2012-11-26T14:38:20-06:00 2012-06-30 560747981 DIXON HUGHES GOODMAN LLP 3700 FESTIVAL PARK PLAZA CHESTER VA 238314415 990 2011-07-01 541663905 WMBG AREA MEDICAL ASSISTANCE CORP A/K/A OLDE TOWNE MEDICAL CENTER WILL 7572593252 5249 OLDE TOWNE ROAD WILLIAMSBURG VA 23188 STEVEN SMITH 7572593252 2012-11-16 1 LESLIE ROBERTS P00040492 8044252600 2011 2016-02-24 21:20:13Z STEVEN SMITH 5249 OLDE TOWNE ROAD WILLIAMSBURG VA 23188 1944351 0 X WWW.OLDETOWNEMEDICALCENTER.ORG X 1993 VA OLDE TOWNE MEDICAL CENTER WILL PROVIDE QUALITY, COST-EFFECTIVE, COORDINATED AND PREVENTIVE PRIMARY HEALTH CARE TO CLIENTS, REGARDLESS OF ABILITY TO PAY. 29 29 38 0 0 0 1640489 1369300 499300 570485 12979 4566 0 -1114 2152768 1943237 0 0 0 0 1673887 1711934 0 0 14808 593639 619019 2267526 2330953 -114758 -387716 4374709 3953463 2325346 2291816 2049363 1661647 OLDE TOWNE MEDICAL CENTER WILL PROVIDE QUALITY, COST-EFFECTIVE, COORDINATED AND PREVENTIVE PRIMARY HEALTH CARE TO CLIENTS, REGARDLESS OF ABILITY TO PAY. 0 0 1957093 570485 THE ORGANIZATION PROVIDES HEALTH CARE SERVICES TO THE ECONOMICALLY DISADVANTAGED RESIDENTS OF JAMES CITY AND YORK COUNTIES AND THE CITY OF WILLIAMSBURG, VA. 1957093 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 8 0 1 38 0 0 0 0 0 0 0 0 0 0 0 X 29 29 0 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 DAVID R BURRIS 1.00 X 0 0 0 BETH CARLSON 1.00 X 0 0 0 NANCY V MARSH 1.00 X 0 0 0 THOMAS A TYLMAN DO 1.00 X 0 0 0 PETER WALENTISCH 1.00 X 0 0 0 JENNIFER Y RYU 1.00 X 0 0 0 SHEILA NOLL 1.00 X 0 0 0 KENNETH O DREES 1.00 X 0 0 0 LAWRENCE VOLZ MD 1.00 X 0 0 0 MARGARET DRISCOLL 1.00 X 0 0 0 STEPHEN D FOXX MD 1.00 X 0 0 0 TOM G LUCKAM DDS 1.00 X 0 0 0 JENNIFER BICKHAM MENDEZ 1.00 X 0 0 0 RENE CABRAL DANIELS 1.00 X 0 0 0 JAMES DRAKE MD 1.00 X 0 0 0 JAMES IVEY 1.00 X 0 0 0 JUDITH N KNUDSON 1.00 X 0 0 0 JOHN MCDONALD 1.00 X 0 0 0 ALLISON MORRISON 1.00 X 0 0 0 LYNDA NESTOR 1.00 X 0 0 0 JOHN R SMITH 1.00 X 0 0 0 JUDI FOREHAND WOODS 1.00 X 0 0 0 JOHN MCGLENNON 1.00 X 0 0 0 RAYMOND E BEDARD 1.00 X 0 0 0 ALFRED L WOODS 1.00 X 0 0 0 BARBARA REYNOLDS 1.00 X 0 0 0 DENISE BOWLES 40.00 X 40721 0 19254 MARTHA KLINGER 40.00 X 83816 0 21625 ALAN P NORMAN 40.00 X 112046 0 29283 DAVID PRIBBLE 40.00 X 78297 0 21043 314880 0 91205 1 0 0 0 0 6122 60422 491147 811609 1369300 PATIENT BILLING 621300 218366 218366 MEDICAID - BILLINGS 621300 166176 166176 MEDICARE - BILLINGS 621300 119566 119566 MEDICAID DENTAL - BILL 621300 66377 66377 570485 4566 4566 0 60422 1114 -1114 -1114 1943237 570485 0 3452 365174 65545 294114 5515 965582 965582 108409 108409 177917 177917 94852 75661 18838 353 10413 10413 68148 68148 168 168 22905 21185 1075 645 93936 73149 20787 5109 5109 4279 4279 13217 13217 SUPPLIES 276493 254373 13825 8295 LABORATORY SERVICES 74846 74846 FURNITURE AND EQUIPMENT 20286 20286 PROFESSIONAL DEVELOPMEN 9511 9511 19708 19708 2330953 1957093 359052 14808 197735 94631 4096530 3774009 80444 84823 4374709 3953463 75346 41816 2250000 2250000 2325346 2291816 X 0 0 0 0 2049363 1661647 2049363 1661647 4374709 3953463 -387716 0 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3969087 0 4804 200000 3773891 3764425 200000 4662 3969087 3544481 200000 19944 3764425 3487533 56948 3544481 1 0 0 1943237 2330953 -387716 -387716 1947344 4107 4107 1943237 0 1943237 2365597 34644 34644 2330953 0 2330953 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: 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. $200,000 OF ACCUMULATED INCOME WAS TRANSFERRED FROM THE ENDOWMENT DURING THE CURRENT FISCAL YEAR TOWARD OPERATING EXPENSES. PART XII, LINE 2D - OTHER ADJUSTMENTS: ACCRUAL BASED REVENUES INCLUDED IN PRIOR YEAR 2,993. FUND RAISING EXPENSES NETTED AGAINST REVENUES 1,114. PART XIII, LINE 2D - OTHER ADJUSTMENTS: ACCRUED EXPENSES TAKEN IN A PRIOR YEAR 33,530. FUND RAISING EXPENSES NETTED AGAINST REVENUES 1,114. THE FINANCIAL STATEMENT OF THE ORGANIZATION REPORTED AUDITED CASH RECEIPTS AND DISBURSEMENTS. THE TAX RETURN IS REPORTED ON AN ACCRUAL BASIS. GOLF EVENT 60247 60247 1114 OTHER 175 175 60422 60422 1114 1114 -1114 FORM 990, PART VI, SECTION B, LINE 11 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. 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.