American Shared Hospital Services reported its fourth quarter and full year 2025 financial results, revealing a year of transition marked by strategic expansion in direct patient care services alongside challenges in its equipment leasing segment. The company also announced a significant seven-year extension of its Proton Beam Radiation Therapy System lease agreement with Orlando Health, extending the partnership through 2033.
For the full year 2025, total revenue was $28.1 million, a slight decrease from $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 to net income of $2.2 million, or $0.33 per diluted share, in the prior year. Revenue performance showed mixed results across business segments, with LINAC revenue increasing 35.4% year-over-year to $11.5 million, while Gamma Knife revenue declined 5.5% to $9.2 million and Proton Beam Radiation Therapy revenue decreased 26.0% to $7.4 million.
The company's strategic shift toward direct patient care services continued to gain momentum throughout 2025. Revenue from this segment increased 23.7% year-over-year, driven by the first full year of operations from three radiation therapy centers in Rhode Island and the company's radiation therapy center in Puebla, Mexico. LINAC treatment sessions totaled 28,147 in full year 2025, nearly doubling from 14,662 in 2024, supported by the company's stand-alone radiation therapy treatment centers. More information about the company's services can be found at https://www.ashs.com.
Gary Delanois, Chief Executive Officer, stated that 2025 was a year of transition and operational expansion. "We successfully integrated the Rhode Island radiation therapy treatment centers and completed the first full year of operations at our radiation therapy treatment center in Puebla, Mexico," Delanois said. "These facilities significantly expanded our direct patient care services footprint and contributed to growth in LINAC treatment volumes."
The seven-year lease extension with Orlando Health represents a significant development for the company's equipment leasing segment. Delanois emphasized the importance of this partnership, 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."
Medical equipment leasing faced challenges during 2025, with revenue declining year-over-year primarily due to the expiration of three Gamma Knife agreements and lower PBRT volumes. However, the company experienced improved same-center procedure volumes at certain existing sites following equipment upgrades that expanded treatment capabilities. The company completed the upgrade of its Gamma Knife unit in Lima, Peru to the Esprit platform, positioning the center for improved treatment capabilities and expanded patient access.
Ray Stachowiak, Executive Chairman, commented on the company's strategic direction, noting that the shift toward direct patient care services strengthens long-term growth potential and creates more stable revenue streams. "Our strategic shift toward direct patient care services strengthens our long-term growth potential and creates more stable revenue streams," Stachowiak said. The company has received Certificate of Need approvals for additional radiation therapy treatment centers in Rhode Island, including a proton beam radiation therapy treatment center in Johnston, Rhode Island.
Financial results for the fourth quarter showed revenue decreased 14.8% to $7.7 million compared to $9.1 million in the prior year period. Revenue from direct patient care services represented 63% of total sales in Q4 2025, up from 52% in the prior year period. The company reported a net loss of $631,000 for Q4 2025, an improvement from a net loss of $1.3 million in Q4 2024.
Balance sheet highlights revealed the company had $3.7 million in cash and cash equivalents as of December 31, 2025, down from $11.3 million at December 31, 2024. The decrease was driven by $7.5 million in capital expenditures reflecting investments in the Rhode Island centers, international operations, and other strategic initiatives. The company's shareholders' equity was $24.0 million or $3.66 per outstanding share.
Scott Frech, Chief Financial Officer, noted the company remains focused on driving revenue growth and anticipates additional contributions from the new Esprit at the Guadalajara, Mexico Gamma Knife center. "Additionally, our market value highlights a steep discount to our underlying shareholders' equity of $3.66 per share," Frech stated. The company is engaged in discussions with its lender regarding certain financial covenants under its credit facility that were not met as of December 31, 2025.
The company scheduled a conference call to discuss its financial results, with a webcast available through the company's website. A replay of the call will be available through April 7, 2026, accessible at https://event.choruscall.com/mediaframe/webcast.html?webcastid=QqZruHXQ.
