401k Plan data: ST. MARYS NURSING CENTER RETIREMENT PLAN plan

ST. MARYS NURSING CENTER RETIREMENT PLAN 401k Plan overview

Plan Name	ST. MARYS NURSING CENTER RETIREMENT PLAN
Plan identification number	002

ST. MARYS NURSING CENTER RETIREMENT 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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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

ST. MARYS NURSING CENTER INC. has sponsored the creation of one or more 401k plans.

Company Name: ST. MARYS NURSING CENTER INC.

Employer identification number (EIN): 522327829

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ST. MARYS NURSING CENTER RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2023-01-01
002 2022-01-01
002 2021-01-01
002 2020-01-01
002 2019-01-01
002 2018-01-01 L ANNETTE HODGES
002 2017-01-01 L ANNETTE HODGES
002 2016-01-01 LOIS ANNETTE HODGES
002 2015-01-01 LOIS ANNETTE HODGES
002 2015-01-01 LOIS ANNETTE HODGES
002 2015-01-01
002 2014-01-01 LOIS ANNETTE HODGES LOIS ANNETTE HODGES 2015-07-28
002 2013-01-01 LOIS ANNETTE HODGES LOIS ANNETTE HODGES 2014-08-01
002 2012-01-01 L. ANNETTE HODGES L. ANNETTE HODGES 2013-09-20

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2023-01-01
002	2022-01-01
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2018-01-01	L ANNETTE HODGES
002	2017-01-01	L ANNETTE HODGES
002	2016-01-01	LOIS ANNETTE HODGES
002	2015-01-01	LOIS ANNETTE HODGES
002	2015-01-01	LOIS ANNETTE HODGES
002	2015-01-01
002	2014-01-01	LOIS ANNETTE HODGES	LOIS ANNETTE HODGES	2015-07-28
002	2013-01-01	LOIS ANNETTE HODGES	LOIS ANNETTE HODGES	2014-08-01
002	2012-01-01	L. ANNETTE HODGES	L. ANNETTE HODGES	2013-09-20

Plan Statistics for ST. MARYS NURSING CENTER RETIREMENT PLAN

401k plan membership statisitcs for ST. MARYS NURSING CENTER RETIREMENT PLAN

Measure Date Value
2023: ST. MARYS NURSING CENTER RETIREMENT PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 269
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 132
Number of retired or separated participants receiving benefits 2023-01-01 0
Number of other retired or separated participants entitled to future benefits 2023-01-01 132
Total of all active and inactive participants 2023-01-01 264
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2023-01-01 0
Total participants 2023-01-01 264
Number of participants with account balances 2023-01-01 237
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2023-01-01 1
2022: ST. MARYS NURSING CENTER RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 233
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 135
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 134
Total of all active and inactive participants 2022-01-01 269
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 269
Number of participants with account balances 2022-01-01 216
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 6
2021: ST. MARYS NURSING CENTER RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 233
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 124
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 109
Total of all active and inactive participants 2021-01-01 233
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 233
Number of participants with account balances 2021-01-01 197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 12
2020: ST. MARYS NURSING CENTER RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 248
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 145
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 88
Total of all active and inactive participants 2020-01-01 233
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 233
Number of participants with account balances 2020-01-01 197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 14
2019: ST. MARYS NURSING CENTER RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 248
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 188
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 60
Total of all active and inactive participants 2019-01-01 248
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 248
Number of participants with account balances 2019-01-01 193
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 9
2018: ST. MARYS NURSING CENTER RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 231
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 200
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 48
Total of all active and inactive participants 2018-01-01 248
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 248
Number of participants with account balances 2018-01-01 177
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 9
2017: ST. MARYS NURSING CENTER RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 224
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 202
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 29
Total of all active and inactive participants 2017-01-01 231
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 231
Number of participants with account balances 2017-01-01 165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: ST. MARYS NURSING CENTER RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 221
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 206
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 18
Total of all active and inactive participants 2016-01-01 224
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 224
Number of participants with account balances 2016-01-01 167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: ST. MARYS NURSING CENTER RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 220
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 198
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 17
Total of all active and inactive participants 2015-01-01 215
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 215
Number of participants with account balances 2015-01-01 150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: ST. MARYS NURSING CENTER RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 216
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 204
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 9
Total of all active and inactive participants 2014-01-01 213
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 213
Number of participants with account balances 2014-01-01 137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: ST. MARYS NURSING CENTER RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 199
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 198
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 4
Total of all active and inactive participants 2013-01-01 202
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 202
Number of participants with account balances 2013-01-01 123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: ST. MARYS NURSING CENTER RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 209
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 194
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 5
Total of all active and inactive participants 2012-01-01 199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 199
Number of participants with account balances 2012-01-01 111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0

