401k Plan data: RHA WINFREY CENTER 401(K) PLAN plan

RHA WINFREY CENTER 401(K) PLAN 401k Plan overview

Plan Name	RHA WINFREY CENTER 401(K) PLAN
Plan identification number	001

RHA WINFREY CENTER 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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

401k Sponsoring company profile

RHA TRENTON MR, INC. DBA WINFREY CENTER has sponsored the creation of one or more 401k plans.

Company Name: RHA TRENTON MR, INC. DBA WINFREY CENTER

Employer identification number (EIN): 581848247

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RHA WINFREY CENTER 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01 WAYNE ADDISON 2017-07-17 WAYNE ADDISON 2017-07-17
001 2015-01-01 WAYNE ADDISON WAYNE ADDISON 2016-09-22
001 2014-01-01 WAYNE ADDISON WAYNE ADDISON 2015-10-02
001 2013-01-01 WAYNE ADDISON WAYNE ADDISON 2014-08-25
001 2012-01-01 WAYNE ADDISON WAYNE ADDISON 2013-10-14
001 2011-01-01 WAYNE ADDISON 2012-06-15 WAYNE ADDISON 2012-06-15
001 2010-01-01 WAYNE ADDISON 2011-04-04 WAYNE ADDISON 2011-04-04

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2016-01-01	WAYNE ADDISON	2017-07-17	WAYNE ADDISON	2017-07-17
001	2015-01-01	WAYNE ADDISON		WAYNE ADDISON	2016-09-22
001	2014-01-01	WAYNE ADDISON		WAYNE ADDISON	2015-10-02
001	2013-01-01	WAYNE ADDISON		WAYNE ADDISON	2014-08-25
001	2012-01-01	WAYNE ADDISON		WAYNE ADDISON	2013-10-14
001	2011-01-01	WAYNE ADDISON	2012-06-15	WAYNE ADDISON	2012-06-15
001	2010-01-01	WAYNE ADDISON	2011-04-04	WAYNE ADDISON	2011-04-04

Plan Statistics for RHA WINFREY CENTER 401(K) PLAN

401k plan membership statisitcs for RHA WINFREY CENTER 401(K) PLAN

Measure Date Value
2015: RHA WINFREY CENTER 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 6
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 12
Total of all active and inactive participants 2015-01-01 18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 18
Number of participants with account balances 2015-01-01 18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: RHA WINFREY CENTER 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 151
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 150
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 7
Total of all active and inactive participants 2014-01-01 157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 157
Number of participants with account balances 2014-01-01 22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 1
2013: RHA WINFREY CENTER 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 166
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 131
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 6
Total of all active and inactive participants 2013-01-01 137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 137
Number of participants with account balances 2013-01-01 22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 1
2012: RHA WINFREY CENTER 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 138
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 144
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 5
Total of all active and inactive participants 2012-01-01 149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 149
Number of participants with account balances 2012-01-01 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0

Measure	Date	Value
2015: RHA WINFREY CENTER 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	6
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	12
Total of all active and inactive participants	2015-01-01	18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	18
Number of participants with account balances	2015-01-01	18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: RHA WINFREY CENTER 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	151
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	150
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	7
Total of all active and inactive participants	2014-01-01	157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	157
Number of participants with account balances	2014-01-01	22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	1
2013: RHA WINFREY CENTER 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	166
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	131
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	6
Total of all active and inactive participants	2013-01-01	137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	137
Number of participants with account balances	2013-01-01	22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	1
2012: RHA WINFREY CENTER 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	138
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	144
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	5
Total of all active and inactive participants	2012-01-01	149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	149
Number of participants with account balances	2012-01-01	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0

Financial Data on RHA WINFREY CENTER 401(K) PLAN

Measure	Date	Value
2015 : RHA WINFREY CENTER 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$23,400
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$145,527
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$143,988
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$21,010
Value of total assets at end of year	2015-12-31	$85,579
Value of total assets at beginning of year	2015-12-31	$207,706
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$1,539
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2015-12-31	$0
Administrative expenses professional fees incurred	2015-12-31	$325
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$21,010
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$0
Administrative expenses (other) incurred	2015-12-31	$0
Total non interest bearing cash at end of year	2015-12-31	$350
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-122,127
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$85,579
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$207,706
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in pooled separate accounts at end of year	2015-12-31	$85,229
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$195,917
Net investment gain/loss from pooled separate accounts	2015-12-31	$2,390
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$0
Employer contributions (assets) at end of year	2015-12-31	$0
Employer contributions (assets) at beginning of year	2015-12-31	$11,789
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$143,988
Contract administrator fees	2015-12-31	$1,214
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	WATKINS UIBERALL PLLC
Accountancy firm EIN	2015-12-31	621804252
2014 : RHA WINFREY CENTER 401(K) PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$40,559
Total of all expenses incurred	2014-12-31	$13,589
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$12,038
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$35,374
Value of total assets at end of year	2014-12-31	$207,706
Value of total assets at beginning of year	2014-12-31	$180,736
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$1,551
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Administrative expenses professional fees incurred	2014-12-31	$75
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$24,066
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$26,970
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$207,706
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$180,736
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in pooled separate accounts at end of year	2014-12-31	$195,917
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$173,817
Net investment gain/loss from pooled separate accounts	2014-12-31	$5,185
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$11,308
Employer contributions (assets) at end of year	2014-12-31	$11,789
Employer contributions (assets) at beginning of year	2014-12-31	$6,919
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$12,038
Contract administrator fees	2014-12-31	$1,476
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	WATKINS UIBERALL PLLC
Accountancy firm EIN	2014-12-31	621804252
2013 : RHA WINFREY CENTER 401(K) PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$40,902
Total of all expenses incurred	2013-12-31	$60,831
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$59,484
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$20,373
Value of total assets at end of year	2013-12-31	$180,736
Value of total assets at beginning of year	2013-12-31	$200,665
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$1,347
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$14,403
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$-19,929
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$180,736
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$200,665
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Investment advisory and management fees	2013-12-31	$100
Value of interest in pooled separate accounts at end of year	2013-12-31	$173,817
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$192,267
Net investment gain/loss from pooled separate accounts	2013-12-31	$20,529
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$5,970
Employer contributions (assets) at end of year	2013-12-31	$6,919
Employer contributions (assets) at beginning of year	2013-12-31	$8,398
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$59,484
Contract administrator fees	2013-12-31	$1,247
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	WATKINS UIBERALL PLLC
Accountancy firm EIN	2013-12-31	621804252
2012 : RHA WINFREY CENTER 401(K) PLAN 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$50,629
Total of all expenses incurred	2012-12-31	$1,640
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$359
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$34,392
Value of total assets at end of year	2012-12-31	$200,665
Value of total assets at beginning of year	2012-12-31	$151,676
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$1,281
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$25,994
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$48,989
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$200,665
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$151,676
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$192,267
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$143,513
Net investment gain/loss from pooled separate accounts	2012-12-31	$16,237
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$8,398
Employer contributions (assets) at end of year	2012-12-31	$8,398
Employer contributions (assets) at beginning of year	2012-12-31	$8,163
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$359
Contract administrator fees	2012-12-31	$1,281
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	WATKINS UIBERALL PLLC
Accountancy firm EIN	2012-12-31	621804252

Form 5500 Responses for RHA WINFREY CENTER 401(K) PLAN

2015: RHA WINFREY CENTER 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: RHA WINFREY CENTER 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: RHA WINFREY CENTER 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: RHA WINFREY CENTER 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

93810

Policy instance

Insurance contract or identification number	93810
Number of Individuals Covered	17
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $456
Total amount of fees paid to insurance company	USD $325
Commission paid to Insurance Broker	USD $380
Insurance broker organization code?	3
Amount paid for insurance broker fees	325
Insurance broker name	PLAN ADMINISTRATION & CONSULTING

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

93810

Policy instance

Insurance contract or identification number	93810
Number of Individuals Covered	28
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $541
Total amount of fees paid to insurance company	USD $75
Commission paid to Insurance Broker	USD $451
Insurance broker organization code?	3
Amount paid for insurance broker fees	75
Insurance broker name	PLAN ADMINISTRATION & CONSULTING

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

93810

Policy instance

Insurance contract or identification number	93810
Number of Individuals Covered	28
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $492
Total amount of fees paid to insurance company	USD $100
Commission paid to Insurance Broker	USD $410
Insurance broker organization code?	3
Amount paid for insurance broker fees	100
Insurance broker name	PLAN ADMINISTRATION & CONSULTING

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

93810

Policy instance

Insurance contract or identification number	93810
Number of Individuals Covered	17
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $502
Commission paid to Insurance Broker	USD $418
Insurance broker organization code?	3
Insurance broker name	PLAN ADMINISTRATION & CONSULTING

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Company Name:	RHA TRENTON MR, INC. DBA WINFREY CENTER
Employer identification number (EIN):	581848247
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities