American Shared Hospital Services (AMS) 10-Year Financial Performance & Capital Metrics

AMS • • Industrial / General

HealthcareHealthcare FacilitiesMedical Equipment & Technology ServicesMedical Equipment Management

AboutAmerican Shared Hospital Services leases radiosurgery and radiation therapy equipment to health care providers. The company offers radiosurgery equipment for the Gamma Knife stereotactic radiosurgery, a non-invasive procedure to treat malignant and benign brain tumors, and arteriovenous malformations, as well as for trigeminal neuralgia. It also provides financing services for Leksell Gamma Knife units. In addition, the company offers proton beam radiation therapy services in Orlando, Florida and Long Beach, California, as well as offers planning, installation, reimbursement, and marketing support services to its customers. As of December 31, 2021, it had 115 operating Gamma Knife units located in the United States, as well as two in South America in Lima, Peru and Guayaquil, Ecuador. The company also operates one PBRT system. American Shared Hospital Services was founded in 1980 and is based in San Francisco, California.Show more

Revenue $28M +32.9%
EBITDA $3M -38.0%
Net Income $2M +258.4%
EPS (Diluted) 0.33 +245.9%
Gross Margin 32.41% -26.0%
EBITDA Margin 11.89% -53.4%
Operating Margin -9.9% -881.7%
Net Margin 7.71% +169.7%
ROE 7.76% +230.3%
ROIC -5.81% -929.3%
Debt/Equity 0.77 +15.2%
Interest Coverage -1.87 -870.7%

Technical Analysis

Key Insights

Based on financial data analysis

✓Strengths

✓Strong 5Y profit CAGR of 27.1%
✓Trading at only 0.5x book value

✗Weaknesses

✗Negative free cash flow
✗Low quality earnings: Net income not backed by cash flow
✗Trading more than 30% below 52-week high

Price & Volume

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Growth Metrics

Revenue CAGR

10Y6.28%

5Y6.58%

3Y17.15%

TTM17.84%

Profit (Net Income) CAGR

10Y-

5Y27.1%

3Y124.19%

TTM-157.27%

EPS CAGR

10Y-

5Y6.58%

3Y117.66%

TTM-164.3%

ROCE

10Y Avg-1.06%

5Y Avg-4.07%

3Y Avg0.16%

Latest-6.44%

Peer Comparison

Medical Equipment Management

Name	Market Cap	Current Price	P/E Ratio	Revenue Growth 1Y	Net Margin	ROE	FCF Yield	Debt/Equity
AMSAmerican Shared Hospital Services	14.07M	2.15	6.52	32.9%	-7.65%	-7.87%		0.77
CCMConcord Medical Services Holdings Limited	13.15M	4.67	-0.00	-28.55%	-44.6%	-9.47%		2.43

