Executive Summary

Q4 2018 was communicated via an 8‑K financial update rather than a traditional quarterly press release; management disclosed preliminary FY 2018 net revenues of approximately $15.3M, up by ~$10.7M year over year, driven by the addition of Jamestown Regional Medical Center acquired on June 1, 2018 .
Quarterly trajectory into Q4 remained constructive: Q1–Q3 net revenues rose from $1.60M to $3.29M to $5.04M on conservative revenue recognition for hospital operations; Q4 specifics were not disclosed, but monthly hospital collections reached ~$2.0M in September and ~$2.1M in October, supporting targeted collectible revenues of ~$2.5M per month .
No earnings call transcript or Wall Street consensus estimates (S&P Global) were available for Q4 2018; as a result, beats/misses versus Street cannot be determined (S&P Global mapping unavailable for RNVA).
Management expects increased 2019 revenue from full‑year ownership of existing facilities and continues to evaluate additional acquisitions, positioning potential catalysts around footprint expansion and improved collections .

What Went Well and What Went Wrong

What Went Well

Preliminary FY 2018 net revenues of ~~$15.3M reflect significant growth vs. 2017 (+~~$10.7M) following the Jamestown acquisition and operational ramp; CEO described 2018 as “a pivotal year” and expects “profits and significant growth” in coming years .
Quarterly revenue momentum through Q3: net revenues climbed to $5.04M, supported by a full quarter from Jamestown and conservative revenue recognition; management affirmed targeted collectible revenue of ~$2.5M per month across two hospitals .
Collections execution: hospitals delivered approximately $2.0M (Sep) and $2.1M (Oct) in cash collections, confirming previously indicated run‑rate potential; CFO reiterated filing cadence and operational progress .

What Went Wrong

Liquidity and leverage concerns persisted: at September 30, 2018, RNVA had no cash from continuing operations, a ~$30.0M working capital deficit, and a ~$30.1M stockholders’ deficit, with fixed operating expenses of ~$2.6M per month in Q3 .
Profitability heavily influenced by non‑operating items: Q3 net income from continuing operations of $97.4M was primarily due to a $109.3M gain from change in fair value of derivative instruments; interest expense remained elevated ($9.32M in Q3) .
Capital structure actions and dilution risks: a 1‑for‑500 reverse stock split effective Nov. 12, 2018, and ongoing use of convertible debentures underscore equity issuance dependency amid operational turnaround .

Financial Results

Quarterly Financials (reported)

Metric	Q1 2018	Q2 2018	Q3 2018	Q4 2018
Net Revenues ($USD)	$1,601,661	$3,292,217	$5,039,112	Not disclosed (Company provided FY 2018 preliminary only)
Loss from Continuing Ops before Other/Taxes ($USD)	$(3,712,024)	$(2,393,385)	$(2,815,575)	Not disclosed
Basic Net Income (Loss) per Share ($)	$(0.66)	$0.06	$14.33	Not disclosed

Notes:

Q4 2018 quarter-specific figures were not disclosed; company provided preliminary full-year revenues. Comparisons to estimates are unavailable (no S&P Global consensus).

Full-Year Revenue

Metric	FY 2018
Preliminary Net Revenues ($USD)	~$15.3M

Operating Loss Margin % (calculated)

Metric	Q1 2018	Q2 2018	Q3 2018
Operating Loss Margin % (Loss before Other/Taxes ÷ Net Revenues)	−231.6% (calc from )	−72.7% (calc from )	−55.9% (calc from )

KPIs

KPI	Period	Value
Monthly Hospital Cash Collections ($USD)	Sep 2018	~$2.0M
Monthly Hospital Cash Collections ($USD)	Oct 2018	~$2.1M
Targeted Collectible Revenue ($USD per month across both hospitals)	Ongoing	~$2.5M
Jamestown Expected Collectible Revenue ($USD per month)	Ongoing	~$1.2–$1.5M

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Revenue (Company narrative)	FY 2019	Not provided	Expect increased revenue from full‑year ownership of existing facilities; evaluating acquisitions	Initiated directional outlook
Monthly Hospital Collectible Revenue	Ongoing	“> $2M per month” target indicated earlier; Sep/Oct collections ~$2.0–$2.1M	Targeted ~$2.5M per month for the two hospitals	Raised target
Profitability Outlook (Hospitals)	Ongoing	Expect profitable and cash flow positive hospitals	Reiterated expectation of profits/significant growth for rural hospital sector model	Maintained directional

Note: No numeric ranges for revenue, margins, OpEx, OI&E, tax rate, or dividends were provided in Q4 materials .

Earnings Call Themes & Trends

No Q4 2018 earnings call transcript was found for RNVA.

Topic	Previous Mentions (Q2 2018)	Previous Mentions (Q3 2018)	Current Period (Q4 2018 Update)	Trend
Hospital expansion & acquisitions	Completed Jamestown acquisition; evaluating further acquisitions	Full quarter from Jamestown; continued to explore acquisitions in same geography	Expect increased 2019 revenue and potential acquisitions	Positive momentum
Collections/run‑rate	Initial monthly collections expectations post‑CMS tie‑in; conservative recognition	Achieved ~$2.0M (Sep) and ~$2.1M (Oct); targeted ~$2.5M/month	Maintains conservative recognition; 2019 revenue expected to rise	Improving collections
Revenue recognition policy	Conservative provisioning for bad debt under new rules	Continued conservative policy until adequate historical collection data	Continued conservative stance on hospital revenue recognition	Stable conservative approach
Capital structure & funding	Raised $5.5M; increased authorized shares to 3B	Raised $2.5M; 1‑for‑500 reverse split; steps to manage derivative liability	No new detail; prior balance sheet pressures remain context	Ongoing restructuring
Segment strategy (Lab vs. Hospital)	Hospital growth offset by decline in lab revenues	Hospital growth offset by ~$0.7M decline in lab revenues YoY	Emphasis on hospital segment as growth driver	Mix shifting to hospitals

Management Commentary

“We believe that 2018 was a pivotal year and expect our business model for the rural hospital sector to deliver profits and significant growth for Rennova in the coming years.” – Seamus Lagan, CEO .
“Initial indications confirm our previously announced expectation that [Jamestown]… will contribute $1.2 million to $1.5 million a month in collectible revenue… targeted collectible revenue for the current two hospitals is approximately $2.5 million per month.” – Company statement (Q3) .
“September saw us achieve the previously predicted collections of approximately $2 million a month, and… we expect that our hospitals will be profitable and cash flow positive.” – Seamus Lagan (Q3 update) .
“We expect increased revenue in 2019 from ownership of existing facilities for the full year and continue to analyze additional acquisition opportunities…” – Seamus Lagan .

Q&A Highlights

No Q4 2018 earnings call transcript was available; therefore, Q&A themes, clarifications, and tone relative to prior quarters cannot be assessed.

Estimates Context

Wall Street consensus estimates via S&P Global for Q4 2018 (EPS, revenue, EBITDA, target price) were unavailable due to missing CIQ mapping for RNVA; consequently, we cannot determine beats/misses or quantify estimate revisions for the quarter.

Key Takeaways for Investors

Revenue ramp into Q4 remained intact on conservative hospital revenue recognition, with FY 2018 preliminary revenues of ~$15.3M and monthly hospital collections reaching ~$2.0–$2.1M, supporting a ~$2.5M/month target across two facilities .
The hospital segment is the core growth driver; Jamestown’s expected collectible contribution of ~$1.2–$1.5M/month underpins 2019 revenue uplift narratives .
Liquidity and balance sheet risk are material: zero cash from continuing ops at Q3‑end, large working capital and stockholders’ deficits, and high interest expense necessitate continued external financing and potential dilution .
Reported profitability was dominated by non‑operating derivative gains in Q3; evaluate operating metrics (collections, expense control) rather than GAAP net income for trend analysis .
No Q4 transcript and no S&P Global estimates limit the ability to gauge Street expectations; near‑term trading likely responds to further disclosures on 2018 audited results, 2019 revenue cadence, and acquisition progress .
Watch for operational KPIs (monthly collections sustaining ≥$2.5M, payer mix stability, cash conversion) and any formal guidance initiation to support re‑rating .
Corporate actions (reverse split, debentures) and any steps to reduce derivative liabilities remain pivotal to equity value stabilization and institutional participation .

Rennova Health, Inc. (RNVA)·Q4 2018 Earnings Summary