|  |  |  |
|--|--|--|
|  |

|        |                                                                                         |  |  |  |  |
|--------|-----------------------------------------------------------------------------------------|--|--|--|--|
| ý | QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |

|        |                                                                                          |  |  |  |  |
|--------|------------------------------------------------------------------------------------------|--|--|--|--|
|  ̈ | TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |

|                                                               |                                  |  |  |  |  |
|---------------------------------------------------------------|----------------------------------|--|--|--|--|
| California                                                    | 94-2918118                       |
| (State or other jurisdiction ofincorporation or organization) | (IRS EmployerIdentification No.) |

|                                                                                                      |                 |  |  |  |  |
|------------------------------------------------------------------------------------------------------|-----------------|--|--|--|--|
| Two Embarcadero Center, Suite 410, San Francisco, California(Address of principal executive offices) | 94111(Zip code) |

|                                                              |  |                   |  |                                           |  |  |  |  |  |  |  |  |  |  |
|--------------------------------------------------------------|--|-------------------|--|-------------------------------------------|--|--|--|--|--|--|--|--|--|--|
| Title of each class                                          |  | Trading Symbol(s) |  | Name of each exchange on which registered |
| American Shared Hospital Services Common Stock, No Par Value |  | AMS               |  | NYSE AMERICAN                             |

----

|                                                                                                                                                                             |  |                  |                  |                   |                  |        |                  |        |  |  |  |  |  |  |
|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--|------------------|------------------|-------------------|------------------|--------|------------------|--------|--|--|--|--|--|--|
| ASSETS                                                                                                                                                                      |  | March 31, 2020   |                  | December 31, 2019 |
| Current assets:                                                                                                                                                         |  |                  |                  |                   |
| Cash and cash equivalents                                                                                                                                                   |  | $                | 2,673,000   |              |                  | $      | 1,429,000   |   |
| Restricted cash                                                                                                                                                             |  | 350,000     |             |                   | 350,000     |   |
| Accounts receivable, net of allowance for doubtful accounts of $100,000 at March 31, 2020 and $100,000 at December 31, 2019                                            |  | 5,988,000   |             |                   | 6,894,000   |   |
|                                                                                                                                                                             |  |                  |                  |                   |
|                                                                                                                                                                             |  |                  |                  |                   |
| Other receivables                                                                                                                                                           |  | 265,000     |             |                   | 169,000     |   |
| Prepaid expenses and other current assets                                                                                                                                   |  | 1,362,000   |             |                   | 1,900,000   |   |
|                                                                                                                                                                             |  |                  |                  |                   |
| Total current assets                                                                                                                                                        |  | 10,638,000  |             |                   | 10,742,000  |   |
|                                                                                                                                                                             |  |                  |                  |                   |
| Property and equipment:                                                                                                                                                 |  |                  |                  |                   |
| Medical equipment and facilities                                                                                                                                            |  | 93,429,000  |             |                   | 92,132,000  |   |
| Office equipment                                                                                                                                                            |  | 597,000     |             |                   | 594,000     |   |
| Deposits and construction in progress                                                                                                                                       |  | 4,256,000   |             |                   | 4,215,000   |   |
|                                                                                                                                                                             |  | 98,282,000  |             |                   | 96,941,000  |   |
| Accumulated depreciation and amortization                                                                                                                                   |  | (57,112,000)     |             |                   | (55,461,000)     |   |
| Net property and equipment                                                                                                                                                  |  | 41,170,000  |             |                   | 41,480,000  |   |
|                                                                                                                                                                             |  |                  |                  |                   |
| Right of use assets                                                                                                                                                         |  | 972,000     |             |                   | 1,106,000   |   |
|                                                                                                                                                                             |  |                  |                  |                   |
| Other assets                                                                                                                                                                |  | 411,000     |             |                   | 455,000     |   |
|                                                                                                                                                                             |  |                  |                  |                   |
| Total assets                                                                                                                                                                |  | $                | 53,191,000  |              |                  | $      | 53,783,000  |   |
|                                                                                                                                                                             |  |                  |                  |                   |
| LIABILITIES AND SHAREHOLDERS' EQUITY                                                                                                                                        |  | March 31, 2020   |                  | December 31, 2019 |
| Current liabilities:                                                                                                                                                    |  |                  |                  |                   |
| Accounts payable                                                                                                                                                            |  | $                | 851,000     |              |                  | $      | 557,000     |   |
| Employee compensation and benefits                                                                                                                                          |  | 285,000     |             |                   | 234,000     |   |
| Other accrued liabilities                                                                                                                                                   |  | 1,681,000   |             |                   | 1,779,000   |   |
| Income taxes payable                                                                                                                                                        |  | 95,000      |             |                   | 130,000     |   |
|                                                                                                                                                                             |  |                  |                  |                   |
| Current portion of lease liabilities                                                                                                                                        |  | 255,000     |             |                   | 279,000     |   |
| Current portion of long-term debt                                                                                                                                           |  | 1,451,000   |             |                   | 1,526,000   |   |
| Current portion of finance leases                                                                                                                                           |  | 3,211,000   |             |                   | 3,709,000   |   |
|                                                                                                                                                                             |  |                  |                  |                   |
| Total current liabilities                                                                                                                                                   |  | 7,829,000   |             |                   | 8,214,000   |   |
|                                                                                                                                                                             |  |                  |                  |                   |
| Long-term lease liabilities, less current portion                                                                                                                           |  | 717,000     |             |                   | 827,000     |   |
| Long-term debt, less current portion                                                                                                                                        |  | 2,923,000   |             |                   | 1,954,000   |   |
| Long-term finance leases, less current portion                                                                                                                              |  | 7,499,000   |             |                   | 8,177,000   |   |
| Deferred revenue, less current portion                                                                                                                                      |  | 264,000     |             |                   | 286,000     |   |
|                                                                                                                                                                             |  |                  |                  |                   |
| Deferred income taxes                                                                                                                                                       |  | 2,486,000   |             |                   | 2,514,000   |   |
|                                                                                                                                                                             |  |                  |                  |                   |
| Shareholders' equity:                                                                                                                                                   |  |                  |                  |                   |
| Common stock, no par value (10,000,000 authorized; 5,688,000 and 5,817,000 shares issued and outstanding at March 31, 2020 and at December 31, 2019, respectively) |  | 10,753,000  |             |                   | 10,753,000  |   |
|                                                                                                                                                                             |  |                  |                  |                   |
| Additional paid-in capital                                                                                                                                                  |  | 6,781,000   |             |                   | 6,725,000   |   |
| Retained earnings                                                                                                                                                           |  | 8,420,000   |             |                   | 8,555,000   |   |
| Total equity-American Shared Hospital Services                                                                                                                              |  | 25,954,000  |             |                   | 26,033,000  |   |
| Non-controlling interests in subsidiaries                                                                                                                                   |  | 5,519,000   |             |                   | 5,778,000   |   |
| Total shareholders' equity                                                                                                                                                  |  | 31,473,000  |             |                   | 31,811,000  |   |
|                                                                                                                                                                             |  |                  |                  |                   |
| Total liabilities and shareholders' equity                                                                                                                                  |  | $                | 53,191,000  |              |                  | $      | 53,783,000  |   |

