American Shared Hospital Services reported financial results for the fourth quarter and full year 2025, revealing a year of transition marked by a strategic shift toward direct patient care services. The company announced total revenue of $28.1 million for 2025, a slight decrease from $28.3 million in 2024, while reporting a net loss attributable to the company of $1.6 million, or $0.23 per diluted share. This contrasts with net income of $2.2 million, or $0.33 per diluted share, in the prior year.
The financial results underscore the company's ongoing transformation from primarily an equipment leasing business to an integrated provider of cancer treatment services. Revenue from direct patient care services increased 23.7% year-over-year to $15.5 million, now representing the majority of total revenue. This growth was 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, which began treating patients in July 2024. More information about the company's services can be found at www.ashs.com.
CEO Gary Delanois described 2025 as "a year of transition and operational expansion" for the company. He highlighted the successful integration of the Rhode Island radiation therapy treatment centers and the completion of the first full year of operations in Puebla, Mexico. "These facilities significantly expanded our direct patient care services footprint and contributed to growth in LINAC treatment volumes," Delanois stated. LINAC revenue increased 35.4% year-over-year to $11.5 million, with treatment sessions totaling 28,147 in 2025 compared to 14,662 in 2024.
The company also announced a significant seven-year lease extension with Orlando Health, Inc. for its Proton Beam Radiation Therapy System, extending the partnership through 2033. Delanois emphasized that this extension "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." This development is particularly important as proton beam radiation therapy revenue declined 26.0% year-over-year to $7.4 million, with procedures totaling 4,056 in 2025 compared to 5,139 in 2024.
Executive Chairman Ray Stachowiak emphasized the strategic importance of the shift toward direct patient care services, stating that it "strengthens our long-term growth potential and creates more stable revenue streams." The company is pursuing expansion opportunities, including Certificate of Need approvals for a radiation therapy treatment center in Bristol, Rhode Island, and a proton beam radiation therapy treatment center in Johnston, Rhode Island. These initiatives position the company to further expand its Rhode Island footprint and growth potential.
Despite the strategic progress, the medical equipment leasing segment faced challenges. Revenue from this segment decreased 33.9% to $2.9 million in the fourth quarter of 2025 compared to $4.2 million in the prior year period. The decline was attributed to lower proton therapy volumes and the expiration of three Gamma Knife contracts. Gamma Knife revenue decreased 5.5% year-over-year to $9.2 million, though same-center procedures increased 11.3% following equipment upgrades that expanded treatment capabilities.
Financial metrics reflected the transition costs associated with the business model shift. Gross margin was 12% in the fourth quarter of 2025, compared to 35% in the same period of 2024, due to lower treatment volumes and increased operating costs driven by the move to direct patient care services, which have lower margins compared to equipment leasing. Adjusted EBITDA, a non-GAAP financial measure, was $5.5 million for the full year 2025, compared to $8.9 million for 2024.
The company's balance sheet showed $3.7 million in cash and cash equivalents as of December 31, 2025, down from $11.3 million at the end of 2024. The decrease was driven by $7.5 million in capital expenditures for strategic initiatives. American Shared Hospital Services' shareholders' equity was $24.0 million or $3.66 per outstanding share. The company acknowledged that certain financial covenants under its credit facility were not met as of December 31, 2025, and is engaged in discussions with its lender to secure waivers and amendments. Investors can access the conference call webcast at https://event.choruscall.com/mediaframe/webcast.html?webcastid=QqZruHXQ.
This strategic shift has significant implications for the healthcare industry, particularly in cancer treatment accessibility. By expanding its direct patient care footprint, American Shared Hospital Services is positioning itself to capture more value from the growing demand for advanced radiation therapy while navigating the challenges of transitioning from a leasing-focused model to an integrated service provider. The company's international expansion, including operations in Mexico and Peru, further demonstrates its commitment to broadening access to advanced cancer treatments across the Americas.
