American Shared Hospital Services (NYSE American: AMS) reported financial results for the fourth quarter and full year ended December 31, 2025, revealing a net loss attributable to the company of $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. Total revenue for 2025 was $28.1 million, slightly down from $28.3 million in the prior year. The company also announced a seven-year lease extension with Orlando Health, Inc. for its Proton Beam Radiation Therapy System, extending the agreement through 2033.
The shift toward direct patient care services continued to reshape the company's revenue mix. Direct patient care revenue increased 23.7% year over year to $15.5 million, driven by the first full year of operations at three radiation therapy centers in Rhode Island and a center in Puebla, Mexico. LINAC treatment sessions totaled 28,147 in 2025, up from 14,662 in 2024. However, the medical equipment leasing segment faced headwinds, with revenue declining to $12.6 million from $15.6 million due to the expiration of three Gamma Knife agreements and lower proton beam radiation therapy volumes. Gamma Knife procedures fell 13.6% overall, though same-center procedures improved 11.3% following equipment upgrades.
Gross margin for 2025 dropped to 18% from 32%, primarily due to increased operating costs from the direct patient care services expansion, which carries lower margins than equipment leasing. Adjusted EBITDA, a non-GAAP measure, was $5.5 million compared to $8.9 million in 2024. The company ended the year with $3.7 million in cash and cash equivalents, down from $11.3 million, reflecting $7.5 million in capital expenditures for the Rhode Island centers and international operations.
CEO Gary Delanois emphasized the strategic importance of the Orlando Health lease extension, stating, 'Our longstanding partnership of over two decades with Orlando Health highlights the long-term nature of the Company’s relationships and reflects the ongoing collaboration between the two organizations in delivering advanced cancer treatment services utilizing proton beam radiation therapy technology.' Executive Chairman Ray Stachowiak added that the company's Certificate of Need approvals for new centers in Bristol and Johnston, Rhode Island, position it for further expansion.
Financial covenants under the company's credit facility were not met as of December 31, 2025, but management is engaged in constructive discussions with its lender to secure waivers or amendments. Shareholders' equity stood at $24.0 million, or $3.66 per share, compared to $25.2 million, or $3.92 per share, at the end of 2024.
For more details, visit the company's website at www.ashs.com.