----

|                                                                     |                              |                 |        |                 |        |                 |        |  |  |  |  |  |  |  |  |
|---------------------------------------------------------------------|------------------------------|-----------------|--------|-----------------|--------|-----------------|--------|--|--|--|--|--|--|--|--|
|                                                                     | Three Months ended March 31, |                 |        |                 |        |                 |        |
|                                                                     | 2020                         |                 | 2019   |                 |        |                 |        |
|                                                                     |                              |                 |        |                 |        |                 |        |
| Revenues                                                            | $                            | 4,568,000  |   |                 | $      | 5,321,000  |   |  |  |  |  |
|                                                                     |                              |                 |        |                 |        |                 |        |
| Costs of revenue:                                               |                              |                 |        |                 |        |                 |        |
|                                                                     |                              |                 |        |                 |        |                 |        |
| Maintenance and supplies                                            | 633,000                 |            |        | 668,000    |   |                 |        |  |  |
|                                                                     |                              |                 |        |                 |        |                 |        |
| Depreciation and amortization                                       | 1,647,000               |            |        | 1,894,000  |   |                 |        |  |  |
|                                                                     |                              |                 |        |                 |        |                 |        |
| Other direct operating costs                                        | 894,000                 |            |        | 822,000    |   |                 |        |  |  |
|                                                                     |                              |                 |        |                 |        |                 |        |
|                                                                     | 3,174,000               |            |        | 3,384,000  |   |                 |        |  |  |
|                                                                     |                              |                 |        |                 |        |                 |        |
| Gross Margin                                                        | 1,394,000               |            |        | 1,937,000  |   |                 |        |  |  |
|                                                                     |                              |                 |        |                 |        |                 |        |
| Selling and administrative expense                                  | 1,211,000               |            |        | 1,055,000  |   |                 |        |  |  |
|                                                                     |                              |                 |        |                 |        |                 |        |
| Interest expense                                                    | 282,000                 |            |        | 367,000    |   |                 |        |  |  |
|                                                                     |                              |                 |        |                 |        |                 |        |
| Operating (loss) income                                             | (99,000)                     |            |        | 515,000    |   |                 |        |  |  |
|                                                                     |                              |                 |        |                 |        |                 |        |
|                                                                     |                              |                 |        |                 |        |                 |        |
|                                                                     |                              |                 |        |                 |        |                 |        |
| Interest and other income                                           | 3,000                   |            |        | 4,000      |   |                 |        |  |  |
|                                                                     |                              |                 |        |                 |        |                 |        |
| (Loss) income before income taxes                                   | (96,000)                     |            |        | 519,000    |   |                 |        |  |  |
|                                                                     |                              |                 |        |                 |        |                 |        |
| Income tax (benefit) expense                                        | (28,000)                     |            |        | 124,000    |   |                 |        |  |  |
|                                                                     |                              |                 |        |                 |        |                 |        |
| Net (loss) income                                                   | (68,000)                     |            |        | 395,000    |   |                 |        |  |  |
| Less: Net income attributable to non-controlling interest       | (67,000)                     |            |        | (125,000)       |   |                 |        |  |  |
|                                                                     |                              |                 |        |                 |        |                 |        |
| Net (loss) income attributable to American Shared Hospital Services | $                            | (135,000)       |   |                 | $      | 270,000    |   |  |  |  |  |
|                                                                     |                              |                 |        |                 |        |                 |        |
| Net (loss) income per share:                                    |                              |                 |        |                 |        |                 |        |
|                                                                     |                              |                 |        |                 |        |                 |        |
| (Loss) earnings per common share - basic                            | $                            | (0.02)          |   |                 | $      | 0.05       |   |  |  |  |  |
|                                                                     |                              |                 |        |                 |        |                 |        |
| (Loss) earnings per common share - diluted                          | $                            | (0.02)          |   |                 | $      | 0.05       |   |  |  |  |  |
|                                                                     |                              |                 |        |                 |        |                 |        |

----

|                                                 |  |                                                           |        |               |               |                          |               |                  |        |                 |               |                                         |               |                 |        |               |               |                  |               |               |        |                 |        |  |   |                  |        |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
|-------------------------------------------------|--|-----------------------------------------------------------|--------|---------------|---------------|--------------------------|---------------|------------------|--------|-----------------|---------------|-----------------------------------------|---------------|-----------------|--------|---------------|---------------|------------------|---------------|---------------|--------|-----------------|--------|--|---|------------------|--------|--|--|--|--|--|--|--|--|--|--|--|--|--|--|--|--|--|
|                                                 |  |                                                           |        |               |               |                          |               |                  |        |                 |               |                                         |               |                 |
|                                                 |  | FOR THE THREE-MONTH PERIODS ENDED MARCH 31, 2020 AND 2019 |        |               |               |                          |               |                  |        |                 |               |                                         |               |                 |
|                                                 |  | CommonShares                                              |        | CommonStock   |               | AdditionalPaid-inCapital |               | RetainedEarnings |        | Sub-TotalASHS   |               | Non-controllingInterests inSubsidiaries |               | Total           |
|                                                 |  |                                                           |        |               |               |                          |               |                  |        |                 |               |                                         |               |                 |
| Balances at January 1, 2019                     |  | 5,714,000                                            |   |               | $             | 10,711,000          |          |                  | $      | 6,495,000  |          |                                         | $             | 7,896,000  |   |               | $             | 25,102,000  |          |               | $      | 5,946,000  |   |  | $ | 31,048,000  |   |
|                                                 |  |                                                           |        |               |               |                          |               |                  |        |                 |               |                                         |               |                 |
| Stock-based compensation expense                |  | —                                              |   |               | —  |                     |               | 55,000      |   |                 | —  |                                    |               | 55,000     |   |               | —  |             |               | 55,000   |   |
|                                                 |  |                                                           |        |               |               |                          |               |                  |        |                 |               |                                         |               |                 |
| Cash distributions to non-controlling interests |  | —                                              |   |               | —  |                     |               | —     |   |                 | —  |                                    |               | —    |   |               | (19,000)      |             |               | (19,000)      |   |
|                                                 |  |                                                           |        |               |               |                          |               |                  |        |                 |               |                                         |               |                 |
| Net income                                      |  | —                                              |   |               | —  |                     |               | —     |   |                 | 270,000  |                                    |               | 270,000    |   |               | 125,000  |             |               | 395,000  |   |
|                                                 |  |                                                           |        |               |               |                          |               |                  |        |                 |               |                                         |               |                 |
| Balances at March 31, 2019                      |  | 5,714,000                                            |   |               | $             | 10,711,000          |          |                  | $      | 6,550,000  |          |                                         | $             | 8,166,000  |   |               | $             | 25,427,000  |          |               | $      | 6,052,000  |   |  | $ | 31,479,000  |   |
|                                                 |  |                                                           |        |               |               |                          |               |                  |        |                 |               |                                         |               |                 |
| Balances at January 1, 2020                     |  | 5,817,000                                            |   |               | $             | 10,753,000          |          |                  | $      | 6,725,000  |          |                                         | $             | 8,555,000  |   |               | $             | 26,033,000  |          |               | $      | 5,778,000  |   |  | $ | 31,811,000  |   |
|                                                 |  |                                                           |        |               |               |                          |               |                  |        |                 |               |                                         |               |                 |
| Stock-based compensation expense                |  | —                                              |   |               | —  |                     |               | 56,000      |   |                 | —  |                                    |               | 56,000     |   |               | —  |             |               | 56,000   |   |
|                                                 |  |                                                           |        |               |               |                          |               |                  |        |                 |               |                                         |               |                 |
| Restricted common shares returned to plan       |  | (129,000)                                                 |        | —  |          |                          | —  |             |        | —    |          |                                         | —  |            |        | —  |          |                  | —  |          |
|                                                 |  |                                                           |        |               |               |                          |               |                  |        |                 |               |                                         |               |                 |
| Cash distributions to non-controlling interests |  | —                                              |   |               | —  |                     |               | —     |   |                 | —  |                                    |               | —    |   |               | (326,000)     |             |               | (326,000)     |   |
|                                                 |  |                                                           |        |               |               |                          |               |                  |        |                 |               |                                         |               |                 |
| Net (loss) income                               |  | —                                              |   |               | —  |                     |               | —     |   |                 | (135,000)     |                                    |               | (135,000)       |   |               | 67,000   |             |               | (68,000)      |   |
|                                                 |  |                                                           |        |               |               |                          |               |                  |        |                 |               |                                         |               |                 |
| Balances at March 31, 2020                      |  | 5,688,000                                            |   |               | $             | 10,753,000          |          |                  | $      | 6,781,000  |          |                                         | $             | 8,420,000  |   |               | $             | 25,954,000  |          |               | $      | 5,519,000  |   |  | $ | 31,473,000  |   |
|                                                 |  |                                                           |        |               |               |                          |               |                  |        |                 |               |                                         |               |                 |

----

|                                                                                |                              |                 |        |                 |               |                 |        |  |  |  |  |
|--------------------------------------------------------------------------------|------------------------------|-----------------|--------|-----------------|---------------|-----------------|--------|--|--|--|--|
|                                                                                | Three Months ended March 31, |                 |        |
|                                                                                | 2020                         |                 | 2019   |
| Operating activities:                                                      |                              |                 |        |
| Net (loss) income                                                              | $                            | (68,000)        |   |                 | $             | 395,000    |   |
|                                                                                |                              |                 |        |
| Adjustments to reconcile net income to net cash from operating activities: |                              |                 |        |
|                                                                                |                              |                 |        |
| Depreciation and amortization                                                  | 1,676,000               |            |        | 1,910,000  |          |
|                                                                                |                              |                 |        |
| Non cash lease expense                                                         | 67,000                  |            |        | —    |          |
|                                                                                |                              |                 |        |
| Deferred income taxes                                                          | (28,000)                     |            |        | 124,000    |          |
|                                                                                |                              |                 |        |
| Stock-based compensation expense                                               | 56,000                  |            |        | 55,000     |          |
|                                                                                |                              |                 |        |
| Accrued interest on lease financing                                            | —                 |            |        | 2,000      |          |
|                                                                                |                              |                 |        |
| Interest expense associated with lease liabilities                             | 17,000                  |            |        | —    |          |
|                                                                                |                              |                 |        |
| Changes in operating assets and liabilities:                               |                              |                 |        |
|                                                                                |                              |                 |        |
| Receivables                                                                    | 848,000                 |            |        | (477,000)       |          |
|                                                                                |                              |                 |        |
| Prepaid expenses and other assets                                              | 557,000                 |            |        | 254,000    |          |
|                                                                                |                              |                 |        |
| Accounts payable, accrued liabilities and deferred revenue                     | 383,000                 |            |        | 37,000     |          |
|                                                                                |                              |                 |        |
| Income taxes payable                                                           | (35,000)                     |            |        |                 | —  |            |
|                                                                                |                              |                 |        |
| Lease liability                                                                | (84,000)                     |            |        | —    |          |
|                                                                                |                              |                 |        |
| Net insurance proceeds receivable                                              | —                 |            |        | 160,000    |          |
|                                                                                |                              |                 |        |
| Net cash provided by operating activities                                      | 3,389,000               |            |        | 2,460,000  |          |
|                                                                                |                              |                 |        |
| Investing activities:                                                      |                              |                 |        |
| Payment for purchase of property and equipment                                 | (195,000)                    |            |        | (272,000)       |          |
|                                                                                |                              |                 |        |
|                                                                                |                              |                 |        |
|                                                                                |                              |                 |        |
| Net cash used in investing activities                                          | (195,000)                    |            |        | (272,000)       |          |
|                                                                                |                              |                 |        |
| Financing activities:                                                      |                              |                 |        |
| Principal payments on long-term debt                                           | (554,000)                    |            |        | (516,000)       |          |
|                                                                                |                              |                 |        |
| Principal payments on finance leases                                           | (912,000)                    |            |        | (1,046,000)     |          |
|                                                                                |                              |                 |        |
| Principal payments on short-term financing                                     | (158,000)                    |            |        | —    |          |
|                                                                                |                              |                 |        |
| Distributions to non-controlling interests                                     | (326,000)                    |            |        | (19,000)        |          |
|                                                                                |                              |                 |        |
|                                                                                |                              |                 |        |
|                                                                                |                              |                 |        |
| Net cash used in financing activities                                          | (1,950,000)                  |            |        | (1,581,000)     |          |
|                                                                                |                              |                 |        |
| Net change in cash, cash equivalents, and restricted cash                      | 1,244,000               |            |        | 607,000    |          |
|                                                                                |                              |                 |        |
| Cash, cash equivalents, and restricted cash at beginning of period             | 1,779,000               |            |        | 1,792,000  |          |
|                                                                                |                              |                 |        |
| Cash, cash equivalents, and restricted cash at end of period                   | $                            | 3,023,000  |   |                 | $             | 2,399,000  |   |
|                                                                                |                              |                 |        |

----

|                                                              |   |                 |        |  |   |                 |        |  |  |  |  |
|--------------------------------------------------------------|---|-----------------|--------|--|---|-----------------|--------|--|--|--|--|
| Supplemental cash flow disclosure:                       |   |                 |        |
| Cash paid during the period for:                         |   |                 |        |
|                                                              |   |                 |        |
| Interest                                                     | $ | 282,000    |   |  | $ | 367,000    |   |
|                                                              |   |                 |        |
| Income taxes paid                                            | $ | 34,000     |   |  | $ | 67,000     |   |
|                                                              |   |                 |        |
| Schedule of non-cash investing and financing activities      |   |                 |        |
| Lease reassessment right of use assets and lease liabilities | $ | 67,000     |   |  | $ | —    |   |
|                                                              |   |                 |        |
| Right of use assets and lease liabilities                    | $ | —    |   |  | $ | 1,300,000  |   |
|                                                              |   |                 |        |
| Interest capitalized to property and equipment               | $ | 32,000     |   |  | $ | 27,000     |   |
|                                                              |   |                 |        |
| Acquisition of equipment with long-term debt financing       | $ | 1,184,000  |   |  | $ | —    |   |

----

----

----

|                                                  |  |                  |                  |              |                  |        |                  |        |  |  |  |  |  |  |
|--------------------------------------------------|--|------------------|------------------|--------------|------------------|--------|------------------|--------|--|--|--|--|--|--|
|                                                  |  | March 31,        |                  | December 31, |
|                                                  |  | 2020             |                  | 2019         |
|                                                  |  |                  |                  |              |
| Medical equipment and facilities                 |  | $                | 93,429,000  |         |                  | $      | 92,132,000  |   |
| Office equipment                                 |  | 597,000     |             |              | 594,000     |   |
| Deposits and construction in progress            |  | 2,006,000   |             |              | 1,965,000   |   |
| Deposits towards purchase of proton beam systems |  | 2,250,000   |             |              | 2,250,000   |   |
|                                                  |  |                  |                  |              |
|                                                  |  | 98,282,000  |             |              | 96,941,000  |   |
| Accumulated depreciation                         |  | (57,112,000)     |             |              | (55,461,000)     |   |
|                                                  |  |                  |                  |              |
| Net property and equipment                       |  | $                | 41,170,000  |         |                  | $      | 41,480,000  |   |

----

|                                                        |                  |               |        |  |  |
|--------------------------------------------------------|------------------|---------------|--------|--|--|
| Year ending December 31,                               | Operating Leases |
|                                                        |                  |
| 2020 (excluding the three-months ended March 31, 2020) | $                | 229,000  |   |
| 2021                                                   | 313,000     |          |
| 2022                                                   | 321,000     |          |
| 2023                                                   | 214,000     |          |
| 2024                                                   | 5,000       |          |
|                                                        |                  |
|                                                        |                  |
| Total lease payments                                   | 1,082,000   |          |
| Less imputed interest                                  | (110,000)        |          |
| Total                                                  | $                | 972,000  |   |

----

|                                                                     |  |                              |           |        |                 |        |               |        |  |  |  |  |  |  |  |  |  |  |
|---------------------------------------------------------------------|--|------------------------------|-----------|--------|-----------------|--------|---------------|--------|--|--|--|--|--|--|--|--|--|--|
|                                                                     |  | Three Months ended March 31, |           |        |                 |        |               |        |
|                                                                     |  | 2020                         |           | 2019   |                 |        |               |        |
| Net (loss) income attributable to American Shared Hospital Services |  | $                            | (135,000) |   |                 | $      | 270,000  |   |  |  |  |  |
|                                                                     |  |                              |           |        |                 |        |               |        |
| Weighted average common shares for basic earnings per share         |  | 6,126,000               |      |        | 5,853,000  |   |               |        |  |  |
| Diluted effect of stock options and restricted stock                |  | 27,000                  |      |        | 33,000     |   |               |        |  |  |
| Weighted average common shares for diluted earnings per share       |  | 6,153,000               |      |        | 5,886,000  |   |               |        |  |  |
|                                                                     |  |                              |           |        |                 |        |               |        |
| Basic (loss) earnings per share                                     |  | $                            | (0.02)    |   |                 | $      | 0.05     |   |  |  |  |  |
| Diluted (loss) earnings per share                                   |  | $                            | (0.02)    |   |                 | $      | 0.05     |   |  |  |  |  |

----

|                                |  |               |        |                                         |   |                                                    |        |                |      |  |   |               |        |  |  |  |  |  |  |  |  |  |  |  |  |  |
|--------------------------------|--|---------------|--------|-----------------------------------------|---|----------------------------------------------------|--------|----------------|------|--|---|---------------|--------|--|--|--|--|--|--|--|--|--|--|--|--|--|
|                                |  | StockOptions  |        | Grant DateWeighted-AverageExercisePrice |   | Weighted-AverageRemainingContractualLife (inYears) |        | IntrinsicValue |
| Outstanding at January 1, 2020 |  | 450,000  |   |                                         | $ | 2.78                                          |   |                | 2.44 |  | $ | 27,000   |   |
|                                |  |               |        |                                         |   |                                                    |        |                |
|                                |  |               |        |                                         |   |                                                    |        |                |
|                                |  |               |        |                                         |   |                                                    |        |                |
| Outstanding at March 31, 2020  |  | 450,000  |   |                                         | $ | 2.78                                          |   |                | 2.20 |  | $ | —  |   |
| Exercisable at March 31, 2020  |  | 425,000  |   |                                         | $ | 2.79                                          |   |                | 2.00 |  | $ | —  |   |
|                                |  |               |        |                                         |   |                                                    |        |                |
| Outstanding at January 1, 2019 |  | 613,000  |   |                                         | $ | 2.85                                          |   |                | 3.14 |  | $ | —  |   |
|                                |  |               |        |                                         |   |                                                    |        |                |
|                                |  |               |        |                                         |   |                                                    |        |                |
| Outstanding at March 31, 2019  |  | 613,000  |   |                                         | $ | 2.85                                          |   |                | 2.43 |  | $ | 34,000   |   |
| Exercisable at March 31, 2019  |  | 489,000  |   |                                         | $ | 2.87                                          |   |                | 2.31 |  | $ | —  |   |

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|                                    |  |                        |                  |        |                 |           |                 |                  |        |                   |                  |        |  |                 |                 |        |  |   |                 |        |  |  |  |  |  |  |  |  |  |  |  |  |
|------------------------------------|--|------------------------|------------------|--------|-----------------|-----------|-----------------|------------------|--------|-------------------|------------------|--------|--|-----------------|-----------------|--------|--|---|-----------------|--------|--|--|--|--|--|--|--|--|--|--|--|--|
|                                    |  | Payments Due by Period |                  |        |                 |           |                 |                  |        |                   |
| Contractual Obligations            |  | Total amountscommitted |                  | 2020   |                 | 2021-2023 |                 | 2024             |        | After5 years |
|                                    |  |                        |                  |        |                 |           |                 |                  |        |                   |
| Long-term debt (includes interest) |  | $                      | 4,970,000   |   |                 | $         | 1,346,000  |             |        | $                 | 2,482,000   |   |  | $               | 668,000    |   |  | $ | 474,000    |   |
| Finance leases (includes interest) |  | 12,149,000        |             |        | 3,179,000  |      |                 | 8,449,000   |   |                   | 521,000     |   |  | —    |            |
| Future equipment purchases         |  | 39,560,000        |             |        | 400,000    |      |                 | 39,160,000  |   |                   | —     |   |  | —    |            |
| Equipment service contracts        |  | 10,036,000        |             |        | 1,787,000  |      |                 | 4,655,000   |   |                   | 1,734,000   |   |  | 1,860,000  |            |
| Operating leases                   |  | 1,094,000         |             |        | 233,000    |      |                 | 856,000     |   |                   | 5,000       |   |  | —    |            |
|                                    |  |                        |                  |        |                 |           |                 |                  |        |                   |
| Total contractual obligations      |  | $                      | 67,809,000  |   |                 | $         | 6,945,000  |             |        | $                 | 55,602,000  |   |  | $               | 2,928,000  |   |  | $ | 2,334,000  |   |

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|                |        |                                                                                                                                                                                |  |                                  |  |         |  |      |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
|----------------|--------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--|----------------------------------|--|---------|--|------|--|--|--|--|--|--|--|--|--|--|--|--|--|--|--|--|--|--|
|                |        |                                                                                                                                                                                |  | Incorporated by reference herein |  |         |  |      |
| Exhibit Number |        | Description                                                                                                                                                                    |  | Form                             |  | Exhibit |  | Date |
| 10.1           | *      | Fourth Amendment to Purchased Services Agreement (for a Gamma Knife Unit) dated as of May 1, 2019 between GK Financing, LLC and Jackson HMA, LLC                               |  |                                  |  |         |  |      |
| 31.1           | *      | Certification of Chief Executive Officer pursuant to Rule 13a-14a/15d-14a, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002                            |  |                                  |  |         |  |      |
| 31.2           | *      | Certification of Chief Financial Officer pursuant to Rule 13a-14a/15d-14a, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002                            |  |                                  |  |         |  |      |
| 32.1           | ǂ | Certifications of Chief Executive Officer and Chief Financial Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002 |  |                                  |  |         |  |      |
| 101.INS        | *      | XBRL Instance Document                                                                                                                                                         |  |                                  |  |         |  |      |
| 101.SCH        | *      | XBRL Taxonomy Extension Schema Document                                                                                                                                        |  |                                  |  |         |  |      |
| 101.CAL        | *      | XBRL Taxonomy Calculation Linkbase Document                                                                                                                                    |  |                                  |  |         |  |      |
| 101.DEF        | *      | XBRL Taxonomy Definition Linkbase Document                                                                                                                                     |  |                                  |  |         |  |      |
| 101.LAB        | *      | XBRL Taxonomy Label Linkbase Document                                                                                                                                          |  |                                  |  |         |  |      |
| 101.PRE        | *      | XBRL Taxonomy Extension Presentation Linkbase Document                                                                                                                         |  |                                  |  |         |  |      |
| 104            | *      | Cover Page Interactive Data File - the cover page XBRL tags are embedded within the Inline Instance XBRL                                                                       |  |                                  |  |         |  |      |
|                |        |                                                                                                                                                                                |  |                                  |  |         |  |      |
|                | *      | Filed herewith.                                                                                                                                                                |  |                                  |  |         |  |      |
|                | ǂ | Furnished herewith.                                                                                                                                                            |  |                                  |  |         |  |      |
|                | #      | Portions of this exhibit (indicated therein by asterisks) have been omitted for confidential treatment.                                                                        |  |                                  |  |         |  |      |
|                |        |                                                                                                                                                                                |  |                                  |  |         |  |      |

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|           |              |                                       |  |  |  |  |  |  |
|-----------|--------------|---------------------------------------|--|--|--|--|--|--|
| Date: | May 11, 2020 | /s/ Ray Stachowiak            |
|           |              | Ray Stachowiak                        |
|           |              | Interim President and CEO             |
|           |              |                                       |
| Date: | May 11, 2020 | /s/ Craig K. Tagawa           |
|           |              | Craig K. Tagawa                       |
|           |              | Senior Vice President                 |
|           |              | Chief Operating and Financial Officer |