American Shared Hospital Services (AMS) announced a seven-year extension of its proton beam radiation therapy lease agreement with Orlando Health, Inc., through 2033, alongside its fourth quarter and full year 2025 financial results. The extension underscores a long-standing partnership that spans over two decades, reflecting the company's focus on sustaining long-term relationships in the advanced cancer treatment sector.
For the full year 2025, AMS reported total revenue of $28.1 million, a slight decrease from $28.3 million in 2024. The company posted 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 decline was primarily driven by the expiration of three Gamma Knife agreements and lower proton beam radiation therapy (PBRT) volumes, partially offset by growth in the direct patient care services segment.
Revenue from direct patient care services increased 23.7% year-over-year to $15.5 million, benefiting from the first full year of operations at three radiation therapy centers in Rhode Island and a center in Puebla, Mexico. LINAC treatment sessions surged to 28,147 in 2025 from 14,662 in 2024, reflecting expanded capacity. However, LINAC revenue of $11.5 million was up 35.4% year-over-year, while Gamma Knife revenue fell 5.5% to $9.2 million and PBRT revenue dropped 26.0% to $7.4 million.
During the fourth quarter, total revenue declined 14.8% to $7.7 million, with direct patient care services accounting for 63% of sales. Gross margin fell to 12% from 35% in the prior year period due to lower treatment volumes and higher operating costs from the shift to direct patient care, which typically carries lower margins than equipment leasing.
CEO Gary Delanois emphasized that 2025 was a year of transition, marked by successful integration of new centers and recruitment initiatives. He noted that same-center Gamma Knife procedure volumes improved following equipment upgrades, and the company completed an upgrade of its Gamma Knife unit in Lima, Peru to the Esprit platform. Executive Chairman Ray Stachowiak highlighted Certificate of Need approvals for new centers in Rhode Island, including a proton beam therapy center in Johnston, positioning the company for future growth.
CFO Scott Frech pointed to a steep discount in market value relative to shareholders' equity of $3.66 per share and ongoing discussions with the lender to optimize the balance sheet. As of December 31, 2025, cash and cash equivalents stood at $3.7 million, down from $11.3 million a year earlier, due to $7.5 million in capital expenditures. The company also noted that certain financial covenants under its credit facility were not met, but constructive discussions with the lender are underway.
Adjusted EBITDA for the full year was $5.5 million, compared to $8.9 million in 2024. The company continues to focus on operational optimization and strategic opportunities to strengthen both its equipment leasing and direct patient care segments. For more details, the conference call webcast is available at this link.