Profit & Loss

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Sales/Revenue+	16.55M	18.7M	19.56M	19.71M	20.61M	17.84M	17.63M	19.75M	21.32M	28.34M
Revenue Growth %	0.07%	0.13%	0.05%	0.01%	0.05%	-0.13%	-0.01%	0.12%	0.08%	0.33%
Cost of Goods Sold+	9.83M	9.9M	10.89M	12.23M	13.69M	13.37M	10.9M	11.36M	11.98M	19.16M
COGS % of Revenue	0.59%	0.53%	0.56%	0.62%	0.66%	0.75%	0.62%	0.58%	0.56%	0.68%
Gross Profit+	6.71M	8.79M	8.66M	7.49M	6.92M	4.47M	6.73M	8.38M	9.34M	9.19M
Gross Margin %	0.41%	0.47%	0.44%	0.38%	0.34%	0.25%	0.38%	0.42%	0.44%	0.32%
Gross Profit Growth %	0.27%	0.31%	-0.02%	-0.14%	-0.08%	-0.35%	0.51%	0.25%	0.11%	-0.02%
Operating Expenses+	3.5M	3.8M	4.32M	3.99M	4.06M	13.93M	5.38M	5.95M	9.07M	11.99M
OpEx % of Revenue	0.21%	0.2%	0.22%	0.2%	0.2%	0.78%	0.3%	0.3%	0.43%	0.42%
Selling, General & Admin	3.5M	3.8M	4.32M	3.99M	4.06M	4.61M	4.53M	5.14M	7.02M	7.41M
SG&A % of Revenue	0.21%	0.2%	0.22%	0.2%	0.2%	0.26%	0.26%	0.26%	0.33%	0.26%
Research & Development	0	0	0	0	0	0	0	0	0	0
R&D % of Revenue	-	-	-	-	-	-	-	-	-	-
Other Operating Expenses	18K	15K	3K	0	0	9.32M	844K	806K	2.05M	4.58M
Operating Income+	1.98M	3.29M	2.41M	1.86M	-4.54M	-9.46M	1.35M	2.43M	270K	-2.81M
Operating Margin %	0.12%	0.18%	0.12%	0.09%	-0.22%	-0.53%	0.08%	0.12%	0.01%	-0.1%
Operating Income Growth %	40.6%	0.66%	-0.27%	-0.23%	-3.44%	-1.09%	1.14%	0.8%	-0.89%	-11.39%
EBITDA+	8.17M	9.61M	9.09M	8.68M	2.88M	-2.49M	6.63M	7.55M	5.43M	3.37M
EBITDA Margin %	0.49%	0.51%	0.46%	0.44%	0.14%	-0.14%	0.38%	0.38%	0.25%	0.12%
EBITDA Growth %	0.29%	0.18%	-0.05%	-0.05%	-0.67%	-1.87%	3.66%	0.14%	-0.28%	-0.38%
D&A (Non-Cash Add-back)	6.19M	6.33M	6.68M	6.82M	7.41M	6.97M	5.28M	5.12M	5.17M	6.17M
EBIT	3.22M	4.99M	4.34M	3.49M	2.86M	-8.4M	1.69M	3.32M	1.81M	2.74M
Net Interest Income+	-1.22M	-1.69M	-1.92M	-1.43M	-1.3M	-1.05M	-742K	-719K	-686K	-1.25M
Interest Income	18K	15K	3K	198K	16K	10K	0	87K	426K	248K
Interest Expense	1.24M	1.71M	1.93M	1.63M	1.32M	1.06M	742K	806K	1.11M	1.5M
Other Income/Expense	-2.12M	-93K	-576K	220K	16K	10K	-404K	87K	426K	4.04M
Pretax Income+	-142K	3.19M	1.84M	2.08M	1.56M	-9.45M	947K	2.52M	696K	1.24M
Pretax Margin %	-0.01%	0.17%	0.09%	0.11%	0.08%	-0.53%	0.05%	0.13%	0.03%	0.04%
Income Tax+	434K	943K	-1.1M	451K	128K	-1.74M	269K	963K	431K	-295K
Effective Tax Rate %	10.72%	0.29%	1.05%	0.49%	0.42%	0.75%	0.2%	0.53%	0.88%	1.77%
Net Income+	-1.52M	930K	1.92M	1.02M	659K	-7.06M	194K	1.33M	610K	2.19M
Net Margin %	-0.09%	0.05%	0.1%	0.05%	0.03%	-0.4%	0.01%	0.07%	0.03%	0.08%
Net Income Growth %	-0.6%	1.61%	1.07%	-0.47%	-0.36%	-11.71%	1.03%	5.85%	-0.54%	2.58%
Net Income (Continuing)	-576K	2.25M	2.94M	1.63M	1.43M	-7.72M	678K	1.55M	265K	1.53M
Discontinued Operations	0	0	0	0	0	0	0	0	0	0
Minority Interest	5.05M	5.68M	6.03M	5.95M	5.78M	4.38M	4.35M	4M	3.65M	4.84M
EPS (Diluted)+	-0.28	0.17	0.33	0.17	0.24	-1.14	0.03	0.21	0.10	0.33
EPS Growth %	-0.47%	1.61%	0.94%	-0.48%	0.41%	-5.75%	1.03%	5.56%	-0.55%	2.46%
EPS (Basic)	-0.28	0.17	0.33	0.18	0.24	-1.14	0.03	0.21	0.10	0.34
Diluted Shares Outstanding	5.44M	5.47M	5.83M	6.02M	5.93M	6.18M	6.06M	6.3M	6.39M	6.7M
Basic Shares Outstanding	5.44M	5.47M	5.75M	5.84M	5.92M	6.18M	6.04M	6.3M	6.36M	6.5M
Dividend Payout Ratio	-	-	-	-	-	-	-	-	-	-

