401k Plan data: CLEARY NURSING HOMES 401(K) PLAN plan

CLEARY NURSING HOMES 401(K) PLAN 401k Plan overview

Plan Name	CLEARY NURSING HOMES 401(K) PLAN
Plan identification number	002

CLEARY NURSING HOMES 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

MERIDIAN MANOR CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: MERIDIAN MANOR CORPORATION

Employer identification number (EIN): 060812340

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CLEARY NURSING HOMES 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-10-01
002 2021-10-01
002 2020-10-01 THOMAS F. OWENS JR. 2022-07-12
002 2019-10-01 THOMAS F. OWENS JR. 2021-07-12
002 2018-10-01 MARY PEDANE 2020-07-13
002 2017-10-01 MARY PEDANE 2019-07-12
002 2016-10-01
002 2015-10-01
002 2014-10-01
002 2013-10-01 JAMES E. CLEARY
002 2012-10-01 BRIAN J. CLEARY BRIAN J. CLEARY 2014-07-15
002 2011-10-01 JAMES E. CLEARY JAMES E. CLEARY 2013-07-16
002 2010-10-01 JAMES E. CLEARY JAMES E. CLEARY 2012-07-13
002 2009-10-01 JAMES E. CLEARY JAMES E. CLEARY 2011-07-15
002 2008-10-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-10-01
002	2021-10-01
002	2020-10-01	THOMAS F. OWENS JR.	2022-07-12
002	2019-10-01	THOMAS F. OWENS JR.	2021-07-12
002	2018-10-01	MARY PEDANE	2020-07-13
002	2017-10-01	MARY PEDANE	2019-07-12
002	2016-10-01
002	2015-10-01
002	2014-10-01
002	2013-10-01	JAMES E. CLEARY
002	2012-10-01	BRIAN J. CLEARY		BRIAN J. CLEARY	2014-07-15
002	2011-10-01	JAMES E. CLEARY		JAMES E. CLEARY	2013-07-16
002	2010-10-01	JAMES E. CLEARY		JAMES E. CLEARY	2012-07-13
002	2009-10-01	JAMES E. CLEARY		JAMES E. CLEARY	2011-07-15
002	2008-10-01

Plan Statistics for CLEARY NURSING HOMES 401(K) PLAN

401k plan membership statisitcs for CLEARY NURSING HOMES 401(K) PLAN

Measure Date Value
2020: CLEARY NURSING HOMES 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-10-01 165
Total number of active participants reported on line 7a of the Form 5500 2020-10-01 12
Number of retired or separated participants receiving benefits 2020-10-01 0
Number of other retired or separated participants entitled to future benefits 2020-10-01 66
Total of all active and inactive participants 2020-10-01 78
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-10-01 2
Total participants 2020-10-01 80
Number of participants with account balances 2020-10-01 74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-10-01 0
2019: CLEARY NURSING HOMES 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-10-01 196
Total number of active participants reported on line 7a of the Form 5500 2019-10-01 129
Number of retired or separated participants receiving benefits 2019-10-01 0
Number of other retired or separated participants entitled to future benefits 2019-10-01 35
Total of all active and inactive participants 2019-10-01 164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-10-01 1
Total participants 2019-10-01 165
Number of participants with account balances 2019-10-01 86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-10-01 0
2018: CLEARY NURSING HOMES 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-10-01 205
Total number of active participants reported on line 7a of the Form 5500 2018-10-01 167
Number of retired or separated participants receiving benefits 2018-10-01 0
Number of other retired or separated participants entitled to future benefits 2018-10-01 27
Total of all active and inactive participants 2018-10-01 194
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-10-01 2
Total participants 2018-10-01 196
Number of participants with account balances 2018-10-01 94
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-10-01 0
2017: CLEARY NURSING HOMES 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-10-01 223
Total number of active participants reported on line 7a of the Form 5500 2017-10-01 174
Number of retired or separated participants receiving benefits 2017-10-01 0
Number of other retired or separated participants entitled to future benefits 2017-10-01 30
Total of all active and inactive participants 2017-10-01 204
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-10-01 1
Total participants 2017-10-01 205
Number of participants with account balances 2017-10-01 103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-10-01 0
2016: CLEARY NURSING HOMES 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-10-01 235
Total number of active participants reported on line 7a of the Form 5500 2016-10-01 185
Number of retired or separated participants receiving benefits 2016-10-01 0
Number of other retired or separated participants entitled to future benefits 2016-10-01 37
Total of all active and inactive participants 2016-10-01 222
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-10-01 1
Total participants 2016-10-01 223
Number of participants with account balances 2016-10-01 117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-10-01 0
2015: CLEARY NURSING HOMES 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-10-01 269
Total number of active participants reported on line 7a of the Form 5500 2015-10-01 207
Number of retired or separated participants receiving benefits 2015-10-01 0
Number of other retired or separated participants entitled to future benefits 2015-10-01 28
Total of all active and inactive participants 2015-10-01 235
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-10-01 0
Total participants 2015-10-01 235
Number of participants with account balances 2015-10-01 117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-10-01 0
2014: CLEARY NURSING HOMES 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-10-01 282
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 228
Number of retired or separated participants receiving benefits 2014-10-01 0
Number of other retired or separated participants entitled to future benefits 2014-10-01 41
Total of all active and inactive participants 2014-10-01 269
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-10-01 0
Total participants 2014-10-01 269
Number of participants with account balances 2014-10-01 129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-10-01 0
2013: CLEARY NURSING HOMES 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-10-01 127
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 241
Number of retired or separated participants receiving benefits 2013-10-01 0
Number of other retired or separated participants entitled to future benefits 2013-10-01 40
Total of all active and inactive participants 2013-10-01 281
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-10-01 1
Total participants 2013-10-01 282
Number of participants with account balances 2013-10-01 134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-10-01 0
2012: CLEARY NURSING HOMES 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-10-01 130
Total number of active participants reported on line 7a of the Form 5500 2012-10-01 85
Number of retired or separated participants receiving benefits 2012-10-01 0
Number of other retired or separated participants entitled to future benefits 2012-10-01 33
Total of all active and inactive participants 2012-10-01 118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-10-01 0
Total participants 2012-10-01 118
Number of participants with account balances 2012-10-01 65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-10-01 0
2011: CLEARY NURSING HOMES 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-10-01 140
Total number of active participants reported on line 7a of the Form 5500 2011-10-01 98
Number of retired or separated participants receiving benefits 2011-10-01 0
Number of other retired or separated participants entitled to future benefits 2011-10-01 34
Total of all active and inactive participants 2011-10-01 132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-10-01 0
Total participants 2011-10-01 132
Number of participants with account balances 2011-10-01 66
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-10-01 0
2010: CLEARY NURSING HOMES 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-10-01 128
Total number of active participants reported on line 7a of the Form 5500 2010-10-01 97
Number of other retired or separated participants entitled to future benefits 2010-10-01 38
Total of all active and inactive participants 2010-10-01 135
Total participants 2010-10-01 135
Number of participants with account balances 2010-10-01 70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-10-01 0
2009: CLEARY NURSING HOMES 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-10-01 138
Total number of active participants reported on line 7a of the Form 5500 2009-10-01 87
Number of retired or separated participants receiving benefits 2009-10-01 0
Number of other retired or separated participants entitled to future benefits 2009-10-01 35
Total of all active and inactive participants 2009-10-01 122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-10-01 0
Total participants 2009-10-01 122
Number of participants with account balances 2009-10-01 72
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-10-01 0

