Civic Intelligence

Fhs Provider Services Inc.

990 • Fiscal year 2023 • EIN 83-1369177

Oct 01, 2022 to Sep 30, 2023 • Filed on Jul 15, 2024

178 Highway 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

94th percentile

1.00x

Higher debt load relative to assets than 94% of similar nonprofits.

2023 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2023

Liabilities / Revenue

19th percentile

0.00x

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

2023 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2023

Net Margin

40th percentile

0.0%

Higher net margin than 40% of similar nonprofits.

2023 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2023

Top Officer Pay

98th percentile

$570,392

Higher top officer pay than 98% of similar nonprofits.

Top officer pay equals 23.2% of source-year revenue.

2023 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2023

Asset Growth

36th percentile

0.0%

Faster asset growth than 36% of similar nonprofits.

2023 filings • 501(c)3 • $1M-$5M nonprofits • Annualized from 2022 to 2023

Revenue Growth

50th percentile

7.0%

Faster revenue growth than 50% of similar nonprofits.

2023 filings • 501(c)3 • $1M-$5M nonprofits • Annualized from 2022 to 2023

Assets

Flat

$2,500

Flat from 2022

Net Assets

Flat

$0

Flat from 2022

Liabilities

Flat

$2,500

Flat from 2022

Revenue

Up

$2,462,918

Up $160,474 (+7.0%) from 2022

Expenses

Up

$2,462,918

Up $43,916 (+1.8%) from 2022

Net Income

Up

$0

Up $116,558 (+100%) from 2022

Historical Trend

Balance Sheet Trend

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

2023

Assets$2,500
Liabilities$2,500
Net Assets$0

Operations Trend

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

2023

Revenue$2,462,918
Expenses$2,462,918
Net Income$0
Jump To
Filing Snapshot
Filing Period
Oct 1, 2022 to Sep 30, 2023
Signed
Jul 15, 2024
Return Version
2022v5.0
Gross Receipts
$2,462,918
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$2,500$2,500→ $0
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--
Investments Program Related$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$2,500$2,500→ $0
Other Assets Total$0$0→ $0
Liabilities
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
Unsecured Notes Loans Payable$0$0→ $0
Deferred Revenue$0$0→ $0
Escrow Account Liability$0$0→ $0
Tax Exempt Bond Liabilities$0$0→ $0
Total Liabilities$2,500$2,500→ $0
Net Assets / Fund Balance
Net Assets With Donor Restrictions$0$0→ $0
Net Assets Without Donor Restrictions$0$0→ $0
Total Net Assets Fund Balance$0$0→ $0
Total Liabilities and Net Assets / Fund Balance$2,500$2,500→ $0
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
-PhysicianFT$304,593$18,276$322,869
-Director, PhysicianFT$260,493$26,675$287,168
-President, Director-$158,000$20,846$178,846
-Treasurer, Director--$126,519$126,519

Board Members and Trustees

NameTitle
-Director
-Secretary, Director
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$2,462,918
Investment Income
$0
Other Revenue
$0
All Other Contributions
$0
Change in Net Assets
$0
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$2,459,891
Other Expenses$3,027
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$1,276,842--$1,276,842
Current Officers, Directors, Trustees, and Key Employees$1,047,557--$1,047,557
Payroll Taxes$135,492--$135,492
Fees for Services Other$3,027$0$0$3,027
Total Functional Expenses$2,462,918$0$0$2,462,918
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
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
Yes
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, Line 2 Family/business relationships amongst interested persons

RICHARD WILLIAMS, PRADEEP SELVARAJ, SHERRY MIX, AND ROBERT LEWIS - Business relationship

Form 990, Part VI, Line 3 Delegation of management duties

The organization was established to provide 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, Line 11B Review of form 990 by governing body

The president and the cfo of field memorial community hospital review the form 990 prepared by an outside firm prior to signing.

Form 990, Part VI, Line 15A Process to establish compensation of top management official

The organization uses the following methods to establish compensation of the president: written employment contract, and approval by the board or compensation commitee. This process was last undertaken in 2022.

Form 990, Part VI, Line 19 Required documents available to the public

Governing documents available to the public: available upon request.

Filing and Contact Details

Filer

Filer Name
FHS Provider Services Inc
EIN
83-1369177
Phone
6018900546
Address
178 Highway 24 East, Centreville, MS 39631-0639

Signing Officer

Name
Richard Williams
Title
President
Signed
2024-07-15
Discuss with paid preparer
Yes

Organization Details

Formed
2019
Legal Domicile
Ms
Voting Board Members
6
Independent Board Members
2
Employees
23
Volunteers
2

Preparer

Firm
Forvis Mazars LLP
Address
211 N Broadway Suite 600, St Louis, MO 63102-2733
Preparer
Kristen Hankins
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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IRS990/PYOtherExpensesAmt03123
IRS990/PYOtherRevenueAmt00
IRS990/PYProgramServiceRevenueAmt02302444
IRS990/PYRevenuesLessExpensesAmt0-116558
IRS990/PYSalariesCompEmpBnftPaidAmt02415879
IRS990/PYTotalExpensesAmt02419002
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IRS990/PYTotalRevenueAmt02302444
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IRS990/ReceivablesFromOfficersEtcGrp/BOYAmt00
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IRS990/RentalIncomeOrLossGrp/RealAmt00
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IRS990/ReportOtherLiabilitiesInd0true
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IRS990/RevenueAmt02462918
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IRS990ScheduleA/IRSWrittenDeterminationInd0X
IRS990ScheduleA/OtherSupportSumAmt02462918
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IRS990ScheduleA/SupportedOrgInformationGrp/OrganizationTypeCd06
IRS990ScheduleA/SupportedOrgInformationGrp/OtherSupportAmt02462918
IRS990ScheduleA/SupportedOrgInformationGrp/SupportAmt00
IRS990ScheduleA/SupportedOrgInformationGrp/SupportedOrganizationName/BusinessNameLine1Txt0FIELD MEMORIAL COMMUNITY HOSPITAL
IRS990ScheduleA/SupportingOrganization509a3Ind0X
IRS990ScheduleA/SupportingOrgType1Ind0X
IRS990ScheduleA/SupportSumAmt00
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IRS990ScheduleD/OtherLiabilitiesOrgGrp/Amt02500
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Desc0DUE TO AFFILIATES
IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt0MANAGEMENT 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 UNCERTAIN TAX POSITION FOOTNOTE
IRS990ScheduleD/TotalLiabilityAmt02500
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt1540703
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt2260493
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt4267841
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt5199203
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt6304593
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusRelatedOrganizationsAmt60
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BusinessName/BusinessNameLine1Txt0Richard Williams
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BusinessName/BusinessNameLine1Txt1PRADEEP SELVARAJ MD
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BusinessName/BusinessNameLine1Txt2ROBERT LEWIS MD
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BusinessName/BusinessNameLine1Txt3KIMBERLY GABRIEL MD
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BusinessName/BusinessNameLine1Txt4DAVID MCGRAW MD
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BusinessName/BusinessNameLine1Txt5RICHARD FIELD
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BusinessName/BusinessNameLine1Txt6JESSICA WILLIS DO
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompensationBasedOnRltdOrgsAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompensationBasedOnRltdOrgsAmt20
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompensationBasedOnRltdOrgsAmt60
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompReportPrior990RltdOrgsAmt60
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompensationFlngOrgAmt08487
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompensationFlngOrgAmt121000
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompensationFlngOrgAmt29545
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompensationFlngOrgAmt315369
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompensationFlngOrgAmt50

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