* Sees 2013 net income of 110 mln euros vs 134 mln expected
* Points to challenges in 2013
* Lowered outlook twice last year on wage increases (Recasts, adds CEO comment)
FRANKFURT, Feb 21 (Reuters) - German hospital operator Rhoen-Klinikum warned of challenges ahead and kept its 2013 earnings outlook below analysts' expectations after twice downgrading profit forecasts last year.
"Some of the challenges we face in 2013 are typical of the industry, while others are of our own making. It will be the shared responsibility of the management board to quickly improve the company's position," Chief Executive Martin Siebert said as the group published 2012 earnings.
The company, which Fresenius unsuccessfully tried to take over last year, said it expects 2013 net profit of about 110 million euros ($147 million), short of the 134 million euros average forecast in a Reuters poll of analysts.
It predicted earnings before interest, tax, depreciation and amortisation (EBITDA) of about 325 million euros ($435 million) this year, against the poll average of 343 million euros.
Rhoen has been struggling to fix problems at Giessen-Marburg, Germany's only privately owned university teaching hospital, and recently struck a restructuring deal with a regional government there.
It had to cut its full-year outlook twice last year because of wage increases within the industry and losses at Giessen-Marburg. An overhaul there was delayed, complicated by the fact that the German state of Hesse remains in charge of medical research and teaching at the hospital.
A shareholder spat over the planned takeover by Fresenius, which led Rhoen to hire expensive consultants, and the subsequent replacement of top managers also hurt the bottom line.
EBITDA for 2012 fell 14 percent to 292 million euros, slightly less than the 294 million euros expected and broadly in line with the company's reduced guidance. ($1 = 0.7479 euros) (Reporting by Ludwig Burger; Editing by David Goodman)