401k Plan data: PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN plan

PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 401k Plan overview

Plan Name	PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN
Plan identification number	001

PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

PARK AVENUE NURSING & REHABILITATION CENTER, INC. has sponsored the creation of one or more 401k plans.

Company Name: PARK AVENUE NURSING & REHABILITATION CENTER, INC.

Employer identification number (EIN): 042480536

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2014-01-01 JOHN ALESSANDRONI
001 2013-01-01 JOHN ALESSANDRONI
001 2012-01-01 JOHN J. ALESSANDRONI
001 2011-01-01 JOHN J. ALESSANDRONI
001 2009-01-01 JOHN J. ALESSANDRONI JOHN J. ALESSANDRONI 2010-09-20

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2014-01-01	JOHN ALESSANDRONI
001	2013-01-01	JOHN ALESSANDRONI
001	2012-01-01	JOHN J. ALESSANDRONI
001	2011-01-01	JOHN J. ALESSANDRONI
001	2009-01-01	JOHN J. ALESSANDRONI	JOHN J. ALESSANDRONI	2010-09-20

Plan Statistics for PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN

401k plan membership statisitcs for PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN

Measure Date Value
2014: PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 150
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 0
Number of participants with account balances 2014-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 138
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 110
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 35
Total of all active and inactive participants 2013-01-01 145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 145
Number of participants with account balances 2013-01-01 81
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 129
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 96
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 30
Total of all active and inactive participants 2012-01-01 126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 126
Number of participants with account balances 2012-01-01 79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 120
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 88
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 32
Total of all active and inactive participants 2011-01-01 120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 120
Number of participants with account balances 2011-01-01 79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 142
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 88
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 30
Total of all active and inactive participants 2009-01-01 118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 118
Number of participants with account balances 2009-01-01 91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 3

Measure	Date	Value
2014: PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	150
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	0
Number of participants with account balances	2014-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	138
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	110
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	35
Total of all active and inactive participants	2013-01-01	145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	145
Number of participants with account balances	2013-01-01	81
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	129
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	96
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	30
Total of all active and inactive participants	2012-01-01	126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	126
Number of participants with account balances	2012-01-01	79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	120
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	88
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	32
Total of all active and inactive participants	2011-01-01	120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	120
Number of participants with account balances	2011-01-01	79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	142
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	88
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	30
Total of all active and inactive participants	2009-01-01	118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	118
Number of participants with account balances	2009-01-01	91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	3

