American Shared Hospital Services reported financial results for the fourth quarter and full year ended December 31, 2025, revealing a year of strategic transition marked by a shift toward direct patient care services and the announcement of a key long-term partnership extension. The company, a provider of stereotactic radiosurgery equipment and advanced radiation therapy cancer treatment services, posted full-year revenue of $28.1 million, a slight decrease from $28.3 million in 2024. However, 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.
The financial results underscore a fundamental strategic shift. Revenue from the direct patient care services segment 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 center in Puebla, Mexico. LINAC (Linear Accelerator) treatment sessions more than doubled to 28,147 for the full year, demonstrating the expansion of this service line. Conversely, the medical equipment leasing segment faced headwinds, with revenue declining to $12.6 million from $15.6 million in 2024, primarily due to the expiration of three Gamma Knife agreements and lower Proton Beam Radiation Therapy (PBRT) volumes.
A central announcement from the report was a seven-year extension of the proton therapy lease agreement with Orlando Health through 2033. Chief Executive Officer Gary Delanois stated this extension highlights the long-term nature of the company's relationships and its collaboration in delivering advanced cancer treatment. This partnership, spanning over two decades, provides stability for a segment that experienced revenue decline of 26.0% year-over-year to $7.4 million in 2025. The company attributed lower PBRT volumes to normal cyclical fluctuations in patient volumes common in the healthcare industry.
The strategic implications of the shift toward direct patient care are significant for the industry. While this segment offers growth and more stable revenue streams, it also carries lower margins compared to equipment leasing. This was reflected in the company's gross margin, which decreased to 18% for the full year 2025 from 32% in 2024. Executive Chairman Ray Stachowiak emphasized that this strategic shift strengthens long-term growth potential. The company is pursuing further expansion with Certificate of Need approvals for new treatment centers in Bristol and Johnston, Rhode Island, which includes a planned proton beam radiation therapy treatment center.
Operationally, the company focused on upgrading its technology to expand treatment capabilities. It completed the upgrade of its Gamma Knife unit in Lima, Peru to the Esprit platform and noted improved same-center Gamma Knife procedure volumes following equipment upgrades at several sites. For business leaders, the company's balance sheet highlights both challenges and potential value. Cash and cash equivalents decreased to $3.7 million as of December 31, 2025, from $11.3 million the prior year, driven by capital expenditures. The company also reported that certain financial covenants under its credit facility were not met, and it is engaged in discussions with its lender. However, the company noted its market value represents a discount to its underlying shareholders' equity of $3.66 per share.
Looking ahead, management remains focused on optimizing operations at existing centers and pursuing strategic opportunities. The company anticipates additional contributions from its new Esprit platform at its Guadalajara, Mexico Gamma Knife center. For investors and industry observers, American Shared Hospital Services' 2025 results illustrate the financial and operational realities of transitioning a business model within the specialized healthcare technology sector, balancing near-term margin pressure from service expansion against the pursuit of long-term, stable growth in cancer care delivery. More information can be found on the company's website at https://www.ashs.com.
