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PINES NURSING HOME 2015 401(K) PLAN 401k Plan overview

Plan NamePINES NURSING HOME 2015 401(K) PLAN
Plan identification number 001

PINES NURSING HOME 2015 401(K) PLAN Benefits

401k Plan TypeDefined 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

PINES NURSING HOME 2015 LLC has sponsored the creation of one or more 401k plans.

Company Name:PINES NURSING HOME 2015 LLC
Employer identification number (EIN):352537248
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PINES NURSING HOME 2015 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-01-01
0012020-01-01
0012019-01-01ANDREW NEUMAN2020-04-20
0012018-01-01ANDREW NEUMAN2018-12-18
0012018-01-01MEIR COSIOL2019-07-19
0012017-01-01ANDREW NEUMAN2018-06-05
0012016-01-01ANDREW NEUMAN2017-07-25
0012015-01-01ANDREW NEUMAN2016-10-14 ANDREW NEUMAN2016-10-14

Plan Statistics for PINES NURSING HOME 2015 401(K) PLAN

401k plan membership statisitcs for PINES NURSING HOME 2015 401(K) PLAN

Measure Date Value
2021: PINES NURSING HOME 2015 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01130
Total number of active participants reported on line 7a of the Form 55002021-01-0192
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0120
Total of all active and inactive participants2021-01-01112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01112
Number of participants with account balances2021-01-0162
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: PINES NURSING HOME 2015 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01126
Total number of active participants reported on line 7a of the Form 55002020-01-01105
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0119
Total of all active and inactive participants2020-01-01124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01124
Number of participants with account balances2020-01-0165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-013

Financial Data on PINES NURSING HOME 2015 401(K) PLAN

Measure Date Value
2021 : PINES NURSING HOME 2015 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$112,331
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$71,158
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$65,237
Expenses. Certain deemed distributions of participant loans2021-12-31$0
Value of total corrective distributions2021-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$79,217
Value of total assets at end of year2021-12-31$451,403
Value of total assets at beginning of year2021-12-31$410,230
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$5,921
Total interest from all sources2021-12-31$358
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$33,931
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$33,931
Assets. Real estate other than employer real property at beginning of year2021-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2021-12-31$0
Was this plan covered by a fidelity bond2021-12-31No
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$54,032
Participant contributions at end of year2021-12-31$5,616
Participant contributions at beginning of year2021-12-31$4,279
Participant contributions at end of year2021-12-31$0
Participant contributions at beginning of year2021-12-31$0
Assets. Other investments not covered elsewhere at end of year2021-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$0
Assets. Loans (other than to participants) at beginning of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$0
Administrative expenses (other) incurred2021-12-31$0
Liabilities. Value of operating payables at beginning of year2021-12-31$0
Total non interest bearing cash at beginning of year2021-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$41,173
Value of net assets at end of year (total assets less liabilities)2021-12-31$451,403
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$410,230
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Assets. partnership/joint venture interests at beginning of year2021-12-31$0
Investment advisory and management fees2021-12-31$3,945
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$445,689
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$389,228
Value of interest in pooled separate accounts at end of year2021-12-31$0
Value of interest in pooled separate accounts at beginning of year2021-12-31$0
Interest on participant loans2021-12-31$358
Value of interest in master investment trust accounts at end of year2021-12-31$0
Value of interest in master investment trust accounts at beginning of year2021-12-31$0
Value of interest in common/collective trusts at end of year2021-12-31$0
Value of interest in common/collective trusts at beginning of year2021-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$98
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$16,723
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$16,723
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2021-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2021-12-31$0
Asset value of US Government securities at beginning of year2021-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$-1,175
Net investment gain/loss from pooled separate accounts2021-12-31$0
Net investment gain or loss from common/collective trusts2021-12-31$0
Net gain/loss from 103.12 investment entities2021-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Assets. Invements in employer securities at beginning of year2021-12-31$0
Assets. Value of employer real property at beginning of year2021-12-31$0
Contributions received in cash from employer2021-12-31$25,185
Employer contributions (assets) at end of year2021-12-31$0
Employer contributions (assets) at beginning of year2021-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$65,237
Asset. Corporate debt instrument preferred debt at beginning of year2021-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2021-12-31$0
Contract administrator fees2021-12-31$1,976
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-12-31No
Assets. Corporate common stocks other than exployer securities at beginning of year2021-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2021-12-31$0
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Liabilities. Value of acquisition indebtedness at beginning of year2021-12-31$0
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
2020 : PINES NURSING HOME 2015 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$125,554
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$22,654
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$17,876
Expenses. Certain deemed distributions of participant loans2020-12-31$0
Value of total corrective distributions2020-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$85,050
Value of total assets at end of year2020-12-31$410,230
Value of total assets at beginning of year2020-12-31$307,330
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$4,778
Total interest from all sources2020-12-31$394
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$25,151
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$25,151
Assets. Real estate other than employer real property at beginning of year2020-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2020-12-31$0
Was this plan covered by a fidelity bond2020-12-31No
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$52,979
Participant contributions at end of year2020-12-31$4,279
Participant contributions at beginning of year2020-12-31$6,630
Participant contributions at end of year2020-12-31$0
Participant contributions at beginning of year2020-12-31$0
Assets. Other investments not covered elsewhere at end of year2020-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2020-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$7,896
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$0
Assets. Loans (other than to participants) at beginning of year2020-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$0
Administrative expenses (other) incurred2020-12-31$0
Liabilities. Value of operating payables at beginning of year2020-12-31$0
Total non interest bearing cash at beginning of year2020-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$102,900
Value of net assets at end of year (total assets less liabilities)2020-12-31$410,230
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$307,330
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Assets. partnership/joint venture interests at beginning of year2020-12-31$0
Investment advisory and management fees2020-12-31$3,179
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$389,228
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$300,602
Value of interest in pooled separate accounts at end of year2020-12-31$0
Value of interest in pooled separate accounts at beginning of year2020-12-31$0
Interest on participant loans2020-12-31$337
Value of interest in master investment trust accounts at end of year2020-12-31$0
Value of interest in master investment trust accounts at beginning of year2020-12-31$0
Value of interest in common/collective trusts at end of year2020-12-31$0
Value of interest in common/collective trusts at beginning of year2020-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$16,723
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$98
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$98
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$57
Assets. Value of investments in 103.12 investment entities at end of year2020-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2020-12-31$0
Asset value of US Government securities at beginning of year2020-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$14,959
Net investment gain/loss from pooled separate accounts2020-12-31$0
Net investment gain or loss from common/collective trusts2020-12-31$0
Net gain/loss from 103.12 investment entities2020-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Assets. Invements in employer securities at beginning of year2020-12-31$0
Assets. Value of employer real property at beginning of year2020-12-31$0
Contributions received in cash from employer2020-12-31$24,175
Employer contributions (assets) at end of year2020-12-31$0
Employer contributions (assets) at beginning of year2020-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$17,876
Asset. Corporate debt instrument preferred debt at beginning of year2020-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2020-12-31$0
Contract administrator fees2020-12-31$1,599
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-12-31No
Assets. Corporate common stocks other than exployer securities at beginning of year2020-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2020-12-31$0
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Liabilities. Value of acquisition indebtedness at beginning of year2020-12-31$0
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31GRIFFIN GROUP, CPA
Accountancy firm EIN2020-12-31811553182

Form 5500 Responses for PINES NURSING HOME 2015 401(K) PLAN

2021: PINES NURSING HOME 2015 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: PINES NURSING HOME 2015 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes

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