Financial Data on PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN

Measure	Date	Value
2014 : PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-10-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-10-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-10-31	$0
Total income from all sources (including contributions)	2014-10-31	$65,844
Total loss/gain on sale of assets	2014-10-31	$0
Total of all expenses incurred	2014-10-31	$1,444,261
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-10-31	$1,433,126
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-10-31	$33,628
Value of total assets at end of year	2014-10-31	$0
Value of total assets at beginning of year	2014-10-31	$1,378,417
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-10-31	$11,135
Total interest from all sources	2014-10-31	$1,685
Total dividends received (eg from common stock, registered investment company shares)	2014-10-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-10-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2014-10-31	$0
Was this plan covered by a fidelity bond	2014-10-31	Yes
Value of fidelity bond cover	2014-10-31	$500,000
If this is an individual account plan, was there a blackout period	2014-10-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-10-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-10-31	No
Contributions received from participants	2014-10-31	$25,929
Participant contributions at end of year	2014-10-31	$0
Participant contributions at beginning of year	2014-10-31	$53,267
Administrative expenses (other) incurred	2014-10-31	$2,907
Total non interest bearing cash at end of year	2014-10-31	$0
Total non interest bearing cash at beginning of year	2014-10-31	$2,078
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-10-31	No
Value of net income/loss	2014-10-31	$-1,378,417
Value of net assets at end of year (total assets less liabilities)	2014-10-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2014-10-31	$1,378,417
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-10-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-10-31	No
Were any leases to which the plan was party in default or uncollectible	2014-10-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-10-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-10-31	$1,204,897
Interest on participant loans	2014-10-31	$1,353
Interest earned on other investments	2014-10-31	$332
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-10-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-10-31	$115,876
Net investment gain/loss from pooled separate accounts	2014-10-31	$30,531
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-10-31	No
Was there a failure to transmit to the plan any participant contributions	2014-10-31	No
Has the plan failed to provide any benefit when due under the plan	2014-10-31	No
Contributions received in cash from employer	2014-10-31	$7,699
Employer contributions (assets) at end of year	2014-10-31	$0
Employer contributions (assets) at beginning of year	2014-10-31	$2,299
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-10-31	$1,433,126
Contract administrator fees	2014-10-31	$8,228
Did the plan have assets held for investment	2014-10-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-10-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-10-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-10-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-10-31	Disclaimer
Accountancy firm name	2014-10-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2014-10-31	043499945
2013 : PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$249,277
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$148,625
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$137,285
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$70,437
Value of total assets at end of year	2013-12-31	$1,378,417
Value of total assets at beginning of year	2013-12-31	$1,277,765
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$11,340
Total interest from all sources	2013-12-31	$2,219
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$54,946
Participant contributions at end of year	2013-12-31	$53,267
Participant contributions at beginning of year	2013-12-31	$69,806
Participant contributions at end of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$1,586
Administrative expenses (other) incurred	2013-12-31	$135
Total non interest bearing cash at end of year	2013-12-31	$2,078
Total non interest bearing cash at beginning of year	2013-12-31	$1,438
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$100,652
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,378,417
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,277,765
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$1,204,897
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$1,095,415
Interest on participant loans	2013-12-31	$2,439
Interest earned on other investments	2013-12-31	$-220
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$115,876
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$109,942
Net investment gain/loss from pooled separate accounts	2013-12-31	$176,621
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$13,905
Employer contributions (assets) at end of year	2013-12-31	$2,299
Employer contributions (assets) at beginning of year	2013-12-31	$1,164
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$137,285
Contract administrator fees	2013-12-31	$11,205
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2013-12-31	043499945
2012 : PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$184,962
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$105,790
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$94,917
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$69,818
Value of total assets at end of year	2012-12-31	$1,277,765
Value of total assets at beginning of year	2012-12-31	$1,198,593
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$10,873
Total interest from all sources	2012-12-31	$4,201
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$53,240
Participant contributions at end of year	2012-12-31	$69,806
Participant contributions at beginning of year	2012-12-31	$87,094
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$1,075
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$0
Administrative expenses (other) incurred	2012-12-31	$10,873
Total non interest bearing cash at end of year	2012-12-31	$1,438
Total non interest bearing cash at beginning of year	2012-12-31	$4,382
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$79,172
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,277,765
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,198,593
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$1,095,415
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$1,002,227
Interest on participant loans	2012-12-31	$3,012
Interest earned on other investments	2012-12-31	$1,189
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$109,942
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$102,322
Net investment gain/loss from pooled separate accounts	2012-12-31	$110,943
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$16,578
Employer contributions (assets) at end of year	2012-12-31	$1,164
Employer contributions (assets) at beginning of year	2012-12-31	$1,493
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$94,917
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2012-12-31	043499945
2011 : PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$54,409
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$183,923
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$165,277
Expenses. Certain deemed distributions of participant loans	2011-12-31	$7,821
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$67,239
Value of total assets at end of year	2011-12-31	$1,198,593
Value of total assets at beginning of year	2011-12-31	$1,328,107
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$10,825
Total interest from all sources	2011-12-31	$4,696
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$50,546
Participant contributions at end of year	2011-12-31	$87,094
Participant contributions at beginning of year	2011-12-31	$118,305
Participant contributions at end of year	2011-12-31	$1,075
Participant contributions at beginning of year	2011-12-31	$1,142
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$0
Administrative expenses (other) incurred	2011-12-31	$10,825
Total non interest bearing cash at end of year	2011-12-31	$4,382
Total non interest bearing cash at beginning of year	2011-12-31	$3
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-129,514
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,198,593
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,328,107
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$1,002,227
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$1,071,193
Interest on participant loans	2011-12-31	$3,911
Interest earned on other investments	2011-12-31	$785
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$102,322
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$135,584
Net investment gain/loss from pooled separate accounts	2011-12-31	$-17,526
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$16,693
Employer contributions (assets) at end of year	2011-12-31	$1,493
Employer contributions (assets) at beginning of year	2011-12-31	$1,880
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$165,277
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2011-12-31	043499945
2010 : PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$205,153
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$99,855
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$88,757
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$92,844
Value of total assets at end of year	2010-12-31	$1,328,107
Value of total assets at beginning of year	2010-12-31	$1,222,809
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$11,098
Total interest from all sources	2010-12-31	$6,263
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Administrative expenses professional fees incurred	2010-12-31	$230
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$68,823
Participant contributions at end of year	2010-12-31	$118,305
Participant contributions at beginning of year	2010-12-31	$130,668
Participant contributions at end of year	2010-12-31	$1,142
Participant contributions at beginning of year	2010-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$2,780
Administrative expenses (other) incurred	2010-12-31	$10,868
Total non interest bearing cash at end of year	2010-12-31	$3
Total non interest bearing cash at beginning of year	2010-12-31	$678
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$105,298
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$1,328,107
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,222,809
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$1,071,193
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$946,719
Interest on participant loans	2010-12-31	$4,969
Interest earned on other investments	2010-12-31	$1,294
Value of interest in common/collective trusts at end of year	2010-12-31	$0
Value of interest in common/collective trusts at beginning of year	2010-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$135,584
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$138,643
Net investment gain/loss from pooled separate accounts	2010-12-31	$106,046
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$21,241
Employer contributions (assets) at end of year	2010-12-31	$1,880
Employer contributions (assets) at beginning of year	2010-12-31	$6,101
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$88,757
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2010-12-31	043499945

Form 5500 Responses for PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN

2014: PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	Yes
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: PARK AVENUE NURSING & REHABILITATION CENTER, INC. PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	PARK AVENUE NURSING & REHABILITATION CENTER, INC.
Employer identification number (EIN):	042480536
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities