The struggles of Las Vegas continued yesterday when MGM Resorts (NYSE: MGM) reported a loss of $139.2 million during the fourth quarter. The desert city where the company gets 70% of its revenue is struggling to recover from the recession, and as more casinos fight for fewer customers, MGM looks as if it's playing against a stacked deck.

Adjusted loss per share of $0.20 was a penny better than expectations of a $0.21 loss, but that didn't seem to matter as shares fell yesterday. The reaction to this quarter is a stark contrast to third-quarter results, which sent shares higher and gave some hope that a turnaround was under way, even if I wasn't buying it.

The company's new flagship property CityCenter shows you everything you need to know about how Las Vegas is performing. A year after opening, the property posted a $38.4 million operating loss attributable to MGM's share of the venture. The most expensive project in U.S. history isn't coming even close to being the transformational project MGM hoped it would be.

On the positive side, long-term debt is slowly but surely coming down as the company gets payments from Macau and unloads properties. MGM's debt burden fell from $14.1 billion in the third quarter to $12.0 billion to end last quarter.

The one bright spot was MGM Macau, the company's joint venture with Pansy Ho, which is starting to perform a little more like a Macau casino should. Operating income in Macau was $58.4 million, up from $9.7 million last year. VIP volume was up nearly 80% year over year, and the company is planning to cash in some of those winnings. A planned IPO of the Macau property could bring $800 million to the venture. Macau has produced great results from MGM and its competitors, and next week we find out if Melco Crown (Nasdaq: MPEL) can continue the hot streak in the gambling enclave.

MGM's Macau casino is a bright spot, but MGM is still left in the dust when compared to competitors who rely less on Las Vegas. Wynn Resorts (Nasdaq: WYNN) and Las Vegas Sands (NYSE: LVS) barely discuss Las Vegas operations when reporting results, and analysts ask even fewer questions in the Q&A session of their conference calls. The focus is on Asia where gaming is growing and profits are up. MGM may have hoped the same would be true for the future of Las Vegas, but it's a long road and it looks to be an uphill climb.

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Fool contributor Travis Hoium plays poker in his free time and is short Melco Crown put options. You can follow Travis on Twitter at @FlushDrawFool, check out his personal stock holdings or follow his CAPS picks at TMFFlushDraw.

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