First Consulting Group Inc. shares fell 19 percent Wednesday after the company reported fourth quarter earnings that failed to meet Wall Street expectations and lowered its first quarter profit outlook.

The Long Beach health care consulting and outsourcing firm reported fourth-quarter net income of $5.1 million (19 cents a share), compared to a net loss of $10.2 million (41 cents) for the fourth quarter a year ago. Revenue fell 4.5 percent to $69.8 million. Analysts polled by Thomson Financial had expected net income of 21 cents per share.

Company executives said they expect first-quarter revenue of $64 million to $66 million with continued operating profitability and positive cash flow. The figures are off from a year ago and below the $70.9 million projected by analysts.

First Consulting, which has been in the midst of a restructuring, also was downgraded by Avondale Partners analyst P. Shaw Jackson to “Market Perform” from “Market Outperform.” Jackson lowered his price target $1 to $11.50.

Shares of First Consulting dropped $2.20 to close at $9.46 on the Nasdaq.