401k Plan data: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT plan

LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 401k Plan overview

Plan Name	LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT
Plan identification number	002

LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.

401k Sponsoring company profile

LIFECARE INC. D/B/A FRIENDSHIP VILLAGE has sponsored the creation of one or more 401k plans.

Company Name: LIFECARE INC. D/B/A FRIENDSHIP VILLAGE

Employer identification number (EIN): 382067110

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2020-10-01
002 2019-10-01
002 2019-10-01
002 2018-10-01
002 2017-10-01
002 2016-10-01 STEPHANIE EDWARDS BETSY BALE 2018-07-09
002 2015-10-01 STEPHANIE EDWARDS BETSY STANDISH 2017-06-08
002 2014-10-01 STEPHANIE EDWARDS KATHRYN HARMON 2016-07-15
002 2013-10-01 JEFFREY HAGEN JEFFREY HAGEN 2015-05-07
002 2012-10-01 JEFFREY HAGEN
002 2011-10-01 JEFFREY HAGEN JEFFREY HAGEN 2013-07-15
002 2010-10-01 JEFFREY HAGEN
002 2009-10-01 LINDA WISE
002 2008-10-01

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2020-10-01
002	2019-10-01
002	2019-10-01
002	2018-10-01
002	2017-10-01
002	2016-10-01	STEPHANIE EDWARDS	BETSY BALE	2018-07-09
002	2015-10-01	STEPHANIE EDWARDS	BETSY STANDISH	2017-06-08
002	2014-10-01	STEPHANIE EDWARDS	KATHRYN HARMON	2016-07-15
002	2013-10-01	JEFFREY HAGEN	JEFFREY HAGEN	2015-05-07
002	2012-10-01	JEFFREY HAGEN
002	2011-10-01	JEFFREY HAGEN	JEFFREY HAGEN	2013-07-15
002	2010-10-01	JEFFREY HAGEN
002	2009-10-01	LINDA WISE
002	2008-10-01

Plan Statistics for LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT

401k plan membership statisitcs for LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT

Measure Date Value
2020: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2020 401k membership
Total participants, beginning-of-year 2020-10-01 278
Total number of active participants reported on line 7a of the Form 5500 2020-10-01 198
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 83
Total of all active and inactive participants 2020-10-01 281
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-10-01 0
Total participants 2020-10-01 281
Number of participants with account balances 2020-10-01 180
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-10-01 2
2019: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2019 401k membership
Total participants, beginning-of-year 2019-10-01 130
Total number of active participants reported on line 7a of the Form 5500 2019-10-01 199
Number of retired or separated participants receiving benefits 2019-10-01 8
Number of other retired or separated participants entitled to future benefits 2019-10-01 71
Total of all active and inactive participants 2019-10-01 278
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-10-01 0
Total participants 2019-10-01 278
Number of participants with account balances 2019-10-01 184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-10-01 7
2018: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2018 401k membership
Total participants, beginning-of-year 2018-10-01 247
Total number of active participants reported on line 7a of the Form 5500 2018-10-01 208
Number of retired or separated participants receiving benefits 2018-10-01 3
Number of other retired or separated participants entitled to future benefits 2018-10-01 67
Total of all active and inactive participants 2018-10-01 278
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-10-01 0
Total participants 2018-10-01 278
Number of participants with account balances 2018-10-01 189
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-10-01 7
2017: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2017 401k membership
Total participants, beginning-of-year 2017-10-01 244
Total number of active participants reported on line 7a of the Form 5500 2017-10-01 189
Number of retired or separated participants receiving benefits 2017-10-01 7
Number of other retired or separated participants entitled to future benefits 2017-10-01 51
Total of all active and inactive participants 2017-10-01 247
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-10-01 0
Total participants 2017-10-01 247
Number of participants with account balances 2017-10-01 175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-10-01 15
2016: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2016 401k membership
Total participants, beginning-of-year 2016-10-01 212
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 2
Number of other retired or separated participants entitled to future benefits 2016-10-01 57
Total of all active and inactive participants 2016-10-01 244
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-10-01 0
Total participants 2016-10-01 244
Number of participants with account balances 2016-10-01 149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-10-01 5
2015: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2015 401k membership
Total participants, beginning-of-year 2015-10-01 217
Total number of active participants reported on line 7a of the Form 5500 2015-10-01 158
Number of retired or separated participants receiving benefits 2015-10-01 4
Number of other retired or separated participants entitled to future benefits 2015-10-01 50
Total of all active and inactive participants 2015-10-01 212
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-10-01 0
Total participants 2015-10-01 212
Number of participants with account balances 2015-10-01 137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-10-01 7
2014: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2014 401k membership
Total participants, beginning-of-year 2014-10-01 185
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 160
Number of retired or separated participants receiving benefits 2014-10-01 5
Number of other retired or separated participants entitled to future benefits 2014-10-01 52
Total of all active and inactive participants 2014-10-01 217
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-10-01 0
Total participants 2014-10-01 217
Number of participants with account balances 2014-10-01 128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-10-01 6
2013: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2013 401k membership
Total participants, beginning-of-year 2013-10-01 129
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 138
Number of retired or separated participants receiving benefits 2013-10-01 1
Number of other retired or separated participants entitled to future benefits 2013-10-01 46
Total of all active and inactive participants 2013-10-01 185
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-10-01 0
Total participants 2013-10-01 185
Number of participants with account balances 2013-10-01 126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-10-01 0
2012: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2012 401k membership
Total participants, beginning-of-year 2012-10-01 123
Total number of active participants reported on line 7a of the Form 5500 2012-10-01 59
Number of retired or separated participants receiving benefits 2012-10-01 70
Number of other retired or separated participants entitled to future benefits 2012-10-01 0
Total of all active and inactive participants 2012-10-01 129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-10-01 0
Total participants 2012-10-01 129
Number of participants with account balances 2012-10-01 123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-10-01 0
2011: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2011 401k membership
Total participants, beginning-of-year 2011-10-01 119
Total number of active participants reported on line 7a of the Form 5500 2011-10-01 108
Number of retired or separated participants receiving benefits 2011-10-01 15
Number of other retired or separated participants entitled to future benefits 2011-10-01 0
Total of all active and inactive participants 2011-10-01 123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-10-01 0
Total participants 2011-10-01 123
Number of participants with account balances 2011-10-01 123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-10-01 0
2010: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2010 401k membership
Total participants, beginning-of-year 2010-10-01 127
Total number of active participants reported on line 7a of the Form 5500 2010-10-01 105
Number of retired or separated participants receiving benefits 2010-10-01 14
Number of other retired or separated participants entitled to future benefits 2010-10-01 0
Total of all active and inactive participants 2010-10-01 119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-10-01 0
Total participants 2010-10-01 119
Number of participants with account balances 2010-10-01 119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-10-01 0
2009: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2009 401k membership
Total participants, beginning-of-year 2009-10-01 136
Total number of active participants reported on line 7a of the Form 5500 2009-10-01 115
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 12
Total of all active and inactive participants 2009-10-01 127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-10-01 0
Total participants 2009-10-01 127
Number of participants with account balances 2009-10-01 127