Measure	Date	Value
2023: ST. MARYS NURSING CENTER RETIREMENT PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	269
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	132
Number of retired or separated participants receiving benefits	2023-01-01	0
Number of other retired or separated participants entitled to future benefits	2023-01-01	132
Total of all active and inactive participants	2023-01-01	264
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2023-01-01	0
Total participants	2023-01-01	264
Number of participants with account balances	2023-01-01	237
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2023-01-01	1
2022: ST. MARYS NURSING CENTER RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	233
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	135
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	134
Total of all active and inactive participants	2022-01-01	269
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	269
Number of participants with account balances	2022-01-01	216
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	6
2021: ST. MARYS NURSING CENTER RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	233
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	124
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	109
Total of all active and inactive participants	2021-01-01	233
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	233
Number of participants with account balances	2021-01-01	197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	12
2020: ST. MARYS NURSING CENTER RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	248
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	145
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	88
Total of all active and inactive participants	2020-01-01	233
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	233
Number of participants with account balances	2020-01-01	197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	14
2019: ST. MARYS NURSING CENTER RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	248
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	188
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	60
Total of all active and inactive participants	2019-01-01	248
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	248
Number of participants with account balances	2019-01-01	193
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	9
2018: ST. MARYS NURSING CENTER RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	231
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	200
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	48
Total of all active and inactive participants	2018-01-01	248
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	248
Number of participants with account balances	2018-01-01	177
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	9
2017: ST. MARYS NURSING CENTER RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	224
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	202
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	29
Total of all active and inactive participants	2017-01-01	231
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	231
Number of participants with account balances	2017-01-01	165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: ST. MARYS NURSING CENTER RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	221
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	206
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	18
Total of all active and inactive participants	2016-01-01	224
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	224
Number of participants with account balances	2016-01-01	167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: ST. MARYS NURSING CENTER RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	220
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	198
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	17
Total of all active and inactive participants	2015-01-01	215
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	215
Number of participants with account balances	2015-01-01	150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: ST. MARYS NURSING CENTER RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	216
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	204
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	9
Total of all active and inactive participants	2014-01-01	213
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	213
Number of participants with account balances	2014-01-01	137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: ST. MARYS NURSING CENTER RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	199
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	198
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	4
Total of all active and inactive participants	2013-01-01	202
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	202
Number of participants with account balances	2013-01-01	123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: ST. MARYS NURSING CENTER RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	209
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	194
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	5
Total of all active and inactive participants	2012-01-01	199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	199
Number of participants with account balances	2012-01-01	111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0

