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 of $1.6 million for the year, compared to net income of $2.2 million in 2024. 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.
Total revenue for 2025 was $28.1 million, slightly down from $28.3 million in 2024. LINAC revenue grew 35.4% to $11.5 million, while Gamma Knife revenue declined 5.5% to $9.2 million, and Proton Beam Radiation Therapy revenue fell 26.0% to $7.4 million. The company's direct patient care services segment, which now represents the majority of total revenue, saw a 23.7% increase to $15.5 million, driven by the first full year of operations at three Rhode Island centers and a center in Puebla, Mexico.
“2025 was a year of transition and operational expansion,” said Gary Delanois, Chief Executive Officer. “We successfully integrated the Rhode Island radiation therapy treatment centers and completed the first full year of operations at our Puebla, Mexico center. These facilities significantly expanded our direct patient care services footprint and contributed to growth in LINAC treatment volumes.”
The company ended 2025 with eight domestic medical equipment leasing agreements and six direct patient care service centers in the U.S. and Latin America. It completed the upgrade of its Gamma Knife unit in Lima, Peru to the Esprit platform, expanding treatment capabilities. Same-center Gamma Knife procedure volumes improved following equipment upgrades at three sites.
Ray Stachowiak, Executive Chairman, emphasized the company's strategic shift: “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 the new business development initiatives that we have in place to drive continued momentum and growth. Our Certificate of Need approvals for the first radiation therapy treatment center in Bristol, Rhode Island, where permitting activities are underway, and a proton beam radiation therapy treatment center in Johnston, Rhode Island, put us on track to further expand our Rhode Island footprint.”
The leasing segment faced headwinds from the expiration of three Gamma Knife agreements and lower proton therapy volumes. For the full year, Gamma Knife procedures declined 13.6%, though same-center procedures increased 11.3%. PBRT procedures totaled 4,056 in 2025 versus 5,139 in 2024, reflecting what the company believes are normal cyclical fluctuations.
Financially, the company reported a gross margin of 18% for 2025, down from 32% in 2024, due to increased operating costs from the shift to direct patient care services. Adjusted EBITDA was $5.5 million for 2025, compared to $8.9 million in 2024. As of December 31, 2025, cash and cash equivalents were $3.7 million, down from $11.3 million a year earlier, driven by $7.5 million in capital expenditures. The company noted that certain financial covenants under its credit facility were not met and that it is in constructive discussions with its lender.
Scott Frech, Chief Financial Officer, added, “We remain focused on driving revenue growth and anticipate additional contributions from the new Esprit at our Guadalajara, Mexico Gamma Knife center. Additionally, we are proactively optimizing our balance sheet and strategic flexibility with ongoing discussions with our lender.”
The company will hold a conference call at 12:00 PM ET today to discuss the results. A webcast can be accessed through the company's website at www.ashs.com or directly at https://event.choruscall.com/mediaframe/webcast.html?webcastid=QqZruHXQA.