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: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2020 401k membership
Total participants, beginning-of-year	2020-10-01	278
Total number of active participants reported on line 7a of the Form 5500	2020-10-01	198
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	83
Total of all active and inactive participants	2020-10-01	281
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-10-01	0
Total participants	2020-10-01	281
Number of participants with account balances	2020-10-01	180
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-10-01	2
2019: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2019 401k membership
Total participants, beginning-of-year	2019-10-01	130
Total number of active participants reported on line 7a of the Form 5500	2019-10-01	199
Number of retired or separated participants receiving benefits	2019-10-01	8
Number of other retired or separated participants entitled to future benefits	2019-10-01	71
Total of all active and inactive participants	2019-10-01	278
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-10-01	0
Total participants	2019-10-01	278
Number of participants with account balances	2019-10-01	184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-10-01	7
2018: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2018 401k membership
Total participants, beginning-of-year	2018-10-01	247
Total number of active participants reported on line 7a of the Form 5500	2018-10-01	208
Number of retired or separated participants receiving benefits	2018-10-01	3
Number of other retired or separated participants entitled to future benefits	2018-10-01	67
Total of all active and inactive participants	2018-10-01	278
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-10-01	0
Total participants	2018-10-01	278
Number of participants with account balances	2018-10-01	189
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-10-01	7
2017: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2017 401k membership
Total participants, beginning-of-year	2017-10-01	244
Total number of active participants reported on line 7a of the Form 5500	2017-10-01	189
Number of retired or separated participants receiving benefits	2017-10-01	7
Number of other retired or separated participants entitled to future benefits	2017-10-01	51
Total of all active and inactive participants	2017-10-01	247
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-10-01	0
Total participants	2017-10-01	247
Number of participants with account balances	2017-10-01	175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-10-01	15
2016: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2016 401k membership
Total participants, beginning-of-year	2016-10-01	212
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	2
Number of other retired or separated participants entitled to future benefits	2016-10-01	57
Total of all active and inactive participants	2016-10-01	244
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-10-01	0
Total participants	2016-10-01	244
Number of participants with account balances	2016-10-01	149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-10-01	5
2015: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2015 401k membership
Total participants, beginning-of-year	2015-10-01	217
Total number of active participants reported on line 7a of the Form 5500	2015-10-01	158
Number of retired or separated participants receiving benefits	2015-10-01	4
Number of other retired or separated participants entitled to future benefits	2015-10-01	50
Total of all active and inactive participants	2015-10-01	212
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-10-01	0
Total participants	2015-10-01	212
Number of participants with account balances	2015-10-01	137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-10-01	7
2014: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2014 401k membership
Total participants, beginning-of-year	2014-10-01	185
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	160
Number of retired or separated participants receiving benefits	2014-10-01	5
Number of other retired or separated participants entitled to future benefits	2014-10-01	52
Total of all active and inactive participants	2014-10-01	217
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-10-01	0
Total participants	2014-10-01	217
Number of participants with account balances	2014-10-01	128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-10-01	6
2013: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2013 401k membership
Total participants, beginning-of-year	2013-10-01	129
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	138
Number of retired or separated participants receiving benefits	2013-10-01	1
Number of other retired or separated participants entitled to future benefits	2013-10-01	46
Total of all active and inactive participants	2013-10-01	185
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-10-01	0
Total participants	2013-10-01	185
Number of participants with account balances	2013-10-01	126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-10-01	0
2012: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2012 401k membership
Total participants, beginning-of-year	2012-10-01	123
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	59
Number of retired or separated participants receiving benefits	2012-10-01	70
Number of other retired or separated participants entitled to future benefits	2012-10-01	0
Total of all active and inactive participants	2012-10-01	129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-10-01	0
Total participants	2012-10-01	129
Number of participants with account balances	2012-10-01	123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-10-01	0
2011: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2011 401k membership
Total participants, beginning-of-year	2011-10-01	119
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	108
Number of retired or separated participants receiving benefits	2011-10-01	15
Number of other retired or separated participants entitled to future benefits	2011-10-01	0
Total of all active and inactive participants	2011-10-01	123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-10-01	0
Total participants	2011-10-01	123
Number of participants with account balances	2011-10-01	123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-10-01	0
2010: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2010 401k membership
Total participants, beginning-of-year	2010-10-01	127
Total number of active participants reported on line 7a of the Form 5500	2010-10-01	105
Number of retired or separated participants receiving benefits	2010-10-01	14
Number of other retired or separated participants entitled to future benefits	2010-10-01	0
Total of all active and inactive participants	2010-10-01	119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-10-01	0
Total participants	2010-10-01	119
Number of participants with account balances	2010-10-01	119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-10-01	0
2009: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2009 401k membership
Total participants, beginning-of-year	2009-10-01	136
Total number of active participants reported on line 7a of the Form 5500	2009-10-01	115
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	12
Total of all active and inactive participants	2009-10-01	127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-10-01	0
Total participants	2009-10-01	127
Number of participants with account balances	2009-10-01	127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-10-01	0

Financial Data on LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT

Measure	Date	Value
2021 : LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 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	$1,025,298
Total loss/gain on sale of assets	2021-09-30	$0
Total of all expenses incurred	2021-09-30	$1,091,773
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-09-30	$1,084,841
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-09-30	$344,361
Value of total assets at end of year	2021-09-30	$3,918,956
Value of total assets at beginning of year	2021-09-30	$3,985,431
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-09-30	$6,932
Total interest from all sources	2021-09-30	$21,649
Total dividends received (eg from common stock, registered investment company shares)	2021-09-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-09-30	No
Was this plan covered by a fidelity bond	2021-09-30	No
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	$231,368
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	$-66,475
Value of net assets at end of year (total assets less liabilities)	2021-09-30	$3,918,956
Value of net assets at beginning of year (total assets less liabilities)	2021-09-30	$3,985,431
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-09-30	$3,111,104
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-09-30	$3,014,716
Interest earned on other investments	2021-09-30	$21,649
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-09-30	$807,852
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-09-30	$970,715
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-09-30	$659,288
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	Yes
Has the plan failed to provide any benefit when due under the plan	2021-09-30	No
Contributions received in cash from employer	2021-09-30	$112,993
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-09-30	$1,084,841
Contract administrator fees	2021-09-30	$6,932
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	Unqualified
Accountancy firm name	2021-09-30	PLANTE & MORAN, PLLC
Accountancy firm EIN	2021-09-30	381357951
2020 : LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 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	$567,134
Total loss/gain on sale of assets	2020-09-30	$0
Total of all expenses incurred	2020-09-30	$561,438
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-09-30	$554,412
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-09-30	$371,755
Value of total assets at end of year	2020-09-30	$3,985,431
Value of total assets at beginning of year	2020-09-30	$3,979,735
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-09-30	$7,026
Total interest from all sources	2020-09-30	$25,314
Total dividends received (eg from common stock, registered investment company shares)	2020-09-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-09-30	No
Was this plan covered by a fidelity bond	2020-09-30	No
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	$252,134
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	$5,696
Value of net assets at end of year (total assets less liabilities)	2020-09-30	$3,985,431
Value of net assets at beginning of year (total assets less liabilities)	2020-09-30	$3,979,735
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-09-30	$3,014,716
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-09-30	$3,040,788
Interest earned on other investments	2020-09-30	$25,314
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-09-30	$970,715
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-09-30	$938,947
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-09-30	$170,065
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	$119,621
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-09-30	$554,412
Contract administrator fees	2020-09-30	$7,026
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	PLANTE & MORAN, PLLC
Accountancy firm EIN	2020-09-30	381357951
2019 : LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 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	$385,775
Total loss/gain on sale of assets	2019-09-30	$0
Total of all expenses incurred	2019-09-30	$226,204
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-09-30	$218,284
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-09-30	$346,825
Value of total assets at end of year	2019-09-30	$3,979,735
Value of total assets at beginning of year	2019-09-30	$3,820,164
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-09-30	$7,920
Total interest from all sources	2019-09-30	$26,915
Total dividends received (eg from common stock, registered investment company shares)	2019-09-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-09-30	No
Was this plan covered by a fidelity bond	2019-09-30	No
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	$235,357
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	$159,571
Value of net assets at end of year (total assets less liabilities)	2019-09-30	$3,979,735
Value of net assets at beginning of year (total assets less liabilities)	2019-09-30	$3,820,164
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-09-30	$3,040,788
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-09-30	$2,833,360
Interest earned on other investments	2019-09-30	$26,915
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-09-30	$938,947
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-09-30	$986,804
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-09-30	$12,035
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	$111,468
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-09-30	$218,284
Contract administrator fees	2019-09-30	$7,920
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	PLANTE & MORAN, PLLC
Accountancy firm EIN	2019-09-30	381357951
2018 : LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 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	$572,045
Total loss/gain on sale of assets	2018-09-30	$0
Total of all expenses incurred	2018-09-30	$106,307
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-09-30	$99,202
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-09-30	$308,443
Value of total assets at end of year	2018-09-30	$3,820,164
Value of total assets at beginning of year	2018-09-30	$3,354,426
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-09-30	$7,105
Total interest from all sources	2018-09-30	$26,347
Total dividends received (eg from common stock, registered investment company shares)	2018-09-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-09-30	No
Was this plan covered by a fidelity bond	2018-09-30	No
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	$212,916
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	$465,738
Value of net assets at end of year (total assets less liabilities)	2018-09-30	$3,820,164
Value of net assets at beginning of year (total assets less liabilities)	2018-09-30	$3,354,426
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	$7,105
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-09-30	$2,833,360
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-09-30	$2,463,237
Interest earned on other investments	2018-09-30	$26,347
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-09-30	$986,804
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-09-30	$891,189
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-09-30	$237,255
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	$95,527
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-09-30	$99,202
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	PLANTE & MORAN, PLLC
Accountancy firm EIN	2018-09-30	381357951
2017 : LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 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	$589,905
Total loss/gain on sale of assets	2017-09-30	$0
Total of all expenses incurred	2017-09-30	$130,812
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-09-30	$125,130
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-09-30	$260,386
Value of total assets at end of year	2017-09-30	$3,354,426
Value of total assets at beginning of year	2017-09-30	$2,895,333
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-09-30	$5,682
Total interest from all sources	2017-09-30	$23,882
Total dividends received (eg from common stock, registered investment company shares)	2017-09-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-09-30	No
Was this plan covered by a fidelity bond	2017-09-30	No
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	$179,423
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	$459,093
Value of net assets at end of year (total assets less liabilities)	2017-09-30	$3,354,426
Value of net assets at beginning of year (total assets less liabilities)	2017-09-30	$2,895,333
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	$5,682
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-09-30	$2,463,237
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-09-30	$2,078,062
Interest earned on other investments	2017-09-30	$23,882
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-09-30	$891,189
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-09-30	$817,271
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-09-30	$305,637
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	No
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	$80,963
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-09-30	$125,130
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	PLANTE & MORAN, PLLC
Accountancy firm EIN	2017-09-30	381357951
2016 : LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 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	$446,523
Total loss/gain on sale of assets	2016-09-30	$0
Total of all expenses incurred	2016-09-30	$222,704
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-09-30	$217,775
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-09-30	$214,579
Value of total assets at end of year	2016-09-30	$2,895,333
Value of total assets at beginning of year	2016-09-30	$2,671,514
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-09-30	$4,929
Total interest from all sources	2016-09-30	$21,815
Total dividends received (eg from common stock, registered investment company shares)	2016-09-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-09-30	No
Was this plan covered by a fidelity bond	2016-09-30	No
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	$145,524
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	$223,819
Value of net assets at end of year (total assets less liabilities)	2016-09-30	$2,895,333
Value of net assets at beginning of year (total assets less liabilities)	2016-09-30	$2,671,514
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
Investment advisory and management fees	2016-09-30	$4,929
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-09-30	$2,078,062
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-09-30	$1,944,555
Interest earned on other investments	2016-09-30	$21,815
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-09-30	$817,271
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-09-30	$726,959
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-09-30	$210,129
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	No
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	$69,055
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-09-30	$217,775
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	PLANTE & MORAN, PLLC
Accountancy firm EIN	2016-09-30	381357951
2015 : LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 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	$132,996
Total loss/gain on sale of assets	2015-09-30	$0
Total of all expenses incurred	2015-09-30	$250,060
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-09-30	$244,183
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-09-30	$166,493
Value of total assets at end of year	2015-09-30	$2,671,514
Value of total assets at beginning of year	2015-09-30	$2,788,578
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-09-30	$5,877
Total interest from all sources	2015-09-30	$21,545
Total dividends received (eg from common stock, registered investment company shares)	2015-09-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-09-30	No
Was this plan covered by a fidelity bond	2015-09-30	No
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	$112,088
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	$-117,064
Value of net assets at end of year (total assets less liabilities)	2015-09-30	$2,671,514
Value of net assets at beginning of year (total assets less liabilities)	2015-09-30	$2,788,578
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
Investment advisory and management fees	2015-09-30	$5,877
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-09-30	$1,944,555
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-09-30	$2,048,849
Interest earned on other investments	2015-09-30	$21,545
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-09-30	$726,959
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-09-30	$739,729
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-09-30	$-55,042
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	$54,405
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-09-30	$244,183
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	PLANTE & MORAN, PLLC
Accountancy firm EIN	2015-09-30	381357951
2014 : LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-09-30	$0
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	$396,849
Total loss/gain on sale of assets	2014-09-30	$0
Total of all expenses incurred	2014-09-30	$276,928
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-09-30	$271,499
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-09-30	$163,537
Value of total assets at end of year	2014-09-30	$2,788,578
Value of total assets at beginning of year	2014-09-30	$2,668,657
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-09-30	$5,429
Total interest from all sources	2014-09-30	$22,217
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	No
If this is an individual account plan, was there a blackout period	2014-09-30	No
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	$109,392
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	$119,921
Value of net assets at end of year (total assets less liabilities)	2014-09-30	$2,788,578
Value of net assets at beginning of year (total assets less liabilities)	2014-09-30	$2,668,657
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
Investment advisory and management fees	2014-09-30	$5,429
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-09-30	$2,048,849
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-09-30	$1,948,364
Interest earned on other investments	2014-09-30	$22,217
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-09-30	$739,729
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-09-30	$720,293
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-09-30	$211,095
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	No
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	$54,145
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-09-30	$271,499
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	PLANTE & MORAN, PLLC
Accountancy firm EIN	2014-09-30	381357951
2013 : LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-09-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-09-30	$0
Total income from all sources (including contributions)	2013-09-30	$454,036
Total loss/gain on sale of assets	2013-09-30	$0
Total of all expenses incurred	2013-09-30	$170,016
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-09-30	$164,431
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-09-30	$152,976
Value of total assets at end of year	2013-09-30	$2,668,657
Value of total assets at beginning of year	2013-09-30	$2,384,637
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-09-30	$5,585
Total interest from all sources	2013-09-30	$20,979
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
Was this plan covered by a fidelity bond	2013-09-30	No
If this is an individual account plan, was there a blackout period	2013-09-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-09-30	$0
Were there any nonexempt tranactions with any party-in-interest	2013-09-30	No
Contributions received from participants	2013-09-30	$100,271
Income. Received or receivable in cash from other sources (including rollovers)	2013-09-30	$3,127
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
Value of net income/loss	2013-09-30	$284,020
Value of net assets at end of year (total assets less liabilities)	2013-09-30	$2,668,657
Value of net assets at beginning of year (total assets less liabilities)	2013-09-30	$2,384,637
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	$5,585
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-09-30	$1,948,364
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-09-30	$1,740,619
Interest earned on other investments	2013-09-30	$20,979
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-09-30	$720,293
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-09-30	$644,018
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-09-30	$280,081
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	No
Has the plan failed to provide any benefit when due under the plan	2013-09-30	No
Contributions received in cash from employer	2013-09-30	$49,578
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-09-30	$164,431
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
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	PLANTE & MORAN, PLLC
Accountancy firm EIN	2013-09-30	381357951
2012 : LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-09-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-09-30	$0
Total income from all sources (including contributions)	2012-09-30	$474,014
Total loss/gain on sale of assets	2012-09-30	$0
Total of all expenses incurred	2012-09-30	$145,914
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-09-30	$142,708
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-09-30	$154,948
Value of total assets at end of year	2012-09-30	$2,384,637
Value of total assets at beginning of year	2012-09-30	$2,056,537
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-09-30	$3,206
Total interest from all sources	2012-09-30	$20,377
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
Was this plan covered by a fidelity bond	2012-09-30	No
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	$103,464
Participant contributions at end of year	2012-09-30	$0
Participant contributions at beginning of year	2012-09-30	$116,588
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
Value of net income/loss	2012-09-30	$328,100
Value of net assets at end of year (total assets less liabilities)	2012-09-30	$2,384,637
Value of net assets at beginning of year (total assets less liabilities)	2012-09-30	$2,056,537
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	$3,206
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-09-30	$1,740,619
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-09-30	$1,386,094
Interest earned on other investments	2012-09-30	$20,377
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-09-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-09-30	$35,953
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-09-30	$35,953
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-09-30	$644,018
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-09-30	$517,902
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-09-30	$298,689
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
Contributions received in cash from employer	2012-09-30	$51,484
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-09-30	$142,708
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
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	PLANTE & MORAN, PLLC
Accountancy firm EIN	2012-09-30	381357951
2011 : LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 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	$109,732
Total loss/gain on sale of assets	2011-09-30	$0
Total of all expenses incurred	2011-09-30	$90,076
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-09-30	$85,176
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-09-30	$117,458
Value of total assets at end of year	2011-09-30	$2,056,537
Value of total assets at beginning of year	2011-09-30	$2,036,881
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-09-30	$4,900
Total interest from all sources	2011-09-30	$20,439
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
Was this plan covered by a fidelity bond	2011-09-30	No
If this is an individual account plan, was there a blackout period	2011-09-30	No
Were there any nonexempt tranactions with any party-in-interest	2011-09-30	No
Contributions received from participants	2011-09-30	$101,644
Participant contributions at end of year	2011-09-30	$116,588
Participant contributions at beginning of year	2011-09-30	$107,588
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	$19,656
Value of net assets at end of year (total assets less liabilities)	2011-09-30	$2,056,537
Value of net assets at beginning of year (total assets less liabilities)	2011-09-30	$2,036,881
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
Investment advisory and management fees	2011-09-30	$4,900
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-09-30	$1,386,094
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-09-30	$1,413,016
Interest on participant loans	2011-09-30	$4,326
Interest earned on other investments	2011-09-30	$16,113
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-09-30	$35,953
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-09-30	$29,574
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-09-30	$29,574
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-09-30	$517,902
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-09-30	$486,703
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-09-30	$-28,165
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
Contributions received in cash from employer	2011-09-30	$15,814
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-09-30	$85,176
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	PLANTE & MORAN, PLLC
Accountancy firm EIN	2011-09-30	381357951

Form 5500 Responses for LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT

2020: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 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: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2019 form 5500 responses
2019-10-01	Type of plan entity	Single employer plan
2019-10-01	Submission has been amended	Yes
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: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 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: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 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: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 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: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 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: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 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: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 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: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 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: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	Submission has been amended	No
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: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 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: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 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: LIFECARE INC., D/B/A FRIENDSHIP VILLAGE 403 B EMPLOYER RETIREMENT 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

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

52208

Policy instance

Insurance contract or identification number	52208
Number of Individuals Covered	180
Insurance policy start date	2020-10-01
Insurance policy end date	2021-09-30
Total amount of commissions paid to insurance broker	USD $4,529
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	1
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?	No
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 $4,228
Insurance broker organization code?	3

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

52208

Policy instance

Insurance contract or identification number	52208
Number of Individuals Covered	184
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $8,043
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	1
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?	No
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 $3,589
Insurance broker organization code?	3

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

52208

Policy instance

Insurance contract or identification number	52208
Number of Individuals Covered	187
Insurance policy start date	2018-10-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $12,916
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	1
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?	No
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 $10,060
Insurance broker organization code?	3

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

52208

Policy instance

Insurance contract or identification number	52208
Number of Individuals Covered	176
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $14,723
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	1
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?	No
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:	LIFECARE INC. D/B/A FRIENDSHIP VILLAGE
Employer identification number (EIN):	382067110
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities