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. Total revenue for the full year was $28.1 million, slightly down from $28.3 million in 2024, while net loss attributable to the company was $1.6 million, or $0.23 per diluted share, compared to net income of $2.2 million in the prior year. The decline was primarily due to lower Gamma Knife and proton beam radiation therapy (PBRT) volumes, partially offset by growth in LINAC revenue and direct patient care services.
The company announced a seven-year lease extension with Orlando Health, Inc. for its Proton Beam Radiation Therapy System, extending the agreement through 2033. This extension underscores the long-standing partnership of over two decades between the two organizations. Gary Delanois, CEO, stated, 'We are extremely pleased to announce a seven-year lease extension with Orlando Health, a valued partner in advancing access to cutting-edge cancer care.'
Direct patient care services revenue 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 the center in Puebla, Mexico. LINAC treatment sessions totaled 28,147 in 2025, compared to 14,662 in 2024. However, leasing segment revenue declined due to the expiration of three Gamma Knife agreements and lower PBRT volumes. Gamma Knife procedures fell 13.6% year-over-year, but same-center procedures increased 11.3% following equipment upgrades.
For the fourth quarter, total revenue decreased 14.8% to $7.7 million. Gross margin fell to 12% from 35% due to lower treatment volumes and higher operating costs from the shift to direct patient care services. Net loss attributable to the company improved to $631,000 from $1.3 million in the prior year quarter. Adjusted EBITDA was $868,000, down from $3.8 million.
Looking ahead, the company is focused on optimizing operations and expanding its footprint. Certificates of Need have been approved for a radiation therapy center in Bristol, Rhode Island, and a proton beam therapy center in Johnston, Rhode Island, with permitting activities underway. Executive Chairman Ray Stachowiak noted, 'Our strategic shift toward direct patient care services strengthens our long-term growth potential and creates more stable revenue streams.' The company also completed an upgrade of its Gamma Knife unit in Lima, Peru to the Esprit platform, expanding treatment capabilities.
Financially, the company ended the year with $3.7 million in cash and cash equivalents, down from $11.3 million due to capital expenditures of $7.5 million. Shareholders' equity was $24.0 million, or $3.66 per share. The company is in discussions with its lender to address certain financial covenants that were not met as of December 31, 2025. A conference call to discuss results is scheduled for today at 12:00 PM ET, accessible via the company's website at www.ashs.com or by dialing 1-844-413-3972.
