American Shared Hospital Services Reports 2025 Financial Results and Announces Key Proton Therapy Lease Extension

American Shared Hospital Services reported financial results for the fourth quarter and full year 2025, highlighting a strategic transition toward direct patient care services while announcing a key seven-year lease extension for its Proton Beam Radiation Therapy System with Orlando Health, Inc. through 2033. The company's full-year revenue was $28.1 million, a slight decrease from $28.3 million in 2024, while it reported a net loss of $1.6 million compared to net income of $2.2 million in the prior year.

The company's direct patient care services segment showed significant growth, with revenue increasing 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 company's radiation therapy center in Puebla, Mexico. LINAC treatment sessions more than doubled to 28,147 in 2025 compared with 14,662 in 2024, supported by the company's expanded network of stand-alone radiation therapy centers. The strategic shift toward direct patient care services, which represented 63% of total sales in Q4 2025 compared to 52% in the prior year period, reflects the company's focus on creating more stable revenue streams and strengthening long-term growth potential.

Chief Executive Officer Gary Delanois emphasized the importance of the seven-year lease extension with Orlando Health, stating it highlights the long-term nature of the company's relationships and reflects ongoing collaboration in delivering advanced cancer treatment services. The partnership, spanning over two decades, represents a significant commitment to advancing access to cutting-edge cancer care. Executive Chairman Ray Stachowiak noted that the company's strategic shift toward direct patient care services strengthens long-term growth potential, with certificate of need approvals for additional treatment centers in Rhode Island positioning the company for further expansion.

The medical equipment leasing segment experienced challenges in 2025, with revenue declining to $12.6 million from $15.6 million in 2024 due to lower Gamma Knife volumes and Proton Beam Radiation Therapy procedures. The expiration of three Gamma Knife agreements contributed to the decline, though same-center procedures increased 11.3% following equipment upgrades that expanded treatment capabilities. The company completed the upgrade of its Gamma Knife unit in Lima, Peru to the Esprit platform, expanding treatment capabilities to support future patient growth, while also upgrading equipment at three other sites to improve same-center Gamma Knife procedure volumes.

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, primarily due to the expiration of Gamma Knife agreements and lower PBRT volumes. Gross margin declined to 12% in Q4 2025 from 35% in Q4 2024, reflecting increased operating costs associated with the shift to direct patient care services, which have lower margins compared to the equipment leasing segment. The company ended the quarter with eight domestic medical equipment leasing agreements and six direct patient care service centers operating in the United States and Latin America.

Balance sheet highlights showed the company had $3.7 million in cash and cash equivalents as of December 31, 2025, compared with $11.3 million at December 31, 2024, with the decrease driven by $7.5 million in capital expenditures for strategic initiatives. The company reported that certain financial covenants under its credit facility were not met as of December 31, 2025, and it is engaged in constructive discussions with its lender to secure waivers and amendments. American Shared Hospital Services' shareholders' equity was $24.0 million or $3.66 per outstanding share, compared to $25.2 million or $3.92 per outstanding share at December 31, 2024.

Looking ahead, the company remains focused on optimizing operations at existing centers, expanding patient access to advanced radiation therapy treatment options, and pursuing strategic opportunities that strengthen both equipment leasing and direct patient care services segments. The momentum in Rhode Island operations and growing international business position the company to deliver value to patients, partners, and shareholders in 2026 and beyond. Additional information about the company's financial results and operations can be found through its website at https://www.ashs.com.