2020-07-11T11:57:37-05:00 2019-12-31 562382653 NORTHWEST CPA GROUP PLLC 1333 COLUMBIA PARK TRAIL STE 210 RICHLAND WA 99352 990 2019-01-01 911952283 SIGN FRACTURE CARE INTERNATIONAL SIGN 5093711107 451 HILLS STREET SUITE B RICHLAND WA 99354 JEANNE DILLNER CHIEF EXECUTIVE OFFICER 5093711107 2020-07-09 1 ALISON C GEBERS P00423745 5097351300 71.93.21.222 2020-07-09 11:58:01 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 09F94F2A71F18F99E8312EBEF808C9C8B41C6C78 2019 2021-01-29 14:40:06Z SIGN 451 HILLS STREET SUITE B RICHLAND WA 99354 10442400 0 X WWW.SIGNFRACTURECARE.ORG X 1999 WA BUILD ORTHOPAEDIC CAPACITY IN DEVELOPING COUNTRIES BY PROVIDING ORTHOPAEDIC TRAINING AND IMPLANTS. 10 10 49 84 0 0 3573413 8367998 831528 943761 591242 275085 -24986 -6784 4971197 9580060 143435 71934 0 0 2338900 2614789 0 0 556524 3851630 5087142 6333965 7773865 -1362768 1806195 9652006 11949446 283605 324872 9368401 11624574 X SEE SCHEDULE O 0 0 722395 71934 39993 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 FRACTURES.EXPAND TRAINING AND EDUCATIONAL OPPORTUNITIES:THE 2019 SIGN CONFERENCE HELD AT HEADQUARTERS IN RICHLAND, WASHINGTON INCLUDED SIX BIOSKILLS LABS FOR PELVIC FRACTURES, HIP FRACTURES, ELBOW FRACTURES, ANKLE FUSIONS, AND SOFT TISSUE WOUND COVERAGE. THIS ELEVATED THE SURGICAL TRAINING EXPERIENCE FOR ALL SIGN SURGEONS IN ATTENDANCE. WE CONTINUE TO PARTNER WITH IGOT WHICH PROVIDES ADDITIONAL CADAVER TRAINING IN FLAPS AND PELVIC FRACTURES AFTER THE SIGN CONFERENCE. IGOT ALSO PROVIDES REGIONAL TRAINING IN OTHER SURGICAL TECHNIQUES TO SIGN SURGEONS IN EAST AFRICA AND NEPAL.THE ANNUAL SIGN CONFERENCE IS A TREMENDOUS EXPERIENCE FOR THE SIGN SURGEONS. HOWEVER, THE CONFERENCE IS LIMITED TO 150 PARTICIPANTS. WE HAVE A LONG-TERM GOAL TO ESTABLISH REGIONAL TRAUMA COURSES. IN 2019, A REGIONAL SIGN CONFERENCE WAS HELD IN ADDIS ABABA, ETHIOPIA. IN ADDITION, WE ARE PARTNERING WITH BLACK LION HOSPITAL, IN ADDIS ABABA, ETHIOPIA ON THE FIRST EAST AFRICAN PELVIC FELLOWSHIP PROGRAM.BOARD MEMBER, RICHARD GELLMAN, MD, IS NOW TRAVELING TO PROVIDE REGIONAL WORKSHOPS ON DEFORMITY CORRECTION. IN 2019, HE HELD TRAINING SESSIONS IN KENYA, NIGERIA, AND THE PHILIPPINES. EACH TRIP INCLUDES DONATION OF APPROPRIATE IMPLANTS.IN AN EFFORT TO EXPAND OUR EDUCATIONAL OPPORTUNITIES TO THOSE WHO LACK THE ABILITY TO TRAVEL AWAY FROM THEIR HOSPITAL, WE HAVE LAUNCHED A NEW WEBSITE, CALLED THE HUB. THE HUB ALLOWS SIGN SURGEONS TO COLLABORATE WITH COLLEAGUES AROUND THE WORLD VIA FORUM POSTS AND PROVIDES EASY ACCESS TO OUR MOST UP TO DATE EDUCATIONAL RESOURCES. 6073795 903768 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 2019, WE DEVELOPED A NEW INSTRUMENT CALLED THE BONE SCOOP WHICH IS DESIGNED TO COLLECT ADDITIONAL BONE GRAFT MATERIAL FROM A REAMED BONE CANAL WHICH CAN BE USED TO PROMOTE HEALING. THE SCOOP IS SCHEDULED TO GO INTO PRODUCTION FOR DISTRIBUTION IN 2020. THE COMPRESSOR SYSTEM, WHICH IS USED TO REDUCE AND COMPRESS FRACTURES OF THE TIBIA PLATEAU, RECEIVED A PATENT.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 2019, WE DISTRIBUTED 29,177 SIGN NAILS TO 53 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 22 NEW SIGN PROGRAMS IN 2019. THE BREAKDOWN WAS AS FOLLOWS: AFRICA: 15 PROGRAMS ASIA: 4 PROGRAMS NORTH AMERICA: 2 PROGRAMS SOUTH AMERICA: 1 PROGRAMAS OF DECEMBER 31, 2019, THE WORLD BANK INCOME CLASSIFICATIONS BY GNI FOR THE COUNTRIES WITH NEW SIGN PROGRAMS WERE AS FOLLOWS: LOW INCOME 50%, LOWER MIDDLE INCOME 32%, AND UPPER MIDDLE INCOME 0.5%. (17.5% 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. IN 2019, SIGN RESPONDED TO AN URGENT REQUEST TO START A PROGRAM IN MUTARE, ZIMBABWE FOLLOWING THE DESTRUCTION OF CYCLONE IDAI. THE SURGEON THERE WAS ALREADY TRAINED IN THE SIGN TECHNIQUE AND WE WERE ABLE TO START THE PROGRAM WITHIN TWO WEEKS.WE ALSO STARTED A SIGN PROGRAM AT ST. JOSEPH HOSPITAL, KITGUM, NEAR THE BORDER OF SOUTH SUDAN AND PALABEK REFUGEE CAMP (NOW HOME TO 36,000 REFUGEES). THIS HOSPITAL SERVES BOTH THE UGANDAN AND REFUGEE POPULATIONS IN THE REGION.DUE TO THE POLITICAL SITUATION IN VENEZUELA, PATIENTS WERE FACING MANY BARRIERS TO RECEIVING MEDICAL CARE. WE WERE PUT IN TOUCH WITH A SURGEON AT HOSPITAL UNIVERSITARIO DE CARACAS IN VENEZUELA VIA ONE OF OUR BOARD MEMBERS. THE SURGEON WAS ABLE TO RECEIVE SIGN EQUIPMENT AND, ONCE ANESTHESIA BECAME AVAILABLE, HE WAS ABLE TO BEGIN PERFORMING SIGN SURGERIES. 6796190 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 0 1 0 1 0 0 0 0 1 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 1 8 0 1 49 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 10 10 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 SANDY BROWN 5093711107 451 HILLS STREET SUITE B RICHLAND WA 99354 CARLA SMITH MD PHD BOARD MEMBER 3.00 X 0 0 0 DAVID WHITNEY MD BOARD MEMBER 3.00 X 0 0 0 JOHN STAEHELI MD BOARD MEMBER 3.00 X 0 0 0 LEWIS G ZIRKLE MD PRESIDENT/FOUNDER 72.00 X X 0 0 0 RANDALL HUEBNER BOARD MEMBER 10.00 X 0 0 0 STEPHEN SCHWARTZ BOARD MEMBER 2.00 X 0 0 0 RICHARD GELLMAN MD BOARD MEMBER 3.00 X 0 0 0 THOMAS VASILEFF MD BOARD MEMBER 2.00 X 0 0 0 PATRICK YOON MD BOARD MEMBER 2.00 X 0 0 0 DAVID SHEARER MD BOARD MEMBER 2.00 X 0 0 0 JEANNE DILLNER SECRETARY /TREASURER 75.00 X 151349 0 13226 JOEL GILLARD SENIOR R&D ENGINEER 40.00 X 119224 0 13552 ROBERT SCHMITT REGULATORY AFFAIRS MANAGER 40.00 X 111372 0 11627 TERRY SMITH ENGINEERING MANAGER 40.00 X 129774 0 5479 SANDRA BROWN BUSINESS ADMIN MANAGER 40.00 X 108248 0 18905 PAUL GEE SENIOR PROCESS ENGINEER 40.00 X 111490 0 4460 731457 0 67249 7 0 1 0 0 406856 7961142 2267190 8367998 IMPLANT REVENUE 339110 903768 903768 OTHER REVENUE 541900 25167 25167 TRAINING CONFERENCE 611430 14826 14826 943761 101338 101338 42130 7762 34368 34368 34368 934737 760290 700 174447 -700 173747 173747 52436 406856 93588 -41152 -41152 9580060 943761 0 268301 71934 71934 152984 117974 35010 2461805 1752579 326589 382637 14588 14588 63086 16818 16216 30052 17733 11980 1137 4616 76902 65530 1210 10162 183255 183255 78575 65105 5253 8217 15818 11389 1829 2600 SUPPLIES 2256866 2189822 13029 54015 COST OF PRODUCT DISTRIB 2048305 2048305 SHIPPING 117092 117092 MISCELLANEOUS 72340 40675 23704 7961 142582 89144 32184 21254 7773865 6796190 421151 556524 150413 316805 3118877 1883641 855490 1705279 80496 69051 1116328 872479 65225 95225 6072341 2533103 944320 3539238 3305392 3450428 15465 17300 9652006 11949446 283605 324872 283605 324872 X 8111450 9619533 1256951 2005041 9368401 11624574 9652006 11949446 1806195 449978 0 X X 0 1 X 1 0 X 10945635 2449418 2952158 3629218 8420434 28396863 1362502 1098905 1514890 831528 943761 5751586 12308137 3548323 4467048 4460746 9364195 34148449 1185897 707896 811252 792373 1557089 5054507 537418 692199 1051967 370893 517401 3169878 1723315 1400095 1863219 1163266 2074490 8224385 25924064 179527 200177 165317 163467 143468 851956 179527 200177 165317 163467 143468 851956 12487664 3748500 4632365 4624213 9507663 35000405 0.74070 0.71460 0.02430 0.02770 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 880000 880000 1631388 38484 1592904 1263248 508126 755122 2007751 1711846 295905 289954 274647 15307 3539238 10941985 449978 841861 101350 1393189 9548796 31264 31264 9580060 8685812 841861 102050 943911 7741901 31964 31964 7773865 PART XI, LINE 2D - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSES 93,588. RENTAL EXPENSES 7,762. PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON EQUIPMENT DISPOSAL -700. DONATED AUCTION ITEMS 31,964. PART XII, LINE 2D - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSES 93,588. LOSS ON EQUIPMENT DISPOSAL 700. RENTAL EXPENSES 7,762. PART XII, LINE 4B - OTHER ADJUSTMENTS: DONATED AUCTION ITEMS 31,964. 1 CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICES ORTHOPAEDIC IMPLANTS 78645 EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES ORTHOPAEDIC IMPLANTS 550806 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 PROGRAM SERVICES ORTHOPAEDIC IMPLANTS 32716 MIDDLE EAST AND NORTH AFRICA 0 0 PROGRAM SERVICES ORTHOPAEDIC IMPLANTS 12880 SOUTH AMERICA 0 0 PROGRAM SERVICES ORTHOPAEDIC IMPLANTS 7546 SOUTH ASIA 0 0 PROGRAM SERVICES ORTHOPAEDIC IMPLANTS 217574 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES ORTHOPAEDIC IMPLANTS 809419 SUB-SAHARAN AFRICA 0 0 GRANTS TRAINING, IMPLANTS, STIPEND 67284 SOUTH ASIA 0 0 GRANTS TRAINING 500 EAST ASIA AND THE PACIFIC 0 0 GRANTS STIPEND 4150 0 0 0 0 0 0 1776870 4650 1781520 STIPEND AND TRAVEL EXPENSES SUB-SAHARAN AFRICA 1 18772 CASH PAYMENT FELLOWSHIP STIPEND SUB-SAHARAN AFRICA 1 27000 CASH PAYMENT STIPEND SUB-SAHARAN AFRICA 2 13000 CASH PAYMENT STIPEND SOUTH ASIA 1 500 CASH PAYMENT STIPEND EAST ASIA & THE PACIFIC 2 4150 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: TRI-CITIES BENEFIT 340465 303981 36484 25494 7105 10991 200 12913 PORTLAND BENEFIT 118827 102875 15952 6470 7549 9483 5084 7669 1 630 459292 406856 52436 31964 14654 20474 5284 21212 93588 -41152 X X 0 0 0 0 0 0 0 0 0 JEANNE DILLNER SECRETARY /TREASURER 151349 0 0 0 0 0 6119 0 7107 0 164575 0 0 0 RICHARD GELLMAN BOARD MEMBER 2150 CASH PAYMENT TRAINING X 1 2305 FAIR VALUE X 15733 FAIR VALUE X 10 63846 FAIR VALUE X 7 3492 FAIR VALUE X 13 1761602 FAIR VALUE X OTHER 7 361991 FAIR VALUE X TRAVEL EXPENSES FOR TRAINING 16 46703 FAIR VALUE X OFFICE SUPPLIES 2 9644 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.