American Shared Hospital Services (AMS) 2026 Q2 法說會逐字稿

Good day and welcome to the American Shared Hospital Services second quarter 2026 earnings conference call. All participants will be in a listen-only mode.

大家好，歡迎參加 American Shared Hospital Services 2026 年第二季財報電話會議。所有與會者將以僅收聽模式參與。

(Operator Instructions)

(接線員指示)

After today's presentation, there will be an opportunity to ask questions.

在今天的簡報結束後，將有提問的機會。

(Operator Instructions)

(接線員指示)

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

請注意，本活動正在錄音。現在我想把會議交給投資人關係的 Kieran Smith。請開始。

Thank you, Nick, and thank you everyone for joining us today.

謝謝你，Nick，也謝謝各位今天加入我們。

AMS's second quarter 2026 earnings press release was issued earlier today. If you need a copy, it can be accessed on the company's website at www.ashs.com under the Investors section. Before turning the call over to management, I would like to make the following remarks concerning forward-looking statements.

AMS 2026 年第二季財報新聞稿已於今日稍早發布。如需副本，可至公司網站 www.ashs.com 的 Investors（投資人）專區取得。在把電話交給管理團隊之前，我想先就前瞻性陳述做以下說明。

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 1,995. 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, including the company's annual report on Form 10-K for the year ended December 31.

請注意，本次電話會議中可能提及的各項關於公司未來預期、計畫與前景的評論，均構成《1995 年私人證券訴訟改革法》安全港條款所定義之「前瞻性陳述」。由於多項重要因素，實際結果可能與這些前瞻性陳述所示有重大差異，包括公司向美國證券交易委員會（SEC）提交之文件中所討論者，例如截至 12 月 31 日止年度的 Form 10-K 年報。

And Form 10-Q for the quarter ended March 31, 2026. The company assumes no obligation to update this information contained on this conference call. Before I turn the call over to management, I would 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 will be happy to take additional questions offline. With that, I would now like to turn the call over to Ray Stachowiak, Executive Chairman. Ray, please go ahead.

以及截至 2026 年 3 月 31 日止季度的 Form 10-Q。公司不承擔更新本次電話會議所含資訊的任何義務。在我把電話交給管理團隊之前，也提醒各位我們的問答政策：每位與會者可提一個問題並追問一次。一如往常，我們也很樂意在會後私下回覆其他問題。接下來，我想把電話交給執行董事長 Ray Stachowiak。Ray，請開始。

Thank you, Kirin, and good afternoon, everyone. Thanks for joining us today and for your continued interest in American Shared Hospital Services. Before we begin, I would like to take a moment to point out that we recently promoted Alexis Wallace, our longstanding Chief Accounting Officer, to the role of interim CFO. Our previous CFO, Scott Freck, has moved on to pursue other endeavors.

謝謝你，Kirin，各位下午好。感謝各位今天加入我們，並持續關注 American Shared Hospital Services。在開始之前，我想先提一下，我們最近已將資深的首席會計長 Alexis Wallace 晉升為代理財務長（interim CFO）。我們前任財務長 Scott Freck 已離職，去追求其他發展。

We wish Scott all the best and appreciate his contributions while welcoming Alexis to this well-deserved role after her many years of excellent service on our accounting team. Now let us get into the quarter. The second quarter represented another period of meaningful operational progress for our company.

我們祝福 Scott 一切順利，並感謝他過去的貢獻；同時也歡迎 Alexis 在會計團隊多年卓越服務後，獲得這個實至名歸的職務。現在讓我們進入本季表現。第二季對公司而言，是營運面持續取得實質進展的另一個期間。

We delivered strong quarterly revenue of approximately $8.4 million, representing year-over-year growth of 19%, while first half revenue increased 18% to more than $15.5 million.

我們本季營收表現強勁，約為 840 萬美元，年增 19%；而上半年營收亦年增 18%，超過 1,550 萬美元。

These results are driven by continued strength across our direct patient services business, increasing proton beam radiation therapy activity, and improving performance from our international operations. More importantly, we believe these results validate the strategic direction we have been executing over the past several years. We have intentionally transformed American Shared Hospital Services. From a company primarily dependent on equipment leasing into a more diversified radiation oncology platform with multiple avenues for growth. Today, we benefit from recurring revenues generated through our direct patient care operations, long-standing hospital partnerships, international treatment centers, gaminized leadership.

這些成果來自我們直接病患服務業務的持續強勁、質子束放射治療活動增加，以及國際營運表現改善。更重要的是，我們相信這些結果驗證了我們過去數年所執行的策略方向。我們有意識地轉型 American Shared Hospital Services，從主要依賴設備租賃的公司，轉變為更為多元的放射腫瘤平台，具備多條成長途徑。如今，我們受益於透過直接病患照護營運、長期醫院合作夥伴關係、國際治療中心、伽瑪刀領導地位所帶來的經常性收入。

And our participation in proton beam radiation therapy. Each of these businesses contribute differently to our overall growth strategy, but together they provide us with a broader, more resilient operating platform than at any point in our history. One of the most encouraging trends we continue to see is improving utilization across our network.

