Q2 2024 American Shared Hospital Services Earnings Call

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Speaker Change: Good day and welcome to the American shared hospital services second quarter 2024 earnings Conference call all participants will be in listen only mode.

Operator: Good day, and welcome to the American Shared Hospital Service. Second Quarter 2024 Earnings Conference. All participants will be enlisted on, Should you need assistance, please signal a conference special. Cutting the star key, fallen by- After today's presentation, there will be an opportunity to ask questions, to ask a question. He may press star, then one on a touchdown zone.

Unknown Attendee: Good day, and welcome to the American Shared Hospital Services, checking quarter in 2024 earnings conference call. All participants will be in listen-only mode. Should you need assistance, please signal conference specialists by pressing the star key followed by zero.

Speaker Change: Need assistance. Please signal a conference specialist by pressing the star key followed by zero. After today's presentation, there will be an opportunity to ask questions to ask any question. You May Press Star then one on a touchtone phone.

Unknown Attendee: After today's presentation, there will be an opportunity to ask questions. To ask a question, you may press star then one on a touch tone phone. To withdraw your questions, please press star and then two. Please note this event is being recorded.

Speaker Change: To withdraw your question. Please press Star then two please note. This event is being recorded.

Operator: Unknown AttendeeN. Please note this event is being recorded. I would now like to turn the conference over to Kieran Smith, Investor Relations. Please go ahead.

Kirin Smith: I would now like to turn the conference over to Kirin Smith, Investor Relations. Please go ahead.

Speaker Change: Now I'd like to turn the conference over to Karen Smith Investor Relations. Please go ahead.

Kirin Smith: Thank you, Dave, and thank you, everyone, for joining us today. AMS' second quarter 2024 earnings press release was issued today after the market closed. If you need a copy, it can be accessed on the company's website at www.ashs.com, at press releases under the investors tab.

Karen Smith: Thank you, Dave and thank you everyone for joining us today.

Kieran Smith: Thank you, Dave, and thank you, everyone, for joining us today. AMS's second quarter 2024 earnings early earnings press release was issued today after the market closed. If you need a copy, it can be accessed on the company's website at www.ashs.com in press releases under the investors tab. Before turning the call over to management, I would like to make the following remarks concerning forward-looking statements. Please note that various remarks that may be made on this conference call about future expectations, plans, and prospects for the company constitute forward-looking statements for the purposes of the safe harbor provisions under the Private Securities Litigation Reform Act of 1995.

Speaker Change: Second quarter 2020 for earnings.

Speaker Change: <unk> press release was issued today after the market close if you need a copy can be accessed on the company's website at Www Hey, yes.

Speaker Change: <unk> Dot com at press releases under the investors tab before turning the call over to management I would like to make the following remarks concerning forward looking statements.

Kirin Smith: Before turning the call over to management, I would like to make the following remarks concerning forward-looking statements. Please note that various remarks that may be made on this conference call about future expectations, plans, and prospects for the company constitute forward-looking statements for the purposes of safe harbor provisions under the Private Securities Litigation Reform Act of 1995. Actual results may vary materially from those indicated by these forward-looking statements as a result of various important factors, including those discussed in the company's filings with the SEC. This includes the company's quarterly report on Form 10-Q for the three-month period ended March 31, 2024.

Kieran Smith: Actual results may vary materially from those indicated by these forward-looking statements as a result of various important factors, including those discussed in the company's filings with the FAA. This includes the company's quarterly report on Form 10-Q for the three-month period ended March 31, 2024, the annual report on Form 10-K for the year ended December 31, 2023, and the definitive proxy statement for the annual meeting of shareholders that was held on June 25, 2024.

Speaker Change: Please note that various remarks that may be made on this conference call about future expectations plans and prospects for the company constitute forward looking statements for the purposes of Safe Harbor provisions under the private Securities Litigation Reform Act of 1995.

Speaker Change: Actual results may vary materially from those indicated by these forward looking statements as a result of various important factors, including those discussed in the company's filings with the SEC.

Speaker Change: <unk> the company's quarterly report on Form 10-Q for the three months period ended March 31, 2020 for the annual report on Form 10-K for the year ended December 31, 2023, and the definitive proxy statement for the annual meeting of shareholders. It was held on June 25 2024.

Kirin Smith: The annual report on Form 10-K for the year ended December 31, 2023, and the definitive proxy statement for the annual meeting of shareholders that was held on June 25, 2024. The company assumes no obligation to update the information contained in this conference call.

Speaker Change: The company assumes no obligation to update the information contained in this conference call.

Kieran Smith: The company assumes no obligation to update the information contained in this conference call. Before I turn the call over to Ray, I'd like to remind everyone about our Q&A policy, where we provide each participant the time to ask one question and one follow-up. As always, we'll be happy to take additional questions offline at any time. With that, I'd now like to turn the call over to Ray Stachowiak, Executive Chairman and CEO. Ray, please go ahead.

Kirin Smith: Before I turn the call over to Ray, I'd like to remind everyone about our Q&A policy: we provide each participant the time to ask one question and one follow-up. As always, we'll be happy to take additional questions offline at any time.

Speaker Change: I turn the call over to Ray I'd like to remind everyone about our Q&A policy, but we provide each participant to ask one question one follow up.

Ray: We will be happy to take additional questions offline at anytime with that I'd now like to turn the call over the race to <unk> Executive Chairman and CEO right. Please go ahead.

Raymond Stachowiak: With that, I'd now like to turn the call over to Ray Stacoliac, Executive Chairman and CEO. Please go ahead.

Raymond Stachowiak: Thank you, Karen.

Ray: Thank you Karen and good afternoon, everyone.

Raymond Stachowiak: Good afternoon, everyone. Thank you for joining us today for our second quarter 2024 earnings conference call. I'll begin with some opening remarks and then turn the call over to Bob Hyatt, our Chief Financial Officer, for a financial review of the second quarter results. Following the prepared remarks, we'll open the call for your questions. Now, on to the quarterly results. We're very pleased to report that AMS had a strong second quarter, and we're extremely excited about the upcoming year. We've continued to show market improvement and advancement in several important ways. The quarter showcase an extremely nice early benefit from the Rhode Island acquisition that we closed just this past with an immediate gain of 4.9 million dollars free tax.

Ray: Thank you for joining us today for our second quarter 2024 earnings Conference call.

Raymond Stachowiak: Thank you, Karen. Good afternoon, everyone. Thank you for joining us today for our second quarter 2024 earnings conference call. I'll begin with some opening remarks and then turn the call over to Bob Hiatt, our Chief Financial Officer, for a financial review of the Second Quarter Results. Following the prepared remarks, we will open the call to your questions.

Speaker Change: I'll begin with some opening remarks, and then turn the call over to Bob Hau, Our Chief Financial Officer.

Bob Hau: For a financial review of the second quarter results.

Bob Hau: Following the prepared remarks, we'll open the call for your questions.

Raymond Stachowiak: Now, on to the quarterly results. We're very pleased to report that AMS had a strong second quarter, and we're extremely excited about the upcoming year. We've continued to show market improvement and advancement in several important ways. The quarter showcased an extremely nice early benefit from the Rhode Island acquisition that we closed just this past May, with an immediate gain of $4.9 million free tax.

Bob Hau: Now onto the quarterly results.

Speaker Change: We're very pleased to report that <unk> had a strong second quarter and we're extremely excited about the upcoming year.

Bob Hau: We've continued to show market improvement and advanced smart with several important ways.

Bob Hau: The quarter showcase an extremely nice early benefit.

Bob Hau: From the Rhode Island acquisition.

Bob Hau: We closed just this past may.

Bob Hau: With an immediate gain a $4.9 million pre tax.

Raymond Stachowiak: This gain reflects the value and the net assets we acquired in excess of the purchase price we paid. I've often discussed that we are fortunate to have a robust balance sheet with significant capital to deploy for strategic initiatives and business opportunities that we come across. The Rhode Island acquisition is a great example of how we deployed approximately $3 million and were able to strategically acquire fair market value assets worth approximately $8 million. This was clearly an excellent allocation of our capital. The team continues to focus on strengthening our core business by working with customers to increase utilization of the equipment.

Bob Hau: This gain reflects the value of the net assets we acquired.

Bob Hau: In excess of the purchase price we paid.

Bob Hau: I've often discussed that we are fortunate to have a robust balance sheet.

Raymond Stachowiak: I've often discussed that we are fortunate to have a robust balance, with significant capital to deploy for strategic initiatives and business opportunities that we come across. The Rhode Island acquisition is a great example of how we deployed approximately $3 million, and we were able to strategically acquire Fair Market Value assets worth approximately $8 million. This was clearly an excellent allocation of our capital.

Bob Hau: With significant capital to deploy for strategic initiatives and business opportunities that we come across.

Bob Hau: The Rhode Island acquisition is a great example.

Bob Hau: Well, Paul we deployed approximately $3 million.

Bob Hau: And we're able to strategically acquire.

Fair market value assets worth approximately $8 million.

Bob Hau: This was clearly an excellent allocation of our capital.

Speaker Change: The team continues to focus on strengthening our core business by working with customers to increase utilization of the equipment.

Raymond Stachowiak: The team continues to focus on strengthening our core business by working with customers to increase utilization of the equipment. This focus strategy led to the signing of five lease extensions in the last 15 months from our 10 domestic Gamma Knife customers, with others still on the pipeline. We believe these extended agreements are a testament to our partnership business model and Financial Flexibility. Our International Retail Resolve [inaudible] is also showing continued momentum. In the second quarter, we saw volumes increase following our completed equipment upgrade in Ecuador to a new state-of-the-art Gamma Knife icon, the only Gamma Knife in Ecuador for non-invasive radial surgery.

Raymond Stachowiak: This focus strategy led to the signing of five lease extensions in the last 15 months from our 10 domestic gamenife customers, with others still on the pipeline. We believe these extended agreements are a testament to our partnership business model and financial flexibility. Our international retail results are also showing continued momentum. In a second quarter, we saw a volumes increase following our completed equipment upgrade in Ecuador to a new state-of-the-art gamenife icon. The only gamenife in Ecuador for non-invasive radial surgery. Our gamenife improved; the only gamenife in that country also showed excellent results in the second quarter.

Speaker Change: This focused strategy led to the signing of five lease extensions in the last 15 months from our 10 domestic gamma knife customers with others still in the pipeline.

Speaker Change: We believe these extended agreements are a testament to our partnership business model.

Speaker Change: And financial flexibility.

Speaker Change: Our international retail results.

Speaker Change: Are also showing continued momentum.

Speaker Change: In the second quarter, we saw volumes increase following our completed equipment upgrade and Ecuador.

Speaker Change: So a new state of the art gamma knife icon.

Speaker Change: The only gamma knife in Ecuador for Noninvasive radio surgery.

Speaker Change: Our gamma knife in Peru, the only gamma knife in that country also showed excellent results in the second quarter.

Raymond Stachowiak: Our Gamma Knife in Peru, the only Gamma Knife in that country, also showed excellent results in the second quarter. Just last week, we announced that our Center in Puebla, Mexico had begun treating patients. This newly opened linear accelerator, or LINAC, that we installed has VMAT, IGRT, IMRT, and Radio Surgery capability, offering the most advanced radiation therapy available in our catchment. And in early July, we established our fourth international center with the signing of a joint venture agreement for a Gamma Knife facility in Guadalajara, Mexico.

Raymond Stachowiak: Just last week, we announced that our center in Puebla, Mexico, has begun treating patients. This newly opened linear accelerator or Linux that we installed has VMAT, IGRT, IMRT, and radial surgery capabilities, offering the most advanced radiation therapy available in our catchment area. And in early July, we established our fourth international center with the signing of a joint venture agreement for a gamenife facility in Guadalajara, Mexico. We also continue to invest in three unique business opportunities previously discussed. The first of these opportunities was announced late last year for the acquisition of a 60 percent majority interest in three radiation therapy centers in Rhode Island, which closed this past May.

Speaker Change: Just last week, we announced that our center in Puebla, Mexico has begun treating patients.

Speaker Change: This newly opened linear accelerator or linac that we installed has the mat I G. R. T I am Archie and radio surgery capabilities offering the most advanced radiation therapy available in our catchment area.

Speaker Change: And in early July we established our fourth International center with the signing of a joint venture agreement for a gamma knife facility in Guadalajara, Mexico.

Speaker Change: We also continue to invest in three unique.

Raymond Stachowiak: We also continue to invest in three unique business opportunities previously discussed. The first of these opportunities was announced late last year for the acquisition of a 60% majority interest in three radiation therapy centers in Rhode Island, which closed this past May. These are our first direct patient services or retail centers in the United States.

Speaker Change: Business opportunities previously discussed.

Speaker Change: The first of these opportunities was announced late last year for the acquisition of a 60% majority interest and three radiation therapy centers in Rhode Island, which closed this past may.

Raymond Stachowiak: These are our first direct patient services or retail centers in the United States. This new business, which is the first from our expanded team and new line. Clearly reflects our strong ambitions for the company. The second opportunity is the Certificate of Need for CON that we have been granted to build a Radiation Therapy Center in Bristol, Rhode Island. And the third opportunity is the CON that we have applied for for the Proton Beam Radiation Therapy Center in the state of Rhode Island. This Proton Beam Radiation Therapy Center would be the only system between New York City and Boston.

Speaker Change: These are our first direct patient services or retail centers in the United States.

Raymond Stachowiak: This new business, which is the first from our expanded team and new pipeline, clearly reflects our strong ambitions for the future. The second opportunity is the Certificate of Need for CON that we have been granted to build a radiation therapy center in Bristol, Rhode Island. And the third opportunity is the CON that we have applied for Procon Dean Radiation Therapy Center in the state of Rhode Island. This Proton Beam Radiation Therapy Center would be the only system between New York City and Boston.

Speaker Change: This new business, which is the first from our expanded team and new pipeline.

Speaker Change: Clearly reflects our strong ambitions for the company.

Speaker Change: The second opportunity is the certificate of need for C O N.

Speaker Change: We have been granted.

Speaker Change: Build a radiation therapy center in Bristol, Rhode Island.

Speaker Change: And the third opportunity is a C O N that we have applied for for proton beam radiation therapy center in the state of Rhode Island.

Speaker Change: This proton beam radiation therapy center would be the only system.

Speaker Change: New York City and Boston.

Raymond Stachowiak: We followed quarter one with another solid quarter, reporting total revenue in the second quarter of $7.1 million, a year-over-year increase of 27%. The gross margin percentage came in at 35%, which reflects the change in mix and strong growth in our retail segment. And we earned over $3.6 million, or 55 cents per share, for the quarter, which is a major increase compared with the prior year's second quarter. This includes an after-tax gain of approximately $3.7 million from our Rhode Island acquisition. Our operating income for the second quarter of 2024 was breakeven due to the additional costs related to the closing of the Rhode Island acquisition of 361,000.

Speaker Change: We followed quarter, one with another solid quarter.

Raymond Stachowiak: We follow quarter one with another solid quarter. Reporting total revenue in the second quarter was $7.1 million, a year-over-year increase of 27%. The gross margin percentage came in at 35%, which reflects the change in Next and strong growth in our retail cycle, and we earned over $3.6 million, or $0.55 per share. VertiQuark, which is a major increase.

Speaker Change: Reporting total revenue in the second quarter was $7 $1 million a year.

Speaker Change: Year over year increase of 27%.

Speaker Change: The gross margin percentage came in at 35%.

Speaker Change: Which reflects the change in mix and strong growth in our retail segment.

Speaker Change: And we earned over $3.6 million.

Speaker Change: Or 55 cents per share.

Speaker Change: Verdict court.

Speaker Change: Which is a major increase compared with the prior year's second quarter.

Raymond Stachowiak: Compared with the prior year's spec- [inaudible] This includes an after-tax gain of approximately $3.7 million from our Rhode Island Acquisition. Our operating income for the second quarter of 2024 was breakeven due to the additional costs related to the closing of the Rhode Island Acquisition of $361,000, but compared to an operating loss of $325,000 in the second quarter of 2023. Primarily due to the reduced impaired assets and removal costs. Our balance sheet remains strong.

Speaker Change: This includes an after tax gain of approximately $3 $7 million from our Rhode Island acquisition.

Speaker Change: Our operating income for the second quarter 2024.

Speaker Change: It was breakeven due to the additional costs related to the closing of the Rhode Island acquisition.

Speaker Change: 361000.

Raymond Stachowiak: But compared to an operating loss of 325,000 in the second quarter of 2023, primarily due to the reduced impaired assets and removal costs. Our balance sheet remains strong. We ended the second quarter with over $14.5 million in cash. Roughly equal to $2.24 per share. We also had $3.95 million outstanding on our $7 million line of credit as at June 30, 2024, which we paid off early in the third quarter of 2024. We continued to leverage these resources carefully for additional long-term revenue streams. As we look into the coming months, we expect stronger international growth from additional treatment capabilities and Ecuador.