Measure	Date	Value
2020: CLEARY NURSING HOMES 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-10-01	165
Total number of active participants reported on line 7a of the Form 5500	2020-10-01	12
Number of retired or separated participants receiving benefits	2020-10-01	0
Number of other retired or separated participants entitled to future benefits	2020-10-01	66
Total of all active and inactive participants	2020-10-01	78
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-10-01	2
Total participants	2020-10-01	80
Number of participants with account balances	2020-10-01	74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-10-01	0
2019: CLEARY NURSING HOMES 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-10-01	196
Total number of active participants reported on line 7a of the Form 5500	2019-10-01	129
Number of retired or separated participants receiving benefits	2019-10-01	0
Number of other retired or separated participants entitled to future benefits	2019-10-01	35
Total of all active and inactive participants	2019-10-01	164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-10-01	1
Total participants	2019-10-01	165
Number of participants with account balances	2019-10-01	86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-10-01	0
2018: CLEARY NURSING HOMES 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-10-01	205
Total number of active participants reported on line 7a of the Form 5500	2018-10-01	167
Number of retired or separated participants receiving benefits	2018-10-01	0
Number of other retired or separated participants entitled to future benefits	2018-10-01	27
Total of all active and inactive participants	2018-10-01	194
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-10-01	2
Total participants	2018-10-01	196
Number of participants with account balances	2018-10-01	94
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-10-01	0
2017: CLEARY NURSING HOMES 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-10-01	223
Total number of active participants reported on line 7a of the Form 5500	2017-10-01	174
Number of retired or separated participants receiving benefits	2017-10-01	0
Number of other retired or separated participants entitled to future benefits	2017-10-01	30
Total of all active and inactive participants	2017-10-01	204
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-10-01	1
Total participants	2017-10-01	205
Number of participants with account balances	2017-10-01	103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-10-01	0
2016: CLEARY NURSING HOMES 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-10-01	235
Total number of active participants reported on line 7a of the Form 5500	2016-10-01	185
Number of retired or separated participants receiving benefits	2016-10-01	0
Number of other retired or separated participants entitled to future benefits	2016-10-01	37
Total of all active and inactive participants	2016-10-01	222
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-10-01	1
Total participants	2016-10-01	223
Number of participants with account balances	2016-10-01	117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-10-01	0
2015: CLEARY NURSING HOMES 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-10-01	269
Total number of active participants reported on line 7a of the Form 5500	2015-10-01	207
Number of retired or separated participants receiving benefits	2015-10-01	0
Number of other retired or separated participants entitled to future benefits	2015-10-01	28
Total of all active and inactive participants	2015-10-01	235
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-10-01	0
Total participants	2015-10-01	235
Number of participants with account balances	2015-10-01	117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-10-01	0
2014: CLEARY NURSING HOMES 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-10-01	282
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	228
Number of retired or separated participants receiving benefits	2014-10-01	0
Number of other retired or separated participants entitled to future benefits	2014-10-01	41
Total of all active and inactive participants	2014-10-01	269
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-10-01	0
Total participants	2014-10-01	269
Number of participants with account balances	2014-10-01	129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-10-01	0
2013: CLEARY NURSING HOMES 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-10-01	127
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	241
Number of retired or separated participants receiving benefits	2013-10-01	0
Number of other retired or separated participants entitled to future benefits	2013-10-01	40
Total of all active and inactive participants	2013-10-01	281
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-10-01	1
Total participants	2013-10-01	282
Number of participants with account balances	2013-10-01	134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-10-01	0
2012: CLEARY NURSING HOMES 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-10-01	130
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	85
Number of retired or separated participants receiving benefits	2012-10-01	0
Number of other retired or separated participants entitled to future benefits	2012-10-01	33
Total of all active and inactive participants	2012-10-01	118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-10-01	0
Total participants	2012-10-01	118
Number of participants with account balances	2012-10-01	65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-10-01	0
2011: CLEARY NURSING HOMES 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-10-01	140
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	98
Number of retired or separated participants receiving benefits	2011-10-01	0
Number of other retired or separated participants entitled to future benefits	2011-10-01	34
Total of all active and inactive participants	2011-10-01	132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-10-01	0
Total participants	2011-10-01	132
Number of participants with account balances	2011-10-01	66
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-10-01	0
2010: CLEARY NURSING HOMES 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-10-01	128
Total number of active participants reported on line 7a of the Form 5500	2010-10-01	97
Number of other retired or separated participants entitled to future benefits	2010-10-01	38
Total of all active and inactive participants	2010-10-01	135
Total participants	2010-10-01	135
Number of participants with account balances	2010-10-01	70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-10-01	0
2009: CLEARY NURSING HOMES 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-10-01	138
Total number of active participants reported on line 7a of the Form 5500	2009-10-01	87
Number of retired or separated participants receiving benefits	2009-10-01	0
Number of other retired or separated participants entitled to future benefits	2009-10-01	35
Total of all active and inactive participants	2009-10-01	122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-10-01	0
Total participants	2009-10-01	122
Number of participants with account balances	2009-10-01	72
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-10-01	0

