Pros
There are just a few people there that realize how miserable a place it is to work, and it helps to have a few people to confide in. Location may be the biggest pro, and I'm guessing that's what draws quite a few people to work there, who may not otherwise want to work in such an odd environment. Made a few good hires, but those people have vanished.
Cons
Clear case of right-hand not knowing what the left-hand is doing. The departments are so silo'd that nobody knows whose driving the decision making. Directors are always in closed door meetings, and rarely report out any major decisions. Company is doing great things, but they have poor PR. You'd think they would be in the spotlight of a lot of news stories that are related to how we are trying to get the opioid epidemic under control. At least get your brand out with the local media when they are running these types of stories. Very top down approach. The people on the ground floors often have no idea where the work is coming from, or what's coming next. Departments are splintered, and have poor collaboration. For a company that is so small you would think people would be in the loop. Leadership is not authentic. Company meetings are read from a queue card, as not to say anything wrong, and the entire interaction is just awkward. When there are consistently very few, or zero, questions to the group you might want to think about the culture a little more.