,000 ) $ 33,000
Reconciliation of Operating Profit (Loss) from Segments to Consolidated [Table Text Block]	2024 2023 2024 2023 Net income (loss) attributable to American Shared Hospital Services Leasing $ (427,000 ) $ (26,000 ) $ (258,000 ) $ 229,000 Retail 4,029,000 (85,000 ) 3,979,000 (152,000 ) Total $ 3,602,000 $ (111,000 ) $ 3,721,000 $ 77,000

Note 2 - Property and Equipme_2

Note 2 - Property and Equipment (Tables)	6 Months Ended
	Jun. 30, 2024
Notes Tables
Property, Plant and Equipment [Table Text Block]	June 30, December 31, 2024 2023 Medical equipment and facilities $ 78,688,000 $ 77,150,000 Office equipment 447,000 306,000 Construction in progress 2,674,000 3,771,000 81,809,000 81,227,000 Accumulated depreciation (48,815,000 ) (55,383,000 ) Net property and equipment $ 32,994,000 $ 25,844,000 Net property and equipment held outside of the United States $ 5,760,000 $ 6,174,000
Property, Plant and Equipment, Depreciation [Table Text Block]	Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Depreciation expense $ 1,523,000 $ 1,252,000 $ 2,857,000 $ 2,609,000

Note 3 - Long Term Debt Finan_2

Note 3 - Long Term Debt Financing (Tables)	6 Months Ended
	Jun. 30, 2024
Notes Tables
Schedule of Maturities of Long-Term Debt [Table Text Block]	Year ending December 31, Principal 2024 (excluding the six-months ended June 30, 2024) $ 1,453,000 2025 3,402,000 2026 8,272,000 2027 1,033,000 2028 540,000 Thereafter 585,000 $ 15,285,000

Note 4 - Other Accrued Liabil_2

Note 4 - Other Accrued Liabilities (Tables)	6 Months Ended
	Jun. 30, 2024
Notes Tables
Other Liabilities [Table Text Block]	June 30, December 31, 2024 2023 Professional services $ 714,000 $ 472,000 Operating costs 667,000 450,000 Other 1,017,000 304,000 Total other accrued liabilities $ 2,398,000 $ 1,226,000

Note 5 - Leases (Tables)

Note 5 - Leases (Tables)	6 Months Ended
	Jun. 30, 2024
Notes Tables
Lessee, Operating Lease, Liability, to be Paid, Maturity [Table Text Block]	Year ending December 31, Operating Leases 2024 (excluding the six-months ended June 30, 2024) $ 267,000 2025 346,000 2026 347,000 2027 347,000 2028 348,000 Thereafter 958,000 Total lease payments 2,613,000 Less imputed interest (756,000 ) Total $ 1,857,000
Lease, Cost [Table Text Block]	Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Lease cost Operating lease cost $ 14,000 $ 103,000 $ 35,000 $ 206,000 Sublease income, related party (9,000 ) (49,000 ) (9,000 ) (99,000 ) Total lease cost $ 5,000 $ 54,000 $ 26,000 $ 107,000 Other information Cash paid for amounts included in the measurement of lease liabilities - Operating leases $ 14,000 $ 103,000 $ 35,000 $ 206,000 Weighted-average remaining lease term - Operating leases in years 8.38 0.92 8.38 0.92 Weighted-average discount rate - Operating leases 7.92 % 5.28 % 7.92 % 5.28 %

Note 6 - Per Share Amounts (Tab

Note 6 - Per Share Amounts (Tables)	6 Months Ended
	Jun. 30, 2024
Notes Tables
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Net income (loss) attributable to American Shared Hospital Services $ 3,602,000 $ (111,000 ) $ 3,721,000 $ 77,000 Weighted average common shares for basic earnings (loss) per share 6,482,000 6,336,000 6,467,000 6,336,000 Dilutive effect of stock options and restricted stock awards 101,000 - 97,000 129,000 Weighted average common shares for diluted earnings (loss) per share 6,583,000 6,336,000 6,564,000 6,465,000 Basic earnings (loss) per share $ 0.56 $ (0.02 ) $ 0.58 $ 0.01 Diluted earnings (loss) per share $ 0.55 $ (0.02 ) $ 0.57 $ 0.01

Note 7 - Stock-based Compensa_2

Note 7 - Stock-based Compensation (Tables)	6 Months Ended
	Jun. 30, 2024
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, 2024 146,000 $ 2.83 5.44 $ - Forfeited (84,000 ) $ 2.87 - $ - Outstanding at June 30, 2024 62,000 $ 2.76 2.81 $ 28,000 Exercisable at June 30, 2024 42,000 $ 2.76 1.57 $ - Outstanding at January 1, 2023 95,000 $ 2.76 4.83 $ 25,000 Granted 70,000 $ 2.82 7.00 $ - Forfeited (19,000 ) $ 2.69 - $ - Outstanding at June 30, 2023 146,000 $ 2.80 5.76 $ - Exercisable at June 30, 2023 20,000 $ 2.92 2.67 $ -

Note 10 - Related Party Trans_2

Note 10 - Related Party Transactions and Balances (Tables)	6 Months Ended
	Jun. 30, 2024
Notes Tables
Schedule of Related Party Transactions [Table Text Block]	Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Equipment purchases and de-install costs $ 521,000 $ 1,217,000 $ 2,937,000 $ 1,418,000 Costs incurred to maintain equipment 170,000 295,000 340,000 590,000 Total related party transactions $ 691,000 $ 1,512,000 $ 3,277,000 $ 2,008,000 June 30, December 31, 2024 2023 Accounts payable, asset retirement obligation and other accrued liabilities $ 1,675,000 $ 2,361,000

Note 11 - Rhode Island Acquis_2

Note 11 - Rhode Island Acquisition (Tables)	6 Months Ended
	Jun. 30, 2024
Notes Tables
Schedule of Business Acquisitions, by Acquisition [Table Text Block]	May 7, 2024 Cash and cash equivalents $ 3,388,000 Accounts receivable 919,000 Medical equipment 2,403,000 Facilities 4,697,000 ROU assets 1,835,000 Unfavorable leasehold interest (1,227,000 ) Total assets acquired 12,015,000 Accounts payable (150,000 ) Deferred income taxes (1,226,000 ) Gain on bargain purchase (3,679,000 ) Lease liabilities (1,835,000 ) Base purchase consideration 5,125,000 Non-controlling interest (2,100,000 ) CT Sim (175,000 ) Cash paid by the Company $ 2,850,000
Tangible Assets Acquired as Part of Business Combination [Table Text Block]	Fair Value Average Useful Life (in Years) Facilities $ 4,697,000 15 Medical equipment 2,403,000 4 Total medical equipment and facilities acquired $ 7,100,000
Business Acquisition, Pro Forma Information [Table Text Block]	Three Months Ended June 30, 2024 Revenue $ 1,892,000 Operating income $ 612,000 Six Months Ended June 30, 2024 Revenue $ 13,396,000 Operating income $ 1,045,000 Diluted earnings per share $ 0.21

Note 1 - Basis of Presentatio_2

Note 1 - Basis of Presentation (Details Textual)			3 Months Ended		6 Months Ended
	May 07, 2024 USD ($)	Nov. 10, 2023 USD ($)	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)	Jun. 28, 2024	Jan. 01, 2024 USD ($)	Jan. 01, 2023 USD ($)	Apr. 27, 2022
Number of Medical Centers			10		10
Number of Reportable Segments					2
GKCE [Member]
Revenue from Contract with Customer, Including Assessed Tax			$ 3,157,000	$ 756,000	$ 4,120,000	$ 1,452,000
Accounts Receivable, after Allowance for Credit Loss			4,558,000	980,000	4,558,000	980,000		$ 1,626,000	$ 1,118,000
Rental Income from Medical Services [Member]
Revenue from Contract with Customer, Including Assessed Tax			3,899,000	4,812,000	8,152,000	9,041,000
PBRT Services [Member]
Revenue from Contract with Customer, Including Assessed Tax			$ 2,420,000	$ 2,545,000	$ 5,069,000	$ 4,859,000
Gamma Knife and PBRT Equipment [Member]
Number of Medical Centers			11		11
Lima, Peru and Guayaquil, Ecuador [Member]
Number of Single-unit Facilities			2		2
Single-Unit Radiation Therapy Facilities [Member]
Number of Single-unit Facilities	3
Newco Guadalajara [Member]
Equity Method Investment, Ownership Percentage							70%
Newco Guadalajara [Member] | HSJ [Member]
Equity Method Investment, Ownership Percentage							30%
Newco [Member]
Equity Method Investment, Ownership Percentage										85%
Newco [Member] | Guadalupe [Member]
Equity Method Investment, Ownership Percentage										15%
OR21, LLC [Member]
Equity Method Investment, Ownership Percentage			50%		50%
OR21, LLC [Member] | Architectural Design Company [Member]
Equity Method Investment, Ownership Percentage			50%		50%
Southern New England Regional Cancer Center, LLC and Roger Williams Radiation Therapy, LLC [Member]
Number of Medical Centers			3		3
Business Combination, Consideration Transferred	$ 2,850,000	$ 2,850,000
Business Acquisition, Percentage of Voting Interests Acquired		60%
Accounts Receivable, after Allowance for Credit Loss	$ 919,000
RI Companies [Member]
Business Acquisition, Percentage of Voting Interests Acquired	60%
Number of Single-unit Facilities	3
RI Companies [Member] | Minimum [Member]
Business Combination, Net Payment Terms (Day)	30 days
RI Companies [Member] | Maximum [Member]
Business Combination, Net Payment Terms (Day)	60 days

Note 1 - Basis of Presentatio_3

Note 1 - Basis of Presentation - Revenues Allocations to Reportable Segments (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Revenues	$ 7,056,000	$ 5,568,000	$ 12,272,000	$ 10,493,000
Medical Equipment Leasing [Member]
Revenues	3,899,000	4,812,000	8,152,000	9,041,000
Direct Patient Services [Member]
Revenues	$ 3,157,000	$ 756,000	$ 4,120,000	$ 1,452,000

Note 1 - Basis of Presentatio_4

Note 1 - Basis of Presentation - Allocations to Reportable Segments (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Depreciation and amortization	$ 1,523,000	$ 1,252,000	$ 2,857,000	$ 2,609,000
Interest expense	385,000	277,000	734,000	548,000
Interest income	77,000	110,000	189,000	197,000
Income tax expense	(31,000)	(35,000)	(75,000)	33,000
Medical Equipment Leasing [Member]
Depreciation and amortization	1,219,000	1,074,000	2,311,000	2,254,000
Interest expense	352,000	277,000	668,000	548,000
Interest income	77,000	110,000	189,000	197,000
Income tax expense	71,000	(51,000)	12,000	10,000
Direct Patient Services [Member]
Depreciation and amortization	304,000	178,000	546,000	355,000
Interest expense	33,000	0	66,000	0
Interest income	0	0	0	0
Income tax expense	$ (102,000)	$ 16,000	$ (87,000)	$ 23,000

Note 1 - Basis of Presentatio_5

Note 1 - Basis of Presentation - Profit (Loss) Allocations to Reportable Segments (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Net income (loss)	$ 3,602,000	$ (111,000)	$ 3,721,000	$ 77,000
Medical Equipment Leasing [Member]
Net income (loss)	(427,000)	(26,000)	(258,000)	229,000
Direct Patient Services [Member]
Net income (loss)	$ 4,029,000	$ (85,000)	$ 3,979,000	$ (152,000)

Note 2 - Property and Equipme_3

Note 2 - Property and Equipment (Details Textual)	Jun. 30, 2024
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, 2024	Dec. 31, 2023
Property and equipment, gross		$ 81,227,000
Property, Plant, and Equipment and Finance Lease Right-of-Use Asset, after Accumulated Depreciation and Amortization, Total	$ 81,809,000
Accumulated depreciation	(48,815,000)	(55,383,000)
Net property and equipment	32,994,000	25,844,000
Property and equipment, net	32,994,000	25,844,000
Non-US [Member]
Net property and equipment	5,760,000	6,174,000
Property and equipment, net	5,760,000	6,174,000
Medical Equipment and Facilities [Member]
Property and equipment, gross	78,688,000	77,150,000
Office Equipment [Member]
Property and equipment, gross	447,000	306,000
Construction in Progress [Member]
Property and equipment, gross	$ 2,674,000	$ 3,771,000

Note 2 - Property and Equipme_5

Note 2 - Property and Equipment - Depreciation (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Depreciation, amortization, and other	$ 1,523,000	$ 1,252,000	$ 2,857,000	$ 2,609,000

Note 3 - Long Term Debt Finan_3

Note 3 - Long Term Debt Financing (Details Textual)			3 Months Ended		6 Months Ended
	Jan. 25, 2024 USD ($)	Apr. 09, 2021 USD ($)	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)	Mar. 31, 2024	Dec. 31, 2023 USD ($)
Long-Term Debt			$ 15,083,000		$ 15,083,000
Amortization of Debt Issuance Costs			20,000	$ 19,000	58,000	$ 37,000
Debt Issuance Costs, Net			202,000		202,000			$ 164,000
The Credit Agreement [Member] | Fifth Third Bank, N.A. [Member]
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			13,150,000		13,150,000			10,825,000
The Credit Agreement, Second Loan Facility [Member] | Fifth Third Bank, N.A. [Member]
Debt Instrument, Face Amount		5,500,000
The Credit Agreement, Third Loan Facility [Member] | Fifth Third Bank, N.A. [Member] | Revolving Credit Facility [Member]
Line of Credit Facility, Maximum Borrowing Capacity		$ 7,000,000
Long-Term Line of Credit			3,950,000		3,950,000
Debt Instrument, Term (Year)		5 years
The Credit Agreement, Third Loan Facility [Member] | Fifth Third Bank, N.A. [Member] | Revolving Credit Facility [Member] | London Interbank Offered Rate [Member]
Debt Instrument, Basis Spread on Variable Rate		3%
The Credit Agreement, 2024 Supplemental Term Loan [Member] | Fifth Third Bank, N.A. [Member]
Debt Instrument, Face Amount	$ 2,700,000
Debt Issuance Costs, Gross			$ 97,000		$ 97,000
The Credit Agreement, 2024 Supplemental Term Loan [Member] | Fifth Third Bank, N.A. [Member] | Secured Overnight Financing Rate (SOFR) [Member]
Debt Instrument, Basis Spread on Variable Rate	3%
Debt Instrument, Variable Rate, Floor	0%
DFC Loan, Tranche One [Member]
Debt Instrument, Interest Rate, Stated Percentage			3.67%		3.67%
DFC Loan, Tranche Two [Member]
Debt Instrument, Interest Rate, Stated Percentage							7.49%
DFC Loan [Member]
Long-Term Debt			$ 2,135,000		$ 2,135,000			2,464,000
Debt Issuance Costs, Gross			$ 0		$ 0			$ 9,000

Note 3 - Long Term Debt - Long-

Note 3 - Long Term Debt - Long-term Debt Maturities (Details)	Jun. 30, 2024 USD ($)
2024 (excluding the six-months ended June 30, 2024)	$ 1,453,000
2025	3,402,000
2026	8,272,000
2027	1,033,000
2028	540,000
Thereafter	585,000
Long-Term Debt, Gross	$ 15,285,000

Note 4 - Other Accrued Liabil_3

Note 4 - Other Accrued Liabilities - Other Accrued Liabilities (Details) - USD ($)	Jun. 30, 2024	Dec. 31, 2023
Professional services	$ 714,000	$ 472,000
Operating costs	667,000	450,000
Other	1,017,000	304,000
Total other accrued liabilities	$ 2,398,000	$ 1,226,000

Note 5 - Leases (Details Textua

Note 5 - Leases (Details Textual)		3 Months Ended		6 Months Ended
	Nov. 03, 2021 USD ($) ft²	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)	May 07, 2024 ft²	Dec. 31, 2023 USD ($)
Operating Lease, Right-of-Use Asset		$ 631,000		$ 631,000			$ 57,000
Operating Lease, Liability		$ 1,857,000		$ 1,857,000
RHODE ISLAND
Number of Stand-Alone Facilities		2		2
Minimum [Member]
Lessee, Operating Lease, Discount Rate		4%		4%
Lessee, Operating Lease, Remaining Lease Term (Year)		5 years		5 years
Maximum [Member]
Lessee, Operating Lease, Discount Rate		8%		8%
Lessee, Operating Lease, Remaining Lease Term (Year)		17 years		17 years
Related Party [Member]
Sublease Income		$ 9,000	$ 49,000	$ 9,000	$ 99,000
RI Companies [Member]
Business Acquisition, Percentage of Voting Interests Acquired						60%
Number of Single-unit Facilities						3
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	$ 16,195
Lease Agreement for New Corporate Office [Member]
Area of Real Estate Property (Square Foot) | ft²	900
Operating Lease, Monthly Expense	$ 4,500
Woonsocket Operating Lease [Member]
Area of Real Estate Property (Square Foot) | ft²						1,950
Woonsocket Operating Lease [Member] | Related Party [Member]
Accrued Rent		$ 50,000		$ 50,000

Note 5 - Leases - Summary of Ma

Note 5 - Leases - Summary of Maturities of Lessee Operating Lease Liabilities (Details)	Jun. 30, 2024 USD ($)
2024 (excluding the six-months ended June 30, 2024)	$ 267,000
2025	346,000
2026	347,000
2027	347,000
2028	348,000
Thereafter	958,000
Total lease payments	2,613,000
Less imputed interest	(756,000)
Total	$ 1,857,000

Note 5 - Leases - Lease Cost an

Note 5 - Leases - Lease Cost and Information (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Operating lease cost	$ 14,000	$ 103,000	$ 35,000	$ 206,000
Total lease cost	5,000	54,000	26,000	107,000
Cash paid for amounts included in the measurement of lease liabilities - Operating leases	$ 14,000	$ 103,000	$ 35,000	$ 206,000
Weighted-average remaining lease term - Operating leases in years (Year)	8 years 4 months 17 days	11 months 1 day	8 years 4 months 17 days	11 months 1 day
Weighted-average discount rate - Operating leases	7.92%	5.28%	7.92%	5.28%
Related Party [Member]
Sublease income, related party	$ (9,000)	$ (49,000)	$ (9,000)	$ (99,000)

Note 6 - Per Share Amounts (Det

Note 6 - Per Share Amounts (Details Textual) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Incremental Common Shares Attributable to Dilutive Effect of Share-Based Payment Arrangements (in shares)	101,000	0	97,000	129,000
Share-Based Payment Arrangement, Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount (in shares)	20,000	82,000	20,000	64,000
Restricted Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount (in shares)		121,000
Incremental Common Shares Attributable to Dilutive Effect of Share-Based Payment Arrangements (in shares)	123,000	123,000	123,000	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		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Net income (loss) attributable to American Shared Hospital Services	$ 3,602,000	$ (111,000)	$ 3,721,000	$ 77,000
Weighted average common shares for basic earnings (loss) per share (in shares)	6,482,000	6,336,000	6,467,000	6,336,000
Dilutive effect of stock options and restricted stock awards (in shares)	101,000	0	97,000	129,000
Weighted average common shares for diluted earnings (loss) per share (in shares)	6,583,000	6,336,000	6,564,000	6,465,000
Basic earnings (loss) per share (in dollars per share)	$ 0.56	$ (0.02)	$ 0.58	$ 0.01
Diluted earnings (loss) per share (in dollars per share)	$ 0.55	$ (0.02)	$ 0.57	$ 0.01

Note 7 - Stock-based Compensa_3

Note 7 - Stock-based Compensation (Details Textual) - Incentive Compensation Plan [Member] - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2021
Common Stock, Capital Shares Reserved for Future Issuance (in shares)					2,580,000
Share-Based Compensation Arrangement by Share-Based Payment Award, Number of Shares Available for Grant (in shares)	0		0
Share-Based Payment Arrangement, Expense	$ 99,000	$ 97,000	$ 197,000	$ 193,000
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount	$ 28,000		$ 28,000
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year)			4 years

Note 7 - Stock-based Compensa_4

Note 7 - Stock-based Compensation - Summary of Stock Option Activity (Details) - USD ($)	3 Months Ended	6 Months Ended		12 Months Ended
	Mar. 31, 2023	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023	Dec. 31, 2022
Outstanding, balance (in shares)	95,000	146,000	95,000	95,000
Balance, grant date weighted-average exercise price (in dollars per share)	$ 2.76	$ 2.83	$ 2.76	$ 2.76
Balance, weighted average remaining contractual life (Year)		2 years 9 months 21 days	5 years 9 months 3 days	5 years 5 months 8 days	4 years 9 months 29 days
Balance, aggregate intrinsic value		$ 28,000		$ 0	$ 25,000
Forfeited (in shares)		(84,000)	(19,000)
Forfeited, grant date weighted-average exercise price (in dollars per share)		$ 2.87	$ 2.69
Outstanding, balance (in shares)		62,000	146,000	146,000	95,000
Balance, grant date weighted-average exercise price (in dollars per share)		$ 2.76	$ 2.8	$ 2.83	$ 2.76
Exercisable (in shares)	20,000	42,000
Exercisable, grant date weighted-average exercise price (in dollars per share)	$ 2.92	$ 2.76
Exercisable, weighted average remaining contractual life (Year)	2 years 8 months 1 day
Granted (in shares)			70,000
Granted, grant date weighted-average exercise price (in dollars per share)			$ 2.82
Granted, weighted average remaining contractual life (Year)			7 years
Minimum [Member]
Exercisable, weighted average remaining contractual life (Year)		1 year 6 months 25 days

Note 8 - Income Taxes (Details

Note 8 - Income Taxes (Details Textual)	6 Months Ended
	Jun. 30, 2024 USD ($)
Maximum [Member]
Unrecognized Tax Benefits, Decrease Resulting from Foreign Taxes	$ 100,000

Note 9 - Commitments (Details T

Note 9 - Commitments (Details Textual) - USD ($)		6 Months Ended
	Sep. 04, 2022	Jun. 30, 2024
Leksell Gamma Knife Icon Systems and Linear Accelerator System [Member]
Long-term Install Service and Purchase Commitment, Amount		$ 15,651,000
Long-term Commitment, Cash on Hand to Fund		14,486,000
Long-term Commitment, Line of Credit to Fund		7,000,000
Long-Term Line of Credit		3,950,000
Maintenance And Support Agreement, Mevion Service Agreement [Member] | Mevion Medical Systems Inc [Member]
Purchase Agreement Annual Prepayment	$ 1,865,000
Long-term Purchase Commitment, Period (Year)	1 year
LINAC System [Member]
Long-Term Service Commitment, Amount		$ 14,375,000
LINAC System [Member] | Minimum [Member]
Long-Term Service Commitment, Period (Year)		5 years

Note 10 - Related Party Trans_3

Note 10 - Related Party Transactions and Balances (Details Textual)	Jun. 30, 2024 USD ($)
GKF Subsidiary [Member]
Noncontrolling Interest, Ownership Percentage by Parent	81%
US Subsidiary Of Elekta Member
Noncontrolling Interest, Ownership Percentage by Parent	19%
Purchase Obligation	$ 21,479,000

Note 10 - Related Party Trans_4

Note 10 - Related Party Transactions and Balances - Schedule of Related Party Transactions (Details) - Related Party [Member] - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023
Equipment purchases and de-install costs	$ 521,000	$ 1,217,000	$ 2,937,000	$ 1,418,000
Costs incurred to maintain equipment	170,000	295,000	340,000	590,000
Total related party transactions	691,000	$ 1,512,000	3,277,000	$ 2,008,000
Accounts payable, asset retirement obligation and other accrued liabilities	$ 1,675,000		$ 1,675,000		$ 2,361,000

Note 11 - Rhode Island Acquis_3

Note 11 - Rhode Island Acquisition (Details Textual)				3 Months Ended		6 Months Ended
	May 07, 2024 USD ($)	Apr. 18, 2024 USD ($)	Nov. 10, 2023 USD ($)	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)
Number of Medical Centers				10		10
Payments to Acquire Property, Plant, and Equipment						$ 2,399,000	$ 2,561,000
Business Combination, Bargain Purchase, Gain Recognized, Amount				$ 3,679,000	$ 0	$ 3,679,000	$ 0
Southern New England Regional Cancer Center, LLC and Roger Williams Radiation Therapy, LLC [Member]
Business Combination, Consideration Transferred	$ 2,850,000		$ 2,850,000
Business Acquisition, Percentage of Voting Interests Acquired			60%
Number of Medical Centers				3		3
Payments to Acquire Property, Plant, and Equipment	175,000
Business Combination, Bargain Purchase, Gain Recognized, Amount	$ 3,679,000					$ 3,679,000
Deferred Tax Assets, Net of Valuation Allowance				$ 1,226,000		1,226,000
Business Combination, Acquisition Related Costs						$ 341,000
Southern New England Regional Cancer Center, LLC and Roger Williams Radiation Therapy, LLC [Member] | GE Discovery RT CT Simulator [Member]
Payments to Acquire Property, Plant, and Equipment		$ 175,000

Note 11 - Rhode Island Acquis_4

Note 11 - Rhode Island Acquisition - Major Classes of Assets and Liabilities (Details) - USD ($)			3 Months Ended		6 Months Ended
	May 07, 2024	Nov. 10, 2023	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023
Cash and cash equivalents			$ 14,236,000	$ 13,676,000	$ 14,236,000	$ 13,676,000	$ 13,690,000
Operating Lease, Right-of-Use Asset			631,000		631,000		57,000
Total assets acquired			60,825,000		60,825,000		48,162,000
Deferred income taxes			(1,472,000)		(1,472,000)		(63,000)
Gain on bargain purchase			(3,679,000)	$ 0	(3,679,000)	0
Lease liabilities			(1,857,000)		(1,857,000)
Base purchase consideration			28,473,000		28,473,000		$ 21,883,000
Non-controlling interest			(2,100,000)		(2,100,000)	0
CT Sim					(2,399,000)	$ (2,561,000)
Southern New England Regional Cancer Center, LLC and Roger Williams Radiation Therapy, LLC [Member]
Cash and cash equivalents	$ 3,388,000
Accounts Receivable, after Allowance for Credit Loss	919,000
Property, plant, and equipment			7,100,000		7,100,000
Operating Lease, Right-of-Use Asset	1,835,000
Unfavorable leasehold interest	(1,227,000)
Total assets acquired	12,015,000
Accounts payable	(150,000)
Deferred income taxes	(1,226,000)
Gain on bargain purchase	(3,679,000)				(3,679,000)
Lease liabilities	(1,835,000)
Base purchase consideration	5,125,000
Non-controlling interest	(2,100,000)
CT Sim	(175,000)
Business Combination, Consideration Transferred	2,850,000	$ 2,850,000
Southern New England Regional Cancer Center, LLC and Roger Williams Radiation Therapy, LLC [Member] | Medical Equipment [Member]
Property, plant, and equipment	2,403,000		4,697,000		4,697,000
Southern New England Regional Cancer Center, LLC and Roger Williams Radiation Therapy, LLC [Member] | Medical Facilities [Member]
Property, plant, and equipment	$ 4,697,000		$ 2,403,000		$ 2,403,000

Note 11 - Rhode Island Acquis_5

Note 11 - Rhode Island Acquisition - Tangible Assets Acquired (Details) - Southern New England Regional Cancer Center, LLC and Roger Williams Radiation Therapy, LLC [Member] - USD ($)	Jun. 30, 2024	May 07, 2024
Medical Facilities and Equipment, Value	$ 7,100,000
Medical Equipment [Member]
Medical Facilities and Equipment, Value	$ 4,697,000	$ 2,403,000
Medical Facilities and Equipment, Useful Life (Year)	15 years
Medical Facilities [Member]
Medical Facilities and Equipment, Value	$ 2,403,000	$ 4,697,000
Medical Facilities and Equipment, Useful Life (Year)	4 years

Note 11 - Rhode Island Acquis_6

Note 11 - Rhode Island Acquisition - Pro Forma Information (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Revenues	$ 7,056,000	$ 5,568,000	$ 12,272,000	$ 10,493,000
Operating income	(1,000)	(325,000)	(86,000)	(227,000)
Revenue	7,056,000	5,568,000	12,272,000	10,493,000
Operating income	$ (1,000)	$ (325,000)	$ (86,000)	$ (227,000)
Diluted earnings per share (in dollars per share)	$ 0.55	$ (0.02)	$ 0.57	$ 0.01
Southern New England Regional Cancer Center, LLC and Roger Williams Radiation Therapy, LLC [Member]
Revenues	$ 1,892,000		$ 13,396,000
Operating income	612,000		1,045,000
Revenue	1,892,000		13,396,000
Operating income	$ 612,000		$ 1,045,000
Diluted earnings per share (in dollars per share)			$ 0.21