2018-07-19T17:43:31-05:00 2017-12-31 562382653 Northwest CPA Group PLLC 1333 Columbia Park Trail Ste 210 Richland WA 99352 990 2017-01-01 911952283 SIGN Fracture Care International SIGN 5093711107 451 Hills Street Suite B Richland WA 99354 Jeanne Dillner Chief Executive Officer 5093711107 2018-07-18 1 Alison C Gebers P00423745 5097351300 2017 2022-09-23 18:48:47Z SIGN 451 Hills Street Suite B Richland WA 99354 6063367 0 X www.signfracturecare.org X 1999 WA Build orthopaedic capacity in developing countries by providing orthopaedic training and implants. 10 10 46 68 0 0 4476362 2895228 1098905 1514890 60493 336536 -114629 -33691 5521131 4712963 0 0 0 0 1698203 2131589 0 0 318840 3090457 3529629 4788660 5661218 732471 -948255 12275026 11692188 220266 238375 12054760 11453813 X See Schedule O 0 0 661913 25640 Provide access to orthopaedic training and education to surgeons in developing countries We accomplish this via four primary channels. First, there are onsite visits by local surgeons and North American and European surgeons. Email communications with SIGN Headquarters are an important channel. A third channel is the review of cases submitted onto the SIGN Surgical Database by orthopaedic surgeons on the SIGN Board. The final channel is 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.Establish Regional Trauma Courses as another means of distributing appropriate orthopaedic technology The SIGN Orthopaedic Conference held at SIGN Headquarters has been a tremendous experience for the SIGN Surgeons. However, the conference is limited to 150 participants. SIGN has a long-term goal to establish regional trauma courses. In 2017, the Annual SIGN Conference held at headquarters in Richland, Washington added several cadaver labs for pelvic fractures, elbow fractures, and ankle fusions. This elevated the surgical training experience for all SIGN Surgeons in attendance. We continue to partner with IGOT who provided cadaver training in flaps and pelvic fractures. They also provided regional training in SIGN and other surgical techniques to SIGN Surgeons in East Africa and Nepal. 4343049 1489250 Distribute appropriate orthopaedic technology The design of the SIGN IM Nail and Interlocking System is for use in hospitals in developing countries where C-arms and regular power are not available. SIGN Engineers continually develop new orthopaedic instruments and implants in response to the needs described by the local surgeons. In 2017, SIGN engineers made progress on several new products including drill covers, a new plating system that can reach more areas of the bone, and a linear clamp for use with femur and pelvic fractures.We supply new Programs with the standard SIGN IM Nail System, which surgeons use to repair severe fractures in the femur, tibia, and humerus. Once the 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 2017, we distributed 31,700 SIGN Nails to 50 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 twenty-seven new Programs in 2017. The breakdown was Africa with 14 new Programs, Asia with 9, North America (Haiti, Dominican Republic, and Honduras) with four. As of December 31, 2017, the World Bank income classifications by GNI for SIGN Programs were as follows: Low Income 43%, Lower Middle Income 38%, Upper Middle Income 19%, and Upper Income 0%.Distribution of SIGN Implants can take the form of disaster or conflict response SIGN Volunteers from North America and Europe respond to disasters in countries where SIGN Programs currently exist or where SIGN Programs would be beneficial. In 2017, we supplied instruments and implants to surgeons in Bangladesh who were providing surgical care to the Bengali (Rohingya) refugees located in Cox's Bazaar. We also started a new SIGN Program at Sittwe General Hospital in Myanmar where the Bengali continue to reside. 5004962 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 8 0 1 46 1 0 0 0 0 0 1 1 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 5.00 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 15.00 X 0 0 0 Stephen Schwartz Board Member 2.00 X 0 0 0 Teresa Ford Board Member 2.00 X 0 0 0 Richard Gellman MD Board Member 2.00 X 0 0 0 Thomas Vasileff MD Board Member 1.00 X 0 0 0 Patrick Yoon MD Board Member 2.00 X 0 0 0 Jeanne Dillner Secretary /Treasurer 75.00 X 142412 0 8118 Joel Gillard Senior R&D Engineer 40.00 X 102431 0 23620 Robert Schmitt Regulatory Affairs / Quality Control Manager 40.00 X 105502 0 11223 Terry Smith Engineering Manager 37.00 X 116314 0 2821 466659 0 45782 4 0 1 0 0 302217 2593011 799538 2895228 Implant Revenue 339110 1489250 1489250 Training Conference 611430 12856 12856 Other Revenue 541900 12784 12784 1514890 165317 165317 1431002 1257425 2358 173577 -2358 171219 171219 56930 302217 90621 -33691 -33691 4712963 1514890 0 302845 143000 111650 31350 1988589 1537721 258073 192795 25091 25091 79227 38228 15808 25191 61268 55630 2922 2716 39752 34983 2196 2573 144102 144102 84130 75478 906 7746 11914 10724 617 573 Cost of Product Distrib 2053729 2053729 Supplies 791060 742567 7954 40539 Shipping 89913 89913 Miscellaneous 50932 29386 19427 2119 98511 55760 29513 13238 5661218 5004962 337416 318840 106192 64967 2140776 2162573 2900981 1412950 144089 505911 1356905 946598 47120 32426 3257646 2148179 1244468 1109467 4319901 5440301 14594 16995 12275026 11692188 220266 238375 220266 238375 X 8684350 9534262 3370410 1919551 12054760 11453813 12275026 11692188 -948255 347308 0 X X 0 1 X 1 0 X 4040588 3620639 10945635 2449418 2952158 24008438 1433865 1407710 1362502 1098905 1514890 6817872 5474453 5028349 12308137 3548323 4467048 30826310 777208 1095335 1185897 707896 811252 4577588 907152 656126 537418 692199 1051967 3844862 1684360 1751461 1723315 1400095 1863219 8422450 22403860 151337 140236 179527 200177 165317 836594 151337 140236 179527 200177 165317 836594 5625790 5168585 12487664 3748500 4632365 31662904 0.70760 0.70290 0.02640 0.02730 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1021524 403791 617733 1923697 1511852 411845 312425 232536 79889 1109467 5855276 347308 730275 90621 1168204 4687072 25891 25891 4712963 6456223 730275 92979 823254 5632969 28249 28249 5661218 Part XI, Line 2d - Other Adjustments: Direct fundraising expenses 90,621. Part XI, Line 4b - Other Adjustments: Loss on equipment disposal -2,358. Donated auction items 28,249. Part XII, Line 2d - Other Adjustments: Direct fundraising expenses 90,621. Loss on equipment disposal 2,358. Part XII, Line 4b - Other Adjustments: Donated auction items 28,249. Central America and the Caribbean 0 0 Program Services Orthopaedic Implants 93294 East Asia and the Pacific 0 0 Program Services Orthopaedic Implants 1027908 Europe (Including Iceland & Greenland) 0 0 Program Services Orthopaedic Implants 25127 Middle East and North Africa 0 0 Program Services Orthopaedic Implants 31030 Russia & the Newly Independent States 0 0 Program Services Orthopaedic Implants 2686 South America 0 0 Program Services Orthopaedic Implants 1008 South Asia 0 0 Program Services Orthopaedic Implants 337819 Sub-Saharan Africa 0 0 Program Services Orthopaedic Implants 836816 0 0 0 0 0 0 2355688 0 2355688 0 0 0 0 0 0 Tri-Cities Benefit 187121 147676 39445 23978 6524 15467 250 12629 Portland Benefit 172026 154541 17485 4271 10160 13214 4128 359147 302217 56930 28249 16684 28681 250 16757 90621 -33691 X X 0 0 0 0 0 0 0 0 0 Jeanne Dillner Secretary /Treasurer 142412 0 0 0 0 0 5720 0 2398 0 150530 0 0 0 X 1 4550 Fair value X Fair value X 11469 Fair value X 10 55519 Fair value X 14 5135 Fair value X 16 673025 Fair value X Travel Expenses for Training 8 20001 Fair value X Office Supplies 3 15386 Fair value X Other 5 13937 Fair value 0 0 0 Form 990, Part III, Line 1 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.