Civic Intelligence

Utah Surgical Interventional And

EIN 47-5262046 • 501(c)3 • North Ogden, UT

Profile

(1) providing a high-tech learning and simulation environment designed to facilitate the education of physicians and medical professionals regarding new and innovative surgical techniques, (2) operating an interactive anatomy and medical technology exhibit designed to educate school-aged children in the areas of science, technology, engineering and mathematics within the various medical fields, and (3) providing charitable grants of monetary support to medical schools, foundations and other tax-exempt organizations that will directly improve the human condition through advancements and education in medical fields.

645 E 2800 NNorth Ogden, UT 84414

n/A

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

97th percentile

2.99x

Higher debt load relative to assets than 97% of similar nonprofits.

501(c)3 • <$500k nonprofits • Source year 2016

Liabilities / Revenue

91st percentile

0.43x

Higher debt load relative to revenue than 91% of similar nonprofits.

501(c)3 • <$500k nonprofits • Source year 2016

Net Margin

11th percentile

-79%

Higher net margin than 11% of similar nonprofits.

501(c)3 • <$500k nonprofits • Source year 2016

Top Officer Pay

97th percentile

$75,000

Higher top officer pay than 97% of similar nonprofits.

Top officer pay equals 50.0% of source-year revenue.

501(c)3 • <$500k nonprofits • Source year 2016

Asset Growth

13th percentile

-85%

Faster asset growth than 13% of similar nonprofits.

501(c)3 • <$500k nonprofits • Annualized from 2015 to 2016

Revenue Growth

16th percentile

-57%

Faster revenue growth than 16% of similar nonprofits.

501(c)3 • <$500k nonprofits • Annualized from 2015 to 2016

Balance Sheet
Liabilities / Assets97th percentile

Assets

Down

$21,743

Down $119,366 (-85%) from 2015

Liabilities

Down

$65,000

Down $1,166 (-1.8%) from 2015

Net Assets

Down

-$43,257

Down $118,200 (-158%) from 2015

Operations
Liabilities / Revenue91st percentileNet Margin11th percentile

Revenue

Down

$150,023

Down $199,994 (-57%) from 2015

Expenses

Up

$268,223

Up $16,073 (+6.4%) from 2015

Net Income

Down

-$118,200

Down $216,067 (-221%) from 2015

Trend Graphs

Balance Sheet Trend

Asset Growth13th percentile

Grouped bars show assets, liabilities, and net assets across loaded filings.

$150K$100K$50K$0-$50KAssets 2015: $141,109Liabilities 2015: $66,166Net Assets 2015: $74,9432015Assets 2016: $21,743Liabilities 2016: $65,000Net Assets 2016: -$43,2572016

Highlighted filing

2016

Assets$21,743
Liabilities$65,000
Net Assets-$43,257
Open 2016 Filing

Operations Trend

Revenue Growth16th percentile

Revenue, expenses, and net income by year, with the latest filing highlighted.

$400K$200K$0-$200KRevenue 2015: $350,017Expenses 2015: $252,150Net Income 2015: $97,8672015Revenue 2016: $150,023Expenses 2016: $268,223Net Income 2016: -$118,2002016

Highlighted filing

2016

Revenue$150,023
Expenses$268,223
Net Income-$118,200
Open 2016 Filing

Filings

Most recent year

2016 • Form 990Facts available. Structured filing facts are available, but richer extracted sections are limited.

Open filing
Assets
$21,743
Liabilities
$65,000
Net assets
-$43,257
Revenue
$150,023
Expenses
$268,223
Net income
-$118,200
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2016Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.22$0.65$0.43$1.50$2.68$1.18
2015Detailed filing. Detailed filing data is available for this year.$1.41$0.66$0.75$3.50$2.52$0.98
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jan 1, 2016 to Dec 31, 2016
Signed
Nov 15, 2017
Return Version
2016v3.0
Gross Receipts
$150,023
Mission and Program Overview

Mission

(1) providing a high-tech learning and simulation environment designed to facilitate the education of physicians and medical professionals regarding new and innovative surgical techniques, (2) operating an interactive anatomy and medical technology exhibit designed to educate school-aged children in the areas of science, technology, engineering and mathematics within the various medical fields, and (3) providing charitable grants of monetary support to medical schools, foundations and other tax-exempt organizations that will directly improve the human condition through advancements and education in medical fields.

Balance Sheet Detail
LineBeginningEndChange
Assets
Prepaid Expenses and Deferred Charges$25,000$21,763▼ $3,237
Pd in Cap Srpls Land Bldg Eqp Fund$0$0→ $0
Cap Stk Tr Prin Current Funds$0$0→ $0
Cash and Non-Interest-Bearing Accounts$116,109$-20▼ $116,129
Rtn Earn Endowment Incm Other Fnds$74,943$-43,257▼ $118,200
Total Assets$141,109$21,743▼ $119,366
Liabilities
Unsecured Notes Loans Payable$66,166$65,000▼ $1,166
Total Liabilities$66,166$65,000▼ $1,166
Net Assets / Fund Balance
Total Net Assets Fund Balance$74,943$-43,257▼ $118,200
Total Liabilities and Net Assets / Fund Balance$141,109$21,743▼ $119,366
Compensation and Service Providers
Top Officer Pay97th percentile

Employees

NameTitleFull / Part TimeBaseTotal
Matt WhiteCEOFT$75,000$75,000
Garry BeltonCOOFT$65,000$65,000
Charles BeckSenior StrategistPT$25,000$25,000
Natalie WhiteExecutive AssistantPT$16,750$16,750
Jb HenriksenCFOPT$11,330$11,330
Chris BeltonCMOPT$7,331$7,331
Jim UrryCIOPT$5,500$5,500
Steve NuessleLab DirectorPT$5,500$5,500
Rick WebsterDirector EducationPT$3,000$3,000
Revenue and Support

Revenue Composition

Contributions and Grants
$150,000
Program Service Revenue
$0
Investment Income
$23
Other Revenue
$0
All Other Contributions
$150,000
Change in Net Assets
$-118,200
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$223,161
Other Expenses$45,062
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Current Officers, Directors, Trustees, and Key Employees-$223,161-$223,161
Occupancy-$15,210-$15,210
Fees for Services Accounting-$11,344-$11,344
Office Expenses-$1,967-$1,967
All Other Expenses-$1,847-$1,847
Other Expenses-$1,787-$1,787
Insurance-$1,494-$1,494
Travel-$1,452-$1,452
Information Technology-$963-$963
Advertising-$109-$109
Total Functional Expenses$0$268,223$0$268,223
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
Subject to proxy tax
No
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
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
Yes
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

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

“We create and maintain financial reports on a timely basis that accurately portray our financial status and activities and provide them to all of our trustees. Our internal financial statements identify and explain any material variation between actual and budgeted revenues and expenses. These efforts bolster a thorough review of form 990 by each trustee, with a corresponding unanimous vote for adoption, reflected in the minutes of the board of trustees.”

Form 990, Part VI, Section B, Line 12C

“The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy.”

Form 990, Part VI, Section C, Line 19

“Available within 30 days, upon written request”

Filing and Contact Details

Filer

Filer Name
Utah Surgical Interventional and
EIN
47-5262046
Phone
8016997656
Address
645 E 2800 N, NORTH OGDEN, UT 84414

Signing Officer

Name
Jb Henriksen
Title
CFO/treasurer
Phone
8016997656
Signed
2017-11-15
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Matthew White
Formed
2015
Legal Domicile
Ut
Voting Board Members
5
Independent Board Members
1
Employees
0
Volunteers
0

Preparer

Firm
Tanner LLC
Address
36 S STATE STREET SUITE 600, SALT LAKE CITY, UT 84111
Preparer
Marc a Metcalf
Phone
8015327444
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This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

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IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0WE CREATE AND MAINTAIN FINANCIAL REPORTS ON A TIMELY BASIS THAT ACCURATELY PORTRAY OUR FINANCIAL STATUS AND ACTIVITIES AND PROVIDE THEM TO ALL OF OUR TRUSTEES. OUR INTERNAL FINANCIAL STATEMENTS IDENTIFY AND EXPLAIN ANY MATERIAL VARIATION BETWEEN ACTUAL AND BUDGETED REVENUES AND EXPENSES. THESE EFFORTS BOLSTER A THOROUGH REVIEW OF FORM 990 BY EACH TRUSTEE, WITH A CORRESPONDING UNANIMOUS VOTE FOR ADOPTION, REFLECTED IN THE MINUTES OF THE BOARD OF TRUSTEES.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2AVAILABLE WITHIN 30 DAYS, UPON WRITTEN REQUEST
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PART VI, SECTION B, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PART VI, SECTION B, LINE 12C
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PART VI, SECTION C, LINE 19
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IRS990/TotReportableCompRltdOrgAmt00
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IRS990/USAddress/ZIPCd084414
IRS990/VotingMembersGoverningBodyCnt05
IRS990/VotingMembersIndependentCnt01
IRS990/WebsiteAddressTxt0N/A
IRS990/WhistleblowerPolicyInd00
ReturnHeader/BuildTS02017-02-10 21:41:12Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd01
ReturnHeader/BusinessOfficerGrp/PersonNm0JB HENRIKSEN
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0CFO/TREASURER
ReturnHeader/BusinessOfficerGrp/PhoneNum08016997656
ReturnHeader/BusinessOfficerGrp/SignatureDt02017-11-15
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0UTAH SURGICAL INTERVENTIONAL AND
ReturnHeader/Filer/BusinessName/BusinessNameLine2Txt0MEDICAL SIMULATION CENTER INC
ReturnHeader/Filer/BusinessNameControlTxt0UTAH
ReturnHeader/Filer/EIN0475262046
ReturnHeader/Filer/PhoneNum08016997656
ReturnHeader/Filer/USAddress/AddressLine1Txt0645 E 2800 N
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ReturnHeader/FilingSecurityInformation/AtSubmissionCreationDeviceId0C8006F72E7D0BAB2BBCCCEFAC0601D3397ECDD6C
ReturnHeader/FilingSecurityInformation/AtSubmissionFilingDeviceId0A048973EBE51817971A011BC8A53D60B5A560BA5
ReturnHeader/FilingSecurityInformation/FilingLicenseTypeCd0P
ReturnHeader/FilingSecurityInformation/IPAddress/IPv4AddressTxt0162.218.219.130
ReturnHeader/FilingSecurityInformation/IPDt02017-11-15
ReturnHeader/FilingSecurityInformation/IPTimezoneCd0MS
ReturnHeader/FilingSecurityInformation/IPTm015:59:09
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0202253063
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0TANNER LLC
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt036 S STATE STREET SUITE 600
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0SALT LAKE CITY
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0UT
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd084111
ReturnHeader/PreparerPersonGrp/PhoneNum08015327444
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0MARC A METCALF
ReturnHeader/ReturnTs02017-11-15T18:04:46-06:00
ReturnHeader/ReturnTypeCd0990
ReturnHeader/TaxPeriodBeginDt02016-01-01
ReturnHeader/TaxPeriodEndDt02016-12-31
ReturnHeader/TaxYr02016

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