Financial Data on CLEARY NURSING HOMES 401(K) PLAN

Measure	Date	Value
2021 : CLEARY NURSING HOMES 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-09-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-09-30	$0
Total income from all sources (including contributions)	2021-09-30	$732,937
Total loss/gain on sale of assets	2021-09-30	$0
Total of all expenses incurred	2021-09-30	$580,392
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-09-30	$554,170
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-09-30	$72,440
Value of total assets at end of year	2021-09-30	$4,544,132
Value of total assets at beginning of year	2021-09-30	$4,391,587
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-09-30	$26,222
Total interest from all sources	2021-09-30	$845
Total dividends received (eg from common stock, registered investment company shares)	2021-09-30	$1,632
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-09-30	$1,632
Was this plan covered by a fidelity bond	2021-09-30	Yes
Value of fidelity bond cover	2021-09-30	$500,000
If this is an individual account plan, was there a blackout period	2021-09-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-09-30	$0
Were there any nonexempt tranactions with any party-in-interest	2021-09-30	No
Contributions received from participants	2021-09-30	$72,440
Participant contributions at end of year	2021-09-30	$22,232
Participant contributions at beginning of year	2021-09-30	$39,499
Participant contributions at end of year	2021-09-30	$391
Participant contributions at beginning of year	2021-09-30	$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	2021-09-30	No
Value of net income/loss	2021-09-30	$152,545
Value of net assets at end of year (total assets less liabilities)	2021-09-30	$4,544,132
Value of net assets at beginning of year (total assets less liabilities)	2021-09-30	$4,391,587
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-09-30	No
Were any leases to which the plan was party in default or uncollectible	2021-09-30	No
Investment advisory and management fees	2021-09-30	$22,217
Value of interest in pooled separate accounts at end of year	2021-09-30	$4,470,892
Value of interest in pooled separate accounts at beginning of year	2021-09-30	$4,261,354
Interest on participant loans	2021-09-30	$845
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-09-30	$50,617
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-09-30	$48,964
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-09-30	$658,020
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-09-30	No
Was there a failure to transmit to the plan any participant contributions	2021-09-30	No
Has the plan failed to provide any benefit when due under the plan	2021-09-30	No
Employer contributions (assets) at end of year	2021-09-30	$0
Employer contributions (assets) at beginning of year	2021-09-30	$41,770
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-09-30	$554,170
Contract administrator fees	2021-09-30	$4,005
Did the plan have assets held for investment	2021-09-30	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	2021-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-09-30	No
Opinion of an independent qualified public accountant for this plan	2021-09-30	Disclaimer
Accountancy firm name	2021-09-30	MARCUM, LLP
Accountancy firm EIN	2021-09-30	111986323
2020 : CLEARY NURSING HOMES 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-09-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-09-30	$0
Total income from all sources (including contributions)	2020-09-30	$572,634
Total loss/gain on sale of assets	2020-09-30	$0
Total of all expenses incurred	2020-09-30	$585,871
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-09-30	$560,884
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-09-30	$184,603
Value of total assets at end of year	2020-09-30	$4,391,587
Value of total assets at beginning of year	2020-09-30	$4,404,824
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-09-30	$24,987
Total interest from all sources	2020-09-30	$1,506
Total dividends received (eg from common stock, registered investment company shares)	2020-09-30	$1,447
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-09-30	$1,447
Was this plan covered by a fidelity bond	2020-09-30	Yes
Value of fidelity bond cover	2020-09-30	$500,000
If this is an individual account plan, was there a blackout period	2020-09-30	No
Were there any nonexempt tranactions with any party-in-interest	2020-09-30	No
Contributions received from participants	2020-09-30	$142,833
Participant contributions at end of year	2020-09-30	$39,499
Participant contributions at beginning of year	2020-09-30	$21,931
Participant contributions at end of year	2020-09-30	$0
Participant contributions at beginning of year	2020-09-30	$44
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-09-30	No
Value of net income/loss	2020-09-30	$-13,237
Value of net assets at end of year (total assets less liabilities)	2020-09-30	$4,391,587
Value of net assets at beginning of year (total assets less liabilities)	2020-09-30	$4,404,824
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-09-30	No
Were any leases to which the plan was party in default or uncollectible	2020-09-30	No
Investment advisory and management fees	2020-09-30	$21,223
Value of interest in pooled separate accounts at end of year	2020-09-30	$4,261,354
Value of interest in pooled separate accounts at beginning of year	2020-09-30	$4,330,676
Interest on participant loans	2020-09-30	$1,506
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-09-30	$48,964
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-09-30	$1,102
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-09-30	$385,078
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-09-30	No
Was there a failure to transmit to the plan any participant contributions	2020-09-30	No
Has the plan failed to provide any benefit when due under the plan	2020-09-30	No
Contributions received in cash from employer	2020-09-30	$41,770
Employer contributions (assets) at end of year	2020-09-30	$41,770
Employer contributions (assets) at beginning of year	2020-09-30	$51,071
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-09-30	$560,884
Contract administrator fees	2020-09-30	$3,764
Did the plan have assets held for investment	2020-09-30	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	2020-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2020-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2020-09-30	Disclaimer
Accountancy firm name	2020-09-30	MARCUM, LLP
Accountancy firm EIN	2020-09-30	111986323
2019 : CLEARY NURSING HOMES 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-09-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-09-30	$0
Total income from all sources (including contributions)	2019-09-30	$404,406
Total loss/gain on sale of assets	2019-09-30	$0
Total of all expenses incurred	2019-09-30	$515,489
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-09-30	$491,409
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-09-30	$234,497
Value of total assets at end of year	2019-09-30	$4,404,824
Value of total assets at beginning of year	2019-09-30	$4,515,907
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-09-30	$24,080
Total interest from all sources	2019-09-30	$21,401
Total dividends received (eg from common stock, registered investment company shares)	2019-09-30	$2,520
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-09-30	$2,520
Administrative expenses professional fees incurred	2019-09-30	$1,275
Was this plan covered by a fidelity bond	2019-09-30	Yes
Value of fidelity bond cover	2019-09-30	$500,000
