Cash Generation Collapse In 2024A sudden drop to zero operating and free cash flow materially impairs the firm's ability to self-fund capex, service obligations, and expand clinics. Sustained weak cash generation forces reliance on external financing, increasing risk to operational continuity and strategic investments.
Deteriorating Profitability And MarginsMargins turning negative and declining EBITDA suggest structural pressure from costs, pricing, or utilization. Persistent margin deterioration reduces reinvestment capacity into technology and specialties, undermining long-term competitiveness and the company’s ability to improve operating leverage.
Negative Return On EquityA negative ROE indicates shareholder capital is producing losses, signaling impaired profitability relative to equity. If sustained, this erodes book value, deters new equity investment and constrains the company’s ability to fund strategic initiatives and sustain long-term growth.