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CHARITY REVIEW
Issued: January 2026 Expires: January 2028

SIGN Fracture Care International

Accredited Charity
Accredited Charity

Meets Standards
(509) 371-1107
451 Hills Street, Suite B
Richland, WA, 99354
https://www.signfracturecare.org
📄 Full Report 🖨️ Print 📋 BBB Charity Standards

Standards For Charity Accountability

Governance

  1. Board Oversight
  2. Board Size
  3. Board Meetings
  4. Board Compensation
  5. Conflict of Interest

Measuring Effectiveness

  1. Effectiveness Policy
  2. Effectiveness Report

Finances

  1. Program Expenses
  2. Fundraising Expenses
  3. Accumulating Funds
  4. Audit Report
  5. Detailed Expense Breakdown
  6. Accurate Expense Reporting
  7. Budget Plan

Fundraising & Info

  1. Truthful Materials
  2. Annual Report
  3. Website Disclosures
  4. Donor Privacy
  5. Cause Marketing Disclosures
  6. Complaints

SIGN Fracture Care International meets the 20 Standards for Charity Accountability.

Stated Purpose:
"to create equality of fracture care throughout the world; to build sustainable orthopaedic donating orthopaedic capacity by donating education, instruments, and implants."

Year, State Incorporated:
1999, WA

SIGN Fracture Care International (SIGN) reports that it works with teaching hospitals and hosts educational conferences worldwide, equipping surgeons to successfully assist patients with orthopedic care within their communities. Surgeon training is augmented by online mentorship via the SIGN Surgical Database (SSDB). The organization states it has developed an implant system for treating patients in low-resource hospitals that can be used without x-ray imaging or electricity. In 2024, SIGN reports that it assisted 26,739 patients in ten countries, performed 5,116 surgeries, and established 22 new programs,

For the year ended December 31, 2024, SIGN Fracture Care International's program expenses were:

Program services $7,891,046
Total Program Expenses $7,891,046

Chief Executive
Sariah Khormaee, MD, PhD, Chief Executive Officer

Chair of the Board
Lewis G. Zirkle, MD

Chair's Profession / Business Affiliation
Orthopaedic Surgeon

Board Size
12

Paid Staff Size
41

*2025 compensation, as reported by the organization, includes annual salary and, if applicable, benefit plans, expense accounts, and other allowances.

Note: Sarah Khormaee assumed the position of Chief Executive officer in August 2025. Her compensation is not available at this time. In 2024, Jeanne Dillner served as SIGN's Chief Executive Officer, receiving $198,980 in compensation. 

Method(s) Used:
Direct mail appeals, Invitations to fund raising events, Grant proposals, Internet, Planned giving arrangements, Cause-related marketing (affinity credit cards, consumer product sales, etc.), Workplace Giving

Fundraising costs were 7% of related contributions. (Related contributions, which totaled $8,468,818, are donations received as a result of fundraising activities.)

This organization is tax-exempt under section 501(c)(3) of the Internal Revenue Code. It is eligible to receive contributions deductible as charitable donations for federal income tax purposes.

The following information is based on SIGN Fracture Care International's audited financial statements for the year ended December 31, 2024.

Source of Funds
Contributions $5,690,080
In-kind contributions $2,778,738
Realized/unrealized loss on investments $504,260
Implant revenue $388,072
Dividend income $85,356
Rental income $66,600
Interest income $63,485
Other income $44,164
Conference registration $8,013
Total Income $9,628,768

Programs: 89% Fundraising: 7% Administrative: 4%

Total Income $9,628,768
Total expenses: $8,915,544
  Program expenses $7,891,046
  Fundraising expenses $635,153
  Administrative expenses $371,667
  Other expenses $17,678
Income in Excess of Expenses $713,224
Beginning Net Assets $14,513,245
Other Changes In Net Assets $-11,608
Ending Net Assets $15,190,294
Total Liabilities $407,801
Total Assets $15,598,095

Note 1: As noted in the above financial section, "other expenses" refers to property management.

Note 2: As noted in the above financial section, "other changes in net assets" refers to a loss on the sale of equipment.

Note 3: As noted in SIGN's 2024 audited financial statements, the organization received $2,778,738 in contributed goods and services including professional services ($2,274,581), medical supplies and equipment ($360,384), stock donations ($80,670), fundraising supplies ($18,727), educational travel costs ($18,361), engineering and production supplies ($13,443), quality assurance equipment ($7,172), and facility rent ($5,400).

An organization may change its practices at any time without notice. A copy of this report has been shared with the organization prior to publication. It is not intended to recommend or deprecate, and is furnished solely to assist you in exercising your own judgment. If the report is about a charity and states the charity meets or does not meet the Standards for Charity Accountability, it reflects the results of an evaluation of information and materials provided voluntarily by the charity. The name Better Business Bureau is a registered service mark of the International Association of Better Business Bureaus.

This report is not to be used for fundraising or promotional purposes.

RELATED CONTENT

Report completed by:
BBB Wise Giving Alliance