Financial Data on ST. MARYS NURSING CENTER RETIREMENT PLAN

Measure	Date	Value
2023 : ST. MARYS NURSING CENTER RETIREMENT PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets	2023-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$0
Total income from all sources (including contributions)	2023-12-31	$1,026,645
Total loss/gain on sale of assets	2023-12-31	$0
Total of all expenses incurred	2023-12-31	$129,342
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2023-12-31	$111,829
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2023-12-31	$349,378
Value of total assets at end of year	2023-12-31	$4,688,523
Value of total assets at beginning of year	2023-12-31	$3,791,220
Total of administrative expenses incurred including professional, contract, advisory and management fees	2023-12-31	$17,513
Total interest from all sources	2023-12-31	$6,312
Total dividends received (eg from common stock, registered investment company shares)	2023-12-31	$213,332
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2023-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2023-12-31	$213,332
Was this plan covered by a fidelity bond	2023-12-31	Yes
Value of fidelity bond cover	2023-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2023-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2023-12-31	No
Contributions received from participants	2023-12-31	$249,355
Participant contributions at end of year	2023-12-31	$124,518
Participant contributions at beginning of year	2023-12-31	$144,483
Participant contributions at end of year	2023-12-31	$2,023
Participant contributions at beginning of year	2023-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2023-12-31	$1,343
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2023-12-31	No
Value of net income/loss	2023-12-31	$897,303
Value of net assets at end of year (total assets less liabilities)	2023-12-31	$4,688,523
Value of net assets at beginning of year (total assets less liabilities)	2023-12-31	$3,791,220
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2023-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2023-12-31	No
Were any leases to which the plan was party in default or uncollectible	2023-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2023-12-31	$4,404,210
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2023-12-31	$3,523,390
Interest on participant loans	2023-12-31	$6,312
Value of interest in common/collective trusts at end of year	2023-12-31	$62,155
Value of interest in common/collective trusts at beginning of year	2023-12-31	$60,970
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2023-12-31	$3,248
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2023-12-31	$526
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2023-12-31	$526
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2023-12-31	$457,623
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2023-12-31	No
Was there a failure to transmit to the plan any participant contributions	2023-12-31	No
Has the plan failed to provide any benefit when due under the plan	2023-12-31	No
Contributions received in cash from employer	2023-12-31	$98,680
Employer contributions (assets) at end of year	2023-12-31	$92,369
Employer contributions (assets) at beginning of year	2023-12-31	$61,851
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2023-12-31	$111,829
Did the plan have assets held for investment	2023-12-31	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	2023-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2023-12-31	No
Opinion of an independent qualified public accountant for this plan	2023-12-31	Unqualified
Accountancy firm name	2023-12-31	BAKER TILLY US, LLP
Accountancy firm EIN	2023-12-31	301413443
2022 : ST. MARYS NURSING CENTER RETIREMENT 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	$-582,594
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$525,138
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$504,035
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$292,871
Value of total assets at end of year	2022-12-31	$3,791,220
Value of total assets at beginning of year	2022-12-31	$4,898,952
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$21,103
Total interest from all sources	2022-12-31	$4,662
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$302,899
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$302,899
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$1,000,000
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	$231,020
Participant contributions at end of year	2022-12-31	$144,483
Participant contributions at beginning of year	2022-12-31	$106,731
Administrative expenses (other) incurred	2022-12-31	$21,103
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	$-1,107,732
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$3,791,220
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$4,898,952
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$3,523,390
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$4,717,738
Income. Interest from loans (other than to participants)	2022-12-31	$4,642
Value of interest in common/collective trusts at end of year	2022-12-31	$60,970
Value of interest in common/collective trusts at beginning of year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$526
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$3,143
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$3,143
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$20
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-1,183,819
Net investment gain/loss from pooled separate accounts	2022-12-31	$793
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
Contributions received in cash from employer	2022-12-31	$61,851
Employer contributions (assets) at end of year	2022-12-31	$61,851
Employer contributions (assets) at beginning of year	2022-12-31	$71,340
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$504,035
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	BAKER TILLY US, LLP
Accountancy firm EIN	2022-12-31	390859910
2021 : ST. MARYS NURSING CENTER RETIREMENT PLAN 2021 401k financial data
Unrealized appreciation/depreciation of real estate assets	2021-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2021-12-31	$0
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total transfer of assets to this plan	2021-12-31	$0
Total transfer of assets from this plan	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
Expenses. Interest paid	2021-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$990,952
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$499,668
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$475,043
Expenses. Certain deemed distributions of participant loans	2021-12-31	$0
Value of total corrective distributions	2021-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$333,022
Value of total assets at end of year	2021-12-31	$4,898,952
Value of total assets at beginning of year	2021-12-31	$4,407,668
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$24,625
Total interest from all sources	2021-12-31	$3,967
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$342,211
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$342,211
Assets. Real estate other than employer real property at end of year	2021-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2021-12-31	$0
Administrative expenses professional fees incurred	2021-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2021-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2021-12-31	$0
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$1,000,000
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	$259,648
Participant contributions at end of year	2021-12-31	$106,731
Participant contributions at beginning of year	2021-12-31	$72,786
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2021-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$2,034
Assets. Loans (other than to participants) at end of year	2021-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$0
Other income not declared elsewhere	2021-12-31	$0
Administrative expenses (other) incurred	2021-12-31	$24,625
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	$0
Total non interest bearing cash at beginning of year	2021-12-31	$0
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
Income. Non cash contributions	2021-12-31	$0
Value of net income/loss	2021-12-31	$491,284
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$4,898,952
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$4,407,668
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
Assets. partnership/joint venture interests at end of year	2021-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2021-12-31	$0
Investment advisory and management fees	2021-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$4,717,738
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$4,114,146
Value of interest in pooled separate accounts at end of year	2021-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$0
Interest on participant loans	2021-12-31	$3,967
Income. Interest from loans (other than to participants)	2021-12-31	$0
Interest earned on other investments	2021-12-31	$0
Income. Interest from US Government securities	2021-12-31	$0
Income. Interest from corporate debt instruments	2021-12-31	$0
Value of interest in master investment trust accounts at end of year	2021-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2021-12-31	$0
Value of interest in common/collective trusts at end of year	2021-12-31	$0
Value of interest in common/collective trusts at beginning of year	2021-12-31	$136,508
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$3,143
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$4,772
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$4,772
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2021-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2021-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$0
Asset value of US Government securities at end of year	2021-12-31	$0
Asset value of US Government securities at beginning of year	2021-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$310,702
Net investment gain/loss from pooled separate accounts	2021-12-31	$0
Net investment gain or loss from common/collective trusts	2021-12-31	$1,050
Net gain/loss from 103.12 investment entities	2021-12-31	$0
