American Shared Hospital Services (NYSE American: AMS) reported financial results for the fourth quarter and full year ended December 31, 2025, highlighting a strategic shift toward direct patient care services and a significant lease extension with Orlando Health. The company announced a seven-year extension of its Proton Beam Radiation Therapy (PBRT) lease agreement with Orlando Health, Inc., extending the partnership through 2033. This extension underscores the long-term nature of the company's relationships and its commitment to advancing access to cutting-edge cancer care.
For full year 2025, total revenue was $28.1 million, compared to $28.3 million in 2024. Net loss attributable to American Shared Hospital Services was $1.6 million, or $0.23 per diluted share, compared to net income of $2.2 million, or $0.33 per diluted share, in 2024. The decline in profitability was primarily due to lower margins from the expansion of direct patient care services and the expiration of three Gamma Knife leasing agreements. LINAC revenue increased 35.4% year-over-year to $11.5 million, driven by the company's three stand-alone radiation therapy centers in Rhode Island and a center in Puebla, Mexico. Gamma Knife revenue fell 5.5% to $9.2 million, and PBRT revenue decreased 26.0% to $7.4 million.
The direct patient care services segment continued to represent the majority of total revenue, reflecting the company's strategic expansion. Revenue from this segment increased 23.7% year-over-year to $15.5 million, driven by the first full year of operations from the Rhode Island centers and the Puebla center. LINAC treatment sessions totaled 28,147 in 2025, up from 14,662 in 2024. The medical equipment leasing segment faced headwinds from the expiration of three Gamma Knife agreements and lower PBRT volumes, leading to a decline in leasing revenue to $12.6 million from $15.6 million in 2024. However, same-center Gamma Knife procedure volumes improved 11.3% following equipment upgrades.
CEO Gary Delanois commented, "2025 was a year of transition and operational expansion. We successfully integrated the Rhode Island centers and completed the first full year of operations at our Puebla center. These facilities significantly expanded our direct patient care services footprint." Executive Chairman Ray Stachowiak added, "Our strategic shift toward direct patient care services strengthens our long-term growth potential and creates more stable revenue streams. We are also excited about new business development initiatives, including Certificate of Need approvals for a radiation therapy center in Bristol, Rhode Island, and a proton beam therapy center in Johnston, Rhode Island."
Fourth quarter 2025 revenue decreased 14.8% to $7.7 million from $9.1 million in the prior year period. Direct patient care services revenue increased 2.6% to $4.9 million, while leasing revenue decreased 33.9% to $2.9 million. Gross margin was 12% in Q4 2025, compared to 35% in Q4 2024, due to lower treatment volumes and increased operating costs from the shift to direct patient care. Net loss attributable to the company was $631,000, or $0.09 per share, compared to a net loss of $1.3 million, or $0.20 per share, in Q4 2024. Adjusted EBITDA was $868,000 for Q4 2025, compared to $3.8 million in the prior year period.
As of December 31, 2025, the company had $3.7 million in cash and cash equivalents, down from $11.3 million at year-end 2024, driven by $7.5 million in capital expenditures. Total current portion of long-term debt was approximately $17.3 million, and certain financial covenants under the credit facility were not met. The company is engaged in discussions with its lender to secure waivers or amendments. Shareholders' equity was $24.0 million, or $3.66 per share.
The company completed the upgrade of its Gamma Knife unit in Lima, Peru, to the Esprit platform, expanding treatment capabilities. CFO Scott Frech stated, "We remain focused on driving revenue growth and anticipate additional contributions from the new Esprit at our Guadalajara, Mexico Gamma Knife center. Additionally, our market value highlights a steep discount to our underlying shareholders' equity of $3.66 per share."
A conference call to discuss the results was scheduled for 12:00 PM ET on March 31, 2026. Details are available on the company's website at www.ashs.com.
