2024-11-13T17:15:06-06:00 2023-12-31 135565207 KPMG LLP 515 BROADWAY 4TH FL ALBANY NY 12207 990 2023-01-01 823943636 GLENS FALLS MEDICAL PLLC GLEN 5189265013 100 PARK STREET GLENS FALLS NY 12801 DR SEAN BAIN SOLE MEMBER 5189265013 2024-11-13 1 0 GENEVA FURLANO P01877392 5184274600 2024-11-12 2023 2024-10-15 13:58:12Z DR SEAN BAIN 100 PARK STREET GLENS FALLS NY 12801 0 0 X NA X PLLC 2015 NY SERVED AS PHYSICIAN SERVICES COMPONENT OF AN INTEGRATED HEALTH CARE SYSTEM OF GLENS FALLS HOSPITAL. PROVIDED MEDICAL SERVICES WITHOUT REGARD TO RACE, COLOR, CREED, NATIONALITY, GENDER, AGE, DISABILITY, ORIENTATION, OR ABILITY TO PAY. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1000 1000 0 0 1000 1000 X SERVED AS A PHYSICIAN SERVICES COMPONENT OF AN INTEGRATED HEALTH CARE SYSTEM OF GLENS FALLS HOSPITAL. PROVIDED MEDICAL SERVICES WITHOUT REGARD TO RACE, COLOR, CREED, NATIONALITY, GENDER, AGE, DISABILITY, ORIENTATION, OR ABILITY TO PAY. TO ENCOURAGE AND PROMOTE ACCESSIBLE HEALTH CARE THAT WILL MEET THE MEDICAL NEEDS OF THE COMMUNITY AND THE PATIENTS OF GLENS FALLS HOSPITAL. PROVIDED EFFICIENT, HIGH QUALITY MEDICAL CARE, CONSISTENT WITH GLENS FALLS HOSPITAL AND THE SUPPORTING AFFILIATE'S CHARITABLE PURPOSES. 0 1 SERVED AS A PHYSICIAN SERVICES COMPONENT OF THE GLENS FALLS HOSPITAL HEALTH CARE SYSTEM. PRESENTLY A DORMANT ENTITY. 1 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 1 0 0 1 0 0 0 0 1 0 0 0 0 1 1 1 1 1 1 0 0 0 NY X CRAIG LETOURNEAU - CONTROLLER GLENS FALLS HOSPITAL 5189265013 100 PARK STREET GLENS FALLS NY 12801 SEAN BAIN MD SOLE MEMBER 1.00 40.00 X X 0 527000 14100 0 527000 14100 0 0 1 0 0 0 0 0 0 0 0 0 0 1000 1000 1000 1000 0 0 X 1000 1000 1000 1000 1000 1000 0 0 X 0 0 0 X 1768571 1768571 1768571 1768571 0 0 0 1768571 1768571 1768571 1.00000 0.00000 X 0 0 0 0 0 0 0 0 0 SEAN BAIN MD SOLE MEMBER 0 461662 0 42500 0 22838 0 13200 0 900 0 541100 0 0 FORM 990, PART III, LINE 3 GLENS FALLS MEDICAL PLLC IS IN THE PROCESS OF TERMINATING THE PHYSICIAN SERVICES COMPONENT OF ITS OPERATIONS. ONCE THE TERMINATION IS COMPLETE AND ALL OUTSTANDING LIABILITIES ARE RESOLVED, THE ORGANIZATION WILL RE-EVALUATE ITS ABILITY TO CONTINUE ITS ACTING IN ACCORDANCE WITH ITS EXEMPT PURPOSES AND, IF NEEDED, REPORT A FORMAL TERMINATION OF ITS EXEMPT STATUS. THROUGHOUT 2023, GLENS FALLS MEDICAL PLLC WAS A DORMANT ENTITY. FORM 990, PART VI, SECTION A, LINE 3 GLENS FALLS MEDICAL PLLC EFFECTIVELY BIFURCATES ITS OWNERSHIP, VESTING LEGAL OWNERSHIP UNDER NEW YORK LAW IN DR. SEAN BAIN AND INVESTING BENEFICIAL OWNERSHIP AND STRUCTURAL AND FINANCIAL CONTROL IN GLENS FALLS HOSPITAL. THE CONTROL AGREEMENT REQUIRES DR. BAIN TO VOTE HIS MEMBERSHIP INTEREST ONLY AS APPROVED IN ADVANCE AND IN WRITING BY GLENS FALLS HOSPITAL, PROVIDES THAT GLENS FALL HOSPITAL SHALL INITIATE ANY AND ALL ACTIONS REGARDING THE ELECTION AND REMOVAL OF GLENS FALLS MEMBERS, AND RESTRICTS DR. BAIN'S ABILITY TO TRANSFER HIS INTEREST IN GLENS FALLS MEDICAL AND REQUIRES HIM TO TRANSFER SUCH INTEREST ONLY TO A PERSON DESIGNATED BY GLENS FALLS HOSPITAL. GLENS FALLS HOSPITAL EFFECTIVELY CONTROLS THE STRUCTURAL AND FINANCIAL DECISIONS OF GLENS FALLS MEDICAL PLLC. FORM 990, PART VI, SECTION A, LINE 7B GLENS FALLS HOSPITAL SHALL INITIATE ANY AND ALL ACTIONS REGARDING THE ELECTION AND REMOVAL OF GLENS FALLS MEDICAL MEMBERS, AND RESTRICTS DR. BAIN'S ABILITY TO TRANSFER HIS INTEREST IN GLENS FALLS MEDICAL AND REQUIRES HIM TO TRANSFER SUCH INTEREST ONLY TO A PERSON DESIGNATED NY GLENS FALLS HOSPITAL. GLENS FALLS HOSPITAL EFFECTIVELY CONTROLS THE STRUCTURAL AND FINANCIAL DECISIONS OF GLENS FALLS MEDICAL PLLC. FORM 990, PART VI, SECTION A, LINE 8A THE GLENS FALLS HOSPITAL GOVERNING BODY HAS FULL RESPONSIBILITY FOR OVERSIGHT OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 8B THE GLENS FALLS HOSPITAL GOVERNING BODY HAS FULL RESPONSIBILITY FOR OVERSIGHT OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY GLENS FALLS HOSPITAL STAFF AND REVIEWED BY THE SR. DIRECTOR OF FINANCE, THE CONTROLLER OF GLENS FALLS HOSPITAL AND KPMG TO ENSURE THE FILING OF A COMPLETE AND ACCURATE RETURN. A COPY OF THE FINAL FORM 990 WAS PROVIDED TO DR. BAIN PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE SOLE MEMBER, DR. BAIN. A) HAS RECIEVED A COPY OF THE CONFLICTS OF INTEREST POLICY. B) HAS READ AND UNDERSTANDS THE POLICY. C) HAS AGREED TO COMPLY WITH THE POLICY AND D) UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL EXEMPTION IT MUST ENGAGE PRIMARLY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES. TO ENSURE THAT THE CORPORATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEPORDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS SHALL BE CONDUCTED. FORM 990, PART VI, SECTION B, LINE 12A GLENS FALLS MEDICAL PLLC ADOPTED A CONFLICT OF INTEREST POLICY WHICH IS MONITORED BY A COMPLIANCE OFFICER. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. GLENS FALLS HOSPITAL 100 PARK STREET GLENS FALLS NY 12801 141338413 HOSPITAL NY 501(C)(3) LINE 3 N/A 0 GLENS FALLS HOSPITAL FOUNDATION 100 PARK STREET GLENS FALLS NY 12801 141790805 SUPPORTING ORG. NY 501(C)(3) LINE 12C, III-FI N/A 0 ALBANY MED HEATH SYSTEM 47 NEW SCOTLAND AVENUE ALBANY NY 12208 141641730 SUPPORTING ORG. NY 501(C)(3) LINE 12C, III-FI N/A 0 ALBANY MEDICAL CENTER HOSPITAL 43 NEW SCOTLAND AVENUE ALBANY NY 12208 141338307 HOSPITAL NY 501(C)(3) LINE 3 N/A 0 ALBANY MEDICAL COLLEGE 47 NEW SCOTLAND AVENUE ALBANY NY 12208 141338310 MEDICAL DEGREE PROGRAMS NY 501(C)(3) LINE 2 N/A 0 ALBANY MEDICAL CENTER FOUNDATION 47 NEW SCOTLAND AVENUE ALBANY NY 12208 146023119 FUNDRAISING NY 501(C)(3) LINE 7 N/A 0 ALBANY MEDICAL CENTER KIDSKELLER 47 NEW SCOTLAND AVENUE ALBANY NY 12208 222635792 EDUCATION DAY PROGRAM NY 501(C)(3) LINE 2 ALBANY MED HEALTH SYSTEM 0 CENTER FOR DONATION AND TRANSPLANT 218 GREAT OAKS BLVD ALBANY NY 12203 141820447 ORGAN AND TISSUE BANK NY 501(C)(3) LINE 12A, I ALBANY MEDICAL COLLEGE 0 BETTER HEALTH FOR NORTHEAST NEW YORK 43 NEW SCOTLAND AVENUE ALBANY NY 12208 811861104 DELIVERY SYSTEM REFORM INCENTIVE PROGRAM NY 501(C)(6) ALBANY MEDICAL CENTER HOSPITAL 0 COLUMBIA MEMORIAL HOSPITAL 71 PROSPECT AVENUE HUDSON NY 12534 141338373 HOSPITAL NY 501(C)(3) LINE 3 N/A 0 KAATERSKILL COMMONS INC 163 JEFFERSON HEIGHTS CATSKILL NY 12414 205700964 LOW-INCOME HOUSING NY 501(C)(3) LINE 7 COLUMBIA MEMORIAL HOSPITAL 0 COLUMBIA MEMORIAL HEALTH FOUNDATION 71 PROSPECT AVENUE HUDSON NY 12534 141761112 FUNDRAISING NY 501(C)(3) LINE 10 COLUMBIA MEMORIAL HOSPITAL 0 THE SECOND SHOW INC 519 WARREN STREET HUDSON NY 12534 141796715 THRIFT SHOP NY 501(C)(3) LINE 7 COLUMBIA MEMORIAL HOSPITAL 0 SARATOGA HOSPITAL 211 CHURCH STREET SARATOGA SPRINGS NY 12866 141338547 HOSPITAL NY 501(C)(3) LINE 3 N/A 0 SARATOGA REGIONAL MEDICAL PC 211 CHURCH STREET SARATOGA SPRINGS NY 12866 472468259 HEALTHCARE SERVICES NY 501(C)(3) LINE 3 SARATOGA HOSPITAL 0 SARATOGA CARE INC 211 CHURCH STREET SARATOGA SPRINGS NY 12866 141775218 PROMOTING HEALTH NY 501(C)(3) LINE 12B, II SARATOGA HOSPITAL 0 HEALTHCARE PARTNERS OF SARATOGA LTD 211 CHURCH STREET SARATOGA SPRINGS NY 12866 453303309 EMERGENT CARE NY 501(C)(3) LINE 3 N/A 0 ALBANY VISITING NURSE HOME CARE SERVICES GROUP INC 35 COLVIN AVENUE ALBANY NY 12206 222778949 SUPPORT NY 501(C)(3) LINE 12B, II ALBANY MED HEALTH SYSTEM 0 VISITING NURSES FOUNDATION INC 35 COLVIN AVENUE ALBANY NY 12206 141653755 FUNDRAISING NY 501(C)(3) LINE 12C, III-FI AVNHCS GROUP 0 VISITING NURSE ASSOCIATION OF ALBANY INC 35 COLVIN AVENUE ALBANY NY 12206 141340125 HOME HEALTH NY 501(C)(3) LINE 10 AVNHCS GROUP 0 IMAG SVC OF NENY 100 PARK STREET GLENS FALLS NY 12801 141820955 DIAGNOSTIC RADIOLOGY NY N/A RELATED 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0