2022-07-06T10:49:28-05:00 2021-12-31 562382653 NORTHWEST CPA GROUP PLLC 1333 COLUMBIA PARK TRAIL STE 210 RICHLAND WA 99352 990 2021-01-01 911952283 SIGN FRACTURE CARE INTERNATIONAL SIGN 5093711107 451 HILLS STREET SUITE B RICHLAND WA 99354 JEANNE DILLNER CHIEF EXECUTIVE OFFICER 5093711107 2022-06-30 1 JEANNE DILLNER 999009999 ALISON C GEBERS P00423745 5097351300 2022-06-30 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z SIGN 451 HILLS STREET SUITE B RICHLAND WA 99354 10468768 0 X WWW.SIGNFRACTURECARE.ORG X 1999 WA BUILD ORTHOPAEDIC CAPACITY IN DEVELOPING COUNTRIES BY PROVIDING ORTHOPAEDIC TRAINING AND IMPLANTS. 12 12 50 41 0 0 5247095 7982956 878615 1084354 252688 468009 34037 39317 6412435 9574636 105673 104823 0 0 2797745 2666222 0 0 453707 3806038 3492405 6709456 6263450 -297021 3311186 12430004 16004301 408406 347896 12021598 15656405 X SEE SCHEDULE O 0 0 938350 104823 5533 WE PROVIDE ACCESS TO ORTHOPAEDIC TRAINING AND EDUCATION TO SURGEONS IN DEVELOPING COUNTRIES VIA FIVE PRIMARY CHANNELS:1. ONSITE VISITS BY LOCAL SURGEONS AND NORTH AMERICAN AND EUROPEAN SURGEONS. 2. EMAIL COMMUNICATIONS WITH SIGN HEADQUARTERS.3. DISCUSSION TOPICS AND EDUCATIONAL RESOURCES POSTED ON OUR WEBSITE, THE HUB.4. REVIEW OF CASES SUBMITTED TO THE SIGN SURGICAL DATABASE BY ORTHOPAEDIC SURGEONS ON THE SIGN BOARD. 5. REGIONAL SIGN AND TRAUMA CONFERENCES, AS WELL AS THE ANNUAL INTERNATIONAL ORTHOPAEDIC CONFERENCE HELD AT SIGN HEADQUARTERS.THE OBJECTIVES FOR ALL MODES OF TRAINING ARE: 1) ENSURE SIGN SURGEONS UNDERSTAND THE SURGICAL TECHNIQUE FOR THE SIGN PRODUCTS IN THEIR HOSPITAL; 2) PROVIDE TRAINING ON CURRENT AND RELEVANT ORTHOPAEDIC PRINCIPLES; AND, 3) PROVIDE TRAINING IN ORTHOPAEDIC AND TRAUMA PROCEDURES FOR INJURIES SUCH AS OPEN WOUNDS, LIMB DEFORMITY, PEDIATRIC, AND PELVIC.EXPAND TRAINING AND EDUCATIONAL OPPORTUNITIES:DUE TO THE COVID-19 PANDEMIC, WE WERE UNABLE TO HOLD THE IN-PERSON SIGN CONFERENCE IN 2021; HOWEVER, IN 2020, IN PARTNERSHIP WITH IGOT, WE LAUNCHED THE SUCCESSFUL SIGN TRAUMA SESSIONS WEBINAR SERIES. THESE WEBINARS ARE HELD MONTHLY VIA ZOOM AND RECORDED FOR THOSE SURGEONS WHO CANNOT ATTEND LIVE. NEARLY EVERY SESSION INCLUDES FACULTY WHO ARE SIGN SURGEONS. THE TRAUMA SESSIONS GIVE SIGN SURGEONS A CHANCE TO SHARE THEIR KNOWLEDGE AND EXPERTISE WITH THEIR COLLEAGUES AND DISCUSS RELEVANT TOPICS IN TRAUMA CARE SUCH AS HUMERUS FRACTURES, PEDIATRIC FRACTURES, SOFT TISSUE WOUND COVERAGE, AND PELVIC FRACTURES. IN 2021, WE HELD 9 WEBINARS WHICH REACHED MORE THAN 3000 SIGN SURGEONS. THE HUB, SIGN'S WEBSITE FOR EDUCATIONAL RESOURCES FOR SURGEONS, CONTAINS VIDEOS, ARTICLES, DISCUSSIONS, AND MORE TO PROVIDE ONGOING LEARNING OPPORTUNITIES FOR SURGEONS ACROSS THE GLOBE. IN 2021, THE HUB RECEIVED AN UPDATE, WHICH FEATURED A NEW LOOK AND FEEL AND TWO NEW MAJOR COMPONENTS- ELEARNING AND KNOWLEDGE PAGES. THE SIGN IT DEPARTMENT CONTINUES TO MAKE IMPROVEMENTS TO THE SIGN SURGICAL DATABASE WEBSITE, WHICH IS THE BACKBONE OF REPORTING AND RESEARCHING SURGICAL CASES. THE UPGRADES ALLOWED OUR TEAM TO ASK QUESTIONS ONLY OF CERTAIN PROGRAMS, GIVING US THE ABILITY TO CREATE LIMITED ENROLLMENT STUDIES, AND IMPROVED SITE SECURITY.WE CONTINUE TO PARTNER WITH BLACK LION HOSPITAL, IN ADDIS ABABA, ETHIOPIA ON THE FIRST EAST AFRICAN PELVIC FELLOWSHIP PROGRAM. IN 2021, THEY TRAINED 2 ETHIOPIAN FELLOWS IN ADDITION TO A TANZANIAN SURGEON WHO WAS THEN ABLE TO RETURN HOME AND PUT HIS NEW SKILLS INTO PRACTICE IN HIS LOCAL COMMUNITY.OUR TRAVELING SET PROGRAM MODEL WAS A CONTINUED SUCCESS IN ETHIOPIA AND TANZANIA. IN THIS MODEL, THE MENTOR SURGEON MANAGING THE SET IDENTIFIES A HOSPITAL THEY BELIEVE HAS THE POTENTIAL TO SERVE MANY PATIENTS. THE MENTOR SURGEON THEN TRAVELS TO THE HOSPITAL AND TRAINS THE SURGEONS IN THE SIGN TECHNIQUE AND DATABASE REPORTING. AFTER THE TRAINING IS COMPLETED, THE SET IS STATIONED AT THE HOSPITAL FOR THREE MONTHS. IF THE HOSPITAL REPORTS AT LEAST 10 CASES WITHIN THE THREE-MONTH PERIOD, THEY ARE ELIGIBLE TO APPLY TO START THEIR OWN SIGN PROGRAM. IN 2021, IN ETHIOPIA, THERE WERE FOUR SIGN PROGRAMS STARTED USING THE TEACHING SET MODEL. IN TANZANIA, THERE WERE TWO SIGN PROGRAMS STARTED.ALSO IN 2021, WE PARTNERED WITH A CANADIAN-BASED COMPANY, PRECISIONOS TECHNOLOGY, TO CREATE A VIRTUAL REALITY SURGICAL TRAINING MODULE FOR SIGN SURGEONS. THE MODULE IS LOADED ONTO AN OCULUS HEADSET WHICH IS WORN BY THE TRAINEE. THE HEADSET SHOWS THE SURGEON A VIRTUAL OR, COMPLETE WITH A FRACTURE PATIENT. HAND-HELD SENSORS ARE USED TO MANIPULATE THE VIRTUAL INSTRUMENTS AND "PERFORM" THE SIGN SURGERY. WE SHIPPED 3 OF THESE OCULUS HEADSETS TO SIGN PROGRAMS IN RWANDA, CAMBODIA, AND MALAWI. OUR MENTOR SURGEON IN RWANDA HAD THIS TO SAY: YES! ALL SURGEONS INVOLVED IN USE OF SIGN IMPLANTS HAD AT LEAST A SESSION ON HOW TO USE OCULUS AND VIRTUAL PRACTICAL SESSION. RESIDENTS ROTATING IN ORTHOPEDICS BENEFITED MUCH FROM VIRTUAL PRACTICES BEFORE THEY START TO WORK ON PATIENTS. THE HEADSET IS AVAILED TO THEM FOR REGULAR EXERCISE. WE HAVE FOUND IT VERY EFFECTIVE. 4508584 1078821 DISTRIBUTE APPROPRIATE ORTHOPAEDIC TECHNOLOGY:THE SIGN IM NAIL AND INTERLOCKING SCREW SYSTEM IS DESIGNED FOR USE IN HOSPITALS IN DEVELOPING COUNTRIES WHERE C-ARMS AND RELIABLE POWER ARE NOT AVAILABLE. SIGN ENGINEERS CONTINUALLY DEVELOP NEW ORTHOPAEDIC INSTRUMENTS AND IMPLANTS IN RESPONSE TO THE NEEDS DESCRIBED BY THE LOCAL SURGEONS. IN 2021, SIGN ENGINEERS DEVELOPED ONE NEW PRODUCT AND MADE DESIGN IMPROVEMENTS TO ONE INSTRUMENT TO ASSIST IN A VARIETY OF ORTHOPAEDIC SURGERIES. THE NEW PRODUCT WAS AN L-HANDLE SCREW EXTRACTOR, DESIGNED TO REMOVE SHOULDER CAP SCREWS FROM THE L-HANDLE WHEN BROKEN OFF INSIDE. AND THE SHOULDER CAP SCREW WAS RE-DESIGNED TO INCREASE USAGE AND MINIMIZE THE ABILITY FOR OPERATING STAFF TO OVER TORQUE THE SCREW, WHICH CAN LEAD TO BREAKAGE.WE SUPPLY NEW PROGRAMS WITH THE SIGN IM NAIL SYSTEM, WHICH SURGEONS USE TO REPAIR SEVERE FRACTURES IN THE FEMUR, TIBIA, AND HUMERUS. ONCE A PROGRAM HAS DEMONSTRATED ITS ABILITY TO REPORT THEIR CASES, INCLUDING ADEQUATE FOLLOW-UP THAT CONFIRMS THEIR RESULTS COMPLY WITH OUR EXPECTATIONS, THEY BECOME ELIGIBLE TO RECEIVE ADDITIONAL SIGN PRODUCTS, AS WELL AS IN-KIND DONATIONS RECEIVED FROM FOR-PROFIT ORTHOPAEDIC IMPLANT COMPANIES.IN 2021, WE DISTRIBUTED 34,283 SIGN NAILS TO 54 COUNTRIES. OUR AIM IS TO ENABLE THE POOR TO GAIN ACCESS TO AFFORDABLE ORTHOPAEDIC SURGERY, WHICH MEANS THAT THE MAJORITY OF OUR IMPLANTS ARE DONATED FREE OF CHARGE TO THE PATIENT.WE STARTED 36 NEW SIGN PROGRAMS IN 2021. THE BREAKDOWN WAS AS FOLLOWS: AFRICA: 30 PROGRAMS ASIA: 5 PROGRAMS CARIBBEAN: 1 PROGRAMAS OF DECEMBER 31, 2021, THE WORLD BANK INCOME CLASSIFICATIONS BY GNI FOR THE COUNTRIES WITH NEW SIGN PROGRAMS WERE AS FOLLOWS: LOW INCOME 58%, LOWER MIDDLE INCOME 33%, AND UPPER MIDDLE INCOME 3%. (6% ARE TERRITORIES NOT RECOGNIZED BY THE WORLD BANK.)DISASTER AND CONFLICT RESPONSE:WE BELIEVE IN EQUALITY OF FRACTURE CARE FOR ALL, REGARDLESS OF GENDER, RELIGION, POLITICAL AFFILIATION, OR ANY OTHER IDENTITY. THE CONFLICT IN NORTHERN ETHIOPIA CONTINUED THROUGHOUT 2021, RESULTING IN THOUSANDS OF DEATHS AND INJURIES. SIGN PROVIDED ADDITIONAL SHIPMENTS OF SIGN INSTRUMENTS AND IMPLANTS TO SIGN SURGEONS IN AND AROUND TIGRAY, WHO WERE PROVIDING CARE FOR PATIENTS IN THE REGION. IN 2021, WE SENT ALMOST 4,300 SIGN NAILS TO ETHIOPIAN SIGN PROGRAMS TO TREAT THOSE INJURED IN THE CONFLICT. IN ADDITION TO SIGN NAILS, WE PROVIDED 29 EXTERNAL FIXATOR SETS AND 236 FX PLATES. FOLLOWING THE HAITI EARTHQUAKE, WE SENT OVER 150 NAILS TO HAITIAN SIGN SURGEONS. OUR LOCAL PARTNERS ARE EXPERT SURGEONS AND KNOW THE NEEDS OF THE COMMUNITY BETTER THAN WE CAN FROM THE UNITED STATES, SO WE EMPOWER THEM TO RESPOND TO NEEDS AS THEY ARISE. WE ALSO STARTED A NEW SIGN PROGRAM NEAR THE EARTHQUAKE EPICENTER, TO BOTH RESPOND TO THE IMMEDIATE NEED AND TO CONTINUE SERVING THE COMMUNITY IN THE LONG TERM.SINCE THE TRANSFER OF POWER TO THE TALIBAN IN AFGHANISTAN, TRAVEL IN AND OUT OF THE COUNTRY HAS YET TO NORMALIZE, WHICH HAS GREATLY AFFECTED OUR ABILITY TO SEND NAILS TO THE LOCAL SIGN PROGRAMS. IN LATE NOVEMBER 2021, WE WERE ABLE TO SEND A SHIPMENT VIA AN AIR FREIGHT COMPANY. NOW THAT WE HAVE FOUND A RELIABLE SHIPPING ROUTE INTO AFGHANISTAN, WE WILL CONTINUE TO SUPPLY OUR SIGN SURGEONS WITH THE IMPLANTS THEY NEED TO TREAT THE INJURED POOR. 5446934 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 8 0 1 50 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 AL AK AR CA CO DC FL GA HI IL KS KY MA MD MI MN MS NH NJ NM NV NY NC OH OK OR PA SC TN UT VA WA WI CT ME RI ND WV MO X BRIAN NAKAMURA 5093711107 451 HILLS STREET SUITE B RICHLAND WA 99354 CARLA SMITH MD PHD BOARD MEMBER 1.00 X 0 0 0 DAVID WHITNEY MD BOARD MEMBER 1.00 X 0 0 0 JOHN STAEHELI MD BOARD MEMBER 1.00 X 0 0 0 LEWIS G ZIRKLE MD PRESIDENT/FOUNDER 60.00 X X 0 0 0 RANDALL HUEBNER BOARD MEMBER 20.00 X 0 0 0 STEPHEN SCHWARTZ BOARD MEMBER 1.00 X 0 0 0 RICHARD GELLMAN MD BOARD MEMBER 1.00 X 0 0 0 THOMAS VASILEFF MD BOARD MEMBER 1.00 X 0 0 0 PATRICK YOON MD BOARD MEMBER 1.00 X 0 0 0 DAVID SHEARER MD VICE PRESIDENT 2.00 X X 0 0 0 ANN PENNER BOARD MEMBER 1.00 X 0 0 0 MICHAEL COSCIA MD BOARD MEMBER 10.00 X 0 0 0 JEANNE DILLNER SECRETARY/ TREASURER 75.00 X 162988 0 13355 JOEL GILLARD SENIOR R&D ENGINEER 40.00 X 124387 0 14946 ROBERT SCHMITT REGULATORY AFFAIRS MANAGER 40.00 X 116479 0 12838 TERRY SMITH ENGINEERING MANAGER 40.00 X 135901 0 5801 BRIAN BARNES IT MANAGER 40.00 X 107839 0 11976 647594 0 58916 5 0 1 0 CASCADE FIRE PROTECTION 5104 W BRINKLEY KENNEWICK WA 99338 INSTALL FIRE SUPRESSION SYSTEM 192632 DGR GRANT CONSTRUCTION PO BOX 309 RICHLAND WA 99352 DEMOLITION OF PLC LAB 166585 2 675750 7307206 1082484 7982956 IMPLANT REVENUE 339110 1078821 1078821 OTHER REVENUE 541900 5533 5533 1084354 98255 98255 58300 18983 39317 39317 39317 1219903 25000 870265 4884 349638 20116 369754 369754 9574636 1084354 0 507326 104823 104823 164559 123419 41140 2501663 1919865 277594 304204 22331 22331 66877 22290 18520 26067 9336 8541 374 421 3798 2906 43 849 129012 116705 5509 6798 15648 12406 1525 1717 COST OF PRODUCT DISTRIB 2033123 2033123 SUPPLIES 787243 732799 8101 46343 SHIPPING 168137 168137 DUES, FEES AND TAXES 69008 35278 18727 15003 187892 166642 10085 11165 6263450 5446934 362809 453707 404026 869678 2112094 3978029 395393 172500 146801 237742 1047601 761094 95950 103829 7250493 2761630 3717097 4488863 4496124 5380030 14918 12536 12430004 16004301 408406 347896 408406 347896 X 11156606 14402246 864992 1254159 12021598 15656405 12430004 16004301 3311186 323621 0 X X 0 1 X 1 0 X 2952158 3629218 8420434 5247095 7982956 28231861 1514890 831528 943761 878615 1084354 5253148 4467048 4460746 9364195 6125710 9067310 33485009 811252 792373 1557089 669090 1558238 5388042 1051967 370893 517401 552226 560894 3053381 1863219 1163266 2074490 1221316 2119132 8441423 25043586 165317 163467 143468 151940 156555 780747 165317 163467 143468 151940 156555 780747 4632365 4624213 9507663 6277650 9223865 34265756 0.73090 0.70310 0.02280 0.02860 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 880000 880000 1631388 122006 1509382 1969373 650197 1319176 2416650 1751193 665457 353082 238234 114848 4488863 X 11012094 323621 1114970 18983 1457574 9554520 20116 20116 9574636 7377287 1114970 -1133 1113837 6263450 0 6263450 PART X, LINE 2: MANAGEMENT HAS EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 18,983. PART XI, LINE 4B - OTHER ADJUSTMENTS: GAIN ON SALE OF EQUIPMENT 20,116. PART XII, LINE 2D - OTHER ADJUSTMENTS: GAIN ON SALE OF EQUIPMENT -20,116. RENTAL EXPENSES 18,983. 0 CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICES ORTHOPAEDIC IMPLANTS 74408 EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES ORTHOPAEDIC IMPLANTS 471382 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 PROGRAM SERVICES ORTHOPAEDIC IMPLANTS 70769 MIDDLE EAST AND NORTH AFRICA 0 0 PROGRAM SERVICES ORTHOPAEDIC IMPLANTS 10322 SOUTH AMERICA 0 0 PROGRAM SERVICES ORTHOPAEDIC IMPLANTS 722 SOUTH ASIA 0 0 PROGRAM SERVICES ORTHOPAEDIC IMPLANTS 243960 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES ORTHOPAEDIC IMPLANTS 1155415 SUB-SAHARAN AFRICA 0 0 GRANTS TRAINING, IMPLANTS, STIPEND 50474 RUSSIA & THE NEWLY INDEPENDENT STATES 0 0 PROGRAM SERVICES ORTHOPAEDIC IMPLANTS 8674 0 0 0 0 0 0 2077452 8674 2086126 FELLOWSHIP STIPEND SUB-SAHARAN AFRICA 5 50474 CASH PAYMENT 0 0 0 0 0 0 PART I, LINE 2: GRANT REQUESTS ARE REVIEWED BY THE GRANT REVIEW COMMITTEE AS ESTABLISHED BY THE SIGN COMPLIANCE PROGRAM. MONITORING AWARDS IS A TWO PRONG APPROACH: A) FINANCIAL REPORTS OR RECEIPTS ARE SUBMITTED; AND, B) STATUS UPDATES ARE PROVIDED BY RECIPIENTS. PART III ACCOUNTING METHOD: X X 0 0 0 0 0 0 0 0 0 JEANNE DILLNER SECRETARY/ TREASURER 162988 0 0 0 0 0 6570 0 6785 0 176343 0 0 0 X 1 19833 FAIR VALUE X FAIR VALUE X 20066 FAIR VALUE X 1 150000 FAIR VALUE X 9 398666 FAIR VALUE X 1 123 FAIR VALUE X 22 446355 FAIR VALUE X OTHER 3 36022 FAIR VALUE X OFFICE SUPPLIES 1 10495 FAIR VALUE X TRAVEL EXPENSES FOR TRAINING 1 923 FAIR VALUE 0 0 0 FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: SIGN'S MISSION IS TO BUILD ORTHOPAEDIC CAPACITY IN DEVELOPING COUNTRIES BY PROVIDING ONGOING TRAINING AND EDUCATION TO THE LOCAL ORTHOPAEDIC SURGEONS, WHICH IS AUGMENTED BY PROVIDING A SUSTAINABLE SUPPLY OF ORTHOPAEDIC IMPLANTS DESIGNED FOR USE IN PRIMITIVE LOCAL HOSPITAL CONDITIONS. THE MAJORITY OF THE IMPLANTS AND INSTRUMENTS PROVIDED TO PROGRAMS HAVE BEEN DESIGNED AND MANUFACTURED BY SIGN PERSONNEL. IN-KIND DONATIONS OF PRODUCTS NOT MANUFACTURED BY SIGN ARE DISTRIBUTED TO SOME OF THE BUSIER PROGRAMS. ACCORDING TO THE WORLD HEALTH ORGANIZATION, THE EPIDEMIC OF INJURIES CAUSED BY ROAD TRAFFIC ACCIDENTS, WORK INJURIES, AND CONFLICTS AFFECTS 20 TO 50 MILLION PEOPLE EVERY YEAR. NINETY PERCENT OF THE PEOPLE INJURED LIVE IN DEVELOPING COUNTRIES WHERE ACCESS TO ADEQUATE CARE IS LIMITED. SIGN'S MISSION TO BUILD THE ORTHOPAEDIC CAPACITY WITHIN THESE COUNTRIES WILL SUPPORT THE LOCAL SURGEONS IN PROVIDING APPROPRIATE AND TIMELY CARE TO THE INJURED POOR. THERE ARE APPROXIMATELY 5,000 SURGEONS IN NEARLY 300 HOSPITALS IN 50 DEVELOPING NATIONS WHICH HAVE BENEFITED FROM SIGN TRAINING AND THE PROVISION OF IMPLANTS AND INSTRUMENTS. SIGN ALSO RESPONDS TO DISASTERS IN LOCATIONS WHERE SIGN HAS EXISTING PROGRAMS OR WHERE SIGN PROGRAMS NEED TO BE DEVELOPED. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT OF FORM 990 IS PROVIDED TO SIGN'S CEO. THE FORM 990 IS PRESENTED FOR REVIEW TO THE BOARD OF DIRECTORS. ANY CHANGES ARE THEN DIRECTED TO THE RETURN PREPARER AND ADDRESSED BEFORE THE FINAL RETURN IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS MONITORED AND REVIEWED BY THE CHIEF COMPLIANCE OFFICER. THE CHIEF COMPLIANCE OFFICER REQUESTS ANNUAL CONFLICT OF INTEREST STATEMENTS FROM EACH BOARD MEMBER. THE STATEMENTS ARE REVIEWED WITH THE CEO/SECRETARY AND DISPOSITIONED. THE PRESIDENT IS BRIEFED ON FINDINGS ALONG WITH THE FULL BOARD. FORM 990, PART VI, SECTION B, LINE 15 AN ANNUAL PERFORMANCE REVIEW IS CONDUCTED FOR ALL EMPLOYEES INCLUDING THE CEO. THE ENTITY'S SIZE, INDUSTRY, TYPE OF ORGANIZATION, AND POSITION OF RESPONSIBILITIES ARE CONSIDERED IN DETERMINING COMPENSATION ADJUSTMENTS. ACCORDING TO THE ORGANIZATION'S BY-LAWS, THE PRESIDENT IS AUTHORIZED TO CONDUCT THE CEO'S ANNUAL REVIEW AND DETERMINE COMPENSATION. THE ORGANIZATION UTILIZES A SUBSCRIPTION TO PAYSCALE WHICH PROVIDES ACCURATE SALARY INFORMATION TO ESTABLISH PAY RANGES FOR EMPLOYEES. PAYSCALE ALSO ALLOWS THE ORGANIZATION TO INPUT PERFORMANCE RANKING DATA IN ORDER TO OBTAIN "RECOMMENDED RAISES" VIA THOSE RANKS JUXTAPOSED WITH WHERE EACH INDIVIDUAL'S CURRENT SALARY LANDS IN THE SALARY RANGE FOR THEIR POSITION. FORM 990, PART VI, SECTION C, LINE 19 THE PUBLIC MAY CONTACT THE ORGANIZATION AT IT'S PHYSICAL LOCATION TO REQUEST COPIES OF ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS. FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS NOT CHANGED THEIR OVERSIGHT PROCESS OR SELECTION PROCESS OF SELECTING AN INDEPENDENT AUDITOR DURING THE TAX YEAR.