EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN 401k Plan overview

EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN Benefits

401k Sponsoring company profile

Company Name:	DIVERSICARE LEASING CORPORATION
Employer identification number (EIN):	621317705
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Form 5500 Filing Information

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
505	2022-01-01
505	2021-01-01
505	2020-01-01
505	2019-01-01
505	2018-01-01	VICKY DICLEMENTE
505	2017-01-01	VICKY DICLEMENTE
505	2016-01-01	VICKY DICLEMENTE
505	2015-01-01	VICKY DICLEMENTE
505	2011-01-01	VICKY DICLEMENTE
505	2009-01-01	VICKY DICLEMENTE

Plan Statistics for EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN

Measure	Date	Value
2022: EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	738
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	689
Total of all active and inactive participants	2022-01-01	689
Total participants	2022-01-01	689
2021: EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	827
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	738
Total of all active and inactive participants	2021-01-01	738
Total participants	2021-01-01	738
2020: EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	1,256
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	827
Total of all active and inactive participants	2020-01-01	827
Total participants	2020-01-01	827
2019: EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	1,190
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	1,256
Total of all active and inactive participants	2019-01-01	1,256
Total participants	2019-01-01	1,256
2018: EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	1,083
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	1,190
Total of all active and inactive participants	2018-01-01	1,190
Total participants	2018-01-01	1,190
2017: EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1,373
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	1,083
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	0
Total of all active and inactive participants	2017-01-01	1,083
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	1,083
2016: EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,250
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	1,373
Total of all active and inactive participants	2016-01-01	1,373
Total participants	2016-01-01	1,373
2015: EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,449
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1,250
Total of all active and inactive participants	2015-01-01	1,250
Total participants	2015-01-01	1,250
2011: EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,717
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,732
Total of all active and inactive participants	2011-01-01	1,732
Total participants	2011-01-01	1,732
2009: EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,488
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,601
Total of all active and inactive participants	2009-01-01	1,601
Total participants	2009-01-01	1,601