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
Assets. Invements in employer securities at end of year	2021-12-31	$0
Assets. Invements in employer securities at beginning of year	2021-12-31	$0
Assets. Value of employer real property at end of year	2021-12-31	$0
Assets. Value of employer real property at beginning of year	2021-12-31	$0
Contributions received in cash from employer	2021-12-31	$71,340
Employer contributions (assets) at end of year	2021-12-31	$71,340
Employer contributions (assets) at beginning of year	2021-12-31	$79,456
Income. Dividends from preferred stock	2021-12-31	$0
Income. Dividends from common stock	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$475,043
Asset. Corporate debt instrument preferred debt at end of year	2021-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2021-12-31	$0
Contract administrator fees	2021-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2021-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2021-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2021-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2021-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2021-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2021-12-31	$0
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
Aggregate proceeds on sale of assets	2021-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2021-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2021-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2021-12-31	$0
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	BAKER TILLY US, LLP
Accountancy firm EIN	2021-12-31	390859910
2020 : ST. MARYS NURSING CENTER RETIREMENT 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	$0
Total income from all sources (including contributions)	2020-12-31	$1,079,946
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$347,571
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$333,418
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$443,761
Value of total assets at end of year	2020-12-31	$4,407,668
Value of total assets at beginning of year	2020-12-31	$3,675,293
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$14,153
Total interest from all sources	2020-12-31	$3,698
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$189,262
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$189,262
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$1,000,000
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	$276,150
Participant contributions at end of year	2020-12-31	$72,786
Participant contributions at beginning of year	2020-12-31	$87,195
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$88,155
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$0
Administrative expenses (other) incurred	2020-12-31	$14,153
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	$732,375
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$4,407,668
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$3,675,293
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$4,114,146
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$3,403,467
Interest on participant loans	2020-12-31	$3,690
Value of interest in common/collective trusts at end of year	2020-12-31	$136,508
Value of interest in common/collective trusts at beginning of year	2020-12-31	$93,794
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$4,772
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$2,954
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$2,954
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$8
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$440,929
Net investment gain or loss from common/collective trusts	2020-12-31	$2,296
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
Contributions received in cash from employer	2020-12-31	$79,456
Employer contributions (assets) at end of year	2020-12-31	$79,456
Employer contributions (assets) at beginning of year	2020-12-31	$87,883
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$333,418
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	Unqualified
Accountancy firm name	2020-12-31	BAKER TILLY US, LLP
Accountancy firm EIN	2020-12-31	390859910
2019 : ST. MARYS NURSING CENTER RETIREMENT 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	$0
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	$1,027,361
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$181,623
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$164,157
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$373,454
Value of total assets at end of year	2019-12-31	$3,675,293
Value of total assets at beginning of year	2019-12-31	$2,829,555
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$17,466
Total interest from all sources	2019-12-31	$3,782
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$157,662
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$157,662
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$1,000,000
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	$285,265
Participant contributions at end of year	2019-12-31	$87,195
Participant contributions at beginning of year	2019-12-31	$81,383
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$17,466
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	$845,738
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$3,675,293
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$2,829,555
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$3,403,467
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$2,662,663
Interest on participant loans	2019-12-31	$3,734
Value of interest in common/collective trusts at end of year	2019-12-31	$93,794
Value of interest in common/collective trusts at beginning of year	2019-12-31	$316
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$2,954
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$2,255
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$2,255
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$48
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$490,851
Net investment gain or loss from common/collective trusts	2019-12-31	$1,612
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
Contributions received in cash from employer	2019-12-31	$88,189
Employer contributions (assets) at end of year	2019-12-31	$87,883
Employer contributions (assets) at beginning of year	2019-12-31	$82,938
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$164,157
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	BAKER TILLY VIRCHOW KRAUSE
Accountancy firm EIN	2019-12-31	390859910
2018 : ST. MARYS NURSING CENTER RETIREMENT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$171,545
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$137,909
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$128,047
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$353,958
Value of total assets at end of year	2018-12-31	$2,829,555
Value of total assets at beginning of year	2018-12-31	$2,795,919
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$9,862
Total interest from all sources	2018-12-31	$3,417
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$192,270
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$192,270
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$268,280
Participant contributions at end of year	2018-12-31	$81,383
Participant contributions at beginning of year	2018-12-31	$91,031
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$2,740
Administrative expenses (other) incurred	2018-12-31	$9,862
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$33,636
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$2,829,555
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$2,795,919
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$2,662,663
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$2,629,053
Interest on participant loans	2018-12-31	$3,392
Value of interest in common/collective trusts at end of year	2018-12-31	$316
Value of interest in common/collective trusts at beginning of year	2018-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$2,255
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$605
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$605
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$25
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-378,100
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$82,938
Employer contributions (assets) at end of year	2018-12-31	$82,938
Employer contributions (assets) at beginning of year	2018-12-31	$75,230
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$128,047
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	2018-12-31	No
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	BAKER TILLY VIRCHOW KRAUSE
Accountancy firm EIN	2018-12-31	390859910
2017 : ST. MARYS NURSING CENTER RETIREMENT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$674,625
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$166,922
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$156,386
Value of total corrective distributions	2017-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$358,125
Value of total assets at end of year	2017-12-31	$2,795,919
Value of total assets at beginning of year	2017-12-31	$2,288,216
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$10,536
Total interest from all sources	2017-12-31	$3,793
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$91,431
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$91,431
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$254,836
Participant contributions at end of year	2017-12-31	$91,031
Participant contributions at beginning of year	2017-12-31	$68,244
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$28,059
Administrative expenses (other) incurred	2017-12-31	$10,536
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$507,703
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$2,795,919
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$2,288,216
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$2,629,053
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$2,111,787
Interest on participant loans	2017-12-31	$3,271
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$605
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$522
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$46,959
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$221,276
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$75,230
Employer contributions (assets) at end of year	2017-12-31	$75,230
Employer contributions (assets) at beginning of year	2017-12-31	$61,226
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$156,386
Did the plan have assets held for investment	2017-12-31	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	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	No
Opinion of an independent qualified public accountant for this plan	2017-12-31	Unqualified
Accountancy firm name	2017-12-31	BAKER TILLY VIRCHOW K
Accountancy firm EIN	2017-12-31	390859910
2016 : ST. MARYS NURSING CENTER RETIREMENT PLAN 2016 401k financial data
Unrealized appreciation/depreciation of real estate assets	2016-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2016-12-31	$0
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total transfer of assets to this plan	2016-12-31	$0
Total transfer of assets from this plan	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Expenses. Interest paid	2016-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$450,708
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$100,243
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$84,560
Expenses. Certain deemed distributions of participant loans	2016-12-31	$0
Value of total corrective distributions	2016-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$313,555
Value of total assets at end of year	2016-12-31	$2,288,216
Value of total assets at beginning of year	2016-12-31	$1,937,751
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$15,683
Total income from rents	2016-12-31	$0
Total interest from all sources	2016-12-31	$3,830
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$0
Assets. Real estate other than employer real property at end of year	2016-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2016-12-31	$0
Administrative expenses professional fees incurred	2016-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2016-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$252,329
Participant contributions at end of year	2016-12-31	$68,244
Participant contributions at beginning of year	2016-12-31	$99,989
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$7,375
Assets. Other investments not covered elsewhere at end of year	2016-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$0
Assets. Loans (other than to participants) at end of year	2016-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$0
Other income not declared elsewhere	2016-12-31	$0
Administrative expenses (other) incurred	2016-12-31	$0
Liabilities. Value of operating payables at end of year	2016-12-31	$0
Liabilities. Value of operating payables at beginning of year	2016-12-31	$0
Total non interest bearing cash at end of year	2016-12-31	$0
Total non interest bearing cash at beginning of year	2016-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Income. Non cash contributions	2016-12-31	$0
Value of net income/loss	2016-12-31	$350,465
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$2,288,216
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,937,751
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Assets. partnership/joint venture interests at end of year	2016-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2016-12-31	$0
Investment advisory and management fees	2016-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$2,111,787
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$1,788,851
Value of interest in pooled separate accounts at end of year	2016-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$0
Interest on participant loans	2016-12-31	$3,318
Income. Interest from loans (other than to participants)	2016-12-31	$0
Interest earned on other investments	2016-12-31	$512
Income. Interest from US Government securities	2016-12-31	$0
Income. Interest from corporate debt instruments	2016-12-31	$0
Value of interest in master investment trust accounts at end of year	2016-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2016-12-31	$0
Value of interest in common/collective trusts at end of year	2016-12-31	$0
Value of interest in common/collective trusts at beginning of year	2016-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$46,959
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$41,536
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$0
Asset value of US Government securities at end of year	2016-12-31	$0
Asset value of US Government securities at beginning of year	2016-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$133,323
Net investment gain/loss from pooled separate accounts	2016-12-31	$0
Net investment gain or loss from common/collective trusts	2016-12-31	$0
Net gain/loss from 103.12 investment entities	2016-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Assets. Invements in employer securities at end of year	2016-12-31	$0
Assets. Invements in employer securities at beginning of year	2016-12-31	$0
Assets. Value of employer real property at end of year	2016-12-31	$0
Assets. Value of employer real property at beginning of year	2016-12-31	$0
Contributions received in cash from employer	2016-12-31	$61,226
Employer contributions (assets) at end of year	2016-12-31	$61,226
Employer contributions (assets) at beginning of year	2016-12-31	$0
Income. Dividends from preferred stock	2016-12-31	$0
Income. Dividends from common stock	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$84,560
Asset. Corporate debt instrument preferred debt at end of year	2016-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2016-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2016-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2016-12-31	$0
Contract administrator fees	2016-12-31	$15,683
Assets. Corporate common stocks other than exployer securities at end of year	2016-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2016-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2016-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2016-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2016-12-31	$0
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Aggregate proceeds on sale of assets	2016-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2016-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2016-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2016-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	BAKER TILLY VIRCHOW K
Accountancy firm EIN	2016-12-31	390859910
2015 : ST. MARYS NURSING CENTER RETIREMENT PLAN 2015 401k financial data
Unrealized appreciation/depreciation of real estate assets	2015-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2015-12-31	$0
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total transfer of assets to this plan	2015-12-31	$0
Total transfer of assets from this plan	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Expenses. Interest paid	2015-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$196,537
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$138,385
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$124,139
Expenses. Certain deemed distributions of participant loans	2015-12-31	$0
Value of total corrective distributions	2015-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$230,211
Value of total assets at end of year	2015-12-31	$1,937,751
Value of total assets at beginning of year	2015-12-31	$1,879,599
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$14,246
Total income from rents	2015-12-31	$0
Total interest from all sources	2015-12-31	$4,548
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$0
Assets. Real estate other than employer real property at end of year	2015-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2015-12-31	$0
Administrative expenses professional fees incurred	2015-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2015-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2015-12-31	$0
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$213,718
Participant contributions at end of year	2015-12-31	$99,989
Participant contributions at beginning of year	2015-12-31	$90,225
Participant contributions at end of year	2015-12-31	$7,375
Participant contributions at beginning of year	2015-12-31	$7,146
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$16,493
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$0
Assets. Loans (other than to participants) at end of year	2015-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$0
Other income not declared elsewhere	2015-12-31	$0
Administrative expenses (other) incurred	2015-12-31	$0
Liabilities. Value of operating payables at end of year	2015-12-31	$0
Liabilities. Value of operating payables at beginning of year	2015-12-31	$0
Total non interest bearing cash at end of year	2015-12-31	$0
Total non interest bearing cash at beginning of year	2015-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Income. Non cash contributions	2015-12-31	$0
Value of net income/loss	2015-12-31	$58,152
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,937,751
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,879,599
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Assets. partnership/joint venture interests at end of year	2015-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2015-12-31	$0
Investment advisory and management fees	2015-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$1,788,851
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$1,723,947
Value of interest in pooled separate accounts at end of year	2015-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$0
Interest on participant loans	2015-12-31	$3,947
Income. Interest from loans (other than to participants)	2015-12-31	$0
Interest earned on other investments	2015-12-31	$601
Income. Interest from US Government securities	2015-12-31	$0
Income. Interest from corporate debt instruments	2015-12-31	$0
Value of interest in master investment trust accounts at end of year	2015-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2015-12-31	$0
Value of interest in common/collective trusts at end of year	2015-12-31	$0
Value of interest in common/collective trusts at beginning of year	2015-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$41,536
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$58,281
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$0
Asset value of US Government securities at end of year	2015-12-31	$0
Asset value of US Government securities at beginning of year	2015-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-38,222
Net investment gain/loss from pooled separate accounts	2015-12-31	$0
Net investment gain or loss from common/collective trusts	2015-12-31	$0
Net gain/loss from 103.12 investment entities	2015-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Assets. Invements in employer securities at end of year	2015-12-31	$0
Assets. Invements in employer securities at beginning of year	2015-12-31	$0
Assets. Value of employer real property at end of year	2015-12-31	$0
Assets. Value of employer real property at beginning of year	2015-12-31	$0
Contributions received in cash from employer	2015-12-31	$0
Employer contributions (assets) at end of year	2015-12-31	$0
Employer contributions (assets) at beginning of year	2015-12-31	$0
Income. Dividends from preferred stock	2015-12-31	$0
Income. Dividends from common stock	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$124,139
Asset. Corporate debt instrument preferred debt at end of year	2015-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2015-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2015-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2015-12-31	$0
Contract administrator fees	2015-12-31	$14,246
Assets. Corporate common stocks other than exployer securities at end of year	2015-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2015-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2015-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2015-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2015-12-31	$0
Did the plan have assets held for investment	2015-12-31	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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Aggregate proceeds on sale of assets	2015-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2015-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2015-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2015-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	BAKER TILLY VIRCHOW K
Accountancy firm EIN	2015-12-31	390859910
2014 : ST. MARYS NURSING CENTER RETIREMENT PLAN 2014 401k financial data
Unrealized appreciation/depreciation of real estate assets	2014-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2014-12-31	$0
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total transfer of assets to this plan	2014-12-31	$0
Total transfer of assets from this plan	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Expenses. Interest paid	2014-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$323,478
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$152,716
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$139,679
Expenses. Certain deemed distributions of participant loans	2014-12-31	$0
Value of total corrective distributions	2014-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$225,585
Value of total assets at end of year	2014-12-31	$1,879,599
Value of total assets at beginning of year	2014-12-31	$1,708,837
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$13,037
Total income from rents	2014-12-31	$0
Total interest from all sources	2014-12-31	$5,401
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$0
Assets. Real estate other than employer real property at end of year	2014-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2014-12-31	$0
Administrative expenses professional fees incurred	2014-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2014-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2014-12-31	$0
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$150,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$199,069
Participant contributions at end of year	2014-12-31	$90,225
Participant contributions at beginning of year	2014-12-31	$124,425
Participant contributions at end of year	2014-12-31	$7,146
Participant contributions at beginning of year	2014-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2014-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2014-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$26,516
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$0
Assets. Loans (other than to participants) at end of year	2014-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$0
Other income not declared elsewhere	2014-12-31	$0
Administrative expenses (other) incurred	2014-12-31	$0
Liabilities. Value of operating payables at end of year	2014-12-31	$0
Liabilities. Value of operating payables at beginning of year	2014-12-31	$0
Total non interest bearing cash at end of year	2014-12-31	$0
Total non interest bearing cash at beginning of year	2014-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Income. Non cash contributions	2014-12-31	$0
Value of net income/loss	2014-12-31	$170,762
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,879,599
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,708,837
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Assets. partnership/joint venture interests at end of year	2014-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2014-12-31	$0
Investment advisory and management fees	2014-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$1,723,947
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$1,509,960
Value of interest in pooled separate accounts at end of year	2014-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$0
Interest on participant loans	2014-12-31	$4,438
Income. Interest from loans (other than to participants)	2014-12-31	$0
Interest earned on other investments	2014-12-31	$963
Income. Interest from US Government securities	2014-12-31	$0
Income. Interest from corporate debt instruments	2014-12-31	$0
Value of interest in master investment trust accounts at end of year	2014-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2014-12-31	$0
Value of interest in common/collective trusts at end of year	2014-12-31	$0
Value of interest in common/collective trusts at beginning of year	2014-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$58,281
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$74,452
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$0
Asset value of US Government securities at end of year	2014-12-31	$0
Asset value of US Government securities at beginning of year	2014-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$92,492
Net investment gain/loss from pooled separate accounts	2014-12-31	$0
Net investment gain or loss from common/collective trusts	2014-12-31	$0
Net gain/loss from 103.12 investment entities	2014-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Assets. Invements in employer securities at end of year	2014-12-31	$0
Assets. Invements in employer securities at beginning of year	2014-12-31	$0
Assets. Value of employer real property at end of year	2014-12-31	$0
Assets. Value of employer real property at beginning of year	2014-12-31	$0
Contributions received in cash from employer	2014-12-31	$0
Employer contributions (assets) at end of year	2014-12-31	$0
Employer contributions (assets) at beginning of year	2014-12-31	$0
Income. Dividends from preferred stock	2014-12-31	$0
Income. Dividends from common stock	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$139,679
Asset. Corporate debt instrument preferred debt at end of year	2014-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2014-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2014-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2014-12-31	$0
Contract administrator fees	2014-12-31	$13,037
Assets. Corporate common stocks other than exployer securities at end of year	2014-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2014-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2014-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2014-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2014-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2014-12-31	$0
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Aggregate proceeds on sale of assets	2014-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2014-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2014-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2014-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	BAKER TILLY VIRCHOW KRAUSE, LLP
Accountancy firm EIN	2014-12-31	390859910
2013 : ST. MARYS NURSING CENTER RETIREMENT PLAN 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets	2013-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2013-12-31	$0
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total transfer of assets to this plan	2013-12-31	$0
Total transfer of assets from this plan	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
Expenses. Interest paid	2013-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$413,157
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$40,107
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$29,662
Expenses. Certain deemed distributions of participant loans	2013-12-31	$0
Value of total corrective distributions	2013-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$219,893
Value of total assets at end of year	2013-12-31	$1,708,837
Value of total assets at beginning of year	2013-12-31	$1,335,787
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$10,445
Total income from rents	2013-12-31	$0
Total interest from all sources	2013-12-31	$6,404
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
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$0
Assets. Real estate other than employer real property at end of year	2013-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2013-12-31	$0
Administrative expenses professional fees incurred	2013-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2013-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2013-12-31	$0
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$150,000
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	$172,801
Participant contributions at end of year	2013-12-31	$124,425
Participant contributions at beginning of year	2013-12-31	$127,719
Participant contributions at end of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$47,092
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$0
Assets. Loans (other than to participants) at end of year	2013-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$0
Other income not declared elsewhere	2013-12-31	$0
Administrative expenses (other) incurred	2013-12-31	$0
Liabilities. Value of operating payables at end of year	2013-12-31	$0
Liabilities. Value of operating payables at beginning of year	2013-12-31	$0
Total non interest bearing cash at end of year	2013-12-31	$0
Total non interest bearing cash at beginning of year	2013-12-31	$0
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
Income. Non cash contributions	2013-12-31	$0
Value of net income/loss	2013-12-31	$373,050
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,708,837
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,335,787
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
Assets. partnership/joint venture interests at end of year	2013-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2013-12-31	$0
Investment advisory and management fees	2013-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$1,509,960
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$1,120,688
Value of interest in pooled separate accounts at end of year	2013-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$0
Interest on participant loans	2013-12-31	$5,157
Income. Interest from loans (other than to participants)	2013-12-31	$0
Interest earned on other investments	2013-12-31	$0
Income. Interest from US Government securities	2013-12-31	$0
Income. Interest from corporate debt instruments	2013-12-31	$0
Value of interest in master investment trust accounts at end of year	2013-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2013-12-31	$0
Value of interest in common/collective trusts at end of year	2013-12-31	$0
Value of interest in common/collective trusts at beginning of year	2013-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$1,247
Assets. Value of investments in 103.12 investment entities at end of year	2013-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2013-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$74,452
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$87,380
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$0
Asset value of US Government securities at end of year	2013-12-31	$0
Asset value of US Government securities at beginning of year	2013-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$186,860
Net investment gain/loss from pooled separate accounts	2013-12-31	$0
Net investment gain or loss from common/collective trusts	2013-12-31	$0
Net gain/loss from 103.12 investment entities	2013-12-31	$0
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	Yes
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Assets. Invements in employer securities at end of year	2013-12-31	$0
Assets. Invements in employer securities at beginning of year	2013-12-31	$0
Assets. Value of employer real property at end of year	2013-12-31	$0
Assets. Value of employer real property at beginning of year	2013-12-31	$0
Contributions received in cash from employer	2013-12-31	$0
Employer contributions (assets) at end of year	2013-12-31	$0
Employer contributions (assets) at beginning of year	2013-12-31	$0
Income. Dividends from preferred stock	2013-12-31	$0
Income. Dividends from common stock	2013-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$29,662
Asset. Corporate debt instrument preferred debt at end of year	2013-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2013-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2013-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2013-12-31	$0
Contract administrator fees	2013-12-31	$10,445
Assets. Corporate common stocks other than exployer securities at end of year	2013-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2013-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2013-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2013-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2013-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2013-12-31	$0
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
Aggregate proceeds on sale of assets	2013-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2013-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2013-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2013-12-31	$0
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	PARENTEBEARD LLC
Accountancy firm EIN	2013-12-31	232932984
2012 : ST. MARYS NURSING CENTER RETIREMENT PLAN 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets	2012-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2012-12-31	$0
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total transfer of assets to this plan	2012-12-31	$8,172
Total transfer of assets from this plan	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
Expenses. Interest paid	2012-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$1,344,169
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$16,554
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$7,885
Expenses. Certain deemed distributions of participant loans	2012-12-31	$0
Value of total corrective distributions	2012-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$1,251,016
Value of total assets at end of year	2012-12-31	$1,335,787
Value of total assets at beginning of year	2012-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$8,669
Total income from rents	2012-12-31	$0
Total interest from all sources	2012-12-31	$4,860
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
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$0
Assets. Real estate other than employer real property at end of year	2012-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2012-12-31	$0
Administrative expenses professional fees incurred	2012-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2012-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2012-12-31	$0
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$150,000
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	$141,189
Participant contributions at end of year	2012-12-31	$127,719
Participant contributions at beginning of year	2012-12-31	$0
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$1,109,606
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$0
Assets. Loans (other than to participants) at end of year	2012-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2012-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$0
Other income not declared elsewhere	2012-12-31	$0
Administrative expenses (other) incurred	2012-12-31	$8,669
Liabilities. Value of operating payables at end of year	2012-12-31	$0
Liabilities. Value of operating payables at beginning of year	2012-12-31	$0
Total non interest bearing cash at end of year	2012-12-31	$0
Total non interest bearing cash at beginning of year	2012-12-31	$0
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
Income. Non cash contributions	2012-12-31	$0
Value of net income/loss	2012-12-31	$1,327,615
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,335,787
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$0
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
Assets. partnership/joint venture interests at end of year	2012-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2012-12-31	$0
Investment advisory and management fees	2012-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$1,120,688
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$0
Value of interest in pooled separate accounts at end of year	2012-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$0
Interest on participant loans	2012-12-31	$3,658
Income. Interest from loans (other than to participants)	2012-12-31	$0
Interest earned on other investments	2012-12-31	$0
Income. Interest from US Government securities	2012-12-31	$0
Income. Interest from corporate debt instruments	2012-12-31	$0
Value of interest in master investment trust accounts at end of year	2012-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2012-12-31	$0
Value of interest in common/collective trusts at end of year	2012-12-31	$0
Value of interest in common/collective trusts at beginning of year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$1,202
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$87,380
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$0
Asset value of US Government securities at end of year	2012-12-31	$0
Asset value of US Government securities at beginning of year	2012-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$88,293
Net investment gain/loss from pooled separate accounts	2012-12-31	$0
Net investment gain or loss from common/collective trusts	2012-12-31	$0
Net gain/loss from 103.12 investment entities	2012-12-31	$0
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	Yes
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Assets. Invements in employer securities at end of year	2012-12-31	$0
Assets. Invements in employer securities at beginning of year	2012-12-31	$0
Assets. Value of employer real property at end of year	2012-12-31	$0
Assets. Value of employer real property at beginning of year	2012-12-31	$0
Contributions received in cash from employer	2012-12-31	$221
Employer contributions (assets) at end of year	2012-12-31	$0
Employer contributions (assets) at beginning of year	2012-12-31	$0
Income. Dividends from preferred stock	2012-12-31	$0
Income. Dividends from common stock	2012-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$7,885
Asset. Corporate debt instrument preferred debt at end of year	2012-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2012-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2012-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2012-12-31	$0
Contract administrator fees	2012-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2012-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2012-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2012-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2012-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2012-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2012-12-31	$0
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
Aggregate proceeds on sale of assets	2012-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2012-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2012-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2012-12-31	$0
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	PARENTEBEARD LLC
Accountancy firm EIN	2012-12-31	232932984

