EXECUTIVE DIRECTOR

2011-11-01T07:18:44-05:00 2011-06-30 DIXON HUGHES GOODMAN LLP 3700 FESTIVAL PARK PLAZA CHESTER VA 238314415 990 2010-07-01 541663905 WMBG AREA MEDICAL ASSISTANCE CORP A/K/A OLDE TOWNE MEDICAL CENTER WILL 7572593252 5249 OLDE TOWNE ROAD WILLIAMSBURG VA 23188 DAVID C PRIBBLE EXECUTIVE DIRECTOR 7572593252 2011-10-21 1 LESLIE ROBERTS 8044252600 2010 2016-03-07 17:11:31Z DAVID C PRIBBLE 5249 OLDE TOWNE ROAD WILLIAMSBURG VA 23188 2152768 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 41 0 0 0 1759748 1640489 418258 499300 21578 12979 0 0 2199584 2152768 0 0 0 0 1620099 1673887 0 0 11764 575171 593639 2195270 2267526 4314 -114758 4451586 4374709 2287465 2325346 2164121 2049363 OLDE TOWNE MEDICAL CENTER WILL PROVIDE QUALITY, COST-EFFECTIVE, COORDINATED AND PREVENTIVE PRIMARY HEALTH CARE TO CLIENTS, REGARDLESS OF ABILITY TO PAY. 0 0 1988084 499301 THE ORGANIZATION PROVIDES HEALTH CARE SERVICES TO THE ECONOMICALLY DISADVANTAGED RESIDENTS OF JAMES CITY AND YORK COUNTIES AND THE CITY OF WILLIAMSBURG, VA. 1988084 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 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 0 0 41 1 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 MEMBER 1.00 X 0 0 0 JOHN FAVRET MEMBER 1.00 X 0 0 0 MARK C HANNA MEMBER 1.00 X 0 0 0 LEIGH KADES MEMBER 1.00 X 0 0 0 PAT KEARNS MEMBER 1.00 X 0 0 0 ROBERT LEEK MEMBER 1.00 X 0 0 0 NANCY V MARSH MEMBER 1.00 X 0 0 0 DAVID H TRUMP MD MEMBER 1.00 X 0 0 0 THOMAS A TYLMAN DO MEMBER 1.00 X 0 0 0 ALFRED L WOODS MEMBER 1.00 X 0 0 0 JOHN J MCGLENNON MEMBER 1.00 X 0 0 0 DOUG POWELL ASSISTANT TREASURER 1.00 X X 0 0 0 THOMAS MAINOR MEMBER 1.00 X 0 0 0 PETER WALENTISCH MEMBER 1.00 X 0 0 0 JENNIFER Y RYU MEMBER 1.00 X 0 0 0 SHEILA NOLL MEMBER 1.00 X 0 0 0 KENNETH O DREES MEMBER 1.00 X 0 0 0 MOSES DRAYTON MEMBER 1.00 X 0 0 0 BARBARA REYNOLDS MEMBER 1.00 X 0 0 0 LAWRENCE VOLZ MD MEMBER 1.00 X 0 0 0 FAITH AMOROSO RN MEMBER 1.00 X 0 0 0 MARGARET DRISCOLL MEMBER 1.00 X 0 0 0 STEPHEN D FOXX MD MEMBER 1.00 X 0 0 0 TOM G LUCKAM DDS MEMBER 1.00 X 0 0 0 JENNIFER BICKHAM MENDEZ MEMBER 1.00 X 0 0 0 RONALD E LODZIESKI PRESIDENT 1.00 X 0 0 0 ROBERT L HANCOCK VICE PRESIDENT 1.00 X 0 0 0 RAYMOND E BEDARD TREASURER 1.00 X 0 0 0 DAVID PRIBBLE EXECUTIVE DIRECTOR 40.00 X 78407 0 26161 ALAN P NORMAN MEDICAL DIRECTOR 40.00 X X 112266 0 36356 DENISE BOWLES BUSINESS MANAGER 40.00 X 40521 0 22038 ELAINE BRENNAN ADMIN SECRETARY 40.00 X 29505 0 12209 260699 0 96764 1 0 0 0 0 71017 492830 1076642 1640489 PATIENT BILLING 621300 232225 232225 MEDICAID - BILLINGS 621300 117920 117920 MEDICARE - BILLINGS 621300 80403 80403 MEDICAID DENTAL - BILL 621300 68752 68752 499300 12979 12979 0 71017 0 0 2152768 499300 0 12979 260699 78262 180085 2352 1010561 1010561 138043 119955 17855 233 171066 155247 15616 203 93518 80097 13248 173 9118 9118 119357 119357 254624 233308 12513 8803 76973 57730 19243 4168 4168 2951 2951 11584 11584 LABORATORY SERVICES 63390 63390 CAPITAL EQUIPMENT 23538 23538 GARAGE 12292 12292 PROFESSIONAL DEVELOPMEN 7695 7695 DUES AND SUBSCRIPTIONS 5754 5754 2195 2195 2267526 1988084 267678 11764 347460 197735 3959164 4096530 144962 80444 4451586 4374709 37465 75346 2250000 2250000 2287465 2325346 X 0 0 0 0 2164121 2049363 2164121 2049363 4451586 4374709 -114758 0 X 0 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3764425 200000 4662 3969087 3544481 200000 19944 3764425 3487533 56948 3544481 1 0 0 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. AND, WHILE EACH YEAR $20,000 IS BUDGETED TO COME FROM THE ENDOWMENT FUND'S CURRENT INCOME TO BE USED FOR OPERATIONS, TO DATE NO CURRENT INCOME HAS BEEN WITHDRAWN TO SUPPORT OPERATIONS. STAY HOME MAILING 63836 63836 OTHER 7181 7181 71017 71017 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.