Form 5500 Responses for EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN

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• EMPLOYEE HEALTH PLAN OF BULLDOG BWW [EIN = 274759500]
• EMPLOYEE HEALTH PLAN OF AD ASTRA II, INC [EIN = 811656488]
• EMPLOYEE HEALTH PLAN OF GROUP ENTERPRISE OF NORTH AMERICA, INC. [EIN = 251495862]
• EMPLOYEE HEALTH PLAN OF MERIDIAN RESTAURANTS UNLIMITED, L.C. [EIN = 223863257]
• EMPLOYEE HEALTH PLAN OF GREEN FOOD 2 GO [EIN = 814113582]
• EMPLOYEE HEALTH PLAN OF ESG HOLDINGS, LLC [EIN = 814726985]
• EMPLOYEE HEALTH PLAN OF RACKSON RESTAURANTS, LLC [EIN = 812076912]
• EMPLOYEE HEALTH PLAN OF DSG KANKAKEE LLC [EIN = 461428147]
• EMPLOYEE HEALTH PLAN OF CEMA, INC [EIN = 310992020]
• EMPLOYEE HEALTH PLAN OF MUFFLERS USA, INC [EIN = 742832536]
• EMPLOYEE HEALTH PLAN OF CORLE BUILDING SYSTEMS, INC. [EIN = 251805260]
• EMPLOYEE HEALTH PLAN OF SHAU MUFFLER OGDEN INC DBA MIDAS [EIN = 362697725]
• EMPLOYEE HEALTH PLAN OF RKB ENTERPRISES, INC [EIN = 382792178]
• EMPLOYEE HEALTH PLAN OF ANDERSON MANAGEMENT GROUP [EIN = 201598467]
• EMPLOYEE HEALTH PLAN OF FLYING S WINGS [EIN = 341883073]
• EMPLOYEE HEALTH PLAN OF CORLE BUILDING SYSTEMS, INC. [EIN = 251805260]
• EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE [EIN = 570439385]
• EMPLOYEE HEALTH PLAN OF SMITH VENDING [EIN = 261365659]
• EMPLOYEE HEALTH PLAN OF RESTAURANT SERVICES, INC. [EIN = 650308534]
• EMPLOYEE HEALTH PLAN OF TEXAS RESTAURANT HOLDINGS LLC [EIN = 831060092]
• EMPLOYEE HEALTH PLAN OF MCJJ HOLDING LLC [EIN = 462809280]
• EMPLOYEE HEALTH PLAN OF WEST SIDE PIZZA PIE LLC [EIN = 263776884]
• EMPLOYEE HEALTH PLAN OF DJD FITNESS NAZARETH INC [EIN = 460862497]
• EMPLOYEE HEALTH PLAN OF DEEP VALLEY ENTERPRISES [EIN = 942580612]
• EMPLOYEE HEALTH PLAN OF NW KINGS LLC [EIN = 814140158]
• EMPLOYEE HEALTH PLAN OF PB FITNESS [EIN = 901013012]
• EMPLOYEE HEALTH PLAN OF MEINEKE CAR CARE 2262,1223 [EIN = 454145514]
• EMPLOYEE HEALTH PLAN OF ANGEL-TECH, INC DBA MINEOLA MIDAS AUTO SERVICES & TIRES [EIN = 261495335]
• EMPLOYEE HEALTH PLAN OF PFIFA DBA PF INDEPENDENT FRANCHISEE COUNCIL [EIN = 471014888]
• EMPLOYEE HEALTH PLAN OF PF DENVER, LLC (PF AURORA) [EIN = 463069462]
• EMPLOYEE HEALTH PLAN OF BERKSHIRE FOOD [EIN = 060905660]
• EMPLOYEE HEALTH PLAN OF BEST OF THE BEST INC DBA SUPERCUTS [EIN = 841646602]
• EMPLOYEE HEALTH PLAN OF RKJ AND SONS, LLC [EIN = 581875890]
• EMPLOYEE HEALTH PLAN OF PF RHODE ISLAND (KIWIMEX) [EIN = 453188880]
• EMPLOYEE HEALTH PLAN OF MID MISSOURI CAR CARE, INC. [EIN = 421761633]
• EMPLOYEE HEALTH PLAN OF GOURMET SUBS OF CHARLOTTE, LLC [EIN = 331138976]
• EMPLOYEE HEALTH PLAN OF THE PROCACCIO CORP [EIN = 412207619]
• EMPLOYEE HEALTH PLAN OF EVOLUTION MANAGEMENT, LLC [EIN = 352614267]
• EMPLOYEE HEALTH PLAN OF MLJ FOODS INC [EIN = 204227833]
• EMPLOYEE HEALTH PLAN OF JEFFREY GIANGRANDE CORPORATION [EIN = 521707974]
• EMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC [EIN = 223666724]
• EMPLOYEE HEALTH PLAN OF DONYA CORPORATION [EIN = 820504778]
• EMPLOYEE HEALTH PLAN OF MARCOR LLC DBA MEINEKE [EIN = 273091032]
• EMPLOYEE HEALTH PLAN OF GTM RESTAURANT CORP [EIN = 232108143]
• EMPLOYEE HEALTH PLAN OF NEW KING INC [EIN = 061031059]
• EMPLOYEE HEALTH PLAN OF EMB ENTERPRISE LLC [EIN = 571236293]
• EMPLOYEE HEALTH PLAN OF ROOSTER TAIL INC DBA MEINEKE CAR CARE [EIN = 043087259]
• EMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC [EIN = 465445886]
• EMPLOYEE HEALTH PLAN OF SYED RESTAURANTS ENTERPRISES [EIN = 261276014]
• EMPLOYEE HEALTH PLAN OF NATIONAL CITIES CORPORATION I LP [EIN = 813906458]
• EMPLOYEE HEALTH PLAN OF TOTALLY TASTY ENTREES, LLC [EIN = 275418543]
• EMPLOYEE HEALTH PLAN OF CORAL CAY RESTAURANTS LLC [EIN = 471884804]
• EMPLOYEE HEALTH PLAN OF 413 HAGERSTOWN [EIN = 831386022]
• EMPLOYEE HEALTH PLAN OF BREW AVENUE REFRESHMENT SVCS [EIN = 262960013]
• EMPLOYEE HEALTH PLAN OF JARDEL ENTERPRISES INC [EIN = 840796459]
• EMPLOYEE HEALTH PLAN OF CAROLINA FRANCHISE HOLDINGS [EIN = 824240401]
• EMPLOYEE HEALTH PLAN OF S & F INVESTMENTS, INC [EIN = 571072521]
• EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN [EIN = 760137035]
• EMPLOYEE HEALTH PLAN OF ATLANTA FAMILY NEUROLOGY PC [EIN = 260376624]
• EMPLOYEE HEALTH PLAN OF ALPHARETTA CARDIOLOGY, LLC [EIN = 582575191]
• EMPLOYEE HEALTH PLAN OF FACTORIAL RESTAURANT HOLDINGS LLC [EIN = 852920023]
• EMPLOYEE HEALTH PLAN OF ATLANTA PSYCHIATRY & PSYCHOTHERAPY ASSOCIATES [EIN = 455348915]
• EMPLOYEE HEALTH PLAN OF COLUMBUS FAMILY MEDICINE LLC [EIN = 814243040]
• EMPLOYEE HEALTH PLAN OF CARDIOLOGY CONSULTANTS OF ATLANTA [EIN = 562529451]
• EMPLOYEE HEALTH PLAN OF ADVANCED INTERNAL MEDICINE [EIN = 300058901]
• EMPLOYEE HEALTH PLAN OF 108 ASSETS LLC [EIN = 824424352]
• EMPLOYEE HEALTH PLAN OF ARCNV INC [EIN = 833436725]
• EMPLOYEE HEALTH PLAN OF FIRST MEDICAL CARE INC [EIN = 581716416]
• EMPLOYEE HEALTH PLAN OF DW AUTOMOTIVE SERVICES INC [EIN = 472123446]
• EMPLOYEE HEALTH PLAN OF ALPHA EYE ASSOCIATES, LLC [EIN = 582498161]
• EMPLOYEE HEALTH PLAN OF JOHNS CREEK SURGERY, PC [EIN = 582636217]
• EMPLOYEE HEALTH PLAN OF CHA OB/GYN PC [EIN = 474056884]
• EMPLOYEE HEALTH PLAN OF PROVIDER OF COMPUTER PROFESSIONALS INC [EIN = 752723411]
• EMPLOYEE HEALTH PLAN OF ATLANTA RHEUMATOLOGY CONSULTANTS [EIN = 260455216]
• EMPLOYEE HEALTH PLAN OF SHEEHY ENTERPRISES, INC. [EIN = 860318871]
• EMPLOYEE HEALTH PLAN OF CENTER FOR DERMATOLOGY LLC [EIN = 264301954]
• EMPLOYEE HEALTH PLAN OF IVY FALLS FAMILY MEDICINE INC [EIN = 203545124]
• EMPLOYEE HEALTH PLAN OF PRIMARY CARE CENTER OF GA, INC [EIN = 582407274]
• EMPLOYEE HEALTH PLAN OF RU HUNGRY LLC [EIN = 550907996]
• EMPLOYEE HEALTH PLAN OF PAUL INTERNAL MEDICINE ASSOCIATES [EIN = 680594620]
• EMPLOYEE HEALTH PLAN OF HUNTSVILLE CAESARS INC [EIN = 203472600]
• EMPLOYEE HEALTH PLAN OF T. TIME INC [EIN = 204105437]
• EMPLOYEE HEALTH PLAN OF CAPRI MEDICAL GROUP [EIN = 263128223]
• EMPLOYEE HEALTH PLAN OF B&A REPAIR CO [EIN = 301003982]
• EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN [EIN = 915893103]
• EMPLOYEE HEALTH CENTRE LLC MEDOVA LIFESTYLE HEALTH PLAN [EIN = 300417858]
• EMPLOYEE HEALTHCARE PLAN [EIN = 010822836]
• EMPLOYEE HEALTH PLAN OF FLATBEC INC [EIN = 203612212]
• EMPLOYEE HEALTH PLAN OF ONE T INC [EIN = 204189481]
• EMPLOYEE HEALTH PLAN OF PF BASELINE FITNESS LLC [EIN = 451503978]
• EMPLOYEE HEALTH PLAN OF MRK ENTERPRISES [EIN = 611132949]
• EMPLOYEE HEALTH PLAN OF BURGER BARN [EIN = 862467626]
• EMPLOYEE HEALTH PLAN OF HAWBROOK HOLDINGS LLC [EIN = 202176503]
• EMPLOYEE HEALTH PLAN OF MODERN OBSTETRICS & GYNECOLOGY OF NORTH ATLANTA [EIN = 272887978]
• EMPLOYEE HEALTH PLAN OF MARK ANTHONY ENTERPRISES [EIN = 621813704]
• EMPLOYEE HEALTH PLAN OF THOMPSON KING HOLDINGS [EIN = 872035125]
• EMPLOYEE HEALTH PLAN OF STB INC [EIN = 611261562]
• EMPLOYEE HEALTH PLAN OF CENTRAL MS ENTERPRISES [EIN = 822683857]
• EMPLOYEE HEALTH PLAN OF SOUTHERN BEHAVIORAL HEALTHCARE, PC [EIN = 043730144]
• EMPLOYEE HEALTH PLAN OF CHI INVESTMENTS [EIN = 431834367]
• EMPLOYEE HEALTH PLAN OF MACHINE CUISINE [EIN = 330976445]
• EMPLOYEE HEALTH PLAN OF ACTIVE ANKLE AND FOOT CARE SPECIALISTS [EIN = 262855885]
• EMPLOYEE HEALTH PLAN OF PURPOSEFUL ADAPTATIONS [EIN = 862263067]
• EMPLOYEE HEALTH PLAN OF BURGERS OF COLUMBIA PIKE [EIN = 621320936]
• EMPLOYEE HEALTH PLAN OF KARVID PARTNERS II, LLC [EIN = 833436581]
• EMPLOYEE HEALTH PLAN OF EXTRA PICKLES [EIN = 842499296]
• EMPLOYEE HEALTH PLAN OF ALBERT F JOHARY MD, PC [EIN = 582421431]
• EMPLOYEE HEALTH PLAN OF ATLANTA ROPHEKA MEDICAL CENTER [EIN = 200540802]
• EMPLOYEE HEALTH PLAN OF CENTER FOR MEDICINE, LLC [EIN = 582356591]
• EMPLOYEE HEALTH PLAN OF PANIMOR CORP [EIN = 831436390]
• EMPLOYEE HEALTH PLAN OF K-H ENTERPRISES [EIN = 470757325]
• EMPLOYEE HEALTH PLAN OF APOLLO BEHAVIOR SERVICES LLC [EIN = 843298073]
• EMPLOYEE HEALTH PLAN OF ST. THERESA'S OB/GYN, INC [EIN = 463240302]
• EMPLOYEE HEALTH PLAN OF HOLDINGS LLC [EIN = 843286472]
• EMPLOYEE HEALTH PLAN OF D&D FOODSERVICE, INC [EIN = 680555829]
• EMPLOYEE HEALTH PLAN OF RGT II INC DBA MEINEKE CAR CARE CENTER [EIN = 471082849]
• EMPLOYEE HEALTH PLAN OF PJ FOODS LLC [EIN = 522127598]
• EMPLOYEE HEALTH PLAN OF CONSOLIDATED BURGER C, LLC [EIN = 822435818]
• EMPLOYEE HEALTH PLAN OF SOUTH ATLANTA VASCULAR INSTITUTE LLC [EIN = 830636051]
• EMPLOYEE HEALTH PLAN OF MAS RESTAURANT GROUP LLC [EIN = 862738243]
• EMPLOYEE HEALTH PLAN OF M SQUARED AZ INC [EIN = 851608911]
• EMPLOYEE HEALTH PLAN OF TRI COUNTY INTERNAL MEDICINE, PC [EIN = 582635783]
• EMPLOYEE HEALTH PLAN OF SIRIPI LLC [EIN = 822970722]
• EMPLOYEE HEALTH PLAN OF EAGLESLANDING DIABETES & ENDOCRINOLOGY [EIN = 300084490]
• EMPLOYEE HEALTH PLAN OF MABAM ENTERPRISES [EIN = 341733393]
• EMPLOYEE HEALTH PLAN OF GRALO [EIN = 043834161]
• EMPLOYEE HEALTH PLAN OF NJ WAX 8 [EIN = 872574869]
• EMPLOYEE HEALTH PLAN OF DANKERT DANKERT ASSOCIATES [EIN = 351889838]
• EMPLOYEE HEALTH PLAN OF TLA SERVICES INC [EIN = 270382943]
• EMPLOYEE HEALTH PLAN OF ALPHA MOTOR WORKS [EIN = 853384519]
• EMPLOYEE HEALTH PLAN OF CARDIOLOGY OF ATLANTA [EIN = 260805667]
• EMPLOYEE HEALTH PLAN OF RENDEZVOUS ENTERPRISES [EIN = 941694577]
• EMPLOYEE HEALTH PLAN OF RIVERDALE FOOT ANKLE AND LEG CLINIC [EIN = 030432582]
• EMPLOYEE HEALTH PLAN OF SBA HOLDINGS INC [EIN = 824878919]
• EMPLOYEE HEALTH PLAN OF SBS HOLDINGS [EIN = 844708174]
• EMPLOYEE HEALTH PLAN OF ALIGN SPINE AND PAIN INSTITUTE LLC [EIN = 871751283]
• EMPLOYEE HEALTH PLAN OF CMH AUTO [EIN = 201166092]
• EMPLOYEE HEALTH PLAN OF ASHLAND ENTERPRISES [EIN = 541903968]
• EMPLOYEE HEALTH AND WELFARE PLAN [EIN = 421727335]
• EMPLOYEE HEALTH PLAN OF RADIANT ONE LLC [EIN = 854045032]
• EMPLOYEE HEALTH PLAN OF VENITA GROUP LLC [EIN = 824202772]
• EMPLOYEE HEALTH PLAN OF BUTLER AUTOMOTIVE [EIN = 462798190]
• EMPLOYEE HEALTH PLAN OF C&A AZ LLC [EIN = 920622329]
• EMPLOYEE HEALTH PLAN OF C3M ENTERPRISES, INC. [EIN = 462975736]
• EMPLOYEE HEALTH PLAN OF COVENANT MEDICAL GROUP [EIN = 822423015]
• EMPLOYEE HEALTH PLAN OF KEM HEALTH [EIN = 850838005]
• EMPLOYEE HEALTH PLAN OF KRYGIER MANAGEMENT, INC. [EIN = 271726124]
• EMPLOYEE HEALTH PLAN OF ROYAL RESTAURANT GROUP [EIN = 921116188]
• EMPLOYEE HEALTH PLAN OF SUNSET SUBWAY [EIN = 860730233]
• EMPLOYEE HEALTH CARE OF WOODBURY CAR CARE DBA MEINEKE CAR CARE #538 [EIN = 825528509]
• EMPLOYEE HEALTH PLAN OF NORTHEAST ATLANTA ENT [EIN = 581949171]
• EMPLOYEE HEALTH PLAN OF PACIFIC BELLS, LLC [EIN = 911806191]
• EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN [EIN = 521317705]
• EMPLOYEE HEALTH AND WELFARE BENEFIT PROGRAM OF CTS CORPORATION [EIN = 350225010]

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