Form 5500 Responses for ST. MARYS NURSING CENTER RETIREMENT PLAN

2023: ST. MARYS NURSING CENTER RETIREMENT PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Submission has been amended	No
2023-01-01	This submission is the final filing	No
2023-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2023-01-01	Plan is a collectively bargained plan	No
2023-01-01	Plan funding arrangement – Trust	Yes
2023-01-01	Plan benefit arrangement - Trust	Yes
2022: ST. MARYS NURSING CENTER RETIREMENT 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: ST. MARYS NURSING CENTER RETIREMENT 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: ST. MARYS NURSING CENTER RETIREMENT 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: ST. MARYS NURSING CENTER RETIREMENT 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
2018: ST. MARYS NURSING CENTER RETIREMENT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: ST. MARYS NURSING CENTER RETIREMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: ST. MARYS NURSING CENTER RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: ST. MARYS NURSING CENTER RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	Yes
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: ST. MARYS NURSING CENTER RETIREMENT 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	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: ST. MARYS NURSING CENTER RETIREMENT 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 benefit arrangement - Trust	Yes
2012: ST. MARYS NURSING CENTER RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	First time form 5500 has been submitted	Yes
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 benefit arrangement - Trust	Yes

Insurance Providers Used on plan

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G36389

Policy instance

Insurance contract or identification number	G36389
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-07-17
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G36389

Policy instance

Insurance contract or identification number	G36389
Number of Individuals Covered	150
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G36389

Policy instance

Insurance contract or identification number	G36389
Number of Individuals Covered	137
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G36389

Policy instance

Insurance contract or identification number	G36389
Number of Individuals Covered	123
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G36389

Policy instance

Insurance contract or identification number	G36389
Number of Individuals Covered	111
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	ST. MARYS NURSING CENTER INC.
Employer identification number (EIN):	522327829
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities