2018-03-19T08:03:41-05:00 2017-06-30 560747981 DIXON HUGHES GOODMAN LLP 9401 COURTHOUSE ROAD SUITE 301 CHESTERFIELD VA 23832 990 2016-07-01 541663905 WMBG AREA MEDICAL ASSISTANCE CORP DBA OLDE TOWNE MEDICAL AND DENTAL CENTER WILL 7572593252 5249 OLDE TOWNE ROAD WILLIAMSBURG VA 23188 WILLIAM J MANN JR MD EXECUTIVE / MEDICAL DIRECTOR 7572593252 2018-03-13 1 LESLIE F ROBERTS P00040492 8044252600 2018-03-13 209.60.87.225 2018-03-13 15:13:15 ED P 02C8C3F183F5FDB5309CFB0B1C4488420EC65632 002FEC3BE28171601C60C618263094234A977EA7 2016 2021-01-29 14:40:06Z WILLIAM J MANN JR MD 5249 OLDE TOWNE ROAD WILLIAMSBURG VA 23188 2022264 0 X WWW.OLDETOWNEMEDICALCENTER.ORG X 1993 VA OLDE TOWNE MEDICAL AND DENTAL CENTER'S MISSION IS TO ENSURE ACCESS TO QUALITY HEALTH AND WELLNESS CARE TO THE RESIDENTS AND WORKFORCE OF THE GREATER WILLIAMSBURG COMMUNITY. 25 25 0 100 0 0 1874525 1594457 566780 266707 191066 154575 -776 628 2631595 2016367 0 0 0 0 1941047 1998218 0 0 69738 516100 488169 2457147 2486387 174448 -470020 4607698 4636592 24787 287112 4582911 4349480 OLDE TOWNE MEDICAL AND DENTAL CENTER'S MISSION IS TO ENSURE ACCESS TO QUALITY HEALTH AND WELLNESS CARE TO THE RESIDENTS AND WORKFORCE OF THE GREATER WILLIAMSBURG COMMUNITY. 0 0 1692939 266707 Olde Towne provides primary medical and dental care to uninsured and underinsured adults and children, and has done so since 1994. In addition, prenatal care is available for pregnant women, and we also provide newborn care for infants. We offer specialty care, in gynecology, psychiatry, pulmonology, sports medicine, cardiology, nephrology and HIV/AIDS management.Our goal is to provide high quality, culturally sensitive cost effective care in a welcoming environment, which is easily accessible to the underserved members of our community. We have over 15,000 patient visits annually, and have expanded our facility to offer more services to our patients. 1692939 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 6 0 1 0 0 0 0 0 0 0 0 0 0 0 X 25 25 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X COUNTY OF JAMES CITY VIRGINIA 7572536630 101-F Mounts Bay Road Williamsburg VA 23185 Thomas Brownlie PRESIDENT 1.00 X X 0 0 0 Anne Bradstreet smith Vice Chair 1.00 X X 0 0 0 Richard W Krapf Treasurer 1.00 X X 0 0 0 John Anderson MD MEmber 1.00 X 0 0 0 Mark D Beck Member 1.00 X 0 0 0 William Bennett DDS MEMBER 1.00 X 0 0 0 James Ivey MEMBER 1.00 X 0 0 0 Robert Dickler MEmber 1.00 X 0 0 0 Steve Vignolo Member 1.00 X 0 0 0 Janna Roche MEmber 1.00 X 0 0 0 James White Member 1.00 X 0 0 0 Christopher James Member 1.00 X 0 0 0 Gregory McLeod Ph D MEMBER 1.00 X 0 0 0 CAMILLA BUCHANAN MD MPH MEMber 1.00 X 0 0 0 DAVID R BURRIS MEMber 1.00 X 0 0 0 BRIAN FULLER MEMBER 1.00 X 0 0 0 JUDITH N KNUDSON MEMber 1.00 X 0 0 0 SHARON MARCHELYA MEMber 1.00 X 0 0 0 JOHN MCGLENNON MEMber 1.00 X 0 0 0 SUE MELLON MEMBER 1.00 X 0 0 0 BEN PUCKETT MEMBER 1.00 X 0 0 0 RAMON RODRIGUEZ III MD MEMber 1.00 X 0 0 0 PETER WALENTISCH MEMber 1.00 X 0 0 0 WALTER ZAREMBA MEMBER 1.00 X 0 0 0 BENMING ZHANG MEMber 1.00 X 0 0 0 Denise Bowles Business Manager 40.00 X 0 48454 18996 WILLIAM J MANN JR MD EXECUTIVE MEDICAL DIRECTOR 40.00 X 0 127530 28028 MARTHA KLINGER CLINICAL DIRECTOR - JULY-DEC 2016 40.00 X 0 98376 24698 KENDRA ROBINSON CLINICAL DIRECTOR - March-June 2017 40.00 X 0 0 0 PAULA WOZNIAK PHYSICIAN 40.00 X 0 145027 23825 0 419387 95547 0 0 1 0 0 5721 74084 524827 989825 1594457 Patient Billing 621300 176588 176588 Medicaid - Billings 621300 57795 57795 Commercial Insurance 621300 18204 18204 Medicaid Dental - Bill 621300 13207 13207 MISCELLANEOUS REVENUE 621300 13069 13069 -12156 -12156 266707 154575 154575 6525 74084 5897 628 628 2016367 266707 0 155203 556784 333291 221120 2373 1047346 769081 239783 38482 88188 58204 28220 1764 196542 128095 61553 6894 109358 75829 30582 2947 27500 27500 108780 85637 17400 5743 40873 2203 37462 1208 90645 65715 19706 5224 8254 4049 4130 75 6615 6615 18733 18733 Supplies 121237 100411 18468 2358 Laboratory Services 46076 46076 Furniture and equipment 7087 3274 3144 669 DUES AND SUBSCRIPTIONS 6263 6013 250 6106 2341 2014 1751 2486387 1692939 723710 69738 27960 143575 4278476 4287137 247228 124308 15435 15652 85948 20028 38599 65920 4607698 4636592 24787 25112 0 262000 24787 287112 X 2332911 2099480 2250000 2250000 4582911 4349480 4607698 4636592 -470020 236589 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4278476 391164 382503 4287137 4207422 143268 72214 4278476 4106651 100771 4207422 3807195 323856 24400 4106651 3773891 37423 4119 3807195 0.47520 0.52480 1 0 85948 20028 65920 65920 X 2340476 236589 81623 5897 324109 2016367 0 2016367 2573907 81623 5897 87520 2486387 0 2486387 Part V, Line 4: WILLIAMSBURG AREA MEDICAL ASSISTANCE CORP INTENDS TO ONLY USE FUNDS FROM THE ENDOWMENT FUND AS NEEDED TO SUPPORT THE CENTER'S MISSION AND TO PROVIDE A STEADY SOURCE OF INCOME TO PARTIALLY DEFRAY OPERATIONAL EXPENSES OF THE CENTER. THE INTENT IS TO KEEP THE ORIGINAL CORPUS INTACT, BUT THE PRINCIPAL MAY BE INVADED BY AUTHORITY OF THE BOARD OF DIRECTORS UNDER CERTAIN CIRCUMSTANCES, SUCH AS AN EXTRAORDINARY NATURAL CALAMITY. TO DATE NO PORTION OF THE CORPUS HAS BEEN USED. Part X, Line 2: The Center is exempt from federal and state income taxes as a nonprofit under Section 501(c)(3) of the Internal Revenue Code and the tax statutes of the Commonwealth of Virginia. Accordingly, the accompanying financial statements do not reflect a provision or liability for federal or state income taxes. Part XI, Line 2d - Other Adjustments: Fund raising expenses netted against revenues 5,897. Part XII, Line 2d - Other Adjustments: Fund raising expenses netted against revenues 5,897. Golf Event 71554 71554 2757 Wine Tasting 9055 2530 6525 2475 665 80609 74084 6525 2475 3422 5897 628 0 0 0 0 0 0 0 0 0 WILLIAM J MANN JR MD EXECUTIVE MEDICAL DIRECTOR 0 127530 0 0 0 0 0 15182 0 12846 0 155558 0 0 PAULA WOZNIAK PHYSICIAN 0 145027 0 0 0 0 0 17189 0 6636 0 168852 0 0 Form 990, Part VI, Section A, line 2 Board Member WILLIAM BENNETT is part owner OF BFH Supplies, WHICH SELLS DENTAL SUPPLIES TO THE ORGANIZATION. Form 990, Part VI, Section B, line 11b THE TAX RETURN IS PREPARED BY AN INDEPENDENT ACCOUNTANT AND PRESENTED TO AND REVIEWED WITH THE EXECUTIVE DIRECTOR, BUSINESS MANAGER, AND FINANCE COMMITTEE. ANY REVISIONS TO THE FORM 990 WILL BE GIVEN TO THE ACCOUNTANT FOR CHANGES AND THEN RETURNED TO THE FINANCE COMMITTEE FOR FINAL APPROVAL. Form 990, Part VI, Section B, line 12c NEW BOARD MEMBERS OF THE ORGANIZATION SIGN A CONFLICT OF INTEREST STATEMENT BEFORE BEING APPOINTED TO THE BOARD. THE CONFLICT OF INTEREST STATEMENT IS REVIEWED ANNUALLY AT THE MAY BOARD MEETING TO REMIND BOARD MEMBERS OF THE POLICY. Form 990, Part VI, Section B, line 15 THE EXECUTIVE DIRECTOR'S SALARY AND ANNUAL ADJUSTMENT ARE DETERMINED BY THE BOARD OF DIRECTORS. OTHER KEY EMPLOYEE POSITION SALARIES ARE DETERMINED BY THE ORGANIZATION'S SALARY RANGE SHEET WHICH SHOWS THE MINIMUM, AVERAGE, AND MAXIMUM ANNUAL SALARIES AND HOURLY WAGE BY POSITION. ALL OTHER EMPLOYEES' ANNUAL INCREASES ARE DETERMINED BY THE EXECUTIVE DIRECTOR BASED ON WILLIAMSBURG AREA MEDICAL ASSISTANCE CORP'S BUDGET. JAMES CITY COUNTY VA CONTROLS ALL HIRING PRACTICES, PROCESSING OF PAYROLL, AND PAYROLL TAX REPORTING. JAMES CITY COUNTY IS A MAJOR CONTRIBUTOR TO THE ORGRANIZATION'S BUDGET. IF FUNDS ARE AVAILABLE, EMPLOYEES TYPICALLY GET THE SAME ANNUAL INCREASE PERCENT AS COUNTY EMPLOYEES. Form 990, Part VI, Section C, line 19 THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC ON THEIR WEBSITE AT WWW.OLDETOWNEMEDICALCENTER.ORG. THE MINUTES AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. Form 990, Part XII, Line 2c: THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE CURRENT TAX YEAR. JAMES CITY COUNTY VIRGINIA 101-F MOUNTS BAY ROAD WILLIAMSBURG VA 23185 546001365 LOCAL GOVERNMENT VA 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 James City County Virginia C 340673 Cash Basis james City County Virginia K 90645 Cash Basis james City County Virginia O 1998219 cash Basis james City County Virginia P 18733 cash Basis