Balance Sheet

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Total Current Assets+	6.01M	8.39M	8.89M	9.95M	10.74M	10.85M	15.09M	18.72M	20.46M	26.26M
Cash & Short-Term Investments	2.21M	2.87M	2.15M	1.44M	1.43M	3.96M	8.14M	12.34M	13.69M	11.03M
Cash Only	2.21M	2.87M	2.15M	1.44M	1.43M	3.96M	8.14M	12.34M	13.69M	11.03M
Short-Term Investments	0	0	0	0	0	0	0	0	0	0
Accounts Receivable	3.15M	4.38M	5.24M	6.88M	7.06M	4.58M	4.82M	4.13M	4.85M	12.66M
Days Sales Outstanding	69.37	85.39	97.71	127.34	125.11	93.62	99.88	76.31	82.96	163.09
Inventory	50K	250K	350K	0	0	0	0	0	0	0
Days Inventory Outstanding	1.86	9.21	11.73	-	-	-	-	-	-	-
Other Current Assets	50K	250K	350K	350K	350K	1.15M	944K	1.01M	644K	1.18M
Total Non-Current Assets+	48.11M	52.21M	49.28M	47.56M	43.04M	32.8M	30.34M	25.23M	27.71M	33.94M
Property, Plant & Equipment	47.12M	51.33M	48.49M	46.69M	42.59M	31.32M	28.93M	23.8M	25.92M	32.16M
Fixed Asset Turnover	0.35x	0.36x	0.40x	0.42x	0.48x	0.57x	0.61x	0.83x	0.82x	0.88x
Goodwill	0	0	0	0	0	1.26M	1.26M	1.26M	1.26M	1.26M
Intangible Assets	0	0	0	0	0	78K	78K	78K	78K	78K
Long-Term Investments	579K	579K	0	0	0	0	0	0	0	0
Other Non-Current Assets	405K	300K	-2.91B	-2.96B	-2.51B	137K	73K	87K	443K	437K
Total Assets+	54.11M	60.6M	58.18M	57.5M	53.78M	43.65M	45.43M	43.96M	48.16M	60.2M
Asset Turnover	0.31x	0.31x	0.34x	0.34x	0.38x	0.41x	0.39x	0.45x	0.44x	0.47x
Asset Growth %	-0.2%	0.12%	-0.04%	-0.01%	-0.06%	-0.19%	0.04%	-0.03%	0.1%	0.25%
Total Current Liabilities+	8.7M	8.68M	9.01M	9.47M	8.21M	12.38M	5.89M	5.17M	10.78M	10.4M
Accounts Payable	375K	319K	359K	435K	557K	683K	318K	230K	315K	1.56M
Days Payables Outstanding	13.92	11.76	12.03	12.98	14.86	18.64	10.65	7.39	9.6	29.76
Short-Term Debt	2.67M	2.21M	2.46M	2.12M	1.53M	1.16M	2.42M	1.76M	6.54M	4.16M
Deferred Revenue (Current)	1000K	1000K	1000K	1000K	1000K	0	0	0	0	0
Other Current Liabilities	0	0	0	0	-285.87M	1.68M	1.18M	1.09M	1.41M	2.57M
Current Ratio	0.69x	0.97x	0.99x	1.05x	1.31x	0.88x	2.56x	3.62x	1.90x	2.52x
Quick Ratio	0.68x	0.94x	0.95x	1.05x	1.31x	0.88x	2.56x	3.62x	1.90x	2.52x
Cash Conversion Cycle	57.31	82.85	97.41	-	-	-	-	-	-	-
Total Non-Current Liabilities+	20.24M	24.74M	19.28M	16.98M	13.76M	7.62M	15.3M	13.16M	11.1M	19.77M
Long-Term Debt	6.92M	5.11M	3.6M	3.33M	1.95M	3.44M	14.32M	12.21M	11.04M	17.34M
Capital Lease Obligations	9.19M	14.85M	12.27M	10.31M	9M	3.56M	359K	59K	0	1.5M
Deferred Tax Liabilities	3.4M	4.18M	2.91M	2.96M	2.51M	418K	478K	822K	63K	924K
Other Non-Current Liabilities	0	0	0	0	0	0	0	0	0	0
Total Liabilities	28.93M	33.42M	28.29M	26.45M	21.97M	20M	21.19M	18.33M	21.88M	30.17M
Total Debt+	23.12M	27.04M	23.14M	20.17M	16.47M	14.4M	17.47M	14.31M	17.64M	23.23M
Net Debt	20.91M	24.16M	20.99M	18.72M	14.69M	10.44M	9.33M	1.98M	3.95M	12.2M
Debt / Equity	0.76x	0.82x	0.64x	0.55x	0.44x	0.61x	0.72x	0.56x	0.67x	0.77x
Debt / EBITDA	2.83x	2.81x	2.55x	2.32x	5.73x	-	2.63x	1.90x	3.25x	6.89x
Net Debt / EBITDA	2.56x	2.51x	2.31x	2.16x	5.11x	-	1.41x	0.26x	0.73x	3.62x
Interest Coverage	1.60x	1.93x	1.25x	1.14x	-3.44x	-8.95x	1.82x	3.02x	0.24x	-1.87x
Total Equity+	30.23M	32.85M	35.91M	36.99M	37.59M	23.65M	24.24M	25.63M	26.28M	30.03M
Equity Growth %	-0.02%	0.09%	0.09%	0.03%	0.02%	-0.37%	0.02%	0.06%	0.03%	0.14%
Book Value per Share	5.56	6.01	6.16	6.15	6.34	3.83	4.00	4.07	4.11	4.48
Total Shareholders' Equity	25.18M	27.17M	29.89M	31.05M	31.81M	19.27M	19.89M	21.63M	22.62M	25.18M
Common Stock	10.38M	10.6M	10.71M	10.71M	10.75M	10.75M	10.76M	10.76M	10.76M	10.76M
Retained Earnings	4.02M	4.95M	6.87M	7.9M	8.55M	1.5M	1.69M	3.02M	3.63M	5.82M
Treasury Stock	0	0	0	0	0	0	0	0	0	0
Accumulated OCI	-47.66M	-53.55M	-51.67M	-54.01M	0	0	0	0	0	0
Minority Interest	5.05M	5.68M	6.03M	5.95M	5.78M	4.38M	4.35M	4M	3.65M	4.84M

Cash Flow

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Cash from Operations+	8.55M	8.38M	7.85M	8.06M	8.05M	9.74M	6.27M	7.24M	5.72M	167K
Operating CF Margin %	0.52%	0.45%	0.4%	0.41%	0.39%	0.55%	0.36%	0.37%	0.27%	0.01%
Operating CF Growth %	0.26%	-0.02%	-0.06%	0.03%	-0%	0.21%	-0.36%	0.15%	-0.21%	-0.97%
Net Income	-576K	2.25M	2.94M	1.63M	1.43M	-7.72M	194K	1.55M	265K	1.53M
Depreciation & Amortization	6.19M	6.33M	6.68M	6.82M	7.41M	6.97M	5.28M	4.78M	5.17M	6.17M
Stock-Based Compensation	226K	215K	323K	223K	230K	299K	0	399K	389K	373K
Deferred Taxes	298K	772K	-1.27M	48K	-444K	-2.16M	60K	344K	-759K	-359K
Other Non-Cash Items	2.11M	526K	707K	39K	361K	8.54M	1.58M	450K	952K	-607K
Working Capital Changes	301K	-1.71M	-1.53M	-696K	-941K	3.82M	-853K	-296K	-294K	-6.95M
Change in Receivables	178K	-1.23M	-860K	-420K	-1.19M	2.97M	-519K	696K	-719K	-6.94B
Change in Inventory	0	0	0	0	0	0	0	0	0	0
Change in Payables	175K	-199M	125M	115K	28K	263K	851K	608K	-79K	2.23B
Cash from Investing+	-1.93M	-1.61M	-653K	-1.53M	-990K	-2.39M	-1.67M	-388K	-6.27M	-7.11M
Capital Expenditures	-1.92M	-1.61M	-803K	-1.58M	-990K	-455K	-1.67M	-388K	-6.27M	-7.94M
CapEx % of Revenue	0.12%	0.09%	0.04%	0.08%	0.05%	0.03%	0.09%	0.02%	0.29%	0.28%
Acquisitions	-	-	-	-	-	-	-	-	-	-
Investments	-	-	-	-	-	-	-	-	-	-
Other Investing	-10K	0	150K	51K	0	150K	0	0	0	833K
Cash from Financing+	-5.47M	-6.1M	-7.92M	-7.25M	-7.07M	-4.81M	-655K	-2.66M	1.91M	4.41M
Debt Issued (Net)	-	-	-	-	-	-	-	-	-	-
Equity Issued (Net)	-	-	-	-	-	-	-	-	-	-
Dividends Paid	0	0	0	0	0	0	0	0	0	0
Share Repurchases	-	-	-	-	-	-	-	-	-	-
Other Financing	7.36M	-692K	-551K	-690K	-897K	-761K	-915K	-630K	-211K	-221K
Net Change in Cash	-	-	-	-	-	-	-	-	-	-
Free Cash Flow+	6.63M	6.77M	7.05M	6.49M	7.06M	9.29M	4.59M	6.85M	-555K	-7.77M
FCF Margin %	0.4%	0.36%	0.36%	0.33%	0.34%	0.52%	0.26%	0.35%	-0.03%	-0.27%
FCF Growth %	3.25%	0.02%	0.04%	-0.08%	0.09%	0.32%	-0.51%	0.49%	-1.08%	-13%
FCF per Share	1.22	1.24	1.21	1.08	1.19	1.50	0.76	1.09	-0.09	-1.16
FCF Conversion (FCF/Net Income)	-5.62x	9.01x	4.08x	7.88x	12.21x	-1.38x	32.30x	5.45x	9.37x	0.08x
Interest Paid	1.67M	2.15M	1.57M	1.61M	1.32M	938K	0	722K	1.07M	1.4M
Taxes Paid	25K	266K	126K	459K	397K	339K	0	169K	297K	1.85M

Key Ratios

Metric	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
Return on Equity (ROE)	-4.98%	2.95%	5.59%	2.81%	1.77%	-23.05%	0.81%	5.33%	2.35%	7.76%
Return on Invested Capital (ROIC)	2.55%	4.56%	3.18%	2.48%	-6.28%	-16.37%	3%	5.96%	0.7%	-5.81%
Gross Margin	40.58%	47.03%	44.3%	37.97%	33.58%	25.04%	38.16%	42.45%	43.82%	32.41%
Net Margin	-9.2%	4.97%	9.83%	5.19%	3.2%	-39.57%	1.1%	6.73%	2.86%	7.71%
Debt / Equity	0.76x	0.82x	0.64x	0.55x	0.44x	0.61x	0.72x	0.56x	0.67x	0.77x
Interest Coverage	1.60x	1.93x	1.25x	1.14x	-3.44x	-8.95x	1.82x	3.02x	0.24x	-1.87x
FCF Conversion	-5.62x	9.01x	4.08x	7.88x	12.21x	-1.38x	32.30x	5.45x	9.37x	0.08x
Revenue Growth	7.34%	13%	4.58%	0.81%	4.52%	-13.43%	-1.17%	12.02%	8%	32.9%

Revenue by Segment

	2018	2019	2021	2022	2023	2024
Rental Income from Medical Services	-	-	14.72M	16.66M	17.77M	15.63M
Rental Income from Medical Services Growth	-	-	-	13.15%	6.71%	-12.06%
Patient Income	-	-	2.91M	3.09M	3.55M	12.56M
Patient Income Growth	-	-	-	6.26%	14.95%	253.39%
Equipment Sales	-	-	-	-	200K	155K
Equipment Sales Growth	-	-	-	-	-	-22.50%
Health Care	19.71M	20.61M	-	-	-	-
Health Care Growth	-	4.52%	-	-	-	-

Revenue by Geography

	2018	2019	2021	2022	2023	2024
Domestic	-	-	14.72M	16.66M	-	-
Domestic Growth	-	-	-	13.15%	-	-
Foreign	-	-	2.91M	3.09M	-	-
Foreign Growth	-	-	-	6.26%	-	-

Frequently Asked Questions

Valuation & Price

American Shared Hospital Services (AMS) has a price-to-earnings (P/E) ratio of 6.5x. This may indicate the stock is undervalued or faces growth challenges.

Growth & Financials

American Shared Hospital Services (AMS) reported $29.4M in revenue for fiscal year 2024. This represents a 32% increase from $22.2M in 2011.

American Shared Hospital Services (AMS) grew revenue by 32.9% over the past year. This is strong growth.

American Shared Hospital Services (AMS) reported a net loss of $2.3M for fiscal year 2024.

Dividend & Returns

American Shared Hospital Services (AMS) has a return on equity (ROE) of 7.8%. This is below average, suggesting room for improvement.

American Shared Hospital Services (AMS) had negative free cash flow of $10.2M in fiscal year 2024, likely due to heavy capital investments.

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American Shared Hospital Services (AMS) 10-Year Financial Performance & Capital Metrics

AMS • • Industrial / General

HealthcareHealthcare FacilitiesMedical Equipment & Technology ServicesMedical Equipment Management

Revenue $28M +32.9%
EBITDA $3M -38.0%
Net Income $2M +258.4%
EPS (Diluted) 0.33 +245.9%
Gross Margin 32.41% -26.0%
EBITDA Margin 11.89% -53.4%
Operating Margin -9.9% -881.7%
Net Margin 7.71% +169.7%
ROE 7.76% +230.3%
ROIC -5.81% -929.3%
Debt/Equity 0.77 +15.2%
Interest Coverage -1.87 -870.7%

Technical Analysis

Key Insights

Based on financial data analysis

✓Strengths

✓Strong 5Y profit CAGR of 27.1%
✓Trading at only 0.5x book value

✗Weaknesses

✗Negative free cash flow
✗Low quality earnings: Net income not backed by cash flow
✗Trading more than 30% below 52-week high

Price & Volume

Loading chart...

Growth Metrics

Revenue CAGR

10Y6.28%

5Y6.58%

3Y17.15%

TTM17.84%

Profit (Net Income) CAGR

10Y-

5Y27.1%

3Y124.19%

TTM-157.27%

EPS CAGR

10Y-

5Y6.58%

3Y117.66%

TTM-164.3%

ROCE

10Y Avg-1.06%

5Y Avg-4.07%

3Y Avg0.16%

Latest-6.44%

Peer Comparison

Medical Equipment Management

Name	Market Cap	Current Price	P/E Ratio	Revenue Growth 1Y	Net Margin	ROE	FCF Yield	Debt/Equity
AMSAmerican Shared Hospital Services	14.07M	2.15	6.52	32.9%	-7.65%	-7.87%		0.77
CCMConcord Medical Services Holdings Limited	13.15M	4.67	-0.00	-28.55%	-44.6%	-9.47%		2.43

Profit & Loss

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Sales/Revenue+	16.55M	18.7M	19.56M	19.71M	20.61M	17.84M	17.63M	19.75M	21.32M	28.34M
Revenue Growth %	0.07%	0.13%	0.05%	0.01%	0.05%	-0.13%	-0.01%	0.12%	0.08%	0.33%
Cost of Goods Sold+	9.83M	9.9M	10.89M	12.23M	13.69M	13.37M	10.9M	11.36M	11.98M	19.16M
COGS % of Revenue	0.59%	0.53%	0.56%	0.62%	0.66%	0.75%	0.62%	0.58%	0.56%	0.68%
Gross Profit+	6.71M	8.79M	8.66M	7.49M	6.92M	4.47M	6.73M	8.38M	9.34M	9.19M
Gross Margin %	0.41%	0.47%	0.44%	0.38%	0.34%	0.25%	0.38%	0.42%	0.44%	0.32%
Gross Profit Growth %	0.27%	0.31%	-0.02%	-0.14%	-0.08%	-0.35%	0.51%	0.25%	0.11%	-0.02%