以及我們在質子束放射治療領域的參與。這些業務在整體成長策略中各自扮演不同角色，但合在一起，為我們提供了比公司歷史上任何時點都更廣泛、更具韌性的營運平台。我們持續看到的一個最令人鼓舞的趨勢，是我們網絡整體使用率的提升。

Our Rhode Island centers continue to experience higher patient volumes and improved operating performance. Our proton beam radiation therapy partnership in Orlando, Florida, delivered another strong quarter, benefiting from increased treatment volumes and favorable reimbursement trends. Internationally, our Gamma Knife Center in Peru.

我們在羅德島的中心持續出現更高的病患量與更佳的營運表現。我們在佛羅里達州奧蘭多的質子束放射治療合作夥伴關係，本季再度交出亮眼成績，受惠於治療量增加以及有利的給付（reimbursement）趨勢。在國際方面，我們位於秘魯的伽瑪刀中心。

Continues to demonstrate increased treatment volumes compared with the prior year following the ESPRIT upgrade that we completed in 2025. These operational achievements are especially encouraging because higher utilization remains one of the most important drivers of long-term profitability in our business model.

在我們於 2025 年完成 ESPRIT 升級後，相較前一年持續展現治療量增加。這些營運成果尤其令人振奮，因為在我們的商業模式中，更高的使用率仍是長期獲利能力最重要的驅動因素之一。

I am also proud to report that our operating activities over the first six months generated $4.4 million of cash and our cash balance at the end of the second quarter increased over 80% since the beginning of this year to $6.8 million. It is validating to see the improving cash generating capability of our business.

我也很自豪地報告，我們在前六個月的營運活動產生了 440 萬美元現金，而截至第二季末的現金餘額較今年年初增加逾 80%，達到 680 萬美元。看到公司現金創造能力的提升，令人感到振奮。

As our operating performance continues to strengthen. We also made important progress subsequent to quarter end with respect to our capital structure. As many of we entered into a Third Amendment and forbearance agreement with Fifth Third Bank. Although our financing discussions have required considerable management attention over the past several months.

隨著我們的營運表現持續走強。在季後，我們也在資本結構方面取得重要進展。如各位所知，我們已與 Fifth Third Bank 簽訂第三次修訂及暫緩執行（forbearance）協議。儘管過去幾個月融資討論需要管理團隊投入相當多的注意力。

We believe the agreement provides a defined framework that allows us to remain focused on executing our operating strategy while we continue pursuing longer-term capital solutions. A few months ago, I formed a new company that recently purchased additional shares of our company from a private investor.

我們相信該協議提供了一個明確的框架，使我們在持續尋求較長期資本解決方案的同時，仍能專注於執行營運策略。幾個月前，我成立了一家新公司，近期已自一位私人投資人手中額外買入本公司股份。

In addition, this new company has invested $2 million of subordinated financing after quarter end, which reflects our continued confidence in the long-term prospects of the company and provides additional financial flexibility as we move forward. Importantly, none of these financing activities have changed our long-term strategic priorities.

此外，該新公司在季後投入了 200 萬美元的次順位融資（subordinated financing），這反映我們對公司長期前景的持續信心，並在我們向前推進之際提供額外的財務彈性。重要的是，這些融資活動均未改變我們的長期策略優先事項。

In Rhode Island, we continue advancing opportunities created through our certificate of need approvals, including plans for a new radiation therapy center in Bristol and a proton beam radiation therapy center in Johnston. Internationally, we remain excited about the continued development of our operations in Latin America.

在羅德島，我們持續推進因「需求證明」（certificate of need）核准所創造的機會，包括在 Bristol 規劃新的放射治療中心，以及在 Johnston 規劃質子束放射治療中心。在國際方面，我們對拉丁美洲營運的持續發展仍感到振奮。

And the opportunities we see to further expand our presence in attractive markets. An important component of our international growth strategy is in Guadalajara, Mexico where we are partnering with Hospital San Javier to upgrade their Gamma Knife Center. Importantly, this is an established Gamma Knife market and a well-established clinical partner.

以及我們所看到、可進一步擴大在具吸引力市場之布局的機會。我們國際成長策略的一個重要組成部分是在墨西哥瓜達拉哈拉（Guadalajara），我們正與 Hospital San Javier 合作升級其伽瑪刀中心。重要的是，這是一個成熟的伽瑪刀市場，且臨床合作夥伴也相當成熟。

Hospital San Javier has been providing gamma knife treatments since 1,994, giving us an experienced physician and institutional platform from which to build. While we recognize there is still important work ahead of us, particularly regarding our balance sheet, I remain extremely confident in the underlying strength of our business.

Hospital San Javier 自 1994 年起即提供伽瑪刀治療，讓我們得以在具經驗的醫師與機構平台上持續發展。雖然我們也認知仍有重要工作要完成，特別是在資產負債表方面，但我對公司業務的基本面實力仍然極具信心。

Our focus remains squarely on growing patient volumes, expanding and diversifying our installed base of advanced radiation therapy technologies, strengthening our partnerships with leading healthcare systems, and allocating capital where we believe it can generate attractive long-term returns.

我們的重點仍然聚焦於提升病患量、擴充並多元化我們已裝機的先進放射治療技術基礎、強化與領先醫療體系的合作夥伴關係，並在我們認為可產生具吸引力長期報酬之處配置資本。

With that, I will turn the call over to our interim CEO, Craig Tagawa, who will provide more detail on our operational performance.

接下來，我將把電話交給我們的臨時執行長 Craig Tagawa，由他更詳細說明我們的營運表現。

Craig? Thank you, Ray, and good afternoon, everyone. I would also like to thank all of you for joining us today and for your continued interest in American Shared Hospital Services. The second quarter was another quarter of solid operational execution and meaningful progress across our businesses. While our reported financial results include several substantial items that Alexis will discuss in greater detail, I believe the most important takeaway from the quarter is that the underlying business continues to move in the right direction. We generated strong quarterly revenues of approximately $8.4 million. Representing 19% year-over-year growth, while first-half revenues increased to more than $15.5 million. Those results were driven by continued growth in our direct patient services segment, improving proton beam radiation therapy performance and higher procedure volumes across our international Gamma Knife operations.

Craig？謝謝你，Ray，各位下午好。我也要感謝各位今天加入我們，並持續關注 American Shared Hospital Services。第二季是我們各項業務在營運執行上穩健、並取得實質進展的另一個季度。雖然我們公布的財務結果包含數項重大項目，Alexis 會在稍後更詳細說明，但我認為本季最重要的重點是：基本面業務仍持續朝正確方向前進。我們本季創造了約 840 萬美元的強勁營收。年增 19%，同時上半年營收增加至超過 1,550 萬美元。這些成果主要來自我們直接病患服務部門的持續成長、質子束放射治療表現改善，以及我們國際 Gamma Knife 營運的手術量提升。

More importantly, we continue to see encouraging trends in the metrics that matter most to the long-term success of our business: patient volumes, utilization, physician engagement, and central-level operating performance. Beginning with Rhode Island, our three radiation oncology centers continued to improve during the quarter. These facilities once again generated strong revenue growth. Supported by increased patient procedures and continued operational improvements. Since acquiring these centers, our primary objective has been to strengthen physician relationships, improve operational execution, and expand patient access to high-quality radiation therapy services. We believe we are making meaningful progress against each of those objectives.

更重要的是，我們持續看到對公司長期成功最關鍵的指標出現令人鼓舞的趨勢：病患量、使用率、醫師參與度，以及中心層級的營運表現。先從羅德島開始，我們的三家放射腫瘤中心在本季持續改善。這些設施再次帶來強勁的營收成長。在病患治療程序增加與持續的營運改善支持下。自收購這些中心以來，我們的首要目標一直是強化醫師關係、提升營運執行力，並擴大病患取得高品質放射治療服務的機會。我們相信在上述每一項目標上都取得了實質進展。

While there are still additional opportunities ahead, we are encouraged by the trajectory of these operations and believe they represent an important long-term growth platform for the company. Our Puebla, Mexico radiation therapy center also delivered another strong quarter. Patient activity remained healthy, reimbursement trends continue to be favorable. And the operational improvements we have implemented over the past year are translating into better financial performance. Puebla continues to demonstrate the value of our international operating strategy, and we believe it provides a strong foundation for operational opportunities throughout Latin America. Turning to proton beam radiation therapy, our leasing arrangement in Orlando delivered another excellent quarters.

儘管未來仍有更多機會，我們對這些營運的發展軌跡感到鼓舞，並相信它們代表公司重要的長期成長平台。我們位於墨西哥普埃布拉（Puebla）的放射治療中心本季也再度交出亮眼成績。病患活動維持健康水準，給付趨勢持續有利。而我們在過去一年推動的營運改善，正轉化為更佳的財務表現。Puebla 持續展現我們國際營運策略的價值，我們相信它為拉丁美洲各地的營運機會提供了堅實基礎。談到質子束放射治療，我們在奧蘭多的租賃安排又交出一個極佳的季度。

Revenues increased over 22% year-over-year as both treatment volumes and reimbursement improved. Photon beam radiation therapy remains an important component of our diversified treatment portfolio, and we are pleased with the continued performance of this asset. Our Gamma Life business also continued to make encouraging progress. While domestic leasing volumes continue to reflect the expiration of one customer agreement last year, we experienced strong growth across our international Gamma Knife centers. The ESPRIT upgrade completed in Peru last year continues to produce operational benefits through shorter treatment times, improved patient throughput and higher utilization.

在治療量與給付改善的帶動下，營收年增超過 22%。光子束放射治療仍是我們多元化治療組合中的重要一環，我們對該資產的持續表現感到滿意。我們的 Gamma Life 業務也持續取得令人鼓舞的進展。雖然國內租賃量仍反映去年一項客戶合約到期的影響，但我們在國際 Gamma Knife 中心方面經歷了強勁成長。去年在秘魯完成的 ESPRIT 升級，持續透過縮短治療時間、提升病患周轉率與提高使用率，帶來營運效益。

We believe these improvements demonstrate the value of continuing to invest in next-generation technology across our installed base. As we look across the entire organization, one theme continues to stand out: utilization. Increasing patient throughput remains the single greatest driver of long-term value creation within our business. Many of our facilities have significant operating leverage. As procedure volumes continue to increase, we expect that incremental revenue will increasingly translate into improved profitability and stronger cash generation. That remains a central focus for our management team. Beyond our current operations, we are also excited about the opportunities ahead. In Rhode Island, we will continue to work toward development opportunities associated with our previously approved certificates of need.

我們相信，這些改善展現了在既有裝機基礎上持續投資下一代技術的價值。放眼整個組織，有一個主題持續最為突出：使用率。提升病患周轉量仍是我們業務中創造長期價值的最主要驅動因素。我們許多設施具有顯著的營運槓桿。隨著手術量持續增加，我們預期新增營收將愈來愈多地轉化為更佳的獲利能力與更強的現金創造。這仍是管理團隊的核心重點。除了現有營運之外，我們也對未來機會感到振奮。在羅德島，我們將持續推進與先前已核准之需求證明（certificate of need）相關的開發機會。

These projects have the potential to significantly expand our presence in one of our strongest operating markets and represents an important component of our long-term growth strategy. As Ray mentioned earlier, we also made important progress regarding our financing capabilities after quarter end. While much of the public attention has understandably focused on the balance sheet.

這些專案有潛力在我們最強的營運市場之一大幅擴大布局，並構成我們長期成長策略的重要一環。如 Ray 先前提到的，我們也在季後就融資能力方面取得重要進展。雖然大眾的注意力在可理解的情況下多聚焦於資產負債表。

I believe it is equally important to recognize the progress occurring throughout our operating business. Revenue continues to grow, patient volumes continue to improve, our clinical partners remain strong and our operating teams continue to execute at a very high level. Taken together, these trends reinforce our confidence that the business is becoming stronger and better positioned for sustainable long-term growth.

但我認為同樣重要的是，要看見我們營運業務各處正在發生的進展。營收持續成長、病患量持續改善、我們的臨床合作夥伴依然穩健，而我們的營運團隊也持續以非常高的水準執行。綜合而言，這些趨勢強化了我們的信心：公司正變得更強健，並更有利於實現可持續的長期成長。

While there is still work ahead, I believe the progress we are making today lays the foundation for meaningful long-term value for our shareholders. With that, I will turn the call over to our Interim Chief Financial Officer, Alexis Wallace, who will review our financial results in greater detail. Alexis?

雖然前方仍有工作要做，但我相信我們今天所取得的進展，為股東創造具意義的長期價值奠定了基礎。接下來，我將把電話交給我們的臨時財務長 Alexis Wallace，由她更詳細檢視我們的財務結果。Alexis？

Thank you, Craig, and good afternoon, everyone. As Craig highlighted, the second quarter reflected continued operating momentum across our business.

謝謝你，Craig，各位下午好。如 Craig 所強調，第二季反映了我們整體業務持續的營運動能。

We delivered strong growth in our direct patient services platform, solid improvement in operating cash flow and continued progress strengthening our liquidity. While reported earnings were affected by several significant items during the quarter, we believe our underlying operating performance continued to improve and provides a solid foundation for future growth.

我們在直接病患服務平台實現強勁成長、營運現金流穩健改善，並持續強化流動性。雖然本季公布的獲利受到數項重大項目影響，但我們認為基本營運表現仍持續改善，並為未來成長提供了穩固基礎。

Beginning with revenue, total revenue for the second quarter increased 19.2% to approximately $8.4 million compared with $7.1 million in the prior year period. For the first six months of 2026, revenue increased 17.7% to approximately $15.5 million from $13.2 million in the first half of 2025.

先從營收來看，第二季總營收年增 19.2% 至約 840 萬美元，較去年同期的 710 萬美元增加。2026 年前六個月，營收年增 17.7% 至約 1,550 萬美元，較 2025 年上半年的 1,320 萬美元增加。

The primary driver of this performance continued to be our direct patient services segment. Second quarter direct patient services segment revenue increased approximately 40% to $4.9 million, while first half revenue increased 35% to approximately $8.9 million. This growth was driven by primarily higher patient procedure volumes at our Rhode Island radiation oncology centers.

推動此表現的主要動能仍來自我們的直接病患服務部門。第二季直接病患服務部門營收約成長 40% 至 490 萬美元，而上半年營收成長 35% 至約 890 萬美元。此成長主要由我們羅德島放射腫瘤中心較高的病患治療程序量所帶動。

Together with another strong quarter from our Peru and Pueblo Mexico facilities. Importantly, these centers continue to demonstrate the operating leverage we anticipated when we made these investments. As patient volumes continue to grow, we believe this business will become an increasingly meaningful contributor to both revenue growth and long-term profitability.

再加上我們秘魯與墨西哥普埃布拉（Pueblo Mexico）設施又一個強勁季度的貢獻。重要的是，這些中心持續展現我們在投資時所預期的營運槓桿。隨著病患量持續成長，我們相信這項業務將對營收成長與長期獲利能力做出愈來愈重要的貢獻。

Within our medical equipment leasing segment, overall revenue remained relatively stable compared with the prior year. While domestic gammonized leasing activity reflected the expiration of 1 customer agreement during 2020.

在醫療設備租賃部門方面，整體營收與去年相比大致維持穩定。雖然國內 Gamma Knife 租賃活動反映了 2020 年一項客戶合約到期的影響。

This was substantially offset by continued strength in our proton beam radiation therapy business. Proton beam radiation therapy revenue increased 22% to approximately $2.3 million during the quarter and approximately $4.3 million for the first six months of the year, benefiting from both higher treatment volumes and improved reimbursement levels.

但這在很大程度上被我們質子束放射治療業務的持續強勁表現所抵銷。本季質子束放射治療營收年增 22% 至約 230 萬美元；全年前六個月約為 430 萬美元，受惠於治療量增加與給付水準改善。

CM&I revenue also increased modestly during the quarter as procedure volumes continued recovering at our international treatment centers following completion of the ESPRIT upgrade in Lima. Improved efficiency of the upgraded platform has enhanced patient throughput and contributed to stronger operating performance across our international operations. Turning to profitability, gross margin for the quarter was approximately $1.4 million.

CM&I 營收在本季亦小幅增加，因利馬完成 ESPRIT 升級後，我們的國際治療中心手術量持續復甦。升級後平台效率提升，改善病患周轉量，並促進我們國際營運整體營運表現更為強勁。談到獲利能力，本季毛利約為 140 萬美元。

While modestly below last year's level, it improved sequentially from the first quarter of 2026 despite the continued expansion of our direct patient services business, which carries a different cost structure than our traditional equipment leasing operations. We believe this reflects continued operational execution as we scale that business. Adjusted EBITDA for the second quarter was approximately $1.3 million compared with $1.7 million in the prior year quarter.

雖略低於去年水準，但相較 2026 年第一季呈現連續改善，儘管我們的直接病患服務業務持續擴張，而該業務的成本結構不同於傳統設備租賃營運。我們認為這反映出在擴大該業務規模的同時，營運執行仍持續到位。第二季調整後 EBITDA 約為 130 萬美元，去年同期為 170 萬美元。

On a year-to-date basis, adjusted EBITDA totaled approximately $2.5 million, reflecting the continued cash generating strength of our operating platform. Moving further down the income statement, selling and administrative expenses increased year-over-year, primarily reflecting legal and professional costs of $285,000 associated with negotiating the Third Amendment to our credit agreement.

以年初至今計，調整後 EBITDA 合計約 250 萬美元，反映我們營運平台持續具備強勁的現金創造能力。再往下看損益表，銷售及管理費用年增，主要反映與協商我們信貸協議第三次修訂相關的法律及專業費用 28.5 萬美元。

In addition, we recorded a higher allowance for credit losses of [$909,000] against Rhode Island receivables prior to May 31 to '25. As we mentioned in prior calls, we have been focused on improving our accounts receivable and billing systems and have made good progress in that area, so we are well positioned going forward. These two items represented the primary drivers of the increase in our reported net loss during the quarter.

此外，我們針對 2025 年 5 月 31 日之前的羅德島應收款項，提列較高的信用損失備抵金 [90.9 萬美元]。如我們在先前電話會議中提到的，我們一直專注於改善應收帳款與帳單系統，且在該領域已取得良好進展，因此未來我們具備良好基礎。這兩項因素是本季我們揭露之淨損增加的主要驅動因素。

We view both as largely independent of the operating trends within the business.

我們認為這兩者大致上與公司內部的營運趨勢無關。

Excluding these items, our core operations continue to perform well, supported by higher patient volumes, improving reimbursement trends, and disciplined operating execution.

排除上述項目後，我們的核心營運仍表現良好，受惠於更高的病患量、報銷趨勢改善，以及嚴謹的營運執行。

Another encouraging development with the continued decline in interest expense is our average debt balance has decreased, reflecting our ongoing efforts to strengthen our balance sheet.

另一項令人鼓舞的發展是，隨著利息費用持續下降，我們的平均債務餘額也已降低，反映我們持續強化資產負債表的努力。

Turning to liquidity, we ended the quarter with approximately $6.8 million in cash equivalents and restricted cash, compared with $3.7 million at year-end of $25. Perhaps most encouraging, operating activities generated $4.4 million of cash during the first six months of the year.

談到流動性，我們在季末持有約 680 萬美元的約當現金與受限制現金，較 2025 年底的 370 萬美元增加。更令人振奮的是，今年前六個月營運活動產生 440 萬美元現金。

The strong cash generation enabled us to fund scheduled debt repayments and distributions to our minority partners while simultaneously increasing our cash position.

強勁的現金創造能力使我們得以支付既定的債務償還與對少數股權夥伴的分配，同時也提高了現金部位。

We believe this demonstrates the improving cash generating capability of our business as operating performance continues to strengthen.

我們認為這顯示，隨著營運表現持續強化，我們業務的現金創造能力正在改善。

Subsequent to quarter end, we completed the previously announced Third Amendment and forbearance agreement with the Third Bank.

在季末之後，我們完成先前公告的與 Third Bank 的第三次修訂及暫緩執行（forbearance）協議。

This agreement provides additional flexibility as we continue evaluating longer-term financing alternatives and executing our strategic priorities.

該協議在我們持續評估較長期的融資替代方案並執行策略重點之際，提供了額外的彈性。

Additionally, we completed a $2 million subordinated financing for a newly created company formed by our executive Chairman.

此外，我們也為由我們執行董事長新設立的公司完成 200 萬美元的次順位融資。

Together, these actions enhance our liquidity, provide additional financial flexibility, and allow management to remain focused on executing our operating strategy while pursuing opportunities to further strengthen our capital structure.

綜合而言，這些行動提升了我們的流動性、提供額外的財務彈性，並使管理團隊能在尋求進一步強化資本結構機會的同時，持續專注於執行營運策略。

Looking ahead, our financial priorities remain clear.

展望未來，我們的財務優先事項仍然明確。

First, continuing driving sustainable revenue growth by increasing utilization across our existing treatment network while expanding our installed base of advanced radiation therapy technologies.

第一，透過提高既有治療網絡的使用率，同時擴大先進放射治療技術的裝機基礎，持續推動可持續的營收成長。

Second, translate that revenue growth into improved profitability and operating cash flow through disciplined execution and continued operating efficiency.

第二，透過嚴謹執行與持續提升營運效率，將營收成長轉化為更佳的獲利能力與營運現金流。

And third. Continue strengthening our balance sheet and capital structure while maintaining the flexibility necessary to support future growth opportunities and create long-term shareholder value.

第三。在維持支持未來成長機會所需彈性的同時，持續強化我們的資產負債表與資本結構，並創造長期股東價值。

Overall, we are encouraged by the progress achieved during the first half of 2026.

整體而言，我們對 2026 年上半年所取得的進展感到鼓舞。

The underlying fundamentals of our business continue to improve, our operating cash flow remains strong.

我們業務的基本面持續改善，營運現金流仍然強勁。

Demand across our treatment platform is healthy and we believe the company is well positioned to build on this momentum during the remainder of the year.

我們治療平台的需求維持健康，我們相信公司已具備良好條件，在今年剩餘期間延續這股動能。

With that, Nick, you may open up the call for any questions.

接下來，Nick，你可以開放電話會議進入提問。

Thank you. We will now begin the question-and-answer session.

謝謝。我們現在開始問答環節。

(Operator Instructions)

（接線員指示）

M. Marin, Zacks.

Zacks 的 M. Marin。

Thank you.

謝謝。

So on the back of the strength of this quarter.

所以，基於本季的強勁表現。

I think when you originally went down the path of growing the direct patient operations, one thing you talked about was having much greater control over procedure volumes and control over the ability to drive volume increases.

我想當你們最初走上擴大直接病患營運的道路時，你們提到的一點是，將能更大幅度地掌控手術量，以及掌控推動量能提升的能力。

And it seems.

而且看起來。

Based on, what you have discussed on prior conference calls or this call, that there are a lot of opportunities for that, particularly in Rhode Island, where you have three centers, you have the relationship with the Brown University Healthcare System, and you will be opening over time two new centers. Do you think that you will have the same ability to control and drive. Procedure volume increases in some of the international facilities.

根據你們在先前電話會議或本次會議所討論的內容，這方面有很多機會，特別是在羅德島，你們有三個中心，與布朗大學醫療體系（Brown University Healthcare System）有合作關係，並且將在一段時間內再開設兩個新中心。你認為你們是否也能在某些國際設施中，擁有同樣的能力去掌控並推動。手術量的增加？

Thanks for your question, Marin. This is Ray Stachowiak, Executive Chairman.

謝謝你的提問，Marin。我是執行董事長 Ray Stachowiak。

Yes, we will be growing, have been growing our volumes at our international sites.

是的，我們將會成長，也一直在推動國際據點的量能成長。

Peru has seen substantial volume increases, especially since we upgraded their technology to the latest and greatest Esprit model Gamma Knives.

秘魯的量能大幅增加，尤其是在我們將其技術升級至最新、最先進的 Esprit 型號伽瑪刀（Gamma Knife）之後。

And our linear accelerator in Puebla, Mexico has also experienced increases in volumes.

而我們在墨西哥普埃布拉（Puebla）的直線加速器也同樣出現量能增加。

We are also excited about the opportunity to proceed forward with the Gamma Knife upgrade in Guadalajara, Mexico, in our relationship with San Javier Hospital there. So, we are anxious to get that project going and moving forward as well. And yes, by having greater control and negotiating.

我們也對在墨西哥瓜達拉哈拉（Guadalajara）推進伽瑪刀升級的機會感到興奮，並與當地的 San Javier 醫院維持合作關係。因此，我們也很期待讓該專案啟動並向前推進。而且是的，透過更大的掌控力與協商。

Expanding our relationships with our hospital partners, that has been a key consideration in our business model.

擴大我們與醫院合作夥伴的關係，一直是我們商業模式中的關鍵考量。

Tony Kamen, Eastwood Partners.

Eastwood Partners 的 Tony Kamen。

First, I think it is really notable that with all the sort of investment and kind of collecting of.

首先，我認為非常值得注意的是，在所有這些投資以及某種程度上對。

Different opportunities, the company really at this point seems like it is starting to get the benefits of that and starting to fire on all cylinders, which is really encouraging.

不同機會的整合之下，公司在此刻看起來真的開始享受到這些成果，並開始全速運轉，這非常令人鼓舞。

I also noted that Ray, you, Craig and Alexis all mentioned the word long-term in the sense that growing the value of the company for shareholders long-term and as a long-term shareholder.

我也注意到 Ray、你、Craig 和 Alexis 都提到了「長期」這個詞，意指為股東長期提升公司價值；而作為長期股東。

I am sure all long-term shareholders really would be excited to get the full value of all these investments starting to fire in the right direction. However, I am trying to reconcile that with when I look at the Third Amendment on page 31 of it says the loan parties shall cause their respective subsidiaries to pursue a sale of all or any portion of all of the assets of ASHS.

我相信所有長期股東都會很期待看到這些投資開始朝正確方向發揮作用，並充分反映其價值。然而，我試著把這點與我看到第三次修訂協議第 31 頁的內容做對照，上面寫著貸款方應促使其各自子公司尋求出售 ASHS 全部或任何部分資產。

So, I mean, that seems pretty clear too that in your agreement, it mentions Lake Street, it mentions bid books that you have to start to try to sell the company. I guess I would have preferred that maybe you were able to replace this loan agreement with one from another institution, so you did not have to do that. But again, it seems it is written very clearly.

所以，我的意思是，這也相當清楚：在你們的協議中提到 Lake Street，提到你們必須開始準備投標資料（bid books），並嘗試出售公司。我想我原本會更希望你們能以另一家機構的貸款協議取代這份協議，這樣就不必這麼做。但不管怎麼說，這段文字寫得非常清楚。

Again, in the interest of wanting to capture the long-term opportunity here, how do you do that with at the same time being entering into agreement where you have to sell all or part of the company?

再者，為了把握這裡的長期機會，你要如何在同時又要簽訂一項可能必須出售公司全部或部分的協議的情況下做到這一點？

Well, I think it is fair to say we are pursuing any and all options.

嗯，我想可以公平地說，我們正在追求任何以及所有選項。

It is very clear that we have been given a 12-month extension of the maturity plus over 12-month extension of the maturity of our loans to June 30th of 2027.

很明確的是，我們的貸款到期日已獲得一次12個月的延長，並且又再獲得一次超過12個月的到期延長，延至2027年6月30日。

So our credit agreement with Fifth Third buys us some time so that we can pursue these different options.

因此，我們與 Fifth Third 的信貸協議為我們爭取了一些時間，好讓我們可以追求這些不同的選項。

We owe Fifth Third about $15.5 million. By the end of June of next year, it will be down to about $13.3 million. If you look at our business, we generated $4.4 million of cash in the first six months of this year. That number is going to be right off of our statement of changes in financial position, $4.4 million of cash generation.

我們欠 Fifth Third 約1,550萬美元。到明年6月底，將降至約1,330萬美元。如果你看我們的業務，我們在今年前六個月產生了440萬美元的現金。這個數字將直接來自我們的財務狀況變動表，也就是440萬美元的現金產生。

We ended the quarter with $6.8 million of cash plus the $2 million deposit we have as well.

我們在季末有680萬美元的現金，另外還有我們的200萬美元存款。

So I think we are going to be able to find a solution over this period of time to refinance our indebtedness with Fifth Third Bank.

所以我認為，在這段期間內，我們將能找到一個解決方案，為我們對 Fifth Third Bank 的債務進行再融資。

That will not necessarily require a sale of the company.

這不一定需要出售公司。

We are looking at any and all options, as I would expect our shareholders to expect us to do. So, we are pursuing any and all options, and we are confident we will reach a solution.

我們正在評估任何以及所有選項，正如我預期股東也會希望我們這麼做。因此，我們正在追求任何以及所有選項，而且我們有信心會達成一個解決方案。

Great.

很好。

Thank you very much.

非常感謝。

(Operator Instructions)

（接線員指示）

Anthony Marchese, Private investor.

Anthony Marchese，私人投資人。

I am trying to figure out how a almost million dollar charge for accounts receivable occurs over a year later.

我試著弄清楚，為什麼會在一年多之後才出現一筆將近100萬美元的應收帳款費用。

I just do not, I mean, is it one account, multiple accounts?

我就是不明白，我是說，這是一個帳戶，還是多個帳戶？

I am just trying to figure out what happened.

我只是想弄清楚發生了什麼事。

It just seems like every quarter there is something. If it is not a center that was closed, it was maintenance, if not maintenance now, it is, accounts receivable. It just seems like every quarter the company has some hiccup. So, I am just trying to figure out what was the nature, if you could, in more detail of the $900,000 accounts receivable charge and why it took this long to figure it out.

看起來好像每一季都有狀況。如果不是關閉了一個中心，就是維護費用；如果不是維護，現在又變成應收帳款。感覺公司每一季都有些小插曲。所以我只是想更詳細了解一下這筆90萬美元的應收帳款費用的性質，以及為什麼花了這麼久才發現。

Tony, your comments are very much appreciated.

Tony，你的意見我們非常感謝。

It kind of stands on its own.

這件事本身就很清楚。

We had receivables through May 31 of 2025 that related to several payors and our relationship with those payors, and they reached a point where we.

我們有截至2025年5月31日的應收款項，與數個付款方以及我們與這些付款方的關係有關，而事情發展到一個程度，使得我們。

Expect to have a $909,000 reduction in viability of those receivables.

預期這些應收款項的可收回性將減少909,000美元。

I am not trying to be difficult. I am not sure what that means.

我不是想刁難。我不太確定這是什麼意思。

Are the payers bankrupt? Do they not want to pay you? Was there an issue with the third? I am just trying to figure out. It is fairly large. So, I am just trying to figure out all these payers.

這些付款方破產了嗎？他們是不想付你們錢嗎？還是第三方有什麼問題？我只是想弄清楚。這金額相當大。所以我只是想了解這些付款方到底是怎麼回事。

When you call them payers, are these insurance companies or are these.

你說的付款方，指的是保險公司，還是這些。

Or are these people who got treatment and then could not afford it? I am just trying to figure out the nature of that charge.

還是接受治療的人但負擔不起費用？我只是想了解那筆費用的性質。

Yeah, for the most part, it comes from the insurance carriers that we have relationships with.

是的，大部分來自我們有合作關係的保險承保機構。

And was there an overriding theme as to why they would not pay you?

那他們不付款的原因有沒有一個主因？

I mean, these are insurance companies. These are fairly sophisticated, I would think, sophisticated institutions who are not just going to say, I do not want to pay you, for no reason. So, I am just wondering, was it because the service was not performed properly or there was an issue with the service? And I am not trying to be difficult, right? I am just trying to understand. Can this happen again? And if it does, how does it happen?

我的意思是，這些是保險公司。我想這些都是相當成熟的機構，不會無緣無故就說我不想付你錢。所以我想知道，是不是因為服務沒有正確提供，或服務本身有問題？我不是想刁難，對吧？我只是想理解。這種事會再發生嗎？如果會，又是怎麼發生的？

We are not proud of it, Tony. We are not proud of it.

Tony，我們對此並不自豪。我們對此並不自豪。

But it is what the question are.

但這就是問題所在。

Got it.

了解。

Okay.

好的。

Thank you.

謝謝。

This will conclude our question-and-answer session. I would like to turn the conference back over to Craig Tagawa for any closing remarks.

問答環節到此結束。我想把電話會議交回給 Craig Tagawa，請他做任何結語。

Thank you, Nick, and thank you to everyone who joined us today. Before we conclude, I would like to.

謝謝你，Nick，也謝謝今天加入我們的各位。在我們結束之前，我想要。

Leave you with three key takeaways from today's discussion.

留給各位今天討論的三個重點摘要。

First, our operating business continues to perform well.

第一，我們的營運業務持續表現良好。

We delivered strong quarterly revenue, continued to increase patient volumes across multiple treatment platforms and generated strong operating cash flow during the first half of the year.

我們交出強勁的季度營收，持續在多個治療平台提升病患量，並在上半年產生強勁的營運現金流。

Second, the strategic investments we have made over the past several years are producing meaningful results.

第二，我們在過去幾年所做的策略性投資正在產生具意義的成果。

Our direct patient services business continues to grow, our international operations are gaining momentum, and we have an exciting pipeline of future expansion opportunities that we believe will support long-term value creation.

我們的直接病患服務業務持續成長，我們的國際營運正在累積動能，而且我們有令人振奮的未來擴張機會管線，我們相信這將支持長期價值創造。

Finally, while we remain focused on strengthening our balance sheet. We have taken important steps to enhance our financial flexibility and remain committed to executing our long-term strategy with discipline and transparency.

最後，雖然我們仍專注於強化資產負債表。我們已採取重要步驟以提升財務彈性，並將以紀律與透明度持續致力於執行我們的長期策略。

I would like to thank our physicians, clinical teams, employees, hospital partners, and shareholders for their continued confidence and support.

我要感謝我們的醫師、臨床團隊、員工、醫院合作夥伴以及股東，持續給予信心與支持。

We appreciate your interest in American Shared Hospital Services. And look forward to updating you on our continued progress next quarter.

感謝各位對 American Shared Hospital Services 的關注。並期待在下個季度向各位更新我們持續進展的情況。

Thank you everyone and have a great evening.

謝謝大家，祝各位晚安。

The conference has now concluded.

本次電話會議到此結束。

Thank you for attending today's presentation. You may now disconnect.

感謝各位參加今天的簡報。您現在可以掛線。