Q4 2024 American Shared Hospital Services Earnings Call
Operator: Good day and welcome to the American Shared Hospital Services fourth quarter 2024 earnings conference call. All participants will be in a listen-only mode. Should you need assistance, please signal a conference specialist by pressing the star key followed by zero.
Good day and welcome to the American shared hospital services fourth quarter 2024 earnings Conference call.
All participants will be in a listen only mode.
Should you need assistance. Please signal a conference specialist by pressing the star key followed by zero.
Operator: After today's presentation, there will be an opportunity to ask questions. To ask a question, you may press star, then one on a touchtone phone. To withdraw your question, please press star then 2. Please note, this event is being recorded.
After todays presentation, there will be an opportunity to ask questions.
To ask a question you May press Star then one on a touchtone phone.
To withdraw your question. Please press Star then two.
Please note this event is being recorded.
Kirin Smith: I would now like to turn the conference over to Kirin Smith, Investor Relations. Please go ahead.
Speaker Change: I would now like to turn the conference over to Karen Smith Investor Relations. Please go ahead.
Kirin Smith: Thank you, Betsy, and thank you, everyone, for joining us today. AMS's fourth quarter and full year 2024 earnings press release was issued today before the market opened. 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 Betsy and thank you everyone for joining us today.
Karen Smith: Message <unk> fourth quarter and full year 2024 earnings press release was issued today before the market opened.
Karen Smith: You need a copy it can be accessed on the Companys website at Www Dot Hs.
Karen Smith: <unk> Dot com at press releases under the investors tab.
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 10-2 for the three-month period ended September 30, 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.
Karen Smith: Before turning the call over to management I would like to make the following remarks concerning forward looking statements.
Karen Smith: 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 1095.
Karen 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.
Karen Smith: The company's filings with the SEC.
Karen Smith: Close to the Companys quarterly report on Form 10-Q for the three months period ended September 32020 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 that was held on June 25 2024.
Kirin Smith: The company assumes no obligation to update the information contained in this conference call.
The company assumes no obligation to update the information contained in this conference call.
Kirin Smith: 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.
Speaker Change: Before I turn the call over to Ray I'd like to remind everyone about our Q&A policy, where we provide each participant contest one question and one follow up as always we'll be happy to take additional questions offline at any time.
Ray Stachowiak: With that, I'd now like to turn the call over to Ray Stachowiak, Executive Chairman. Ray, please go ahead. Thank you, Kirin. Good afternoon, everyone. Thanks for joining us today for our fiscal year 2024 earnings conference call.
Karen Smith: With that I'd now like to turn the call over to race to Kodiak Executive Chairman.
Speaker Change: Please go ahead.
Speaker Change: Thank you Karen and good afternoon, everyone.
Speaker Change: Thanks for joining us today for our fiscal year 2024 earnings conference call.
Ray Stachowiak: Before I dive into our financial performance, I'd like to take a moment to announce an important leadership transition. Today, we announce that Gary Delanus was appointed as our Chief Executive Officer of American Shared Hospital Service. I will remain very much involved and continue to serve as Executive Chairman.
Speaker Change: Before I dive into our financial performance I'd like to take them all of that to announce an important leadership transition.
Speaker Change: Today, we announced that Gary Delaney was appointed as our Chief Executive Officer of American shared hospital services.
I will remain very much involved and continue to serve as executive chairman.
Ray Stachowiak: focusing on the strategic direction and key growth opportunities. Gary brings extensive experience in healthcare operations and financial management. I'm very confident in his ability to lead AMS into our next phase of expansion and innovation.
Speaker Change: Focusing on the strategic direction and key growth opportunities.
Gary Delaney: Gary brings extensive experience in health care operations and financial management.
Gary Delaney: I'm very confident in his ability to lead <unk> into our next phase of expansion and innovation.
Ray Stachowiak: Now I'll begin with some opening remarks, then turn the call over to Gary for additional detail, followed by Scott Frech, our CFO, for a financial review of our fiscal year results. Following our prepared remarks, we'll open the call for your questions. We are very pleased to report another year of strong revenue.
Speaker Change: Now I'll begin with some opening remarks, and then turn the call over to Gary for additional detail.
Scott: Followed by Scott <unk>, our CFO.
Brian: Brian just financial review of our fiscal year results.