Operating Expenses+	3.5M	3.8M	4.32M	3.99M	4.06M	13.93M	5.38M	5.95M	9.07M	11.99M
OpEx % of Revenue	0.21%	0.2%	0.22%	0.2%	0.2%	0.78%	0.3%	0.3%	0.43%	0.42%
Selling, General & Admin	3.5M	3.8M	4.32M	3.99M	4.06M	4.61M	4.53M	5.14M	7.02M	7.41M
SG&A % of Revenue	0.21%	0.2%	0.22%	0.2%	0.2%	0.26%	0.26%	0.26%	0.33%	0.26%
Research & Development	0	0	0	0	0	0	0	0	0	0
R&D % of Revenue	-	-	-	-	-	-	-	-	-	-
Other Operating Expenses	18K	15K	3K	0	0	9.32M	844K	806K	2.05M	4.58M
Operating Income+	1.98M	3.29M	2.41M	1.86M	-4.54M	-9.46M	1.35M	2.43M	270K	-2.81M
Operating Margin %	0.12%	0.18%	0.12%	0.09%	-0.22%	-0.53%	0.08%	0.12%	0.01%	-0.1%
Operating Income Growth %	40.6%	0.66%	-0.27%	-0.23%	-3.44%	-1.09%	1.14%	0.8%	-0.89%	-11.39%
EBITDA+	8.17M	9.61M	9.09M	8.68M	2.88M	-2.49M	6.63M	7.55M	5.43M	3.37M
EBITDA Margin %	0.49%	0.51%	0.46%	0.44%	0.14%	-0.14%	0.38%	0.38%	0.25%	0.12%
EBITDA Growth %	0.29%	0.18%	-0.05%	-0.05%	-0.67%	-1.87%	3.66%	0.14%	-0.28%	-0.38%
D&A (Non-Cash Add-back)	6.19M	6.33M	6.68M	6.82M	7.41M	6.97M	5.28M	5.12M	5.17M	6.17M
EBIT	3.22M	4.99M	4.34M	3.49M	2.86M	-8.4M	1.69M	3.32M	1.81M	2.74M
Net Interest Income+	-1.22M	-1.69M	-1.92M	-1.43M	-1.3M	-1.05M	-742K	-719K	-686K	-1.25M
Interest Income	18K	15K	3K	198K	16K	10K	0	87K	426K	248K
Interest Expense	1.24M	1.71M	1.93M	1.63M	1.32M	1.06M	742K	806K	1.11M	1.5M
Other Income/Expense	-2.12M	-93K	-576K	220K	16K	10K	-404K	87K	426K	4.04M
Pretax Income+	-142K	3.19M	1.84M	2.08M	1.56M	-9.45M	947K	2.52M	696K	1.24M
Pretax Margin %	-0.01%	0.17%	0.09%	0.11%	0.08%	-0.53%	0.05%	0.13%	0.03%	0.04%
Income Tax+	434K	943K	-1.1M	451K	128K	-1.74M	269K	963K	431K	-295K
Effective Tax Rate %	10.72%	0.29%	1.05%	0.49%	0.42%	0.75%	0.2%	0.53%	0.88%	1.77%
Net Income+	-1.52M	930K	1.92M	1.02M	659K	-7.06M	194K	1.33M	610K	2.19M
Net Margin %	-0.09%	0.05%	0.1%	0.05%	0.03%	-0.4%	0.01%	0.07%	0.03%	0.08%
Net Income Growth %	-0.6%	1.61%	1.07%	-0.47%	-0.36%	-11.71%	1.03%	5.85%	-0.54%	2.58%
Net Income (Continuing)	-576K	2.25M	2.94M	1.63M	1.43M	-7.72M	678K	1.55M	265K	1.53M
Discontinued Operations	0	0	0	0	0	0	0	0	0	0
Minority Interest	5.05M	5.68M	6.03M	5.95M	5.78M	4.38M	4.35M	4M	3.65M	4.84M
EPS (Diluted)+	-0.28	0.17	0.33	0.17	0.24	-1.14	0.03	0.21	0.10	0.33
EPS Growth %	-0.47%	1.61%	0.94%	-0.48%	0.41%	-5.75%	1.03%	5.56%	-0.55%	2.46%
EPS (Basic)	-0.28	0.17	0.33	0.18	0.24	-1.14	0.03	0.21	0.10	0.34
Diluted Shares Outstanding	5.44M	5.47M	5.83M	6.02M	5.93M	6.18M	6.06M	6.3M	6.39M	6.7M
Basic Shares Outstanding	5.44M	5.47M	5.75M	5.84M	5.92M	6.18M	6.04M	6.3M	6.36M	6.5M
Dividend Payout Ratio	-	-	-	-	-	-	-	-	-	-

Balance Sheet

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Total Current Assets+	6.01M	8.39M	8.89M	9.95M	10.74M	10.85M	15.09M	18.72M	20.46M	26.26M
Cash & Short-Term Investments	2.21M	2.87M	2.15M	1.44M	1.43M	3.96M	8.14M	12.34M	13.69M	11.03M
Cash Only	2.21M	2.87M	2.15M	1.44M	1.43M	3.96M	8.14M	12.34M	13.69M	11.03M
Short-Term Investments	0	0	0	0	0	0	0	0	0	0
Accounts Receivable	3.15M	4.38M	5.24M	6.88M	7.06M	4.58M	4.82M	4.13M	4.85M	12.66M
Days Sales Outstanding	69.37	85.39	97.71	127.34	125.11	93.62	99.88	76.31	82.96	163.09
Inventory	50K	250K	350K	0	0	0	0	0	0	0
Days Inventory Outstanding	1.86	9.21	11.73	-	-	-	-	-	-	-
Other Current Assets	50K	250K	350K	350K	350K	1.15M	944K	1.01M	644K	1.18M
Total Non-Current Assets+	48.11M	52.21M	49.28M	47.56M	43.04M	32.8M	30.34M	25.23M	27.71M	33.94M
Property, Plant & Equipment	47.12M	51.33M	48.49M	46.69M	42.59M	31.32M	28.93M	23.8M	25.92M	32.16M
Fixed Asset Turnover	0.35x	0.36x	0.40x	0.42x	0.48x	0.57x	0.61x	0.83x	0.82x	0.88x
Goodwill	0	0	0	0	0	1.26M	1.26M	1.26M	1.26M	1.26M
Intangible Assets	0	0	0	0	0	78K	78K	78K	78K	78K
Long-Term Investments	579K	579K	0	0	0	0	0	0	0	0
Other Non-Current Assets	405K	300K	-2.91B	-2.96B	-2.51B	137K	73K	87K	443K	437K
Total Assets+	54.11M	60.6M	58.18M	57.5M	53.78M	43.65M	45.43M	43.96M	48.16M	60.2M
Asset Turnover	0.31x	0.31x	0.34x	0.34x	0.38x	0.41x	0.39x	0.45x	0.44x	0.47x
Asset Growth %	-0.2%	0.12%	-0.04%	-0.01%	-0.06%	-0.19%	0.04%	-0.03%	0.1%	0.25%
Total Current Liabilities+	8.7M	8.68M	9.01M	9.47M	8.21M	12.38M	5.89M	5.17M	10.78M	10.4M
Accounts Payable	375K	319K	359K	435K	557K	683K	318K	230K	315K	1.56M
Days Payables Outstanding	13.92	11.76	12.03	12.98	14.86	18.64	10.65	7.39	9.6	29.76
Short-Term Debt	2.67M	2.21M	2.46M	2.12M	1.53M	1.16M	2.42M	1.76M	6.54M	4.16M
Deferred Revenue (Current)	1000K	1000K	1000K	1000K	1000K	0	0	0	0	0
Other Current Liabilities	0	0	0	0	-285.87M	1.68M	1.18M	1.09M	1.41M	2.57M
Current Ratio	0.69x	0.97x	0.99x	1.05x	1.31x	0.88x	2.56x	3.62x	1.90x	2.52x
Quick Ratio	0.68x	0.94x	0.95x	1.05x	1.31x	0.88x	2.56x	3.62x	1.90x	2.52x
Cash Conversion Cycle	57.31	82.85	97.41	-	-	-	-	-	-	-
Total Non-Current Liabilities+	20.24M	24.74M	19.28M	16.98M	13.76M	7.62M	15.3M	13.16M	11.1M	19.77M
Long-Term Debt	6.92M	5.11M	3.6M	3.33M	1.95M	3.44M	14.32M	12.21M	11.04M	17.34M
Capital Lease Obligations	9.19M	14.85M	12.27M	10.31M	9M	3.56M	359K	59K	0	1.5M
Deferred Tax Liabilities	3.4M	4.18M	2.91M	2.96M	2.51M	418K	478K	822K	63K	924K
Other Non-Current Liabilities	0	0	0	0	0	0	0	0	0	0
Total Liabilities	28.93M	33.42M	28.29M	26.45M	21.97M	20M	21.19M	18.33M	21.88M	30.17M
Total Debt+	23.12M	27.04M	23.14M	20.17M	16.47M	14.4M	17.47M	14.31M	17.64M	23.23M
Net Debt	20.91M	24.16M	20.99M	18.72M	14.69M	10.44M	9.33M	1.98M	3.95M	12.2M
Debt / Equity	0.76x	0.82x	0.64x	0.55x	0.44x	0.61x	0.72x	0.56x	0.67x	0.77x
Debt / EBITDA	2.83x	2.81x	2.55x	2.32x	5.73x	-	2.63x	1.90x	3.25x	6.89x
Net Debt / EBITDA	2.56x	2.51x	2.31x	2.16x	5.11x	-	1.41x	0.26x	0.73x	3.62x
Interest Coverage	1.60x	1.93x	1.25x	1.14x	-3.44x	-8.95x	1.82x	3.02x	0.24x	-1.87x
Total Equity+	30.23M	32.85M	35.91M	36.99M	37.59M	23.65M	24.24M	25.63M	26.28M	30.03M
Equity Growth %	-0.02%	0.09%	0.09%	0.03%	0.02%	-0.37%	0.02%	0.06%	0.03%	0.14%
Book Value per Share	5.56	6.01	6.16	6.15	6.34	3.83	4.00	4.07	4.11	4.48
Total Shareholders' Equity	25.18M	27.17M	29.89M	31.05M	31.81M	19.27M	19.89M	21.63M	22.62M	25.18M
Common Stock	10.38M	10.6M	10.71M	10.71M	10.75M	10.75M	10.76M	10.76M	10.76M	10.76M
Retained Earnings	4.02M	4.95M	6.87M	7.9M	8.55M	1.5M	1.69M	3.02M	3.63M	5.82M
Treasury Stock	0	0	0	0	0	0	0	0	0	0
Accumulated OCI	-47.66M	-53.55M	-51.67M	-54.01M	0	0	0	0	0	0
Minority Interest	5.05M	5.68M	6.03M	5.95M	5.78M	4.38M	4.35M	4M	3.65M	4.84M

Cash Flow

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Cash from Operations+	8.55M	8.38M	7.85M	8.06M	8.05M	9.74M	6.27M	7.24M	5.72M	167K
Operating CF Margin %	0.52%	0.45%	0.4%	0.41%	0.39%	0.55%	0.36%	0.37%	0.27%	0.01%
Operating CF Growth %	0.26%	-0.02%	-0.06%	0.03%	-0%	0.21%	-0.36%	0.15%	-0.21%	-0.97%
Net Income	-576K	2.25M	2.94M	1.63M	1.43M	-7.72M	194K	1.55M	265K	1.53M
Depreciation & Amortization	6.19M	6.33M	6.68M	6.82M	7.41M	6.97M	5.28M	4.78M	5.17M	6.17M
Stock-Based Compensation	226K	215K	323K	223K	230K	299K	0	399K	389K	373K
Deferred Taxes	298K	772K	-1.27M	48K	-444K	-2.16M	60K	344K	-759K	-359K
Other Non-Cash Items	2.11M	526K	707K	39K	361K	8.54M	1.58M	450K	952K	-607K
Working Capital Changes	301K	-1.71M	-1.53M	-696K	-941K	3.82M	-853K	-296K	-294K	-6.95M
Change in Receivables	178K	-1.23M	-860K	-420K	-1.19M	2.97M	-519K	696K	-719K	-6.94B
Change in Inventory	0	0	0	0	0	0	0	0	0	0
Change in Payables	175K	-199M	125M	115K	28K	263K	851K	608K	-79K	2.23B
Cash from Investing+	-1.93M	-1.61M	-653K	-1.53M	-990K	-2.39M	-1.67M	-388K	-6.27M	-7.11M
Capital Expenditures	-1.92M	-1.61M	-803K	-1.58M	-990K	-455K	-1.67M	-388K	-6.27M	-7.94M
CapEx % of Revenue	0.12%	0.09%	0.04%	0.08%	0.05%	0.03%	0.09%	0.02%	0.29%	0.28%
Acquisitions	-	-	-	-	-	-	-	-	-	-
Investments	-	-	-	-	-	-	-	-	-	-
Other Investing	-10K	0	150K	51K	0	150K	0	0	0	833K
Cash from Financing+	-5.47M	-6.1M	-7.92M	-7.25M	-7.07M	-4.81M	-655K	-2.66M	1.91M	4.41M
Debt Issued (Net)	-	-	-	-	-	-	-	-	-	-
Equity Issued (Net)	-	-	-	-	-	-	-	-	-	-
Dividends Paid	0	0	0	0	0	0	0	0	0	0
Share Repurchases	-	-	-	-	-	-	-	-	-	-
Other Financing	7.36M	-692K	-551K	-690K	-897K	-761K	-915K	-630K	-211K	-221K
Net Change in Cash	-	-	-	-	-	-	-	-	-	-
Free Cash Flow+	6.63M	6.77M	7.05M	6.49M	7.06M	9.29M	4.59M	6.85M	-555K	-7.77M
FCF Margin %	0.4%	0.36%	0.36%	0.33%	0.34%	0.52%	0.26%	0.35%	-0.03%	-0.27%
FCF Growth %	3.25%	0.02%	0.04%	-0.08%	0.09%	0.32%	-0.51%	0.49%	-1.08%	-13%
FCF per Share	1.22	1.24	1.21	1.08	1.19	1.50	0.76	1.09	-0.09	-1.16
FCF Conversion (FCF/Net Income)	-5.62x	9.01x	4.08x	7.88x	12.21x	-1.38x	32.30x	5.45x	9.37x	0.08x
Interest Paid	1.67M	2.15M	1.57M	1.61M	1.32M	938K	0	722K	1.07M	1.4M
Taxes Paid	25K	266K	126K	459K	397K	339K	0	169K	297K	1.85M

Key Ratios

Metric	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
Return on Equity (ROE)	-4.98%	2.95%	5.59%	2.81%	1.77%	-23.05%	0.81%	5.33%	2.35%	7.76%
Return on Invested Capital (ROIC)	2.55%	4.56%	3.18%	2.48%	-6.28%	-16.37%	3%	5.96%	0.7%	-5.81%
Gross Margin	40.58%	47.03%	44.3%	37.97%	33.58%	25.04%	38.16%	42.45%	43.82%	32.41%
Net Margin	-9.2%	4.97%	9.83%	5.19%	3.2%	-39.57%	1.1%	6.73%	2.86%	7.71%
Debt / Equity	0.76x	0.82x	0.64x	0.55x	0.44x	0.61x	0.72x	0.56x	0.67x	0.77x
Interest Coverage	1.60x	1.93x	1.25x	1.14x	-3.44x	-8.95x	1.82x	3.02x	0.24x	-1.87x
FCF Conversion	-5.62x	9.01x	4.08x	7.88x	12.21x	-1.38x	32.30x	5.45x	9.37x	0.08x
Revenue Growth	7.34%	13%	4.58%	0.81%	4.52%	-13.43%	-1.17%	12.02%	8%	32.9%

Revenue by Segment

	2018	2019	2021	2022	2023	2024
Rental Income from Medical Services	-	-	14.72M	16.66M	17.77M	15.63M
Rental Income from Medical Services Growth	-	-	-	13.15%	6.71%	-12.06%
Patient Income	-	-	2.91M	3.09M	3.55M	12.56M
Patient Income Growth	-	-	-	6.26%	14.95%	253.39%
Equipment Sales	-	-	-	-	200K	155K
Equipment Sales Growth	-	-	-	-	-	-22.50%
Health Care	19.71M	20.61M	-	-	-	-
Health Care Growth	-	4.52%	-	-	-	-

Revenue by Geography

	2018	2019	2021	2022	2023	2024
Domestic	-	-	14.72M	16.66M	-	-
Domestic Growth	-	-	-	13.15%	-	-
Foreign	-	-	2.91M	3.09M	-	-
Foreign Growth	-	-	-	6.26%	-	-

Frequently Asked Questions

Valuation & Price

American Shared Hospital Services (AMS) has a price-to-earnings (P/E) ratio of 6.5x. This may indicate the stock is undervalued or faces growth challenges.

Growth & Financials

American Shared Hospital Services (AMS) reported $29.4M in revenue for fiscal year 2024. This represents a 32% increase from $22.2M in 2011.

American Shared Hospital Services (AMS) grew revenue by 32.9% over the past year. This is strong growth.

American Shared Hospital Services (AMS) reported a net loss of $2.3M for fiscal year 2024.

Dividend & Returns

American Shared Hospital Services (AMS) has a return on equity (ROE) of 7.8%. This is below average, suggesting room for improvement.

American Shared Hospital Services (AMS) had negative free cash flow of $10.2M in fiscal year 2024, likely due to heavy capital investments.