Speaker Change: But compared to an operating loss of 325000 in the second quarter of 2023.

Primarily due to the reduced impaired assets and removal costs.

Speaker Change: Our balance sheet remains strong.

Raymond Stachowiak: We ended the second quarter with over $14.5 million in cash, roughly equal to $2.24 per share. We also had $3.95 million outstanding on our $7 million line of credit as of June 30, 2024, which we paid off early in the third quarter of 2024. We continue to leverage these resources carefully for additional long-term revenue. As we look into the coming months, we expect stronger international growth from additional treatment capabilities and continued strong volume from our Center and Peru and the opening of the new centers in Guadalajara and Puebla, Mexico.

Speaker Change: We ended the second quarter with over $14 $5 million in cash.

Speaker Change: Roughly equal to $2.24 per share.

Speaker Change: We also had $3 $95 million outstanding on our $7 million line of credit as of June 32020 for which we paid off early in the third quarter of 2024.

Speaker Change: We continue to leverage these resources carefully for additional long term revenue streams.

Speaker Change: As we look into the coming months.

Speaker Change: We expect stronger international growth.

Speaker Change: Some additional treatment capabilities in Ecuador.

Raymond Stachowiak: Continued strong volume from our center in Peru, and the opening of the new centers in Guadalajara and Puebla, Mexico. The recent closing of the Rhode Island acquisition adds three new revenue streams to our business. In addition to new business opportunities that are moving through the long and intricate sales sites. Michael.

Speaker Change: Continued strong volume from our center in Peru.

Speaker Change: And the opening of the new centers in Guadalajara, and Puebla Mexico.

The recent closing of the Rhode Island acquisition.

Raymond Stachowiak: The recent closing of the Rhode Island acquisition adds three new revenue streams to our business, in addition to new business opportunities that are moving through the long and intricate sales cycle. With that, I'll turn the call over to Bob for a financial review. Bob

Speaker Change: It's three new revenue streams to our business.

Speaker Change: In addition to new business opportunities that are moving through the long and ensure kit sales cycle.

Robert Hiatt: With that, I'll turn the call over to Bob for a financial review. Bob, thank you, race, and good afternoon everyone.

Speaker Change: With that I'll turn the call over to Bob for a financial review.

Speaker Change: Bob.

Bob Hau: Thank you Ray and good afternoon, everyone.

Robert Hiatt: Thank you, Ray, and good afternoon, everyone. Second Quarter Revenue increased 27% to 7.1 million compared to 5.7 million in a year ago quarter. As previously discussed, we've redefined our business segments to better reflect our revenue sources. Rental revenue from the company's medical equipment leasing segment, which we now refer to as leasing, was $3.9 million for the second quarter, 2024, compared to $4.8 million in the year ago quarter, a decrease of 19%.

Bob Hau: Second quarter revenue increased 27% to $7 1 million compared to $5 7 million in the year ago quarter.

Robert Hiatt: Second quarter revenue increased 27% to 7.1 million compared to 5.7 million in a year-ago quarter.

Robert Hiatt: As previously discussed, we redefined our business segments to better reflect our revenue sources. Rental revenue from the company's medical equipment leasing segment, which we now refer to as leasing, was $3.9 million for the second quarter, 2024, compared to $4.81 million in the year-ago quarter, a decrease of 19%. Revenue from the company's direct patient services, a retail segment, was 3.16 million for the second quarter, and at June 30th, 2024, compared to 756,000 for the year-ago quarter, marking an increase of 318%. This increase was due to the acquisition in Rhode Island, and increased volumes that are existing retail locations.

Speaker Change: As previously discussed we've redefined our business segments to better reflect our revenue sources.

Bob Hau: Revenue from the company's medical equipment leasing segment, which we now referred to as leasing was $3 $9 million for the second quarter 2024, compared to $4 eight 1 million in the year ago quarter, a decrease of 19%.

Speaker Change: Revenue from the company's direct patient services, our retail segment was $3. One 6 million for the second quarter ended June 32024, compared to 756000 for the year ago quarter, marking an increase of 318%.

Robert Hiatt: Revenue from the company's Direct Patient Services, a retail segment, was $3.16 million for the second quarter and June 30th, 2024, compared to $756,000 for the year of a quarter, marking an increase of 318%. This increase was due to the acquisition in Rhode Island and increased volumes at our existing retail location. Additionally, the upgrade of the equipment in Ecuador added capacity, improved patient experience, and volume, and Peruvian revenues increased due to promotion of the center throughout the country.

Speaker Change: This increase was due to the acquisition in Rhode Island, and increased volumes at our existing retail locations.

Robert Hiatt: Additionally, the upgrade of the equipment and Ecuador added capacity, improved patient experience, and volume, and the Peru revenues increased due to promotion of the center throughout the country. Second quarter revenue for the company's proton therapy system in Florida was 2.42 million, a decrease of 5%, primarily due to continued cyclical volume changes. Total proton therapy prices in the second quarter were $1,136 compared to 1,370 proton therapy fractions in the second quarter of 2023. A 10% decrease due to normal cyclical fluctuations. Total gamma-nive preceded revenue decreased 9% to 2.74 million due to a decrease in revenue from two expired contracts, but was nearly upset by high volume in our international location.

Speaker Change: Additionally, the upgrade of the equipment in Ecuador added capacity improved patient experience and volume and the Peru revenues increased due to promotion of the center throughout the country.

Speaker Change: Second quarter revenue for the company's proton therapy system in Florida, with 242 million a decrease of 5% primarily due to continued cyclical volume changes.

Robert Hiatt: Second quarter revenue for the company's proton therapy system in Florida was $2.42 million, a decrease of 5% primarily due to continued cyclical volume change. Total proton therapy fractions in the second quarter were 1236 compared to 1370 proton therapy fractions in the second quarter of 2023. A 10% decrease due to normal cyclical fluctuation. Total Gamma Knife revenue decreased 9% to $2.74 million due to a decrease in revenue from two expired contracts, but was nearly offset by high volume in our international location.

Speaker Change: Total proton therapy prices in the second quarter were 236 compared to $13 70 proton therapy fractions in the second quarter of 2023.

Speaker Change: A 10% decrease due to normal cyclical fluctuations.

Speaker Change: Yeah.

Speaker Change: Total gamma knife revenue.

Speaker Change: Decreased 9% to $2 $74 million due to a decrease in revenue from two expired contract, but was nearly offset by high volume in our international locations.

Robert Hiatt: To put this in perspective, total gamma-nive procedures were 340 for the second quarter compared to 309 in the second quarter a year ago. However, excluding the two customer contracts that expired, gamma-nive procedures increased by 65 or 24% for the second quarter of 2024. Gross margin for the second quarter of 2024 decreased 2% to 2.47 million compared to gross margin of 2.52 million for the second quarter of 2023. The expansion of our retail segment with its lower gross margin percentages will reduce margin percentages going forward. Selling an administrative cost decreased by 5% to 1.9 million for the second quarter of 2024 compared to 2 million in the year-ago quarter.

Robert Hiatt: To put this in perspective, total Gamma Knife procedures were 340 for the second quarter compared to 309 in the second quarter a year ago. However, excluding the two customer contracts that expired, total Gamma Knife procedures increased by 65, or 24%, for the second quarter of 2024. Gross margin for the second quarter of 2024 decreased 2% to 2.47 million compared to gross margin of 2.52 million for the second quarter of 2023. The expansion of our retail segment, with its lower gross margin percentages, will reduce margin percentages going forward.

Speaker Change: To put this in perspective total gamma knife procedures were 340 for the second quarter compared to 309 in the second quarter a year ago.

Speaker Change: However, excluding the two customer contract that expired gamma knife procedures increased by 65 or 24% for the second quarter of 2024.

Gross margin for the second quarter of 2024 decreased 2% to $4 7 million compared to gross margin of 252 million for the second quarter of 2023.

Speaker Change: The expansion of our retail segment with its lower gross margin percentages will reduce margin percentages going forward.

Speaker Change: Okay.

Robert Hiatt: Selling and administrative costs decreased by 5% to $1.9 million for the second quarter of 2024, compared to $2 million in the year-ago quarter. This was due to the expiration of the company's corporate office lease space. Offset by related, Interest expense was $385,000 in the 2024 period compared to $277,000 in the comparable period last year.

Speaker Change: Selling and administrative costs decreased by 5% to $1 9 million for the second quarter.

After a 2024 compared to $2 million in the year ago quarter.

Robert Hiatt: This was due to the expiration of the company's corporate office lease space, offset by related substance income. Interest expense was 385,000 in the 2024 period, compared to 277,000 in the comparable period of last year. The increase is due to an increase in the interest rate and borrowings in the company's variable rate.

Speaker Change: This was due to the expiration of the company's corporate office lease space.

I've said by related income.

Speaker Change: Interest expense was 385000 in the 'twenty 'twenty four period compared to 277000 in the comparable period last year.

Robert Hiatt: The increase is due to an increase in the interest rate and borrowings on the company's variable rate. The operating income for the second quarter of 2024 was breakeven due to the additional costs related to the closing of the Rhode Island acquisition and other new business opportunities of $361,000. In the prior year quarter, the amount of cross-incurred pursuing this deal worked 250,000 and, coupled with higher selling expenses, led to a second quarter loss of 325,000. The income tax benefit was $31,000 for the second quarter of 2024 compared to income tax benefits of $35,000 for the same period last year.

Speaker Change: The increase is due to an increase in the interest rate and borrowings on the company's variable rate debt.

Robert Hiatt: The operating income of the second quarter of 2024 was breakeven due to the additional costs related to the closing of the Rhode Island acquisition and other new business opportunities of $361,000. In the prior year quarter, the amount of costs incurred pursuing this deal worked 250,000, and a couple of the higher selling expenses led to a second quarter loss of $325,000. The income tax benefit was $31,000 for the second quarter of 2024 compared to income tax benefits of $35,000 for the same period last year. The taxes related to the bargain purchase gain reduce the gain from $4.9 million to $3.7 million and do not impact income tax expense.

Speaker Change: The operating income for the second quarter of 2024 was breakeven due to the additional costs related to the closing.

Speaker Change: Rhode Island acquisition, and other new business opportunities with $361.

Speaker Change: In the prior year quarter, the amount of costs incurred pursuing this deal were 250000 and coupled with higher selling expense expenses led to a second quarter loss of 325000.

The income tax benefit was 31.

Speaker Change: For the second quarter of 2024 compared to income tax benefit of 35000 for the same period last year.

Robert Hiatt: The taxes related to the bargain purchase game reduce the gang from $4.9 million to $3.7 million and do not impact income tax. Net income attributable to American Shared Hospital Services in the second quarter of 2024 was $3.6 million, or $0.55 per diluted share, compared to a net loss of $111,000, or $0.02 per diluted share for the second quarter of 2023. The period over period increase was primarily due to the bargain purchase game.

Speaker Change: The taxes related to the bargain purchase gain reduce the gain from $4 9 million to $3 7 million and do not impact income tax expense.

Robert Hiatt: That income attributable to American Shared Hospital Services in the second quarter of 2024 was $3.6 million or $0.55 per diluted share compared to a net loss of $111,000 or $0.20 per diluted share for the second quarter of 2023. The period-over-period increase was primarily due to the bargain purchase gain. Well, we diluted weighted average common shares outstanding worth $6,583,000 and $6,336,000 for the second quarter of 2024 and 2023, respectively. Adjusted to EBITDA, a non-GAAP financial measure, was $2,000,000 for the second quarter of 2024 compared to $1.9 million for the second quarter of 2023. For the six months ended June 30, 2024, revenue increased 17% to $12,272,000 compared to revenue of $10,493,000 for the first six months of 2023.

Speaker Change: Net income attributable to American shared hospital services in the second quarter of 2024 was $3 6 million or 55 cents per diluted share compared to a net loss of 111000 of our two cents per diluted share for the second quarter of 2023.

Speaker Change: Over a period increase was primarily due to the bargain purchase gain.

Robert Hiatt: Fully diluted weighted average common shares outstanding were $6,583,000 and $6,336,000 for the second quarter of 2024 and 2023 respectively. Unknown Attendee, a non-GAAP financial measure was $2 million for the second quarter of 2024 compared to $1.9 million for the second quarter of 2020. For the six months ended June 30, 2024, revenue increased 17% to 12,272,000 compared to revenue of 10,493,000 for the first six months of 2023. Yamanak revenue decreased 6% to $5,311,000 for the first half of 2024, compared to $5,634,000 for the first half of 2023.

Speaker Change: Fully diluted weighted average common shares outstanding were $6 million 583006 million 336000 for the second quarter of 2024 and 2023, respectively.

Unknown Attendee: Good day, and welcome to the American Shared Hospital Services, Checking Quarter in 2024 Earnings Conference Call. All participants will be in listen only mode. Should you need assistance, please signally conference specialists are pressing the star key followed by zero.

Speaker Change: Adjusted EBITDA, a non-GAAP financial measure was $2 million for the second quarter of 2024 compared to $1 9 million for the second quarter of 2023.

Unknown Attendee: After today's presentation, there will be an opportunity to ask questions. To ask a question, you may press star them one on a touch tone phone. To withdraw your questions, please press star and then two. Please note this event is being recorded.

Speaker Change: For the six months ended June 30 of 'twenty 'twenty, four revenue increased 17% to $12 million 272000.

Kirin Smith: I would now like to turn the conference over to Kirin Smith investor relations. Please go ahead.

Speaker Change: Compared to revenue of $10 million quarter 93000 for the first six months of 2023.

Kirin Smith: Thank you, Dave, and thank you, everyone, for joining us today. AMS' second quarter, 2024 Earnings Press release, was issued today after the market closed. If you need a copy, it can be accessed on the company's website at www.ashs.com at press releases under the investors tab.

Robert Hiatt: The M&I's revenue decreased 6% to $5,311,000 for the first half of 2024 compared to $5,234,000 for the first half of 2023. The number of GAM&I procedures in the first six months of 2024 was 613 and increased to 2% compared to 600 and 2 GAM&I procedures in the time period of 2023 due to the steady increase of the international procedures. For the time, therapy revenue increased 4% to $5,069,000 for the first half of 2024 compared to $4,859,000 for the first half of 2023. 12 proton therapy fractions in the first six months of 2024 were 2,512, a decrease of 14% compared to 2,946 proton therapy fractions in the comparable period of 2023.

Speaker Change: Yes, I'm gonna revenue decreased 6% to 5.311 million for the first half of 2024 compared to 5 million $6 34000 for the first half of 2023.

Robert Hiatt: The number of Gamma-Nye procedures in the first six months of 2024 was 613, an increase of 2% compared to 602 Gamma-Nye procedures in the comparable period of 2023 due to the steady increase of international procedures. Proton therapy revenue increased 4% to $5,069,000 for the first half of 2024, compared to $4,859,000 for the first half of 2023. 12 proton therapy fractions in the first six months of 2024 were 2,512, a decrease of 14% compared to 2,906 proton therapy fractions in the comparable period of 2023.

Speaker Change: A number of gamma knife procedures in the first six months of 2024 was 613, an increase of 2%.

Speaker Change: Compared to the 600 <unk>.

Kirin Smith: Before turning the call over to management, I would like to make the following remarks concerning forward-looking statements. Please note that various remarks that may be made on this conference call about future expectations, plans, and prospects for the company constitute forward-looking statements for the purposes of safe harbor provisions under the private securities litigation reform act of 1995. Actual results may vary materially from those indicated by these forward-looking statements as a result of various important factors, including those discussed in the company's filings with the SEC.

Speaker Change: Two gamma knife procedures.

Speaker Change: 2023, due to the steady increase of international procedures.

Speaker Change: Proton therapy revenue increased 4% 5.069 million for the first half of 2024 compared to $4 million 859000 for the first half of 2023.

Speaker Change: Proton therapy fractions in the first six months of 2024 or 2512, a decrease of 14% compared to 2006 proton therapy friction.

Kirin Smith: This includes the company's quarterly report on form 10-2 for the three-month period ended March 31, 2024. The annual report on form 10-K for the year ended December 31, 2023, and the definitive proxy statement for the annual meeting of shareholders that was held on June 25, 2024. The company assumes no obligation to update the information contained in this conference call.

Speaker Change: The comparable period of 2023.

Robert Hiatt: Net income amount to American-chaired hospital services for the first six months of 2024 was $3.7 million or $57 per rooted share compared to net income of $77,000 or $1,000 per rooted share for the first six months of 2023. I just need a GAM&I financial measure with $3.8 million for the first six months of 2024 compared to $3.8 million for the first six months of 2023. This slight decrease was primarily due to higher fees associated with new business opportunities, including the company acquisition and Rhode Island.

Robert Hiatt: Net income attributable to American Shared Hospital Services for the first six months of 2024 was $3.7 million or 57 cents per diluted share compared to net income of $77,000 or one cent credited chair for the first six months of 2023. I just needed a non-gap financial measure was 3.8 million for the first six months of 2024 compared to 3.8 million for the first six months of 2023. This slight decrease was primarily due to higher fees associated with new business opportunities, including the company acquisition in Rhode Island. At June 30th, 2024, Cash, Cash Equivalent, and Restricted Cash was $14.5 million, which converted to $13.8 million at December 31, 2023. Shareholder's equity, excluding non-controlling interest in the subsidiaries, was $26.5 million or $4.17 per outstanding share at June 30, 2024, compared to $22.6 million or $3.59 per outstanding share at December 31, 2023.

Speaker Change: Net income attributable to American shared.

Speaker Change: Food services for the first six months of 2024.

Speaker Change: $3.7 million or <unk> 57 per diluted share compared to net income of 7000 or.

Speaker Change: One cents per diluted share for the first six months of 2023.

Speaker Change: Adjusted EBITDA non-GAAP financial measure was $3 8 million for the first six months of 2024 compared to $3 8 million for the first six months of 2023.

Kirin Smith: Before I turn the call over to Ray, I'd like to remind everyone about our Q&A policy, but we provide each participant the time to ask one question and one follow-up. As always, we'll be happy to take additional questions offline at any time.

Speaker Change: This slight decrease was primarily due to higher fees associated with new business opportunities, including the company acquisition that robot.

Raymond Stachowiak: With that, I'd now like to turn the call over to Ray Stacoliac, Executive Chairman and CEO. Please go ahead. Thank you, Karen. Good afternoon, everyone. Thank you for joining us today for our second quarter 2024 earnings conference call. I'll begin with some opening remarks and then turn the call over to Bob Hyatt, our chief financial officer, for a financial review of the second quarter results. Following the prepared remarks, we'll open the call for your questions.

Robert Hiatt: At June 30th, 2024, cash, cash equivalence, and restricted cash was $14.5 million in the 13.8 million at December 31st, 2023. Chairholder's equity, excluding non-controlling interest in the subsidiaries, was $26.5 million or $4.17 per outstanding share at June 30th, 2024, compared to $22.6 million or $3.59 per outstanding share at December 31st, 2023.

Speaker Change: At June 30 of 2024 cash cash equivalents and restricted cash.

Speaker Change: Was 14 5 million compared to $13 8 million at December 31, 2023.

Speaker Change: Shareholders' equity excluding non controlling interests in subsidiaries was $26 5 million or $4.17 per outstanding share at June 32024.

Speaker Change: Compared to 22 6 million or $3 59.

Speaker Change: Sure at December 31st 2023.

Raymond Stachowiak: Now, on to the quarterly results. We're very pleased to report that AMS had a strong second quarter and we're extremely excited about the upcoming year. We've continued to show market improvement and advancement in several important ways. The quarter showcase an extremely nice early benefit from the Rhode Island acquisition that we closed just this past with an immediate gain of 4.9 million dollars free tax. This gain reflects the value and the net assets we acquired in excess of the purchase price we paid.

Speaker Change: This concludes the formal part of our presentation. Thank you for joining US today, we look forward to updating you on our progress in the quarters ahead.

Robert Hiatt: This concludes the follow-up part of our presentation. Thank you for joining us today. We look forward to updating you on our progress in the quarters ahead.

Operator: This concludes the formal part of our presentation. Thank you for joining us today. We look forward to updating you on our progress in the quarters ahead. Dave, we'd now like to turn the call back to you and open it up for questions. We will now begin the question and answer session. To ask a question, you may press star, then one on your touchtone phone.

Speaker Change: Dave we'd now like to turn the call back to you and open it up for questions.

Unknown Attendee: Dave, we now like to turn the call back to you and open it up for questions. We will now begin the question in the answer session. To ask a question, you may press star the one on your touchstone phone. If you are using a speaker phone, pick up your handset before pressing the keys. If at any time your question has been addressed and you would like to withdraw your question, please press star and then two. Also, please limit yourself to one question and one follow-up.

Dave: We will now begin the question and answer session to ask a question you May Press Star then one on your Touchtone phone if youre using a speakerphone. Please pick up your handset before pressing the keys if at any time. Your question has been addressed and you would like to withdraw your question. Please press Star and then to also please.

Operator: If you're using a speakerphone, please pick up your handset before pressing. If at any time your question has been addressed and you would like to withdraw your question, please press star and then. Also, please limit yourself to one question and one follow-up. Pre-queue to ask additional questions. Our first question comes from Marla Marin with Zach's. Please go ahead.

Limit yourself to one question and one follow up re queue to ask additional questions.

Unknown Attendee: 3Q to ask additional questions.

Marla Marin: Our first question comes from Marla Naren with ZACS. Please go ahead.

Dave: Our first question comes from Marla Marin with Zacks. Please go ahead.

Raymond Stachowiak: I've often discussed that we are fortunate to have a robust balance sheet with significant capital to deploy for strategic initiatives and business opportunities that we come across. The Rhode Island acquisition is a great example of how we deployed approximately $3 million and were able to strategically acquire fair market value assets worth approximately $8 million. This was clearly an excellent allocation of our capital. The team continues to focus on strengthening our core business by working with customers to increase utilization of the equipment.

Marla Marin: Thank you.

Marla Marin: Thank you.

Marla Marin: Thank you. Um, so I, one question, um, So I just wanted to confirm a couple of things as you continue to explore opportunities to grow the direct business. You're also continuing to pursue additional opportunities on the leasing side of the business. And along with that, once or once you begin to upgrade the equipment at Sacred Heart, should we anticipate that there will be service interruptions there that will fall into 3 km potentially 4 km as well.

Marla Marin: So.

Marla Marin: So, one question. I just wanted to confirm a couple of things. As you continue to explore opportunities to grow the direct business, you are also continuing to pursue additional opportunities on the leasing side of the business.

Speaker Change: I have one question.

Marla Marin: So I just wanted to confirm a couple of things.

Speaker Change: You continue to explore opportunities to grow the direct business.

Speaker Change: We're also continuing to pursue additional opportunities.

Speaker Change: On the leasing side of the business and.

Marla Marin: Along with that, once you begin to upgrade the equipment at Sacred Heart, should we anticipate that there will be service interruptions there that will fall into 3Q and potentially 4Q as well?

Speaker Change: Along with that once or once you begin to upgrade that the.

Speaker Change: And then at Sacred Heart.

Speaker Change: Should we anticipate that there will be a service interruptions, there that will fall into three potentially four came as well.

Marla Marin: Thank you.

Speaker Change: Thank you.

Raymond Stachowiak: Thank you, Marla, for your question. I appreciate it. You know, we have been focusing on both of our segments: the leasing segment, where we lease our equipment, and the retail segment, where we own and operate substantially majority control of our own centers that provide the services to the patients directly. And our centers that build the patients or the patients' insurance company. We're pursuing both segments, but I think you can tell from the Rhode Island acquisition and the opening of our operation in Puebla, Mexico, and the signing of a new center in Guadalajara, Mexico that our focus and the business opportunities were signing out.

Thank you for your question I appreciate it.

Raymond Stachowiak: Thank you. Thank you, Marla, for your question. I appreciate it.

Raymond Stachowiak: This focus strategy led to the signing of five lease extensions in the last 15 months from our 10 domestic gamenife customers with others still on the pipeline. We believe these extended agreements are a testament to our partnership business model and financial flexibility. Our international retail results are also showing continued momentum. In a second quarter we saw a volumes increase following our completed equipment upgrade in Ecuador to a new state-of-the-art gamenife icon.

Speaker Change: You know we have been focusing on both of our segments. The leasing segment, where we lease our equipment.

Raymond Stachowiak: You know, we have been focusing on both of our segments, the leasing segment, where we lease our equipment, and the retail segment, where we own and operate substantially majority control of our own centers that provide the services to the patients directly, and our centers that bill the patients or the patient's insurance company. We're pursuing both sections, but I think you can tell from the Rhode Island acquisition and the opening of our operation in Pueblo, Mexico, and the signing of a new center in Guadalajara, Mexico, that our focus and the business opportunities we're exploring are more in the retail sector.

Speaker Change: The retail segment, where we own and operate substantially majority control.

Speaker Change: All of our own.

Speaker Change: Yours that provide the services to the patients directly and our centers that bill the patients or the patients insurance company.

Speaker Change: We're pursuing both segments.

Speaker Change: But I think you can tell from the Rhode Island acquisition.

Speaker Change: And the.

Speaker Change: Opening of our operation in Puebla, Mexico, and the signing of a new center in Guadalajara, Mexico.

Raymond Stachowiak: The only gamenife in Ecuador for non-invasive radial surgery. Our gamenife improved the only gamenife in that country also showed excellent results in the second quarter. Just last week we announced that our center in Puebla, Mexico has begun treating patients. This newly opened linear accelerator or Linux that we installed has VMAT, IGRT, IMRT, and radial surgery capabilities offering the most advanced radiation therapy available in our catchment area. And in early July we established our fourth international center with the signing of a joint venture agreement for a gamenife facility in Guadalajara, Mexico.

Speaker Change: Our focus and the business opportunities, we are signing up or more in the retail segment.

Raymond Stachowiak: So, we're looking very favorably towards that retail segment. in our business model. Thank you.

Raymond Stachowiak: So, you know, we're we're looking very favorably towards that retail segment, you know, in our business model. Thank you, and in terms of any downtime at the Sacred Heart venue. I'm not at liberty to discuss any individual site.

Speaker Change: So you know we're we're.

Speaker Change: We're looking very favorably towards that retail segment.

Speaker Change:

Speaker Change: You know in our business model.

Speaker Change: Thank you.

Marla Marin: And in terms of any downtime at the Sacred Heart venue.

Speaker Change: And in terms of any downtime.

sacred heart: That's sacred heart, but yes.

Raymond Stachowiak: I'm not at liberty to discuss any individual site. Okay.

Speaker Change: I'm not at Liberty to discuss any individual site.

Operator: Okay. Thank you. Yeah. Our next question comes from Tony Kamin with Eastwood Partners. Please go ahead.

Speaker Change: Okay. Thank you.

Tony Kamin: Our next question comes from Tony Kamin with Eastwood Partners. Please go ahead.

Our next question comes from Tony.

Speaker Change: I mean with Eastwood partners. Please go ahead hi.

Tony Kamin: Hi, Ray.

Anthony Kamin: Unknown Speaker Hi, Ray. Question, just for clarification, the acquisition of Rhode Island I think concluded in the first or second week of May, so this quarter that you just reported didn't include a full three months? That is correct. Okay, so that's great. And, and then in terms of maybe your early learning, if any, yet, I know it's very early, but, you know, having this direct relationship, are you guys learning something from it?

Speaker Change:

Speaker Change: Question.

Tony Kamin: Question, just for clarification, the acquisition of Rhode Island, I think, concluded in the first or second week of May. So this quarter that you just reported didn't include a full three months. Is that correct?

Tony: Just for clarification the.

Raymond Stachowiak: We also continue to invest in three unique business opportunities previously discussed. The first of these opportunities was announced late last year for the acquisition of a 60 percent majority interest in three radiation therapy centers in Rhode Island which closed this past May. These are our first direct patient services or retail centers in the United States. This new business which is the first from our expanded team and new Line. Clearly reflects our strong ambitions for the company.

Tony: The acquisition of Rhode Island, I think concluded in the first or second week of May. So this quarter that you just reported did not include a full three months is that correct.

Raymond Stachowiak: The second opportunity is the Certificate of Need for CON that we have been granted to build a Radiation Therapy Center in Bristol, Rhode Island. And the third opportunity is the CON that we have applied for for the Proton Beam Radiation Therapy Center in the state of Rhode Island. This Proton Beam Radiation Therapy Center would be the only system between New York City and Boston. We followed quarter one with another solid quarter, reporting total revenue in the second quarter of $7.1 million, a year-over-year increase of 27%.

Raymond Stachowiak: That is correct. Okay. So that's great.

Speaker Change: That is correct.

Anthony Kamin: And I'm asking that also specifically in relation to the projected proton beam in Rhode Island, you said you got, or you applied for, the certificate. Has the timeline for that changed any from the last call? The timeline for the CON application, we continue to have delays in scheduling the hearing for the CON, but it is looking like it's getting closer to having a hearing on the CON. And we really don't expect any negative feedback from that process.

Speaker Change: Okay. So that's great and and then in terms of maybe your early learning if any yet I know, it's very early but you know having this direct relationship are you guys learning something from it and I'm asking that also specifically in <unk>.

Raymond Stachowiak: And then in terms of maybe your early learning, if any, yet, I know it's very early, but, you know, having this direct relationship, are you guys learning something from it? And I'm asking that also specifically in relation to the projected proton beam in Rhode Island. You said you got how you applied for the certificate, has the timeline and of that changed any from the last call. The timeline for the CLN application: we continue to have delays in scheduling the hearing for the CLN, but it is looking like it's getting closer to have a hearing on the CLN.

Speaker Change: The relation to the projected.

Speaker Change: Projected proton beam in Rhode Island, You said you got how are you applied for the certificate has the timeline of that changed any from the last call.

Speaker Change: That's the timeline.

Speaker Change: For the C O N application.

Speaker Change: We continue to have delays in scheduling the hearing for the C O N, but it is looking like it's getting closer.

Speaker Change: So to have a hearing on the C O N and we really don't expect any.

Raymond Stachowiak: And we really don't expect any, any negative feedback from that process. You know, the, the, what we've been learning, we have been learning, we're always learning, but, you know, we do have a very experienced team. Myself and Craig and Greg McHurials are Senior Vice Presidents of Radiation Oncology.

Speaker Change: Uh huh any negative feedback from that process.

Anthony Kamin: Unknown Attendee. You know, what we've been learning, we have been learning, we're always learning, but you know, we do have a very experienced team, myself, Craig, and Greg Mercurio is our Senior Vice President of Radiation Oncology, but he's not on the call here today.

Speaker Change: The what we've been learning we have been learning were always learning, but you know we do have a very experienced team.

Speaker Change: Myself, Craig and Greg materials, our senior Vice President of radiation oncology, he's not on the call here today.

Raymond Stachowiak: He's not on the call here today. But we probably each have, you know, three decades or more of experience owning and operating such centers in one such form or another. Each situation is unique, and you're going to learn from it. So we are experiencing a learning curve, but we've got a great team of individuals that I'd say are very confident in owning and operating these centers and making them successful. And, you know, here we are. We made this acquisition, and it was from a bankruptcy process, and we benefited from that process. And, you know, when you make acquisitions, a lot of times, you value the assets, and the value of the assets is less than your purchase price, and you wind up recording some goodwill on your books.

Raymond Stachowiak: But we probably each have, you know, three decades or more of experience, owning and operating such centers in one such form or another. Each situation is unique and you're going to learn from it. So we are experiencing a learning curve, but we've got great team of individuals that, I'd say are very comfortable, in owning and operating these centers and making them successful. And, you know, here we are, we made this acquisition, and it was from a bankruptcy process.

But we probably each have three.

Raymond Stachowiak: The gross margin percentage came in at 35%, which reflects the change in mix and strong growth in our retail segment. And we earned over $3.6 million, or 55 cents per share, for the quarter, which is a major increase compared with the prior year's second quarter. This includes an after-tax gain of approximately $3.7 million from our Rhode Island acquisition. Our operating income for the second quarter of 2024 was breakeven due to the additional costs related to the closing of the Rhode Island acquisition of 361,000.

Speaker Change: Three decades or more of experience owning and operating such centers in one such form or another each situation is unique and youre going to learn from it. So we are experiencing a learning curve.

Speaker Change: But we've got great.

Speaker Change: Yeah.

Speaker Change: A team of individuals that.

Speaker Change: I would say are very confident.

Speaker Change: In owning and operating these centers and making them successful.

Raymond Stachowiak: And we benefited from that process. And, you know, when you make acquisitions, a lot of times you value the asset. And the value of the assets is less than your purchase price. And you wind up recording some goodwill on your. Here, it's just the opposite.

Speaker Change: And you know here we are we made this acquisition.

Speaker Change: And it was from a bankruptcy process and.

Speaker Change: We benefited from that process.

Speaker Change: And you know when you make acquisitions a lot of times you value the assets.

Speaker Change: And the value of the assets is less than your purchase price and you wind up recording some goodwill on your books.

Raymond Stachowiak: But compared to an operating loss of 325,000 in the second quarter of 2023, primarily due to the reduced impaired assets and removal costs. Our balance sheet remains strong. We ended the second quarter with over $14.5 million in cash. Roughly equal to $2.24 per share. We also had $3.95 million outstanding on our $7 million line of credit as at June 30, 2024, which we paid off early in the third quarter of 2024.