Speaker Change: Following our prepared remarks, we'll open the call for your questions.
Speaker Change: We are very pleased to report another year of strong revenue growth.
Ray Stachowiak: driven by our strategic initiative. including the continued integration of our Rhode Island Acquisition. Expansion of our Direct Patient Services Segment. and additional international business development.
Speaker Change: Driven by our strategic initiatives.
Speaker Change: <unk> the continued integration of our Rhode Island acquisition.
Speaker Change: Expansion of our direct patient services segment.
Speaker Change: An additional international business development.
Ray Stachowiak: Our commitment to operational efficiency and financial discipline remains steadfast. As we transition.
Speaker Change: Our commitment to operational efficiency.
Speaker Change: And financial discipline remains steadfast.
Speaker Change: As we transition from.
Ray Stachowiak: from a cancer treatment equipment leasing focus. to a more patient centric service model.
Speaker Change: From a cancer treatment equipment leasing focus.
Speaker Change: More patient centric service model.
Ray Stachowiak: From a quarterly perspective, we continued our sequential and year-over-year momentum. as well with another solid quarter of revenue growth. which increased 59% year over year. and 30% from our last quarter. This growth was driven by the continued early benefit from our Rhode Island acquisition that we closed last May. as well as from the opening of our new radiation therapy treatment facility in Puebla, Mexico.
Speaker Change: From a quarterly perspective, we continued our sequential and year over year momentum.
Speaker Change: As well with another solid quarter of revenue growth.
Speaker Change: Which increased 59% year over year.
Speaker Change: And 30% from our last quarter.
Speaker Change: This growth was driven by the continued early benefit from our Rhode Island acquisition that we closed last may.
Speaker Change: As well as from the opening of our new radiation therapy treatment facility in Puebla, Mexico.
Ray Stachowiak: Our fourth quarter 2024 adjusted EBITDA. increased 29% compared to fourth quarter of 2023. For fiscal year 2024, revenue total $28.34 million. and increase the 32.9%. from fiscal year 2023. Adjusted EBITDA for fiscal 24 came in at $8.9 million. an 8.9% increase year over year. Additionally, our adjusted EBITDA came in at $1.38 per share.
Speaker Change: Our fourth quarter 2024 adjusted EBITDA.
Speaker Change: <unk> increased 29%.
Speaker Change: Compared to fourth quarter of 2023.
Speaker Change: For fiscal year 2024 revenue totaled $28 three 4 million.
Speaker Change: An increase of 32, 9%.
From fiscal year 2023.
Speaker Change: Adjusted EBITDA for fiscal 'twenty four came in at $8 9 million.
Speaker Change: And eight 9% increase year over year.
Speaker Change: Additionally, our adjusted EBITDA came in at $1 38 per share.
Ray Stachowiak: providing investors with a clearer perspective. on our financial performance. We encourage investors to consider what a fair EBITDA multiple might be for our enterprise value. Given the recurring nature and growth of our revenue.
Speaker Change: Providing investors with a clearer perspective.
Speaker Change: On our financial performance.
Speaker Change: We encourage investors to consider.
Speaker Change: What a fair EBITDA multiple might be for our enterprise value.
Speaker Change: Given the recurring nature and growth of our revenues.
Ray Stachowiak: Our Expanding International Footprint. and the strategic initiatives we have in motion. We believe this is an opportune time for investors to follow our company closely. as we execute on our growth strategy and working towards growing our shareholder value.
Speaker Change: Our expanding international footprint.
Speaker Change: And the strategic initiatives, we have in motion.
Speaker Change: We believe this is an opportune time for.
Speaker Change: Our invest to follow our company closely.
Speaker Change: As we execute on our growth strategy.
Speaker Change: And working towards growing our shareholder value.
Ray Stachowiak: Before I hand the call over to Gary, I'd also like to highlight our strong balance sheet. Robust Business Development. And exciting strategic growth opportunities that drives our enthusiasm, our confidence. in a long-term trajectory of our company.
Gary Delaney: Before I hand, the call over to Gary.
Gary Delaney: I'd also like to highlight our strong balance sheet.
Gary Delaney: Robust business development.
Gary Delaney: And exciting strategic growth opportunities that drives our enthusiasm or confidence in our long term trajectory of our company.
Gary Delanus: With that, I'll hand the call over to Gary, our new CEO, for additional details. Ferry. Thanks, Ray, and good afternoon, everyone. I'm excited to take on the CEO role and help lead our strong management team and the company into its next phase of growth. Now I will provide some additional details around financial performance as well as our strategic initiative. We are excited about the growth we have been seeing in the overall business that is a direct result of our recent acquisition of the three Rhode Island Cancer Treatment Centers and our new one in Puebla, Mexico.
Gary Delaney: With that I'll hand, the call over to Gary our new CEO for additional deep.
Gary Delaney: Gary.
Gary Delaney: Thanks, Ray and good afternoon, everyone.
Gary Delaney: I'm excited to take on the CEO role and help lead our strong management team and the company into its next phase of growth.
Gary Delaney: Now I will provide some additional details around financial performance as well as our strategic initiatives.
Gary Delaney: We are excited about the growth we have been seeing in the overall business that is a direct result of our recent acquisition of the three Rhode Island Island cancer treatment centers, and our new one in Kuwait Mexico.
Gary Delanus: At the Rhode Island Centers, we have invested in CAPEX by upgrading CT simulators used in the treatment planning process and also added software enhancements for improved efficiency and patient care. We also made significant progress on optimizing our staffing costs that will improve long-term profitability. Specifically, our professional services agreement with Brown University Health System, the largest health system in Rhode Island, for radiation oncologists staffing at our three centers, which is now fully operational. Disagreement streamlines physician recruitment and improves patient service capability. I am confident that once we are fully staffed at each center that we will begin to see growth in treatment volumes at each of our centers and increased physician engagement with the healthcare community.
That's the Rhode Island centers, we have invested in capex by upgrading Cte simulators used in the treatment planning process and also added software enhancements for improved efficiency and patient care.
Gary Delaney: We also made significant progress on optimizing our staffing costs that will improve long term profitability.
Gary Delaney: Specifically, our professional services agreement with Brown University Health system, the largest health system in Rhode Island for radiation oncologist staffing at our three centers, which is now fully operational.
Gary Delaney: Disagreement streamlines physician recruitment and improves patient service capabilities.
Gary Delaney: I am confident that once we are fully staffed at each center that we will begin to see growth in treatment volumes at each of our centers and increased physician engagement with the healthcare community.
Gary Delanus: Additionally, we put our linear accelerators on service and maintenance agreements, which adds to their dependability and higher uptime for better patient service. The team also continues to focus on strengthening our radiation therapy equipment leasing segment by working closely with our health system customers to create greater community awareness among referring physicians to drive increased utilization of their gamma knife systems, the gold standard for stereotactic radiosurgery. Our international business segment also represents a large growth opportunity. where we are expecting continued momentum. As a reminder, we have the only Gamma Knife Centers in the countries of Peru and Ecuador.
Gary Delaney: Additionally, we put our linear accelerators on service and maintenance agreements.
Gary Delaney: Which adds to their dependability and higher uptime for better patient service.
Gary Delaney: The team also continues to focus on strengthening our radiation therapy equipment leasing segment by working closely with our health system customers to create greater community awareness, among referring physicians to drive increased utilization of their gamma knife systems, the gold standard for <unk>.
Speaker Change: Oh tactic radiosurgery.
Speaker Change: Our international business segment also represents a large growth opportunity.
Speaker Change: Where we are expecting continued momentum.
Speaker Change: As a reminder, we have the only gamma knife centers in the countries, Peru and Ecuador.
Gary Delanus: Now, with our third international center in Puebla, Mexico, we are treating cancer patients for a full range of cancer diagnoses with the most advanced radiation therapy treatment capabilities available in our catchment area. In fiscal year 2024, we also established our fourth international center with the signing of a joint venture agreement for a Gamma Knife Center in Guadalajara, Mexico. As we look forward into the coming months and years ahead, we expect stronger international growth from additional treatment volumes in Ecuador. Strong volume from our newly upgraded center in Peru. and from our two news centers in Guadalajara and Puebla, Mexico.
Now with our third International Center employee Mexico, we are treating cancer patients for a full range of cancer diagnoses with the most advanced radiation therapy treatment capabilities.
<unk> and our catchment area.
Speaker Change: In fiscal year 2024, we also established our fourth International center with the signing of a joint venture agreement for our Gamma knife Center in Guadalajara, Mexico.
Speaker Change: As we look forward into the coming months and years ahead, we expect stronger international growth from additional treatment volumes in Ecuador.
Speaker Change: <unk> volume from our newly upgraded center in Peru.
Speaker Change: And from our two new centers in Guadalajara employed law in Mexico.
Gary Delanus: We also continue to expand our business footprint in Rhode Island. The first of these expansion initiatives was for the acquisition of a 60% majority interest in the three radiation therapy treatment centers in Rhode Island, which closed this past May. These are our first direct patient services cancer treatment centers in the U.S. This new business segment clearly reflects the power of our growth strategy and further demonstrates our ability to partner with health systems, Care New England, and Prospect Chartercare, the second and third largest health systems in Rhode Island. The second initiative is the Certificate of Need, or CON, that we have been granted to build and operate a fourth radiation therapy center in Bristol, Rhode Island.
Speaker Change: We also continue to expand our business footprint in Rhode Island.
Speaker Change: The first of these expansion initiatives was for the acquisition of a 60% majority interest in the three radiation therapy treatment centers in Rhode Island, which closed this past may.
Speaker Change: These are our first direct patient services cancer treatment centers in the U S.
Speaker Change: This new business segment, clearly reflects the power of our growth strategy and further demonstrates our ability to partner with health systems care, New England and prospect charter care, the second and third largest health systems in Rhode Island.
Speaker Change: Yeah.
Speaker Change: The second initiative is the certificate of need or C. O M that we have been granted to build and operate a fourth radiation therapy center in Bristol, Rhode Island.
Gary Delanus: And the third initiative is a CON that we officially obtained just this past December to build and operate the first proton beam radiation therapy center in the state of Rhode Unknown Attendee, Marla Marin, Kirin Smith, Robert Hiatt, Amer Shared, Unknown Attendee, We look forward to announcing additional progress on these opportunities in due course.
Speaker Change: And the third initiative is the OEM that we officially obtained just this past December to build and operate the first proton beam radiation therapy center in the state of Rhode Island.
Speaker Change: Which clearly demonstrates represents another significant growth opportunity.
Speaker Change: We look forward to announcing additional progress on these opportunities in due course.
Gary Delanus: I will close now by reiterating our strong confidence in our overall business strategy, and I'm very excited and honored to work collaboratively with our strong management team to lead the company forward for continued revenue and profitability growth over the long term.
Speaker Change: I will close now by reiterating our strong confidence in our overall business strategy and I'm very excited and honored to work collaboratively with our strong management team to lead the company forward for continued revenue and profitability growth over the long term.
Scott Frech: With that, I'll turn the call over to Scott for a financial review.
Scott: With that I'll turn the call over to Scott for a financial review.
Scott Frech: Thank you, Gary. Good afternoon, everyone. I'll start off with a review of the full fiscal year 2024 financial performance, followed by the fourth quarter 2024 financial results. For the fiscal year end of December 31st, 2024, total revenue increased by 33% to $28.3 million, compared to $21.3 million in fiscal year 2023. Revenue from our direct patient services segment was $12.6 million for fiscal year 2024, compared to $3.4 million in fiscal year 2023, marking an increase of $253.5 million. This significant growth was primarily driven by acquisition of the Rhode Island Radiation Therapy Operations, a 20.5% revenue growth in Peru and Ecuador, and launch of operations in Pueblo, Mexico in quarter three of 2024.
Scott: Thank you Gary and good afternoon, everyone I will start off with a review of the full fiscal year 2024 financial performance followed by the fourth quarter of 2024 financial result.
Scott: For the fiscal year ended December 31, 2024, total revenue increased by 33% to $28 3 million compared to $21 3 million in fiscal year 2023.
Scott: Revenue from our direct patient services segment was $12 6 million for fiscal year 2024, compared to $3 4 million in fiscal year 2023, marketing an increase of 253%.
Scott: This significant growth was primarily driven by acquisition of the Rhode Island radiation therapy operations.
Scott: 25% revenue growth in Peru, and Ecuador, and launch of operations in Puebla, Mexico in quarter three of 2024.
Scott Frech: Revenue from the equipment leasing segment decreased $15.6 million from $17.8 million in fiscal year 2023. Gamma Knife revenue declined 11.6% to $9.7 million for fiscal year 2024, compared to $11 million in fiscal year 2020. The number of Gamma Knife procedures in 2024 was 1,084, a 9.3% decrease from the 1,195 procedures done in 2023. This decline is due to the expiration of two contracts during 2023 and one in 2024. Revenue from Proton Beam Radiation Therapy, also called PBRT, decreased 1.8% to $10 million in fiscal year 2024, compared to $10.1 million in fiscal year 2020. Total proton therapy fractions for 2024 were 5,139, a 4.3% decrease from the 5,369 fractions done in 2020.
Scott: Revenue from the equipment leasing segment decreased $15 6 million from 17, $8 $17 8 million in fiscal year 2023.
Scott: Have a nice revenue declined 11, 6% to $9 7 million for fiscal year 2024, compared to $11 million in fiscal year 2023.
Scott: Gamma knife procedures in 2024 was $1 84, a nine 3% decrease from the 1195 procedures done in 2023.
Scott: Decline is due to the expiration of two contracts during 2023 and one in 2024.
Scott: Revenues from truck proton beam radiation therapy also called <unk> decreased one 8% to $10 million in fiscal year 2024, compared to $10 1 million in fiscal year 2023.
Scott: Total proton therapy fractions for 2024 or 5139, a four 3% decrease from the 5369 fractions down in 2023.
Scott Frech: The decline was primarily due to hurricanes in the state of Florida that impacted volumes along with the normal cyclical fluctuations that we've seen. Our gross margin for fiscal year 2024 was $9.2 million, compared to $9.3 million in fiscal year 2023. The decline in gross margin and percentages reflects increased operational expenses, higher staffing costs, and investments in technology infrastructure to support growth initiatives, as well as lower gamma knife treatment volumes and strong growth from our patient services segment, which has a lower gross margin. Fiscal year 2024 operating income was a gain of $279,000, excluding impairment, compared to $1.2 million in fiscal year 2020.
Scott: <unk> was primarily due to hurricanes in the state of Florida that impacted volumes, along with the normal cyclical fluctuations that we see.
Scott: Our gross margin for fiscal year, 2024 was $9 2 million compared to $9 3 million in fiscal year 2023.
Scott: The decline in gross margin percentages reflects increased operational expenses higher staffing costs and investments in technology infrastructure to support growth initiatives as well as lower gamma knife treatment volumes and strong growth from our patient services segment, which has a lower gross margin.
Scott: Full year 2024, operating income was a gain of $279000, excluding impairment compared to $1 2 million in fiscal year 2023.
Scott Frech: Net Income Attributable to American Shared Hospital Services for Fiscal Year 2024 increased 258% to $2.2 million, or $0.33 per diluted share, compared to $610,000, or $0.10 per diluted share, for Fiscal Year 2020. This significant increase was primarily driven by the bargain purchase gain resulting from the Rhode Island acquisition, positive net income contributions from the newly acquired Rhode Island Centers, and improved operational efficiencies across our domestic and international business. Adjusted EBITDA, our non-GAAP financial measure, increased 8.5% to $8.9 million for fiscal year 2024 compared to $8.2 million in fiscal year 2021.
Scott: Net income attributable to American shared hospital services for fiscal year, 2024 increased 258% to $2 2 million or <unk> 33 per diluted share compared to 610000 or 10 cents per diluted share for fiscal year 2023.
Scott: This significant increase was primarily driven by the bargain purchase gain resulting from the Rhode Island acquisition positive net income income contributions from the newly acquired Rhode Island centers and improved operational efficiency efficiencies across our domestic and international business segments.
Scott: Adjusted EBITDA are non-GAAP financial measure increased eight 5% to $8 9 million for fiscal year 2024, compared to $8 2 million in fiscal year 2023.
Scott Frech: Now I'll review the quarter results for the fourth quarter ended December 31st, 2024. Total revenue increased by 59.2% to $9.1 million, compared to $5.7 million in the same period of 2023, driven by the Rhode Island acquisition that closed this past May, as well as the new facility in Pueblo, Mexico. Revenue from the company's direct patient services or segment was $4.8 million, a 420% increase from Q4 2020. This substantial growth is primarily due to the acquisition of the Rhode Island Radiation Therapy Centers and commencement of operations at the facility in Pueblo. Revenue from the leasing segment decreased $4.1 million from $4.8 million in Q4 of 2020.
Scott: Now I'll review the quarter results for the fourth quarter ended December 31 2024.
Scott: Total revenue increased by 59, 2% to $9 1 million compared to $5 7 million in the same period of 2023, driven by the Rhode Island acquisition that closed this past may as well as the new facility in Puebla Mexico.
Scott: Revenue from the company's direct patient services segment was $4 8, million% to 420% increase from Q4 2023.
Scott: <unk> growth was primarily due to the acquisition of the Rhode Island radiation therapy centers and commencement of operations at the facility in Puebla Mexico.
Scott: Revenue from the leasing segment decreased $4 1 million from $4 8 million and.
Scott: In 2000 in Q4 of 2023.
Scott Frech: This decline was mainly due to lower gamma NI volumes driven by the expiration of two contracts in the second and third quarters of 2023, and a third contract expiration in the fourth quarter of 2023. Gamma Knife revenue decreased by 2.2% to 2.6%. Gamma Knife procedures totaled 253, an 8.7% decrease from the 277 procedures in Q4 of 2021. Revenue from protein beam therapy in Florida decreased 16% to $2.6 million from $3.1 million in Q4 of 2023. Proton therapy fractions were 1,471, a 39% decrease compared to the 2,396 fractions in the same period of time. Gross Margin for Q4 of 2024 was $3.2 million compared to $2.8 million in the same period last year.
Scott: This decline was mainly due to lower gamma knife volumes driven by the exploration of two contracts in the second and third quarters of 2023, and a third contract expiration in the fourth quarter of 2024.
Scott: Gamma knife revenue decreased by two 2% to $2 6 million gallon.
Scott: Kevin I procedures totaled 253, and eight 7% decrease from the 277 procedures in Q4 of 2023.
Scott: Revenue from protein being therapy in Florida decreased 16% to $2 6 million from $3 1 million in Q4 of 2023.
Scott: Proton therapy fractions were 1471 or 39% decrease compared to the 2396 fractions in the same period last year.
Scott: Gross margin for Q4 of 2024 was $3 2 million compared to $2 8 million in the same period last year.
Scott Frech: The percentage decrease was primarily due to lower gamma net treatment volumes and growth in the direct patient services segment, which typically has a lower growth rate. Selling and administrative expenses decreased slightly to $1.7 million, compared to $1.8 million in Q4 of 2023. Interest expense was $429,000 in Q4 of 2024, compared to $287,000 in the same period last year. The operating loss for QTOR 2024 was 1.8. compared to an operating income of $407,000 in Q4 of 2023. This is due to a loss on a write down of impaired assets and removal costs in the lease. The income tax expense for Q4 2024 was $71,000 compared to income tax expense of $338,000 in the same period last year.
Scott: The percentage decrease was primarily due to lower gamma knife treatment volumes and growth in the direct patient services segment.
Scott: Typically has a lower gross margin.
Scott: Selling and administrative expenses decreased slightly to $1 7 million compared to $1 8 million in Q4 of 2023.
Scott: Interest expense was 429000 in Q4 of 2024 compared to 287 in the same period last year.
Scott: The operating loss for Q4 of 2024 was $1 8 million.
Scott: Compared to an operating income of 407000 in Q4 of 2023.
Scott: This was due to a loss on a write down of impaired assets and removal costs in the leasing segment.
Scott: Yeah.
Scott: The income tax expense for Q4, 2024 was $71000 per day.
Scott: Income tax expense of 338000 in the same period last year.
Scott Frech: The net loss attributable to American Shared Hospital Services in Q4 2024 was $1.3 million, or $0.20 per share, compared to net income of $415,000, or $0.06 per share, in Q4 of 2020. The Q4 2024 period includes results from our new business development opportunities in the direct patient care segment and increased reserves from impaired assets and removal costs of $2.9 million in lease. Adjusted EBITDA, a non-GAAP financial measure, increased 29% to $3.5 million for Q4 2024, compared to $2.7 million in Q4 2021.
Scott: The net loss attributable to American shared hospital services in Q4, 2024 was $1 3 million or <unk> 20 per share compared to net income of 415000 or <unk> <unk> per share in Q4 of 2023.
Scott: The Q4 2024 period includes results from our new business development opportunities and the direct patient care segment and increase reserves from parent asset removal costs of $2 9 million and leasing segments.
Scott: Adjusted EBITDA, a non-GAAP financial measure increased 29% to $3 5 million for Q4 2024 compared to $2 7 million in Q4 2023.
Scott Frech: We ended the year in a strong financial position, supported by our balance sheet. As of December 31st, 2024, cash and cash equivalents, including restricted cash, stood at $11.3 million, compared to $13.8 million on December 31st, 2023. Shareholders' equity, excluding non-controlling interests and subsidiaries, was $25.2 million, or $3.92 per outstanding share, compared to $22.6 million, or $3.59 per outstanding share, at December 31, 2023. Fully Deleted Weighted Average Common Shares Outstanding for $6,542,000 for Q4 and $6,552,000 for Q4 of 2020.
Scott: We ended the year in strong financial position supported by our balance sheet as of December 31, 2024, cash and cash equivalents, including restricted cash stood at $11 3 million compared to $13 8 million at December 31, 2023.
Scott: Shareholders' equity excluding noncontrolling interests in subsidiaries was $25 2 million or $3 92 per outstanding share compared to $22 6 million or $3 59 per outstanding share at December 31, 2023.
Scott: So we did we did diluted weighted shares average common shares outstanding or $6 million 542000 for Q4 and $6 million 552000 for Q4 of 2023.
Scott Frech: This concludes the formal part of our presentation. Thank you again for joining us today. We look forward to updating you on our progress in the quarters ahead.
Scott: This concludes the formal part of our presentation.
Scott: Again for joining us today, we look forward to updating you on our progress in the quarters ahead, we'd now like to turn the call back to the operator and open it up for questions.
Operator: We'd now like to turn the call back to the operator 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. If you are using a speakerphone, please pick up your handset before pressing the key. If at any time your question has been addressed and you would like to withdraw your question, please press star then two. We ask that you please limit yourself to one question and one follow-up.
We will now begin the question and answer session.
Scott: To ask a question you May Press Star then one on your Touchtone phone.
Scott: If you are using a speakerphone please pick up your handset before pressing the keys.
Scott: Is it any time your question has been addressed and you would like to withdraw your question. Please press Star then two.
Scott: We ask that you please limit yourself to one question and one follow up.
Operator: At this time, we will pause momentarily to assemble our roster.
Scott: At this time, we will pause momentarily to assemble our roster.
Marla Marin: The first question today comes from M. Marin with DACS. Please go ahead. Thank you. Um, so that you There's a lot of growth, you know, footprint growth in the state of Rhode Island that you've talked about. It's, you know, obviously a big factor behind the revenue expansion in 2024. So you mentioned on the call, I think, I think Gary spoke to it in his prepared remarks, the agreement with Brown University and how that will likely accelerate hiring of medical professionals. Are there any other benefits that you, you know, can think about or speak to of operating, of expanding your footprint within the state?
Speaker Change: The first question today comes from and Marin with sacks. Please go ahead.
Speaker Change: Thank you.
Scott: Hum.
Scott: Yeah.
Scott: There's a lot of growth you know footprint growth and the state of Rhode Island.
Scott: That you've talked about it's obviously, a big factor behind the the revenue expansion in 2024. So you mentioned on the call I think as.
Scott: Gary spoke to it in his prepared remarks.
Scott: The agreement with Brown University, and how that will likely accelerate hiring of medical professionals.
Scott: Are there any other.
Scott: Benefits that you.
Scott: You can think about or speak to.
Scott: Operating of expanding your footprint within the scope then all of the facilities that you are contemplating the nuc facilities. The fourth radiation treatment center, the proton beam center or they close enough to the three existing facilities that there can be any kind of economies.
Marla Marin: And are the facilities that you're contemplating, the new facilities, the fourth radiation treatment center, the proton beam center, are they close enough to the three existing facilities that there can be any kind of economies that we can, you know, we can talk about? Thank you.
Scott: But that we cannot.
Scott: We can talk about thank you.
Ray Stachowiak: Marla, Marla, thanks for your question. Very much. Very good question. Very perceptive. There will be synergies from that relationship. And, you know, Rhode Island's a relatively small state. And the three largest health care providers in the state is Brown University Health. And we've now entered into this relationship for their provision of professional services.
Mara: Mara Thanks for your question very much very good questions.
Scott: Very perceptive.
Speaker Change: There will be synergies from that relationship.
Scott: And Rhode Islands, but relatively small state.
Scott: The three largest health care.
Scott: Providers in the state is Brown University health and we've now entered into this relationship for their provision of professional services.
Ray Stachowiak: Unknown Attendee. The second largest healthcare system, Care New England, is actually a 20% equity owner in our three radiation therapy centers. And the third largest healthcare system, Chartercare, Prospect Chartercare is also a 20% equity owner in our free radiation therapy center. will be, I'll say, a central focus of that initiative.
Scott:
Scott: The second largest health care system care, New England.
Scott: It's actually a 20% equity owner in our three radiation therapy centers.
Scott: And the third largest health care system charter care prospect charter care is also a 20% equity owner and our three radiation therapy centers.
Scott: And there will be centered from all of those relationships.
Scott: That will.
Scott: Advanced.
Scott: Provision of cancer care in the state and.
Scott: We will be there.
Scott: Say, a central focus of that initiative.
Operator: Okay, thank you. As a reminder, if you would like to ask a question, please press star and one to join the question queue. That's far than one to ask the question.
Scott: Okay. Thank you.
Scott: Mhm.
Speaker Change: As a reminder, if you would like to ask a question. Please press star one to join the question queue.
Scott: Sorry, the one who asked the question.
Operator: There are no further questions at this time, which concludes our question and answer session.
Scott: There are no further questions at this time, which concludes our question and answer session I would like to turn the call.
Ray Stachowiak: I would like to turn the conference back over to Ray Stachowiak for any closing remarks. Thank you, Betsy. Thanks, everyone, for joining us today.
Vince: Vince back over to Ray <unk> for any closing remarks.
Vince: Thank you Betsy thanks, everyone for joining us today.
Ray Stachowiak: American Shared Hospital Services is at a pivotal moment. We got strong momentum behind our growth strategy. The Rhode Island acquisitions not only expanded our footprint, but also established our first direct patient services business in the United States. Marking a significant milestone for our company. Internationally, our expansion to Mexico, coupled with continued growth in Peru and Ecuador, further strengthens our position as a leader in specialized radiation therapy service.
Vince: American shared hospital services is at a pivotal moment, we got strong momentum behind our growth strategy.
Vince: Rhode Island acquisitions, not only expanded our footprint.
Vince: It also established our first direct patient services business in the United States.
Vince: Marking a significant milestone for our company.
Vince: Internationally, our expansion into Mexico.
Vince: Bold with continued growth in Peru, and Ecuador.
Vince: Further strengthens our position as a leader in specialized radiation therapy services.
Ray Stachowiak: We recognize that growth comes with challenge. were prepared to navigate the complexities of this evolving industry. a recent expansion of our senior leadership team. The upgrade in our equipment portfolio, operational efficiency. will enhance the quality and accessibility of our service. Further, our CON approval in Rhode Island for a fourth radiation therapy center and our CON to develop and operate. The first and only expected proton beam therapy facility in Rhode Island represents another major long-term opportunity for expansion. We're confident in our strategy and our team's ability to work together.
Vince: We recognize that growth comes with challenges.
Vince: We are prepared to navigate the complexities of this evolving industry.
Vince: Our recent expansion of our senior leadership team.
Vince: Upgrading our equipment portfolio.
Vince: Operational efficiencies.
Vince: We will enhance the quality and accessibility of our services.
Vince: Further our C O N approval in Rhode Island for four fourth radiation therapy center or <unk>.
Vince: And to develop and operate.
Vince: The first and only expected proton beam therapy facility in Rhode Island.
Vince: <unk> represents another major long term opportunity for expansion.
Vince: We're confident in our strategy and our team's ability to execute.
Ray Stachowiak: Thank you. We look forward to updating you on our continued progress. as we drive sustainable growth and long-term success. If you have any questions, don't hesitate to reach out. We welcome any conversation. Thanks again for your interest in American Shared Hospital Services. Have a great rest of your day and the rest of the week.
We look forward to updating you on our continued progress.
Vince: As we drive sustainable growth and long term success.
Vince: If you have any questions don't hesitate to reach out we welcome any conversation.
Vince: Thanks again for your interest in American shared hospital services.
Vince: Have a great rest of your day and rest of the week.
Operator: Thank you and goodbye.
Vince: Thank you and goodbye.
Vince: Yes.
Operator: 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.
Operator: You may now disconnect.
Vince: Okay.
Vince: Okay.
Vince: Yes.