401k Plan data: FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN plan

FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN 401k Plan overview

Plan Name	FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN
Plan identification number	001

FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) 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.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Plan covering Self-Employed individuals.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

FSNR SNF LLC D/B/A FOUR SEASONS NURSING & REHABILITATION CENTER has sponsored the creation of one or more 401k plans.

Company Name: FSNR SNF LLC D/B/A FOUR SEASONS NURSING & REHABILITATION CENTER

Employer identification number (EIN): 465518310

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

Additional information about FSNR SNF LLC D/B/A FOUR SEASONS NURSING & REHABILITATION CENTER

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 5519084

More information about FSNR SNF LLC D/B/A FOUR SEASONS NURSING & REHABILITATION CENTER

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2023-01-01 NATHAN ZELCER 2024-09-25
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01

Plan Statistics for FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN

401k plan membership statisitcs for FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN

Measure Date Value
2022: FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 168
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 114
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 24
Total of all active and inactive participants 2022-01-01 138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 138
Number of participants with account balances 2022-01-01 58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 151
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 140
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 22
Total of all active and inactive participants 2021-01-01 162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 162
Number of participants with account balances 2021-01-01 70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 133
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 119
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 24
Total of all active and inactive participants 2020-01-01 143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 143
Number of participants with account balances 2020-01-01 56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 158
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 97
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 26
Total of all active and inactive participants 2019-01-01 123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 123
Number of participants with account balances 2019-01-01 56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0

Measure	Date	Value
2022: FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	168
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	114
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	24
Total of all active and inactive participants	2022-01-01	138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	138
Number of participants with account balances	2022-01-01	58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	151
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	140
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	22
Total of all active and inactive participants	2021-01-01	162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	162
Number of participants with account balances	2021-01-01	70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	133
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	119
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	24
Total of all active and inactive participants	2020-01-01	143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	143
Number of participants with account balances	2020-01-01	56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	158
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	97
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	26
Total of all active and inactive participants	2019-01-01	123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	123
Number of participants with account balances	2019-01-01	56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0

Financial Data on FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN

Measure	Date	Value
2022 : FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-563,357
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$445,589
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$408,939
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$248,483
Value of total assets at end of year	2022-12-31	$3,735,443
Value of total assets at beginning of year	2022-12-31	$4,744,389
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$36,650
Total interest from all sources	2022-12-31	$1,974
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$74,094
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$74,094
Administrative expenses professional fees incurred	2022-12-31	$20,836
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$239,579
Participant contributions at end of year	2022-12-31	$91,084
Participant contributions at beginning of year	2022-12-31	$18,118
Participant contributions at end of year	2022-12-31	$4,398
Participant contributions at beginning of year	2022-12-31	$4,250
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$8,904
Liabilities. Value of operating payables at end of year	2022-12-31	$0
Liabilities. Value of operating payables at beginning of year	2022-12-31	$0
Total non interest bearing cash at end of year	2022-12-31	$1,545
Total non interest bearing cash at beginning of year	2022-12-31	$109
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-1,008,946
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$3,735,443
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$4,744,389
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Investment advisory and management fees	2022-12-31	$15,814
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$3,311,194
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$4,691,027
Interest on participant loans	2022-12-31	$1,974
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$327,222
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$30,885
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$30,885
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-887,908
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$408,939
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	CRAIG, FITZSIMMONS & MEYER, LLP
Accountancy firm EIN	2022-12-31	112442493
2021 : FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$735,744
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$812,543
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$774,953
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$228,327
Value of total assets at end of year	2021-12-31	$4,744,389
Value of total assets at beginning of year	2021-12-31	$4,821,188
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$37,590
Total interest from all sources	2021-12-31	$507
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$78,689
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$78,689
Administrative expenses professional fees incurred	2021-12-31	$21,420
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$228,327
Participant contributions at end of year	2021-12-31	$18,118
Participant contributions at beginning of year	2021-12-31	$17,095
Participant contributions at end of year	2021-12-31	$4,250
Participant contributions at beginning of year	2021-12-31	$4,212
Liabilities. Value of operating payables at end of year	2021-12-31	$0
Liabilities. Value of operating payables at beginning of year	2021-12-31	$0
Total non interest bearing cash at end of year	2021-12-31	$109
Total non interest bearing cash at beginning of year	2021-12-31	$223
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$-76,799
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$4,744,389
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$4,821,188
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$16,170
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$4,691,027
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$4,735,489
Interest on participant loans	2021-12-31	$507
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$30,885
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$64,169
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$64,169
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$428,221
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$774,953
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	CRAIG, FITZSIMMONS & MEYER, LLP
Accountancy firm EIN	2021-12-31	112442493
2020 : FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$10,637
Total income from all sources (including contributions)	2020-12-31	$869,108
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$502,064
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$452,032
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$220,861
Value of total assets at end of year	2020-12-31	$4,821,188
Value of total assets at beginning of year	2020-12-31	$4,464,781
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$50,032
Total interest from all sources	2020-12-31	$2,406
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$78,907
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$78,907
Administrative expenses professional fees incurred	2020-12-31	$19,996
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$217,465
Participant contributions at end of year	2020-12-31	$17,095
Participant contributions at beginning of year	2020-12-31	$29,728
Participant contributions at end of year	2020-12-31	$4,212
Participant contributions at beginning of year	2020-12-31	$11,554
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$3,396
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$4,338
Liabilities. Value of operating payables at end of year	2020-12-31	$0
Liabilities. Value of operating payables at beginning of year	2020-12-31	$10,637
Total non interest bearing cash at end of year	2020-12-31	$223
Total non interest bearing cash at beginning of year	2020-12-31	$4,781
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$367,044
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$4,821,188
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$4,454,144
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Investment advisory and management fees	2020-12-31	$30,036
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$4,735,489
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$4,351,096
Interest on participant loans	2020-12-31	$2,406
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$64,169
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$63,284
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$63,284
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$566,934
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Employer contributions (assets) at end of year	2020-12-31	$0
Employer contributions (assets) at beginning of year	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$452,032
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	CRAIG, FITZSIMMONS & MEYER, LLP
Accountancy firm EIN	2020-12-31	112442493
2019 : FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$10,637
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$969,104
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$637,179
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$559,943
Expenses. Certain deemed distributions of participant loans	2019-12-31	$26,523
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$192,953
Value of total assets at end of year	2019-12-31	$4,464,781
Value of total assets at beginning of year	2019-12-31	$4,122,219
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$50,713
Total interest from all sources	2019-12-31	$2,440
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$110,783
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$110,783
Administrative expenses professional fees incurred	2019-12-31	$20,294
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$192,953
Participant contributions at end of year	2019-12-31	$29,728
Participant contributions at beginning of year	2019-12-31	$69,504
Participant contributions at end of year	2019-12-31	$11,554
Participant contributions at beginning of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$4,338
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$232
Liabilities. Value of operating payables at end of year	2019-12-31	$10,637
Liabilities. Value of operating payables at beginning of year	2019-12-31	$0
Total non interest bearing cash at end of year	2019-12-31	$4,781
Total non interest bearing cash at beginning of year	2019-12-31	$512
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$331,925
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$4,454,144
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$4,122,219
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Investment advisory and management fees	2019-12-31	$30,419
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$4,351,096
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$3,991,139
Interest on participant loans	2019-12-31	$2,440
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$63,284
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$60,590
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$60,590
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$662,928
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$242
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$559,943
Did the plan have assets held for investment	2019-12-31	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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	CRAIG, FITZSIMMONS & MICHAELS, LLP
Accountancy firm EIN	2019-12-31	112442493

Form 5500 Responses for FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN

2022: FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: FOUR SEASONS NURSING & REHABILITATION CENTER 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	FSNR SNF LLC D/B/A FOUR SEASONS NURSING & REHABILITATION CENTER
Employer identification number (EIN):	465518310
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	5519084

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2023-01-01	NATHAN ZELCER	2024-09-25
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01