Tony Kamin: Here, it's just the opposite. We paid about $3 million approximately, and we acquired assets with a fair market value of about $8 million. A $5 million or, you know, $4.9, whatever the number is here, approximately, gain. on that acquisition. It's just remarkable. And not only have we been able to process that game, 3.7 million after tax, but now we have three really good radiation therapy cancer centers in the state of Rhode Island that I think you'll see the benefits of owning and cooperating those in the coming quarters. It's really exciting as a long time shareholder to see, you know, so much sort of momentum and different projects going on.

Speaker Change: Here its just the opposite.

Raymond Stachowiak: We paid about $3 million, approximately. And we acquired assets with a fair market value of about $8 million. $5 million, or you know, 4.9, whatever the number is here, is the approximately gain on that acquisition. And it's just remarkable.

Speaker Change: We paid about $3 million approximately.

Speaker Change: And we acquired assets with a fair market value of about $8 million.

Speaker Change: A $5 million or $4 nine or whatever the number is approximately.

Speaker Change: Gain.

Anthony Kamin: And not only have we been able to process that gain of 3.7 million after tax, but now we have three really good radiation therapy cancer centers in the state of Rhode Island that I think you'll see the benefits of owning and operating those in the coming quarters. Um, it's really exciting as a longtime shareholder to see so much sort of momentum and different projects going on. I quite recall a time when that was the case.

On that acquisition and it's just remarkable and not only have we've been able to process that gained $3 7 million after tax but now we have three really good radiation therapy cancer centers in the state of Rhode Island that I think you'll see.

Speaker Change: The benefits of owning and operating those in the coming quarters.

Raymond Stachowiak: We continued to leverage these resources carefully for additional long-term revenue streams. As we look into the coming months, we expect stronger international growth from additional treatment capabilities and Ecuador. Continued strong volume from our center in Peru, and the opening of the new centers in Guadalajara in Puebla, Mexico. The recent closing of the Rhode Island acquisition adds three new revenue streams to our business. In addition to new business opportunities that are moving through the long and intricate sales sites.

Speaker Change: It's really exciting as a longtime shareholder to see so much sort of momentum and.

Speaker Change: <unk> projects going on I can't quite recall, a time when that was the case so.

Tony Kamin: I can't quite recall a time when that was the case.

Anthony Kamin: So in that in that light, sort of my final question in although I want to slip one common in there. Are you doing more marketing for the or changing the marketing for the Rhode Island centers? And then my last question is there's a quote from Craig in the news release saying we have continued to see a significant increase. And the breadth of opportunities for consideration, our sales pipeline remains extremely strong with additional projects. Is there any sort of further color?

Tony Kamin: So, in that light, sort of my final question in, although I want to slip one comment in there, are you doing more marketing for the, or changing the marketing for the Rhode Island centers? And then my last question is, there's a quote from Craig in those news release saying, "We have continued to see a significant increase in the breadth of opportunities for consideration. Our pipeline remains extremely strong with additional projects." Is there any sort of further color you can do on that?

Speaker Change: In that light.

Speaker Change: Sort of my final question and although slipped one comment in there are you doing more marketing for the.

Speaker Change: We're changing the marketing for the Rhode Island centers and then my last question is there was a quote from Craig in the news release thing.

Craig: We've continued to see a significant increase.

Speaker Change: And the breadth of opportunities for consideration of our sales pipeline remains extremely strong with additional projects is there any sort of further color you can do on that thank you.

Raymond Stachowiak: Michael. With that, I'll turn the call over to Bob for a financial review.

Raymond Stachowiak: Thank you. Well, we're keeping our eyes and ears close to the marketplace, and the result of it was Rhode Island. I mean, we came across this opportunity by keeping our eyes and ears close to the market on the ground, what's going on, and what opportunities exist out there.

Yeah.

Robert Hiatt: Bob, thank you race, and good afternoon everyone. Second quarter revenue increased 27% to 7.1 million compared to 5.7 million in a year ago quarter. As previously discussed, we redefined our business segments to better reflect our revenue sources. Rental revenue from the company's medical equipment leasing segment, which we now refer to as leasing, was $3.9 million for the second quarter, 2024 compared to 4.81 million in the year ago quarter, a decrease of 19%.

Raymond Stachowiak: Well, we're keeping our eyes and ears, I'll say close to the marketplace. And, you know, the, The result of it was Rhode Island. I mean, we came across this opportunity by keeping our eyes and ears close to the market on the ground, what's going on, and what opportunities exist out there. And, you know, we, Took a little bit of a step back, when Peter Gaccione, our CEO, passed away earlier this year.

Speaker Change: Well, we're keeping our eyes and ears, I'll say close to the marketplace and you know the.

Speaker Change: The result of it it was Rhode Island, I mean, we came across this opportunity by keeping our eyes and ears close to the market on the ground, what's going on and what opportunities exist out there.

Tony Kamin: And, you know, we took a little bit of a step back when Peter got the only RCDO passed away earlier this year. But we've regained; we've kind of strengthened our management team and some of the duties and responsibilities. And we've got a good team of people pursuing these opportunities. And, you know, it's probably a bigger, better pipeline than we've ever had. That's great. Congratulations.

Speaker Change: And you know we we.

Speaker Change: Took a little bit of a step back.

Raymond Stachowiak: But we've regained, we've kind of strengthened our management team and some of the duties and responsibilities, and We've got a good team of people pursuing these opportunities, and, You know, it's probably a bigger, better pipeline than we've ever had. That's great. This concludes our question and answer session. I would like to turn the conference back over to Ray, because Tweetak for any clothing remarks.

Speaker Change: When Peter <unk>, our CEO passed away earlier this year.

Speaker Change: But we've regained we've kind of strengthened our management team and some of the duties and responsibilities and.

Robert Hiatt: Revenue from the company's direct patient services, a retail segment, was 3.16 million for the second quarter, and at June 30th, 2024 compared to 756,000 for the year ago quarter, marking an increase of 318%. This increase was due to the acquisition in Rhode Island, and increased volumes that are existing retail locations. Additionally, the upgrade of the equipment and Ecuador added capacity, improved patient experience, and volume, and the Peru revenues increased due to promotion of the center throughout the country.

Speaker Change: We got a good team of people pursuing these opportunities and.

Speaker Change: It's probably a bigger better pipeline than we've ever had.

Speaker Change: That's great congratulations.

Speaker Change: Mhm.

Unknown Attendee: This concludes our question and answer session.

This concludes our question and answer session.

Raymond Stachowiak: I would like to turn the conference back over to Ray, because Tweetac for any closing remarks.

Speaker Change: I'd like to turn the conference back over to Ray.

Ray: Because <unk> for any closing remarks.

Raymond Stachowiak: Okay. Thank you, Dave. And thank you for everyone who joined us today.

Speaker Change: Okay. Thank you, Dave and thank you for everyone, who joined us today.

Raymond Stachowiak: Okay, thank you, Dave. And thank you to everyone who joined us today. We're really excited about our future. We believe that AMS is at a critical inflection point, especially following the recent Rhode Island acquisition. We look forward to updating you on our continued progress. And, as always, if you have any questions in the meantime, please do not hesitate to contact us directly. Thank you for your continued interest in American Shared Hospital Service. The conference is now concluded. Thank you for attending today's presentation.

Robert Hiatt: Second quarter revenue for the company's proton therapy system in Florida was 2.42 million, a decrease of 5%, primarily due to continued cyclical volume changes. Total proton therapy prices in the second quarter were $1,136 compared to 1,370 proton therapy fractions in the second quarter of 2023. A 10% decrease due to normal cyclical fluctuations. Total gamma-nive preceded revenue decreased 9% to 2.74 million due to a decrease in revenue from two expired contracts, but was nearly upset by high volume in our international location.

Raymond Stachowiak: We're really excited about our future. We believe that AMF is at a critical inflection point, especially following the recent Rhode Island acquisition. We look forward to updating you on our continued progress. And as always, if you have any questions in the meantime, please do not hesitate to contact us directly.

Speaker Change: We're really excited about our future.

Speaker Change: We believe that Amp has is at a critical inflection point.

Speaker Change: Especially following the recent Rhode Island acquisition.

We look forward to updating you on our continued progress.

Speaker Change: And as always if you have any questions in the meantime, please do not hesitate to contact us directly.

Unknown Attendee: Thank you for your continued interest in American-shared hospital services.

Speaker Change: Thank you for your continued interest in American shared hospital services.

Unknown Attendee: The conference is now concluded. Thank you for attending today's presentation.

Speaker Change: The conference has now concluded. Thank you for attending today's presentation you may now disconnect.

Robert Hiatt: To put this in perspective, total gamma-nive procedures were 340 for the second quarter compared to 309 in the second quarter a year ago. However, excluding the two customer contracts that expired, gamma-nive procedures increased by 65 or 24% for the second quarter of 2024. Gross margin for the second quarter of 2024 decreased 2% to 2.47 million compared to gross margin of 2.52 million for the second quarter of 2023. The expansion of our retail segment with its lower gross margin percentages will reduce margin percentages going forward.

Robert Hiatt: Selling an administrative cost decreased by 5% to 1.9 million for the second quarter of 2024 compared to 2 million in the year ago quarter. This was due to the expiration of the company's corporate office lease space offset by related substance income. Interest expense was 385,000 in the 2024 period, compared to 277,000 in the comparable period of last year. The increase is due to an increase in the interest rate and borrowings in the company's variable rate.

Robert Hiatt: The operating income of the second quarter of 2024 was breakeven due to the additional costs related to the closing of the Rhode Island acquisition and other new business opportunities of $361,000. In the prior year quarter, the amount of costs incurred pursuing this deal worked 250,000 and a couple of the higher selling expenses led to a second quarter loss of $325,000. The income tax benefit was $31,000 for the second quarter of 2024 compared to income tax benefits of $35,000 for the same period last year.

Robert Hiatt: The taxes related to the bargain purchase gain reduce the gain from $4.9 million to $3.7 million and do not impact income tax expense. That income attributable to American Shared Hospital services in the second quarter of 2024 was $3.6 million or $0.55 per deluded share compared to a net loss of $111,000 or $0.2 per deluded share for the second quarter of 2023. The period over period increase was primarily due to the bargain purchase gain.

Robert Hiatt: Well, we diluted weighted average common shares outstanding worth $6,583,000 and $6,336,000 for the second quarter of 2024 and 2023 respectively. Adjusted to EBITDA, a non-GAF financial measure was $2,000,000 for the second quarter of 2024 compared to $1.9 million for the second quarter of 2023. For the six months ended June 30, 2024 revenue increased 17% to $12,272,000 compared to revenue of $10,493,000 for the first six months of 2023. The M&I's revenue decreased 6% to $5,311,000 for the first half of 2024 compared to $5,234,000 for the first half of 2023.

Robert Hiatt: The number of GAM&I procedures in the first six months of 2024 was 613 and increased to 2% compared to 600 and 2 GAM&I procedures in the time period of 2023 due to the steady increase of the international procedures. For the time therapy revenue increased 4% to $5,069,000 for the first half of 2024 compared to $4,859,000 for the first half of 2023. 12 proton therapy fractions in the first six months of 2024 were 2,512, a decrease of 14% compared to 2,946 proton therapy fractions in the comparable period of 2023.

Robert Hiatt: Net income amount to American-chaired hospital services for the first six months of 2024 was $3.7 million or $57 per rooted share compared to net income of $77,000 or $1,000 per rooted share for the first six months of 2023. I just need a GAM&I financial measure with $3.8 million for the first six months of 2024 compared to $3.8 million for the first six months of 2023. This slight decrease was primarily due to higher fees associated with new business opportunities, including the company acquisition and Rhode Island.

Robert Hiatt: At June 30th, 2024, cash, cash equivalence, and restricted cash was $14.5 million in the 13.8 million at December 31st, 2023. Chairholder's equity, excluding non-controlling interest in the subsidiaries, was $26.5 million or $4.17 per outstanding share at June 30th, 2024, compared to $22.6 million or $3.59 per outstanding share at December 31st, 2023.

Unknown Attendee: This concludes the follow-up part of our presentation. Thank you for joining us today. We look forward to updating you on our progress in the quarters ahead.

Unknown Attendee: Dave, we now like to turn the call back to you and open it up for questions.

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Unknown Attendee: 3Q to ask additional questions.

Marla Marin: Our first question comes from Marla Naren with ZACS. Please go ahead. Thank you. So, one question. I just wanted to confirm a couple of things. As you continue to explore opportunities to grow the direct business, you are also continuing to pursue additional opportunities on the leasing side of the business.

Raymond Stachowiak: Along with that, once you begin to upgrade the equipment at Sacred Heart, should we anticipate that there will be service interruptions there that will fall into 3Q and potentially 4Q as well? Thank you. Thank you, Marla, for your question. I appreciate it. You know, we have been focusing on both of our segments, the leasing segment where we lease our equipment and the retail segment, where we own and operate substantially majority control of our own centers that provide the services to the patients directly.

Raymond Stachowiak: And our centers that build the patients or the patients insurance company. We're pursuing both segments, but I think you can tell from the Rhode Island acquisition and the opening of our operation in Puebla, Mexico and the signing of a new center in Guadalajara, Mexico that our focus and the business opportunities were signing out. So, we're looking very favorably towards that retail segment, in our business model. Thank you. And in terms of any downtime at the Sacred Heart venue.

Raymond Stachowiak: I'm not at liberty to discuss any individual site. Okay. Thank you.

Tony Kamin: Our next question comes from Tony Kamin with Eastwood Partners. Please go ahead. Hi, Ray. Question, just for clarification, the acquisition of Rhode Island, I think, concluded in the first or second week of May. So this quarter that you just reported didn't include a full three months. Is that correct? That is correct. Okay. So that's great. And then in terms of maybe your early learning, if any, yet, I know it's very early, but, you know, having this direct relationship, are you guys learning something from it and I'm asking that also specifically in relation to the projected proton beam in Rhode Island.

Tony Kamin: You said you got how you applied for the certificate has the timeline and of that changed any from the last call. The timeline for the CLN application, we continue to have delays in scheduling the hearing for the CLN, but it is looking like it's getting closer to have a hearing on the CLN. And we really don't expect any, any negative feedback from that process. You know, the, the, what we've been learning, we have been learning, we're always learning, but, you know, we do have a very experienced team.

Tony Kamin: Myself and Craig and Greg McHurials are Senior Vice President of Radiation Oncology. He's not on the call here today. But we probably each have, you know, three decades or more of experience owning and operating such centers in one such form or another. Each situation is unique, and you're going to learn from it. So we are experiencing a learning curve, but we've got great team of individuals that I'd say are very confident in owning and operating these centers and making them successful.

Tony Kamin: And, you know, here we are. We made this acquisition, and it was from a bankruptcy process, and we benefited from that process. And, you know, when you make acquisitions a lot of times, you value the assets and the value of the assets is less than your purchase price, and you wind up recording some goodwill on your books. Here, it's just the opposite. We paid about $3 million approximately, and we acquired assets with a fair market value of about $8 million.

Tony Kamin: A $5 million or, you know, $4.9, whatever the number is here, approximately, gain, on that acquisition. It's just remarkable. And not only have we been able to process that game, 3.7 million after tax, but now we have three really good radiation therapy cancer centers in the state of Rhode Island that I think you'll see the benefits of owning and cooperating those in the coming quarters. It's really exciting as a long time shareholder to see, you know, so much sort of momentum and different projects going on. I can't quite recall a time when that was the case.

Tony Kamin: So in that light, sort of my final question in although I want to slip one comment in there, are you doing more marketing for the or changing the marketing for the Rhode Island centers? And then my last question is, there's a quote from Craig in those news release saying, we have continued to see a significant increase in the breadth of opportunities for consideration ourselves pipeline remains extremely strong with additional projects. Is there any sort of further color you can do on that?

Tony Kamin: Thank you. Well, we're keeping our eyes and ears close to the marketplace and the result of it was Rhode Island. I mean, we came across this opportunity by keeping our eyes and ears close to the market on the ground, what's going on, and what opportunities exist out there. And, you know, we took a little bit of a step back when Peter got the only RCDO passed away earlier this year. But we've regained, we've kind of strengthened our management team and some of the duties and responsibilities. And we've got a good team of people pursuing these opportunities. And, you know, it's probably a bigger, better pipeline than we've ever had. That's great.

Unknown Attendee: Congratulations.

Unknown Attendee: This concludes our question and answer session.

Raymond Stachowiak: I would like to turn the conference back over to Ray, because Tweetac for any closing remarks. Okay. Thank you, Dave. And thank you for everyone who joined us today. We're really excited about our future. We believe that AMF is at a critical inflection point, especially following the recent Rhode Island acquisition. We look forward to updating you on our continued progress. And as always, if you have any questions in the meantime, please do not hesitate to contact us directly. Thank you for your continued interest in American-shared hospital services.

Unknown Attendee: The conference is now concluded.

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