If this is an individual account plan, was there a blackout period	2019-09-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-09-30	$0
Were there any nonexempt tranactions with any party-in-interest	2019-09-30	No
Contributions received from participants	2019-09-30	$183,426
Participant contributions at end of year	2019-09-30	$21,931
Participant contributions at beginning of year	2019-09-30	$39,141
Participant contributions at end of year	2019-09-30	$44
Participant contributions at beginning of year	2019-09-30	$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	2019-09-30	No
Value of net income/loss	2019-09-30	$-111,083
Value of net assets at end of year (total assets less liabilities)	2019-09-30	$4,404,824
Value of net assets at beginning of year (total assets less liabilities)	2019-09-30	$4,515,907
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-09-30	No
Were any leases to which the plan was party in default or uncollectible	2019-09-30	No
Investment advisory and management fees	2019-09-30	$21,212
Value of interest in pooled separate accounts at end of year	2019-09-30	$4,330,676
Value of interest in pooled separate accounts at beginning of year	2019-09-30	$4,362,075
Interest on participant loans	2019-09-30	$1,190
Interest earned on other investments	2019-09-30	$20,211
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-09-30	$1,102
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-09-30	$65,907
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-09-30	$145,988
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-09-30	No
Was there a failure to transmit to the plan any participant contributions	2019-09-30	No
Has the plan failed to provide any benefit when due under the plan	2019-09-30	No
Contributions received in cash from employer	2019-09-30	$51,071
Employer contributions (assets) at end of year	2019-09-30	$51,071
Employer contributions (assets) at beginning of year	2019-09-30	$48,784
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-09-30	$491,409
Contract administrator fees	2019-09-30	$1,593
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	2019-09-30	No
Did the plan have assets held for investment	2019-09-30	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	2019-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2019-09-30	Disclaimer
Accountancy firm name	2019-09-30	MARCUM, LLP
Accountancy firm EIN	2019-09-30	111986323
2018 : CLEARY NURSING HOMES 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-09-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-09-30	$0
Total income from all sources (including contributions)	2018-09-30	$451,490
Total loss/gain on sale of assets	2018-09-30	$0
Total of all expenses incurred	2018-09-30	$633,919
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-09-30	$607,665
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-09-30	$201,054
Value of total assets at end of year	2018-09-30	$4,515,907
Value of total assets at beginning of year	2018-09-30	$4,698,336
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-09-30	$26,254
Total interest from all sources	2018-09-30	$18,568
Total dividends received (eg from common stock, registered investment company shares)	2018-09-30	$8,405
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-09-30	$8,405
Administrative expenses professional fees incurred	2018-09-30	$1,870
Was this plan covered by a fidelity bond	2018-09-30	Yes
Value of fidelity bond cover	2018-09-30	$500,000
If this is an individual account plan, was there a blackout period	2018-09-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-09-30	$0
Were there any nonexempt tranactions with any party-in-interest	2018-09-30	No
Contributions received from participants	2018-09-30	$153,667
Participant contributions at end of year	2018-09-30	$39,141
Participant contributions at beginning of year	2018-09-30	$61,581
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-09-30	No
Value of net income/loss	2018-09-30	$-182,429
Value of net assets at end of year (total assets less liabilities)	2018-09-30	$4,515,907
Value of net assets at beginning of year (total assets less liabilities)	2018-09-30	$4,698,336
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-09-30	No
Were any leases to which the plan was party in default or uncollectible	2018-09-30	No
Investment advisory and management fees	2018-09-30	$22,939
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-09-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-09-30	$0
Value of interest in pooled separate accounts at end of year	2018-09-30	$4,362,075
Value of interest in pooled separate accounts at beginning of year	2018-09-30	$4,515,811
Interest on participant loans	2018-09-30	$2,001
Interest earned on other investments	2018-09-30	$16,567
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-09-30	$65,907
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-09-30	$69,767
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-09-30	$223,463
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-09-30	No
Was there a failure to transmit to the plan any participant contributions	2018-09-30	No
Has the plan failed to provide any benefit when due under the plan	2018-09-30	No
Contributions received in cash from employer	2018-09-30	$47,387
Employer contributions (assets) at end of year	2018-09-30	$48,784
Employer contributions (assets) at beginning of year	2018-09-30	$51,177
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-09-30	$607,665
Contract administrator fees	2018-09-30	$1,445
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	2018-09-30	No
Did the plan have assets held for investment	2018-09-30	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	2018-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2018-09-30	Disclaimer
Accountancy firm name	2018-09-30	MARCUM, LLP
Accountancy firm EIN	2018-09-30	111986323
2017 : CLEARY NURSING HOMES 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-09-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-09-30	$0
Total income from all sources (including contributions)	2017-09-30	$620,482
Total loss/gain on sale of assets	2017-09-30	$0
Total of all expenses incurred	2017-09-30	$882,071
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-09-30	$872,955
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-09-30	$206,481
Value of total assets at end of year	2017-09-30	$4,698,336
Value of total assets at beginning of year	2017-09-30	$4,959,925
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-09-30	$9,116
Total interest from all sources	2017-09-30	$11,557
Total dividends received (eg from common stock, registered investment company shares)	2017-09-30	$8
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-09-30	$8
Was this plan covered by a fidelity bond	2017-09-30	Yes
Value of fidelity bond cover	2017-09-30	$500,000
If this is an individual account plan, was there a blackout period	2017-09-30	No
Were there any nonexempt tranactions with any party-in-interest	2017-09-30	No
Contributions received from participants	2017-09-30	$153,914
Participant contributions at end of year	2017-09-30	$61,581
Participant contributions at beginning of year	2017-09-30	$97,067
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-09-30	No
Value of net income/loss	2017-09-30	$-261,589
Value of net assets at end of year (total assets less liabilities)	2017-09-30	$4,698,336
Value of net assets at beginning of year (total assets less liabilities)	2017-09-30	$4,959,925
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-09-30	No
Were any leases to which the plan was party in default or uncollectible	2017-09-30	No
Investment advisory and management fees	2017-09-30	$5,662
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-09-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-09-30	$0
Value of interest in pooled separate accounts at end of year	2017-09-30	$4,515,811
Value of interest in pooled separate accounts at beginning of year	2017-09-30	$4,357,775
Interest on participant loans	2017-09-30	$3,207
Interest earned on other investments	2017-09-30	$8,350
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-09-30	$69,767
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-09-30	$455,670
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-09-30	$402,436
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-09-30	No
Was there a failure to transmit to the plan any participant contributions	2017-09-30	Yes
Has the plan failed to provide any benefit when due under the plan	2017-09-30	No
Contributions received in cash from employer	2017-09-30	$52,567
Employer contributions (assets) at end of year	2017-09-30	$51,177
Employer contributions (assets) at beginning of year	2017-09-30	$49,413
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-09-30	$872,955
Contract administrator fees	2017-09-30	$3,454
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	2017-09-30	No
Did the plan have assets held for investment	2017-09-30	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	2017-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2017-09-30	Disclaimer
Accountancy firm name	2017-09-30	MARCUM, LLP
Accountancy firm EIN	2017-09-30	111986323
2016 : CLEARY NURSING HOMES 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-09-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-09-30	$0
Total income from all sources (including contributions)	2016-09-30	$630,442
Total loss/gain on sale of assets	2016-09-30	$0
Total of all expenses incurred	2016-09-30	$505,285
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-09-30	$500,838
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-09-30	$214,256
Value of total assets at end of year	2016-09-30	$4,959,925
Value of total assets at beginning of year	2016-09-30	$4,834,768
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-09-30	$4,447
Total interest from all sources	2016-09-30	$7,226
Total dividends received (eg from common stock, registered investment company shares)	2016-09-30	$2
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-09-30	$2
Was this plan covered by a fidelity bond	2016-09-30	Yes
Value of fidelity bond cover	2016-09-30	$500,000
If this is an individual account plan, was there a blackout period	2016-09-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-09-30	$0
Were there any nonexempt tranactions with any party-in-interest	2016-09-30	No
Contributions received from participants	2016-09-30	$162,615
Participant contributions at end of year	2016-09-30	$97,067
Participant contributions at beginning of year	2016-09-30	$123,905
Income. Received or receivable in cash from other sources (including rollovers)	2016-09-30	$2,228
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-09-30	No
Value of net income/loss	2016-09-30	$125,157
Value of net assets at end of year (total assets less liabilities)	2016-09-30	$4,959,925
Value of net assets at beginning of year (total assets less liabilities)	2016-09-30	$4,834,768
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-09-30	No
Were any leases to which the plan was party in default or uncollectible	2016-09-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-09-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-09-30	$0
Value of interest in pooled separate accounts at end of year	2016-09-30	$4,357,775
Value of interest in pooled separate accounts at beginning of year	2016-09-30	$4,424,893
Interest on participant loans	2016-09-30	$4,684
Interest earned on other investments	2016-09-30	$2,542
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-09-30	$455,670
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-09-30	$238,397
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-09-30	$408,958
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-09-30	No
Was there a failure to transmit to the plan any participant contributions	2016-09-30	Yes
Has the plan failed to provide any benefit when due under the plan	2016-09-30	No
Contributions received in cash from employer	2016-09-30	$49,413
Employer contributions (assets) at end of year	2016-09-30	$49,413
Employer contributions (assets) at beginning of year	2016-09-30	$47,573
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-09-30	$500,838
Contract administrator fees	2016-09-30	$4,447
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	2016-09-30	No
Did the plan have assets held for investment	2016-09-30	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	2016-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2016-09-30	Disclaimer
Accountancy firm name	2016-09-30	MARCUM, LLP
Accountancy firm EIN	2016-09-30	111986323
2015 : CLEARY NURSING HOMES 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-09-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-09-30	$0
Total income from all sources (including contributions)	2015-09-30	$88,840
Total loss/gain on sale of assets	2015-09-30	$0
Total of all expenses incurred	2015-09-30	$578,681
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-09-30	$573,811
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-09-30	$196,885
Value of total assets at end of year	2015-09-30	$4,834,768
Value of total assets at beginning of year	2015-09-30	$5,324,609
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-09-30	$4,870
Total interest from all sources	2015-09-30	$8,207
Total dividends received (eg from common stock, registered investment company shares)	2015-09-30	$7
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-09-30	$7
Was this plan covered by a fidelity bond	2015-09-30	Yes
Value of fidelity bond cover	2015-09-30	$500,000
If this is an individual account plan, was there a blackout period	2015-09-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-09-30	$0
Were there any nonexempt tranactions with any party-in-interest	2015-09-30	No
Contributions received from participants	2015-09-30	$149,312
Participant contributions at end of year	2015-09-30	$123,905
Participant contributions at beginning of year	2015-09-30	$129,367
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-09-30	No
Value of net income/loss	2015-09-30	$-489,841
Value of net assets at end of year (total assets less liabilities)	2015-09-30	$4,834,768
Value of net assets at beginning of year (total assets less liabilities)	2015-09-30	$5,324,609
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-09-30	No
Were any leases to which the plan was party in default or uncollectible	2015-09-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-09-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-09-30	$0
Value of interest in pooled separate accounts at end of year	2015-09-30	$4,424,893
Value of interest in pooled separate accounts at beginning of year	2015-09-30	$4,233,498
Interest on participant loans	2015-09-30	$5,369
Interest earned on other investments	2015-09-30	$2,838
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-09-30	$238,397
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-09-30	$911,373
Net investment gain/loss from pooled separate accounts	2015-09-30	$-116,259
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-09-30	No
Was there a failure to transmit to the plan any participant contributions	2015-09-30	No
Has the plan failed to provide any benefit when due under the plan	2015-09-30	No
Contributions received in cash from employer	2015-09-30	$47,573
Employer contributions (assets) at end of year	2015-09-30	$47,573
Employer contributions (assets) at beginning of year	2015-09-30	$50,371
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-09-30	$573,811
Contract administrator fees	2015-09-30	$4,870
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	2015-09-30	No
Did the plan have assets held for investment	2015-09-30	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	2015-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2015-09-30	Disclaimer
Accountancy firm name	2015-09-30	MARCUM, LLP
Accountancy firm EIN	2015-09-30	111986323
2014 : CLEARY NURSING HOMES 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-09-30	$0
Total transfer of assets to this plan	2014-09-30	$3,301,737
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-09-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-09-30	$0
Total income from all sources (including contributions)	2014-09-30	$131,012
Total loss/gain on sale of assets	2014-09-30	$0
Total of all expenses incurred	2014-09-30	$106,502
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-09-30	$106,419
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-09-30	$28,050
Value of total assets at end of year	2014-09-30	$5,324,609
Value of total assets at beginning of year	2014-09-30	$1,998,362
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-09-30	$83
Total interest from all sources	2014-09-30	$2,970
Total dividends received (eg from common stock, registered investment company shares)	2014-09-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-09-30	No
Was this plan covered by a fidelity bond	2014-09-30	Yes
Value of fidelity bond cover	2014-09-30	$500,000
If this is an individual account plan, was there a blackout period	2014-09-30	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-09-30	$0
Were there any nonexempt tranactions with any party-in-interest	2014-09-30	No
Contributions received from participants	2014-09-30	$27,933
Participant contributions at end of year	2014-09-30	$129,367
Participant contributions at beginning of year	2014-09-30	$83,102
Other income not declared elsewhere	2014-09-30	$41
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-09-30	No
Value of net income/loss	2014-09-30	$24,510
Value of net assets at end of year (total assets less liabilities)	2014-09-30	$5,324,609
Value of net assets at beginning of year (total assets less liabilities)	2014-09-30	$1,998,362
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-09-30	No
Were any leases to which the plan was party in default or uncollectible	2014-09-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-09-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-09-30	$1,030,526
Value of interest in pooled separate accounts at end of year	2014-09-30	$4,233,498
Value of interest in pooled separate accounts at beginning of year	2014-09-30	$0
Interest on participant loans	2014-09-30	$2,970
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-09-30	$911,373
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-09-30	$884,734
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-09-30	$99,951
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-09-30	No
Was there a failure to transmit to the plan any participant contributions	2014-09-30	Yes
Has the plan failed to provide any benefit when due under the plan	2014-09-30	No
Contributions received in cash from employer	2014-09-30	$117
Employer contributions (assets) at end of year	2014-09-30	$50,371
Employer contributions (assets) at beginning of year	2014-09-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-09-30	$106,419
Contract administrator fees	2014-09-30	$83
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	2014-09-30	Yes
Did the plan have assets held for investment	2014-09-30	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	2014-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2014-09-30	Disclaimer
Accountancy firm name	2014-09-30	MARCUM, LLC
Accountancy firm EIN	2014-09-30	111986323
2013 : CLEARY NURSING HOMES 401(K) PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2013-09-30	$0
Total unrealized appreciation/depreciation of assets	2013-09-30	$0
Total income from all sources (including contributions)	2013-09-30	$160,309
Total loss/gain on sale of assets	2013-09-30	$0
Total of all expenses incurred	2013-09-30	$57,196
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-09-30	$49,745
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-09-30	$34,443
Value of total assets at end of year	2013-09-30	$1,998,362
Value of total assets at beginning of year	2013-09-30	$1,895,249
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-09-30	$7,451
Total income from rents	2013-09-30	$0
Total interest from all sources	2013-09-30	$2,199
Total dividends received (eg from common stock, registered investment company shares)	2013-09-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-09-30	$0
Administrative expenses professional fees incurred	2013-09-30	$0
Was this plan covered by a fidelity bond	2013-09-30	Yes
Value of fidelity bond cover	2013-09-30	$500,000
If this is an individual account plan, was there a blackout period	2013-09-30	No
Were there any nonexempt tranactions with any party-in-interest	2013-09-30	No
Contributions received from participants	2013-09-30	$34,443
Participant contributions at end of year	2013-09-30	$83,102
Participant contributions at beginning of year	2013-09-30	$39,082
Participant contributions at beginning of year	2013-09-30	$685
Income. Received or receivable in cash from other sources (including rollovers)	2013-09-30	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2013-09-30	$0
Administrative expenses (other) incurred	2013-09-30	$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	2013-09-30	No
Income. Non cash contributions	2013-09-30	$0
Value of net income/loss	2013-09-30	$103,113
Value of net assets at end of year (total assets less liabilities)	2013-09-30	$1,998,362
Value of net assets at beginning of year (total assets less liabilities)	2013-09-30	$1,895,249
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-09-30	No
Were any leases to which the plan was party in default or uncollectible	2013-09-30	No
Investment advisory and management fees	2013-09-30	$7,451
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-09-30	$1,030,526
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-09-30	$943,195
Interest on participant loans	2013-09-30	$2,199
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-09-30	$884,734
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-09-30	$912,287
Expenses. Payments to insurance carriers foe the provision of benefits	2013-09-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-09-30	$123,667
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-09-30	No
Was there a failure to transmit to the plan any participant contributions	2013-09-30	Yes
Has the plan failed to provide any benefit when due under the plan	2013-09-30	No
Assets. Invements in employer securities at end of year	2013-09-30	$0
Assets. Invements in employer securities at beginning of year	2013-09-30	$0
Assets. Value of employer real property at end of year	2013-09-30	$0
Assets. Value of employer real property at beginning of year	2013-09-30	$0
Income. Dividends from preferred stock	2013-09-30	$0
Income. Dividends from common stock	2013-09-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-09-30	$49,745
Contract administrator fees	2013-09-30	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2013-09-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2013-09-30	$0
