Civic Intelligence

Fhs Provider Services Inc.

990 • Fiscal year 2021 • EIN 83-1369177

Oct 01, 2020 to Sep 30, 2021 • Filed on Aug 15, 2022

Organization ProfileN/A
178 Hwy 24 EastCentreville, MS 39631-0639

(601) 890-0546

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

36th percentile

0.02x

Higher debt load relative to assets than 36% of similar nonprofits.

2021 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2021

Liabilities / Revenue

19th percentile

0.00x

Higher debt load relative to revenue than 19% of similar nonprofits.

2021 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2021

Net Margin

38th percentile

6.1%

Higher net margin than 38% of similar nonprofits.

2021 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2021

Top Officer Pay

98th percentile

$539,514

Higher top officer pay than 98% of similar nonprofits.

Top officer pay equals 28.0% of source-year revenue.

2021 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2021

Asset Growth

27th percentile

0.0%

Faster asset growth than 27% of similar nonprofits.

2021 filings • 501(c)3 • $1M-$5M nonprofits • Annualized from 2020 to 2021

Revenue Growth

50th percentile

12%

Faster revenue growth than 50% of similar nonprofits.

2021 filings • 501(c)3 • $1M-$5M nonprofits • Annualized from 2020 to 2021

Balance Sheet
Liabilities / Assets36th percentile

Assets

Flat

$119,058

Flat from 2020

Net Assets

Up

$116,558

Up $116,579 (+555138%) from 2020

Liabilities

Down

$2,500

Down $116,579 (-98%) from 2020

Revenue And Expenses
Liabilities / Revenue19th percentileNet Margin38th percentile

Revenue

Up

$1,925,558

Up $211,703 (+12%) from 2020

Expenses

Up

$1,808,979

Up $95,103 (+5.5%) from 2020

Net Income

Up

$116,579

Up $116,600 (+555238%) from 2020

Historical Trend

Balance Sheet Trend

Asset Growth27th percentile

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$150K$100K$50K$0-$50KAssets 2020: $119,058Liabilities 2020: $119,079Net Assets 2020: -$212020Assets 2021: $119,058Liabilities 2021: $2,500Net Assets 2021: $116,5582021Assets 2022: $2,500Liabilities 2022: $2,500Net Assets 2022: $02022Assets 2023: $2,500Liabilities 2023: $2,500Net Assets 2023: $02023Assets 2024: $2,500Liabilities 2024: $2,500Net Assets 2024: $02024

Highlighted filing

2021

Assets$119,058
Liabilities$2,500
Net Assets$116,558
Open 2021 Filing

Operations Trend

Revenue Growth50th percentile

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$3.0M$2.0M$1.0M$0-$1.0MRevenue 2020: $1,713,855Expenses 2020: $1,713,876Net Income 2020: -$212020Revenue 2021: $1,925,558Expenses 2021: $1,808,979Net Income 2021: $116,5792021Revenue 2022: $2,302,444Expenses 2022: $2,419,002Net Income 2022: -$116,5582022Revenue 2023: $2,462,918Expenses 2023: $2,462,918Net Income 2023: $02023Revenue 2024: $2,404,669Expenses 2024: $2,404,669Net Income 2024: $02024

Highlighted filing

2021

Revenue$1,925,558
Expenses$1,808,979
Net Income$116,579
Open 2021 Filing
Jump To
Filing Snapshot
Filing Period
Oct 1, 2020 to Sep 30, 2021
Signed
Aug 15, 2022
Return Version
2020v4.1
Gross Receipts
$1,925,558
Mission and Program Overview

Mission

NONE

To support and assist Field Memorial Community Hospital, a rural hospital that takes care of patients in Wilkinson and Amite Counties.

Balance Sheet Detail
LineBeginningEndChange
Assets
Cash and Non-Interest-Bearing Accounts$93,560$119,058▲ $25,498
Savings and Temporary Cash Investments$0$0→ $0
Accounts Receivable$0$0→ $0
Other Notes and Loans Receivable, Net$0$0→ $0
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn$0$0→ $0
Receivables From Officers Etc$0$0→ $0
Investments Other Securities$0$0→ $0
Investments Program Related$0$0→ $0
Investments in Publicly Traded Securities$0$0→ $0
Land, Buildings, and Equipment, Net$0$0→ $0
Intangible Assets$0$0→ $0
Inventories for Sale or Use$0$0→ $0
Loans From Officers Directors$0$0→ $0
Prepaid Expenses and Deferred Charges$0$0→ $0
Total Assets$119,058$119,058→ $0
Other Assets Total$25,498$0▼ $25,498
Liabilities
Unsecured Notes Loans Payable$116,579$0▼ $116,579
Other Liabilities$2,500$2,500→ $0
Accounts Payable and Accrued Expenses$0$0→ $0
Grants Payable$0$0→ $0
Mortgage Notes Payable Secured by Investment Property$0$0→ $0
Deferred Revenue$0$0→ $0
Escrow Account Liability$0$0→ $0
Tax Exempt Bond Liabilities$0$0→ $0
Total Liabilities$119,079$2,500▼ $116,579
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$-21$116,558▲ $116,579
Net Assets With Donor Restrictions$0$0→ $0
Total Net Assets Fund Balance$-21$116,558▲ $116,579
Total Liabilities and Net Assets / Fund Balance$119,058$119,058→ $0
Compensation and Service Providers
Top Officer Pay98th percentile

Employees

NameTitleFull / Part TimeBaseOtherTotal
Pradeep Selvaraj MDDirector, PhysicianFT$520,015$19,499$539,514
Robert Lewis MDDIRECTOR, PhysicianFT$271,438$11,906$283,344

Board Members and Trustees

NameTitle
Marlin ReidChairman
Chad NettervillePresident
Christine AndersonDirector
Revenue and Support

Revenue Composition

Contributions and Grants
$116,579
Program Service Revenue
$1,808,979
Investment Income
$0
Other Revenue
$0
Change in Net Assets
$116,579
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$1,807,332
Other Expenses$1,647
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$883,508--$883,508
Current Officers, Directors, Trustees, and Key Employees$822,858--$822,858
Payroll Taxes$83,485--$83,485
Other Employee Benefits$17,481--$17,481
Fees for Services Other$1,647--$1,647
Total Functional Expenses$1,808,979$0$0$1,808,979
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Direct Expenses$0
Fundraising Gross Income$0
Gaming Direct Expenses$0
Gaming Gross Income$0
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Loans from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Receivables from Disqualified Persons$0$0→ $0
Receivables from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Due to Affiliates$2,500
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Audit committee
Yes
Business relationship with 35% controlled entity
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
No
Audited financial statements prepared
Yes
Key decisions subject to board approval
No
Management duties delegated
Yes

Governance Explanations

Form 990, Part VI, Section A, Line 2

“Family or business relationships: chad netterville, pradeep selvaraj, and robert lewis have a business relationship.”

Form 990, Part VI, Section A, Line 3

“Delegation of management duties: the organization was established to proivde health care services for the benefit of patients located in the service area of field memorial community hospital. The hospital's management performs the day-to-day management of the organization's operations.”

Form 990, Part VI, Section B, Line 11B

“Process to review the form 990: the president and the cfo of field memorial community hospital reviews the form 990 prepared by an outside firm prior to signing.”

Form 990, Part VI, Section C, Line 19

“Governing documents available to the public: available upon request.”

Filing and Contact Details

Filer

Filer Name
FHS Provider Services Inc
EIN
83-1369177
In Care Of
% RICHARD WILLIAMS
Phone
6018900546
Address
178 Hwy 24 East, Centreville, MS 39631-0639

Signing Officer

Name
Richard Williams
Title
President
Phone
6018900500
Signed
2022-08-15
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Richard Williams
Formed
2019
Legal Domicile
Ms
Voting Board Members
5
Independent Board Members
2
Employees
17
Volunteers
0

Preparer

Firm
Forvis Llp
Address
211 N BROADWAY SUITE 600, ST LOUIS, MO 63102-2733
Preparer
Troy A Lindsey
Phone
3142315544
Supplemental Narrative

Financial Statement Notes

Schedule D, Part X, Line 2

“Uncertain tax position footnote: management has evaluated their income tax positions under the guidance included in asc 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements.”

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IRS990ScheduleA/SupportedOrganizationsTotalCnt01
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IRS990ScheduleA/SupportedOrgInformationGrp/OrganizationTypeCd06
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IRS990ScheduleA/SupportedOrgInformationGrp/SupportAmt00
IRS990ScheduleA/SupportedOrgInformationGrp/SupportedOrganizationName/BusinessNameLine1Txt0FIELD MEMORIAL COMMUNITY HOSPITAL
IRS990ScheduleA/SupportingOrganization509a3Ind0X
IRS990ScheduleA/SupportingOrgType1Ind0X
IRS990ScheduleA/SupportSumAmt00
IRS990ScheduleB/ContributorInformationGrp/ContributorBusinessName/BusinessNameLine10RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorNum0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine10RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine20RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/City0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/State0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/ZIPCode0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/TotalContributionsAmt0RESTRICTED
IRS990/ScheduleBRequiredInd0true
IRS990ScheduleD/FederalIncomeTaxLiabilityAmt00
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Amt02500
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Desc0DUE TO AFFILIATES
IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt0UNCERTAIN TAX POSITION FOOTNOTE: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc0SCHEDULE D, PART X, LINE 2
IRS990ScheduleD/TotalLiabilityAmt02500
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IRS990ScheduleJ/CompBasedOnRevenueOfFlngOrgInd0false
IRS990ScheduleJ/CompBsdNetEarnsFlngOrgInd0false
IRS990ScheduleJ/CompBsdNetEarnsRltdOrgsInd0false
IRS990ScheduleJ/CompBsdOnRevRelatedOrgsInd0false
IRS990ScheduleJ/EquityBasedCompArrngmInd0false
IRS990ScheduleJ/InitialContractExceptionInd0false
IRS990/ScheduleJRequiredInd0true
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt1520015
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt2271438
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusFilingOrganizationAmount00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusFilingOrganizationAmount10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusFilingOrganizationAmount20
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusRelatedOrganizationsAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusRelatedOrganizationsAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusRelatedOrganizationsAmt20
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompensationBasedOnRltdOrgsAmt0196721
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompensationBasedOnRltdOrgsAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompensationBasedOnRltdOrgsAmt20
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompReportPrior990FilingOrgAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompReportPrior990FilingOrgAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompReportPrior990FilingOrgAmt20
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompReportPrior990RltdOrgsAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompReportPrior990RltdOrgsAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompReportPrior990RltdOrgsAmt20
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompensationFlngOrgAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompensationFlngOrgAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompensationFlngOrgAmt20
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompRltdOrgsAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompRltdOrgsAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompRltdOrgsAmt20
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsFilingOrgAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsFilingOrgAmt119499
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsFilingOrgAmt211906
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsRltdOrgsAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsRltdOrgsAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsRltdOrgsAmt20
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationFilingOrgAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationFilingOrgAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationFilingOrgAmt20
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationRltdOrgsAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationRltdOrgsAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationRltdOrgsAmt20
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm0Chad Netterville
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm1Pradeep Selvaraj MD
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm2Robert Lewis MD
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt0President
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt1Director, Physician
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt2DIRECTOR, Physician
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt1539514
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt2283344
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationRltdOrgsAmt0196721
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationRltdOrgsAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationRltdOrgsAmt20
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IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt0METHODS USED TO ESTABLISH COMPENSATION: COMPENSATION FOR CHAD NETTERVILLE IS ESTABLISHED BY FIELD MEMORIAL COMMUNITY HOSPITAL, A RELATED ORGANIZATION, USING THE FOLLOWING: A. WRITTEN EMPLOYMENT CONTRACT B. APPROVAL BY THE BOARD.
IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc0SCHEDULE J, PART I, LINE 3
IRS990ScheduleJ/SupplementalNonqualRtrPlanInd0false
IRS990/ScheduleORequiredInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0FAMILY OR BUSINESS RELATIONSHIPS: CHAD NETTERVILLE, PRADEEP SELVARAJ, AND ROBERT LEWIS HAVE A BUSINESS RELATIONSHIP.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1DELEGATION OF MANAGEMENT DUTIES: THE ORGANIZATION WAS ESTABLISHED TO PROIVDE HEALTH CARE SERVICES FOR THE BENEFIT OF PATIENTS LOCATED IN THE SERVICE AREA OF FIELD MEMORIAL COMMUNITY HOSPITAL. THE HOSPITAL'S MANAGEMENT PERFORMS THE DAY-TO-DAY MANAGEMENT OF THE ORGANIZATION'S OPERATIONS.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2PROCESS TO REVIEW THE FORM 990: THE PRESIDENT AND THE CFO OF FIELD MEMORIAL COMMUNITY HOSPITAL REVIEWS THE FORM 990 PREPARED BY AN OUTSIDE FIRM PRIOR TO SIGNING.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC: AVAILABLE UPON REQUEST.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PART VI, SECTION A, LINE 2
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PART VI, SECTION A, LINE 3
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PART VI, SECTION B, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PART VI, SECTION C, LINE 19
IRS990ScheduleR/AssetExchangeInd0false
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IRS990ScheduleR/AssetSaleToOtherOrgInd0false
IRS990ScheduleR/DivRelatedOrganizationInd0false
IRS990ScheduleR/GiftGrntCapContriFromOthOrgInd0false
IRS990ScheduleR/GiftGrntOrCapContriToOthOrgInd0false
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd0true
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd1true
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingEntityName/BusinessNameLine1Txt0NA
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingEntityName/BusinessNameLine1Txt1FMCH
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt0Field Memorial Community Hospital
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt1FMCH PUBLIC BENEFIT CORPORATION

Document Assets

No mirrored PDF or thumbnail assets are attached yet.

Filings

Displayed year

2021 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$119,058
Liabilities
$2,500
Net assets
$116,558
Revenue
$1,925,558
Expenses
$1,808,979
Net income
$116,579
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.00$0.00$0.00$2.40$2.40$0.00
2023XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.00$0.00$0.00$2.46$2.46$0.00
2022Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.00$0.00$0.00$2.30$2.42$0.12
2021Detailed filing. Detailed filing data is available for this year.$0.12$0.00$0.12$1.93$1.81$0.12
2020XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.12$0.12$0.00$1.71$1.71$0.00