Operation Smile

Legal name: Operation Smile Inc

Overview

Mission

To provide safe surgery to children with cleft conditions and other surgical needs, transforming lives and strengthening health systems.

What it reported doing in 2024

Operation smile raises awareness of cleft lip and cleft palate and its effects on patients' quality of life and health. Through various communication channels including digital and traditional media, it seeks to educate the public and donors about the surgeries and comprehensive care it provides. Also, critical information is provided to patients, their families and communities to promote access to local health resources and essential cleft treatments including speech therapy, psychological, nutrition and dental care. Prevention-related messaging is highly actionable and focused on prenatal maternal smoking cessation, food preparation and diet, exposure to harmful environmental agents and other factors. Its student programs also create awareness among younger generations of leadership to activate their service as volunteers and advocates. Operation smile establishes partnerships with leading medical and teaching institutions to strengthen the skillsets of clinicians in low- and middle-income countries. Its health care training programs include in-person and virtual conferences, seminar workshops, surgical training rotation programs, visiting professorships, and shortand long-term fellowships. Operation smile funds research programs in collaboration with academic and hospital partners to identify genetic and environmental risk factors related to cleft conditions to one day provide preventative treatments and interventions. It also conducts epidemiological and public health analyses to understand patient populations and the surgical burden of disease related to cleft lip and cleft palate. These research programs allow it to provide better care for the people it serves and contribute to the academic and practical advancement of the global health and global surgery communities.

Operating model

Revenue model
Donor-supported. 81% of the money available for current operations came from contributions and gifts.
Distribution model
Hybrid. The nonprofit split its reported program spending across 70% for direct work, and 30% for grants.
  • Includes noncash contributions: Reported contributions include donated property or goods.

Nonprofit profile at a glance

EIN
541460147
IRS 990 coverage
2009–2024
Official website data refreshed
Aug 2026
Forms available
Form 990 2024
Location
Virginia Beach, VA, USA
Phone
1-888-677-6453
Rating
71
Verdict
SUPPORTED
Rating confidence
Standard
Sector
International Development

Official website

Reported finances

Revenue
$100,175,924
Expenses
$108,108,279
Assets
$115,407,781
Liabilities
$5,437,589

Source: IRS Form 990. Selected filing: tax year 2024. Amounts in USD.

The verdict

SUPPORTED - A large share of available resources goes toward mission work and the filed numbers largely add up. Fundraising costs are high for each dollar raised and the filing reports few safeguards for money sent abroad.

Rating breakdown

  • Financial Efficiency: 61
  • Transparency & Controls: 78
  • Accountability: 85
  • Sustainability: 31
  • Growth: 100

Detailed rating inputs

Financial Efficiency

  • Mission deployment rate: 69.5%; rating input score 70
  • Program expense ratio: 63.5%; rating input score 63
  • Fundraising efficiency: $3.53 raised per $1 spent on fundraising; rating input score 13; 13th percentile among comparable filings

Transparency & Controls

  • Consistency checks: 100%; rating input score 100; 68th percentile among comparable filings
  • Pay-setting controls: 3 of 6 controls in place; rating input score 50
    • Compensation committee: Missing
    • Independent consultant: Missing
    • Other Form 990s reviewed: Pass
    • Written employment contract: Missing
    • Compensation survey or study: Pass
    • Board or committee approval: Pass
  • Foreign activity oversight: 2 of 8 controls in place; rating input score 25
    • Claims monitoring procedures: Pass
    • Requires narrative reports: Fail
    • Conducts field audits: Fail
    • May suspend future funding: Fail
    • Requires financial reports: Fail
    • Conducts site visits: Pass
    • Requires grant agreements: Fail
    • May require repayment: Fail
  • Grant itemization coverage: 100%; rating input score 100; 77th percentile among comparable filings
  • Major donor itemization: Yes; rating input score 100
  • Related-party transparency: Yes; rating input score 100

Accountability

  • Independent voting board: 75%; rating input score 75; 23rd percentile among comparable filings
  • Governance controls: 9 of 9 controls in place; rating input score 100
    • Conflict-of-interest policy: Pass
    • Whistleblower policy: Pass
    • Document-retention policy: Pass
    • CEO compensation review process: Pass
    • Other executive compensation review process: Pass
    • Form 990 shared with the board: Pass
    • Board meeting minutes documented: Pass
    • Audit committee oversight: Pass
    • Independent financial-statement audit: Pass

Sustainability

  • Operating margin: -7.9%; rating input score 9; 9th percentile among comparable filings
  • Total-asset coverage ratio: 1.07; rating input score 41; 41st percentile among comparable filings
  • Liabilities to assets ratio: 0.05; rating input score 89; 89th percentile among comparable filings
  • Officer compensation ratio: 3%; rating input score 38; 38th percentile among comparable filings

Growth

  • Program expense growth: 6% per year; rating input score 100; 49th percentile among comparable filings
  • Revenue growth: 5.5% per year; rating input score 100; 48th percentile among comparable filings
  • Asset growth: 9.8% per year; rating input score 100; 69th percentile among comparable filings

Details

  • What they do: 3 programs and campaigns described on the official site · 3 operating locations identified
  • Where the money goes: 69.5% of revenue deployed · 63.5% of spending went to programs
  • Governance: 6 of 8 board members independent · 9 of 9 filing controls reported
  • Programs: 2 filed program accomplishments · $68.6M in reported program spending
  • Leadership: top reported pay $372K · 19 people listed · 3 of 6 pay-setting controls reported
  • Highest-paid contractors: 5 contractors listed · $33.6M reported
  • Consistency: 42 of 43 current checks pass · 1 finding to review
  • Schedules: 12 filed schedules · includes major donors, foreign activity, grants, executive pay, and related organizations
  • Filing history: 16 annual filings from 2009 to 2024
  • Contacts: How to reach this organization
  • Money network: 12 filed money-flow records
  • Grant readiness: Federal tax and exclusion status, award history, and grant-maker relationships.
  • People: Everyone the filings name, and which of them the filings identify by more than a name.
  • Staff and benefit plans: Retirement and health plans the organization files with the Department of Labor, and the people in them.

Key Signals

Signals prioritize questions for review. They are not findings of misconduct.

  • High — Financial Efficiency: Fundraising efficiency scored 13/100.
  • High — Transparency & Controls: Foreign activity oversight: 6 of 8 not reported.
  • High — Sustainability: Operating margin scored 9/100.
  • Moderate — Sustainability: Total-asset coverage ratio scored 41/100.
  • Moderate — Sustainability: Officer compensation ratio scored 38/100.
  • Moderate — Transparency & Controls: Schedule A contributions reconciliation did not reconcile in the filed values.

Leadership & pay

19 people listed

Highest reported compensation

  • KRISTIE PORCARO (CHIEF STRATEGY OFFICER): $371,801 total reported compensation
  • JAMES SITI (CHIEF FINANCIAL OFFICER): $368,081 total reported compensation
  • RUBEN AYALA (CHIEF POLICY & ADVOCACY OFFICER): $294,179 total reported compensation

Source: IRS Form 990. Selected filing: tax year 2024.