Did the plan have assets held for investment	2013-09-30	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	2013-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-09-30	No
Aggregate proceeds on sale of assets	2013-09-30	$0
Aggregate carrying amount (costs) on sale of assets	2013-09-30	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2013-09-30	Disclaimer
Accountancy firm name	2013-09-30	BLUM SHAPIRO CPA
Accountancy firm EIN	2013-09-30	061009205
2012 : CLEARY NURSING HOMES 401(K) PLAN 2012 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-09-30	$0
Expenses. Interest paid	2012-09-30	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2012-09-30	$0
Total income from all sources (including contributions)	2012-09-30	$181,575
Total loss/gain on sale of assets	2012-09-30	$0
Total of all expenses incurred	2012-09-30	$163,026
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-09-30	$163,026
Expenses. Certain deemed distributions of participant loans	2012-09-30	$0
Value of total corrective distributions	2012-09-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-09-30	$39,088
Value of total assets at end of year	2012-09-30	$1,894,564
Value of total assets at beginning of year	2012-09-30	$1,876,016
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-09-30	$0
Total income from rents	2012-09-30	$0
Total interest from all sources	2012-09-30	$1,979
Total dividends received (eg from common stock, registered investment company shares)	2012-09-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-09-30	$0
Administrative expenses professional fees incurred	2012-09-30	$0
Was this plan covered by a fidelity bond	2012-09-30	Yes
Value of fidelity bond cover	2012-09-30	$500,000
If this is an individual account plan, was there a blackout period	2012-09-30	No
Were there any nonexempt tranactions with any party-in-interest	2012-09-30	No
Contributions received from participants	2012-09-30	$39,088
Participant contributions at end of year	2012-09-30	$39,082
Participant contributions at beginning of year	2012-09-30	$48,746
Participant contributions at end of year	2012-09-30	$0
Participant contributions at beginning of year	2012-09-30	$1,021
Income. Received or receivable in cash from other sources (including rollovers)	2012-09-30	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-09-30	$0
Administrative expenses (other) incurred	2012-09-30	$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	2012-09-30	No
Income. Non cash contributions	2012-09-30	$0
Value of net income/loss	2012-09-30	$18,549
Value of net assets at end of year (total assets less liabilities)	2012-09-30	$1,894,564
Value of net assets at beginning of year (total assets less liabilities)	2012-09-30	$1,876,016
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-09-30	No
Were any leases to which the plan was party in default or uncollectible	2012-09-30	No
Investment advisory and management fees	2012-09-30	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-09-30	$943,195
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-09-30	$810,774
Interest on participant loans	2012-09-30	$1,979
Income. Interest from loans (other than to participants)	2012-09-30	$0
Interest earned on other investments	2012-09-30	$0
Income. Interest from US Government securities	2012-09-30	$0
Income. Interest from corporate debt instruments	2012-09-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-09-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-09-30	$912,287
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-09-30	$1,015,475
Expenses. Payments to insurance carriers foe the provision of benefits	2012-09-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-09-30	$140,508
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-09-30	No
Was there a failure to transmit to the plan any participant contributions	2012-09-30	No
Has the plan failed to provide any benefit when due under the plan	2012-09-30	No
Assets. Invements in employer securities at beginning of year	2012-09-30	$0
Contributions received in cash from employer	2012-09-30	$0
Income. Dividends from preferred stock	2012-09-30	$0
Income. Dividends from common stock	2012-09-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-09-30	$163,026
Contract administrator fees	2012-09-30	$0
Did the plan have assets held for investment	2012-09-30	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	2012-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-09-30	No
Aggregate proceeds on sale of assets	2012-09-30	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2012-09-30	Disclaimer
Accountancy firm name	2012-09-30	BLUM SHAPIRO CPA
Accountancy firm EIN	2012-09-30	061009205
2011 : CLEARY NURSING HOMES 401(K) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-09-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-09-30	$0
Total income from all sources (including contributions)	2011-09-30	$37,489
Total loss/gain on sale of assets	2011-09-30	$0
Total of all expenses incurred	2011-09-30	$42,850
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-09-30	$35,547
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-09-30	$45,670
Value of total assets at end of year	2011-09-30	$1,876,016
Value of total assets at beginning of year	2011-09-30	$1,881,377
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-09-30	$7,303
Total interest from all sources	2011-09-30	$1,176
Total dividends received (eg from common stock, registered investment company shares)	2011-09-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-09-30	No
Administrative expenses professional fees incurred	2011-09-30	$7,303
Was this plan covered by a fidelity bond	2011-09-30	Yes
Value of fidelity bond cover	2011-09-30	$500,000
If this is an individual account plan, was there a blackout period	2011-09-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-09-30	$0
Were there any nonexempt tranactions with any party-in-interest	2011-09-30	No
Contributions received from participants	2011-09-30	$45,670
Participant contributions at end of year	2011-09-30	$48,746
Participant contributions at beginning of year	2011-09-30	$22,259
Participant contributions at end of year	2011-09-30	$1,021
Participant contributions at beginning of year	2011-09-30	$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	2011-09-30	No
Value of net income/loss	2011-09-30	$-5,361
Value of net assets at end of year (total assets less liabilities)	2011-09-30	$1,876,016
Value of net assets at beginning of year (total assets less liabilities)	2011-09-30	$1,881,377
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-09-30	No
Were any leases to which the plan was party in default or uncollectible	2011-09-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-09-30	$810,774
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-09-30	$797,878
Interest on participant loans	2011-09-30	$1,176
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-09-30	$1,015,475
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-09-30	$1,061,240
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-09-30	$-9,357
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-09-30	No
Was there a failure to transmit to the plan any participant contributions	2011-09-30	No
Has the plan failed to provide any benefit when due under the plan	2011-09-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-09-30	$35,547
Did the plan have assets held for investment	2011-09-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2011-09-30	Disclaimer
Accountancy firm name	2011-09-30	BLUM SHAPIRO CPA
Accountancy firm EIN	2011-09-30	061009205

Form 5500 Responses for CLEARY NURSING HOMES 401(K) PLAN

2020: CLEARY NURSING HOMES 401(K) PLAN 2020 form 5500 responses
2020-10-01	Type of plan entity	Single employer plan
2020-10-01	Submission has been amended	No
2020-10-01	This submission is the final filing	No
2020-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-10-01	Plan is a collectively bargained plan	No
2020-10-01	Plan funding arrangement – Insurance	Yes
2020-10-01	Plan funding arrangement – Trust	Yes
2020-10-01	Plan benefit arrangement – Insurance	Yes
2020-10-01	Plan benefit arrangement - Trust	Yes
2019: CLEARY NURSING HOMES 401(K) PLAN 2019 form 5500 responses
2019-10-01	Type of plan entity	Single employer plan
2019-10-01	Submission has been amended	No
2019-10-01	This submission is the final filing	No
2019-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-10-01	Plan is a collectively bargained plan	No
2019-10-01	Plan funding arrangement – Insurance	Yes
2019-10-01	Plan funding arrangement – Trust	Yes
2019-10-01	Plan benefit arrangement – Insurance	Yes
2019-10-01	Plan benefit arrangement - Trust	Yes
2018: CLEARY NURSING HOMES 401(K) PLAN 2018 form 5500 responses
2018-10-01	Type of plan entity	Single employer plan
2018-10-01	Submission has been amended	No
2018-10-01	This submission is the final filing	No
2018-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-10-01	Plan is a collectively bargained plan	No
2018-10-01	Plan funding arrangement – Insurance	Yes
2018-10-01	Plan funding arrangement – Trust	Yes
2018-10-01	Plan benefit arrangement – Insurance	Yes
2018-10-01	Plan benefit arrangement - Trust	Yes
2017: CLEARY NURSING HOMES 401(K) PLAN 2017 form 5500 responses
2017-10-01	Type of plan entity	Single employer plan
2017-10-01	Submission has been amended	No
2017-10-01	This submission is the final filing	No
2017-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-10-01	Plan is a collectively bargained plan	No
2017-10-01	Plan funding arrangement – Insurance	Yes
2017-10-01	Plan funding arrangement – Trust	Yes
2017-10-01	Plan benefit arrangement – Insurance	Yes
2017-10-01	Plan benefit arrangement - Trust	Yes
2016: CLEARY NURSING HOMES 401(K) PLAN 2016 form 5500 responses
2016-10-01	Type of plan entity	Single employer plan
2016-10-01	Submission has been amended	No
2016-10-01	This submission is the final filing	No
2016-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-10-01	Plan is a collectively bargained plan	No
2016-10-01	Plan funding arrangement – Insurance	Yes
2016-10-01	Plan funding arrangement – Trust	Yes
2016-10-01	Plan benefit arrangement – Insurance	Yes
2016-10-01	Plan benefit arrangement - Trust	Yes
2015: CLEARY NURSING HOMES 401(K) PLAN 2015 form 5500 responses
2015-10-01	Type of plan entity	Single employer plan
2015-10-01	Submission has been amended	No
2015-10-01	This submission is the final filing	No
2015-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-10-01	Plan is a collectively bargained plan	No
2015-10-01	Plan funding arrangement – Insurance	Yes
2015-10-01	Plan funding arrangement – Trust	Yes
2015-10-01	Plan benefit arrangement – Insurance	Yes
2015-10-01	Plan benefit arrangement - Trust	Yes
2014: CLEARY NURSING HOMES 401(K) PLAN 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Submission has been amended	No
2014-10-01	This submission is the final filing	No
2014-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-10-01	Plan is a collectively bargained plan	No
2014-10-01	Plan funding arrangement – Insurance	Yes
2014-10-01	Plan funding arrangement – Trust	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement - Trust	Yes
2013: CLEARY NURSING HOMES 401(K) PLAN 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	Submission has been amended	No
2013-10-01	This submission is the final filing	No
2013-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-10-01	Plan is a collectively bargained plan	No
2013-10-01	Plan funding arrangement – Insurance	Yes
2013-10-01	Plan funding arrangement – Trust	Yes
2013-10-01	Plan benefit arrangement – Insurance	Yes
2013-10-01	Plan benefit arrangement - Trust	Yes
2012: CLEARY NURSING HOMES 401(K) PLAN 2012 form 5500 responses
2012-10-01	Type of plan entity	Single employer plan
2012-10-01	Submission has been amended	No
2012-10-01	This submission is the final filing	No
2012-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-10-01	Plan is a collectively bargained plan	No
2012-10-01	Plan funding arrangement – Insurance	Yes
2012-10-01	Plan funding arrangement – Trust	Yes
2012-10-01	Plan benefit arrangement – Insurance	Yes
2012-10-01	Plan benefit arrangement - Trust	Yes
2011: CLEARY NURSING HOMES 401(K) PLAN 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	Submission has been amended	Yes
2011-10-01	This submission is the final filing	No
2011-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-10-01	Plan is a collectively bargained plan	No
2011-10-01	Plan funding arrangement – Insurance	Yes
2011-10-01	Plan funding arrangement – Trust	Yes
2011-10-01	Plan benefit arrangement – Insurance	Yes
2011-10-01	Plan benefit arrangement - Trust	Yes
2010: CLEARY NURSING HOMES 401(K) PLAN 2010 form 5500 responses
2010-10-01	Type of plan entity	Single employer plan
2010-10-01	Submission has been amended	No
2010-10-01	This submission is the final filing	No
2010-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-10-01	Plan is a collectively bargained plan	No
2010-10-01	Plan funding arrangement – Insurance	Yes
2010-10-01	Plan funding arrangement – Trust	Yes
2010-10-01	Plan benefit arrangement – Insurance	Yes
2010-10-01	Plan benefit arrangement - Trust	Yes
2009: CLEARY NURSING HOMES 401(K) PLAN 2009 form 5500 responses
2009-10-01	Type of plan entity	Single employer plan
2009-10-01	Submission has been amended	No
2009-10-01	This submission is the final filing	No
2009-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-10-01	Plan is a collectively bargained plan	No
2009-10-01	Plan funding arrangement – Insurance	Yes
2009-10-01	Plan funding arrangement – Trust	Yes
2009-10-01	Plan benefit arrangement – Insurance	Yes
2009-10-01	Plan benefit arrangement - Trust	Yes
2008: CLEARY NURSING HOMES 401(K) PLAN 2008 form 5500 responses
2008-10-01	Type of plan entity	Single employer plan
2008-10-01	Submission has been amended	No
2008-10-01	This submission is the final filing	No
2008-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-10-01	Plan is a collectively bargained plan	No

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

BRK109930

Policy instance

Insurance contract or identification number	BRK109930
Number of Individuals Covered	74
Insurance policy start date	2020-10-01
Insurance policy end date	2021-09-30
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

BRK109930

Policy instance

Insurance contract or identification number	BRK109930
Number of Individuals Covered	86
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
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 FUNDS (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

BRK109930

Policy instance

Insurance contract or identification number	BRK109930
Number of Individuals Covered	94
Insurance policy start date	2018-10-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $21,212
Total amount of fees paid to insurance company	USD $0
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
Commission paid to Insurance Broker	USD $21,212
Insurance broker organization code?	3

AMERICAN FUNDS (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

BRK109930

Policy instance

Insurance contract or identification number	BRK109930
Number of Individuals Covered	103
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $5,818
Total amount of fees paid to insurance company	USD $0
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

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Company Name:	MERIDIAN MANOR CORPORATION
Employer identification number (EIN):	060812340
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities