American Shared Hospital Services (NYSE American: AMS) reported financial results for the fourth quarter and full year ended December 31, 2025, reflecting a year of transition as the company expanded its direct patient care services footprint while navigating headwinds in its equipment leasing segment. The company also announced a seven-year extension of its proton beam radiation therapy lease agreement with Orlando Health, Inc., extending the partnership through 2033.
For the full year 2025, total revenue was $28.1 million, compared with $28.3 million in 2024. The company reported a net loss attributable to American Shared Hospital Services of $1.6 million, or $0.23 per diluted share, compared with net income of $2.2 million, or $0.33 per diluted share, in the prior year. The decline was primarily due to lower leasing revenue from expiring Gamma Knife agreements and reduced proton therapy volumes, as well as increased operating costs from the shift toward direct patient care services, which carry lower margins.
Revenue from the direct patient care services segment increased 23.7% year over year to $15.5 million, driven by the first full year of operations from three radiation therapy centers in Rhode Island and a center in Puebla, Mexico, which began treating patients in July 2024. LINAC treatment sessions totaled 28,147 in 2025, compared with 14,662 in 2024. In contrast, leasing revenue declined to $12.6 million from $15.6 million due to the expiration of three Gamma Knife contracts and lower proton beam therapy volumes.
CEO Gary Delanois noted that 2025 was a year of operational expansion, with the integration of the Rhode Island centers and the completion of the first full year at the Puebla facility. "We successfully navigated through key Radiation Oncologist recruitment initiatives and fluctuating treatment volumes, while also improving our revenue cycle management infrastructure," he said. The company also completed an upgrade of its Gamma Knife unit in Lima, Peru, to the Esprit platform, expanding treatment capabilities.
The company ended 2025 with eight domestic medical equipment leasing agreements and six direct patient care service centers operating in the United States and Latin America. Executive Chairman Ray Stachowiak highlighted the strategic shift toward direct patient care services, which he said strengthens long-term growth potential and creates more stable revenue streams. He also pointed to Certificate of Need approvals for new centers in Bristol and Johnston, Rhode Island, positioning the company for further expansion.
CFO Scott Frech noted that the company is focused on driving revenue growth and optimizing its balance sheet. As of December 31, 2025, the company had $3.7 million in cash and cash equivalents, down from $11.3 million a year earlier, due to $7.5 million in capital expenditures. Frech also mentioned that certain financial covenants under the company's credit facility were not met, and the company is engaged in discussions with its lender to secure waivers or amendments.
The seven-year lease extension with Orlando Health underscores the long-term nature of the company's relationships and its commitment to advancing proton therapy. "Our longstanding partnership of over two decades with Orlando Health highlights the ongoing collaboration between the two organizations in delivering advanced cancer treatment services utilizing proton beam radiation therapy technology," Delanois said.
Shareholders' equity stood at $24.0 million, or $3.66 per share, compared with $25.2 million, or $3.92 per share, at the end of 2024. The company will hold a conference call at 12:00 PM ET today to discuss the results.
