2015-06-29T12:15:09-05:00 2014-12-31 562382653 Northwest CPA Group PLLC 1333 Columbia Park Trail Ste 210 Richland WA 99352 990 2014-01-01 911952283 SIGN Fracture Care International SIGN 5093711107 451 Hills Street Suite B Richland WA 99354 Jeanne Dillner Chief Executive Officer 5093711107 2015-06-22 1 Alison C Gebers P00423745 5097351300 2014 2016-02-25 16:41:14Z SIGN 451 Hills Street Suite B Richland WA 99354 9414879 0 X www.signfracturecare.org X 1999 WA Build orthopedic capacity in developing countries by providing orthopedic training and implants. 10 10 42 127 0 0 3973566 7510766 1433865 1407710 137547 164609 -123600 -104199 5421378 8978886 0 0 0 0 1177838 1307017 0 0 266192 3852074 3501870 5029912 4808887 391466 4169999 6555273 10692929 296681 234764 6258592 10458165 X See Schedule O 0 0 559066 23317 Provide access to orthopaedic training and education to surgeons in developing countries - This is accomplished through onsite visits by North American and European surgeons, local surgeons, email communications with SIGN headquarters, the review of cases submitted to the SIGN Surgical Database by orthopaedic surgeons on the SIGN Board, and 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 pediatric, hand, and pelvic.To further our educational materials, an animated video was developed to help the surgeon visualize the anatomy of the bone and how the implants and instruments inter-relate. This video helps the surgeon to understand the reasoning behind the prescribed technique of inserting the nail and the sequence of use of the instruments.Establishing Regional Trauma Courses is another means of distributing appropriate orthopaedic technology - The SIGN Orthopaedic Conference held at 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 2014, we partnered with other organizations to conduct a second regional trauma course in Port au Prince, Haiti and one in Dar es Salaam, Tanzania. The Haiti course was organized in conjunction with Project Hope, Partners in Health, and SIGN. Faculty came from surgeons that volunteer with SIGN and with Partners in Health. Faculty also included the local Haitian surgeons. The event was well received and nearly every Haitian orthopaedic surgeon attended. Plans were made to continue the conference in 2015.A similar format was implemented at Muhimbili Orthopaedic Institute (MOI) in Dar es Salaam. SIGN partnered with MOI and the Institute for Global Orthopaedics and Traumatology (IGOT) to develop the curriculum and attract faculty. The course was promoted to hospitals throughout Tanzania and East Africa. It was attended by 90 surgeons from several East African countries. This conference was also well received and plans were made to hold it again in 2015.The surgeons who attend our conferences are highly appreciative. Below is a sampling of the comments we received in 2014.Henry Ndasi, Cameroon"Thank you for the scholarship to attend the SMART course at UCSF and the 2014 annual SIGN conference. These have helped improve my skills in patient care. I also had the opportunity to present some of the surgical techniques I use in the treatment of Coxa Vara deformity.I learnt how to do flaps especially of the lower extremity where we often have open fractures with an exposed tibia without the ability to close these bones.Also management of infection was also a very important topic and I will better be able now to manage infected fracture nonunion. I learnt new techniques of managing fractures /fracture mal-unions with the use of the Taylor spatial frame, something I have never seen being used and also the technique of using the SIGN nail in ankle fusion.I also learnt new ways of treating neglected club foot. The research course at UCSF helped me think through my research plans and topics better. It was also a good forum to build relationships and share contacts. There is much that will improve in my patient care as I have gained many new skills."Fachy-Drice David, Haiti"I would like to thank you and SIGN donators for the scholarship you gave me. It was the inevitable thing I [needed] to go to the conference this year.There, I learned things I never imagine they could exist, I also learned many things that will ameliorate my every day working at the hospital center I'm doing my residencyOne more time I thank you and hope you will still continue helping new surgeons like me going to the conference."Khin Zaw Heine, Myanmar"I really want to thank SIGN. I had a good opportunity for attending SIGN conference. I gained a lot of new knowledge especially trauma care, open fracture management, flap surgery and deformity correction. I hope [to make] improvement in trauma care and share knowledge to our college in our hospital." 3728634 1384393 Distribute appropriate orthopaedic technology - The SIGN IM Nail and Interlocking System is designed 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. New programs are supplied only with the SIGN IM Nail System, which is used to repair severe fractures in the femur, tibia, and humerus. Once the program has demonstrated their ability to report their cases, including adequate follow-up which 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.17 new programs were started in 2014, with Angola, Liberia, and Solomon Islands being new to the SIGN family of countries. More than 11,480 patients were treated with SIGN implants in 2014.Distribution can take the form of disaster 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. Often, where SIGN programs currently exist, it is the local surgeons who provide the disaster response using the SIGN equipment already in the country. In these cases, our response is to send SIGN equipment replenishments along with other materials they request. Otherwise, it is North American surgeons who are carrying in SIGN equipment as well as other supplies. They provide the extra hands needed in surgery as well as train the local surgeons and volunteers to use the SIGN implants. 4287700 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 1 8 0 1 42 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 X Deborah Maier 5093711107 451 Hills Street Suite B Richland WA 99354 Bette Cooper Board Member 2.00 X 0 0 0 Carla Smith MD PhD Board Member 5.00 X 0 0 0 David Whitney MD Board Member 2.00 X 0 0 0 Frederic Wilson MD Board Member 4.00 X 0 0 0 John Staeheli MD Board Member 2.00 X 0 0 0 Lewis G Zirkle MD President/Founder and Chairman of the Board 72.00 X X 0 0 0 Randall Huebner Board Member 10.00 X 0 0 0 Stephen Schwartz Board Member 1.00 X 0 0 0 Teresa Ford Board Member 1.00 X 0 0 0 Joel Gillard Board Member 5.00 X 0 0 0 Cindy Johnson Board Member 1.00 X 0 0 0 Jeanne Dillner Secretary /Treasurer and CEO 75.00 X 148110 0 0 148110 0 0 1 0 0 0 0 383558 7127208 1623067 7510766 Implant Revenue 339110 1384393 1384393 Training Conference 611430 12500 12500 Other Revenue 541900 10817 10817 1407710 56894 56894 83342 142614 -59272 -59272 -59272 306784 197353 1716 109431 -1716 107715 107715 49383 383558 94310 -44927 -44927 8978886 1407710 0 60410 148110 127278 20832 1158907 854328 200896 103683 11086 11086 100307 60742 12560 27005 42441 35642 2774 4025 47680 40580 41 7059 94467 94467 58276 52212 498 5566 8933 7793 465 675 Supplies 1467304 1382073 5190 80041 Cost of Product Distrib 1391169 1391169 Loss on Obsolete Invent 131025 131025 Shipping 57834 57834 91348 41471 32571 17306 4808887 4287700 254995 266192 111121 58574 1763983 1932904 8970 3020160 210186 275737 1301862 1347918 43014 68241 3201985 1700423 1581127 1501562 1517212 2471103 17798 16730 6555273 10692929 295411 229908 1270 4856 296681 234764 X 6207939 7305657 50653 3152508 6258592 10458165 6555273 10692929 4169999 29574 0 X 0 1 X 1 0 X 6180564 2930527 3002918 4040588 3620639 19775236 1127977 1052375 1380648 1433865 1407710 6402575 7308541 3982902 4383566 5474453 5028349 26177811 2795744 1716135 779946 777208 1103625 7172658 1187036 907152 656126 2750314 2795744 1716135 1966982 1684360 1759751 9922972 16254839 193420 202907 193025 151337 140236 880925 193420 202907 193025 151337 140236 880925 7501961 4185809 4576591 5625790 5168585 27058736 0.60070 0.60020 0.03260 0.03670 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1109810 337859 771951 1837330 1185726 651604 254845 176838 78007 1501562 Deposits 4856 4856 9359385 29574 137241 236924 403739 8955646 23240 23240 8978886 5159812 137241 1716 211968 350925 4808887 0 4808887 Part XI, Line 2d - Other Adjustments: Direct fundraising expenses 94,310. Rental expenses 142,614. Part XI, Line 4b - Other Adjustments: Loss on equipment disposal -1,716. Donated auction items 24,956. Part XII, Line 2d - Other Adjustments: Rental expenses 142,614. Direct fundraising expenses 69,354. Central America and the Caribbean 0 0 Program Services Orthopaedic Implants 199481 East Asia and the Pacific 0 0 Program Services Orthopaedic Implants 1329225 Europe (Including Iceland & Greenland 0 0 Program Services Orthopaedic Implants 169026 Middle East and North Africa 0 0 Program Services Orthopaedic Implants 6281 Russia & the Newly Independent States 0 0 Program Services Orthopaedic Implants 10745 South America 0 0 Program Services Orthopaedic Implants 2949 South Asia 0 0 Program Services Orthopaedic Implants 468720 Sub-Saharan Africa 0 0 Program Services Orthopaedic Implants 1300364 0 0 0 0 0 0 3486791 0 3486791 0 0 0 0 0 0 Tri-Cities Benefit 298560 259052 39508 21641 2736 17867 600 19687 Portland Benefit 134381 124506 9875 3315 1610 6560 1100 19194 432941 383558 49383 24956 4346 24427 1700 38881 94310 -44927 X 1 2655 Fair value X 7700 Fair value X 7751 Fair value X 8 260773 Fair value X 18 4065 Fair value X 20 1277004 Fair value X Office Supplies 4 29959 Fair value X Other 33 17196 Fair value X Services 4 10664 Fair value X Travel Packages 5 5300 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. At least 4000 surgeons in nearly 300 hospitals in 55 developing nations 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 11 A draft of Form 990 is provided to SIGN's CEO. The Form 990 is presented for review to the board of directors at a board meeting. 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. During 2014, the Organization began utilizing a subscription to PayScale which provides more accurate salary information to establish pay ranges. 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. Interlocking Associates LLC 451 Hills Street Suite B Richland WA 99352 753089184 Commercial Rental WA -58943 240914 SIGN Fracture Care International