401k Plan data: KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST plan

KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 401k Plan overview

Plan Name	KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST
Plan identification number	001

KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

KEYSTONE COMMUNITIES MANAGEMENT GROUP LLC DBA KEYSTONE SENIOR LIVING has sponsored the creation of one or more 401k plans.

Company Name: KEYSTONE COMMUNITIES MANAGEMENT GROUP LLC DBA KEYSTONE SENIOR LIVING

Employer identification number (EIN): 272951831

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01 SHEILA RIEBE 2016-08-24 SHEILA RIEBE 2016-08-24
001 2015-01-01 SHEILA RIEBE
001 2014-01-01 SHEILA RIEBE
001 2013-01-01 SHEILA RIEBE
001 2012-01-01 SHEILA RIEBE
001 2011-01-01 SHEILA RIEBE
001 2010-01-01 MIKE LEWIS 2011-10-17

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2016-01-01	SHEILA RIEBE	2016-08-24	SHEILA RIEBE	2016-08-24
001	2015-01-01	SHEILA RIEBE
001	2014-01-01	SHEILA RIEBE
001	2013-01-01	SHEILA RIEBE
001	2012-01-01	SHEILA RIEBE
001	2011-01-01	SHEILA RIEBE
001	2010-01-01	MIKE LEWIS	2011-10-17

Plan Statistics for KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST

401k plan membership statisitcs for KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST

Measure Date Value
2015: KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2015 401k membership
Total participants, beginning-of-year 2015-01-01 318
Total of all active and inactive participants 2015-01-01 0
Total participants 2015-01-01 0
Number of participants with account balances 2015-01-01 90
2014: KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2014 401k membership
Total participants, beginning-of-year 2014-01-01 203
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 318
Total of all active and inactive participants 2014-01-01 318
Total participants 2014-01-01 318
Number of participants with account balances 2014-01-01 167
2013: KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2013 401k membership
Total participants, beginning-of-year 2013-01-01 368
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 344
Number of retired or separated participants receiving benefits 2013-01-01 6
Total of all active and inactive participants 2013-01-01 350
Total participants 2013-01-01 350
Number of participants with account balances 2013-01-01 168
2012: KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2012 401k membership
Total participants, beginning-of-year 2012-01-01 188
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 368
Number of other retired or separated participants entitled to future benefits 2012-01-01 6
Total of all active and inactive participants 2012-01-01 374
Total participants 2012-01-01 374
Number of participants with account balances 2012-01-01 31
2011: KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year 2011-01-01 170
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 176
Number of other retired or separated participants entitled to future benefits 2011-01-01 4
Total of all active and inactive participants 2011-01-01 180
Total participants 2011-01-01 180
Number of participants with account balances 2011-01-01 25

Measure	Date	Value
2015: KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2015 401k membership
Total participants, beginning-of-year	2015-01-01	318
Total of all active and inactive participants	2015-01-01	0
Total participants	2015-01-01	0
Number of participants with account balances	2015-01-01	90
2014: KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2014 401k membership
Total participants, beginning-of-year	2014-01-01	203
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	318
Total of all active and inactive participants	2014-01-01	318
Total participants	2014-01-01	318
Number of participants with account balances	2014-01-01	167
2013: KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2013 401k membership
Total participants, beginning-of-year	2013-01-01	368
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	344
Number of retired or separated participants receiving benefits	2013-01-01	6
Total of all active and inactive participants	2013-01-01	350
Total participants	2013-01-01	350
Number of participants with account balances	2013-01-01	168
2012: KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2012 401k membership
Total participants, beginning-of-year	2012-01-01	188
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	368
Number of other retired or separated participants entitled to future benefits	2012-01-01	6
Total of all active and inactive participants	2012-01-01	374
Total participants	2012-01-01	374
Number of participants with account balances	2012-01-01	31
2011: KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year	2011-01-01	170
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	176
Number of other retired or separated participants entitled to future benefits	2011-01-01	4
Total of all active and inactive participants	2011-01-01	180
Total participants	2011-01-01	180
Number of participants with account balances	2011-01-01	25

Financial Data on KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST

Measure	Date	Value
2015 : KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$103,971
Total of all expenses incurred	2015-12-31	$414,475
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$413,486
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$123,398
Value of total assets at end of year	2015-12-31	$391,831
Value of total assets at beginning of year	2015-12-31	$702,335
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$989
Total interest from all sources	2015-12-31	$1,117
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	No
If this is an individual account plan, was there a blackout period	2015-12-31	No
Funding deficiency by the employer to the plan for this plan year	2015-12-31	$0
Minimum employer required contribution for this plan year	2015-12-31	$0
Amount contributed by the employer to the plan for this plan year	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	$123,398
Participant contributions at end of year	2015-12-31	$2,845
Participant contributions at beginning of year	2015-12-31	$8,071
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	$-310,504
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$391,831
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$702,335
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 registered invesment companies (eg mutual funds) at end of year	2015-12-31	$388,986
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$694,068
Interest on participant loans	2015-12-31	$1,117
Value of interest in common/collective trusts at end of year	2015-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$196
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$196
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-20,544
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	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$413,486
Contract administrator fees	2015-12-31	$989
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	CARPENTER EVERT & ASSOCIATES, LTD
Accountancy firm EIN	2015-12-31	411534805
2014 : KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$201,636
Total of all expenses incurred	2014-12-31	$5,257
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$3,242
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$183,886
Value of total assets at end of year	2014-12-31	$702,335
Value of total assets at beginning of year	2014-12-31	$505,956
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$2,015
Total interest from all sources	2014-12-31	$347
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	No
If this is an individual account plan, was there a blackout period	2014-12-31	No
Funding deficiency by the employer to the plan for this plan year	2014-12-31	$0
Minimum employer required contribution for this plan year	2014-12-31	$0
Amount contributed by the employer to the plan for this plan year	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$167,772
Participant contributions at end of year	2014-12-31	$8,071
Participant contributions at beginning of year	2014-12-31	$5,655
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$16,114
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	$196,379
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$702,335
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$505,956
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 registered invesment companies (eg mutual funds) at end of year	2014-12-31	$694,068
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$500,301
Interest on participant loans	2014-12-31	$347
Value of interest in common/collective trusts at end of year	2014-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$196
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$17,403
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$3,242
Contract administrator fees	2014-12-31	$2,015
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	CARPENTER EVERT & ASSOCIATES, LTD
Accountancy firm EIN	2014-12-31	411534805
2013 : KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$204,822
Total of all expenses incurred	2013-12-31	$46,808
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$45,392
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$163,175
Value of total assets at end of year	2013-12-31	$505,956
Value of total assets at beginning of year	2013-12-31	$347,942
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$1,416
Total interest from all sources	2013-12-31	$180
Total income from all sources	2013-12-31	$204,822
Expenses. Total of all expenses incurred	2013-12-31	$46,808
Benefits paid (including direct rollovers)	2013-12-31	$45,392
Total plan assets at end of year	2013-12-31	$505,956
Total plan assets at beginning of year	2013-12-31	$347,942
Total contributions received or receivable from participants	2013-12-31	$163,175
Expenses. Other expenses not covered elsewhere	2013-12-31	$1,416
Other income received	2013-12-31	$41,647
Net income (gross income less expenses)	2013-12-31	$158,014
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$505,956
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$347,942
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	No
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	$163,175
Participant contributions at end of year	2013-12-31	$5,655
Participant contributions at beginning of year	2013-12-31	$2,961
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	$158,014
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$505,956
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$347,942
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$500,301
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$311,898
Interest on participant loans	2013-12-31	$180
Value of interest in common/collective trusts at end of year	2013-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$33,083
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$33,083
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$41,467
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$45,392
Contract administrator fees	2013-12-31	$1,416
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	CARPENTER EVERT & ASSOCIATES, LTD
Accountancy firm EIN	2013-12-31	411534805
2012 : KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$130,372
Total of all expenses incurred	2012-12-31	$39,012
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$36,867
Value of total corrective distributions	2012-12-31	$1,950
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$102,584
Value of total assets at end of year	2012-12-31	$347,942
Value of total assets at beginning of year	2012-12-31	$256,582
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$195
Total interest from all sources	2012-12-31	$144
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$8,669
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$8,669
Was this plan covered by a fidelity bond	2012-12-31	No
Funding deficiency by the employer to the plan for this plan year	2012-12-31	$0
Minimum employer required contribution for this plan year	2012-12-31	$0
Amount contributed by the employer to the plan for this plan year	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$66,849
Participant contributions at end of year	2012-12-31	$2,961
Participant contributions at beginning of year	2012-12-31	$3,832
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$35,735
Administrative expenses (other) incurred	2012-12-31	$195
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	$91,360
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$347,942
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$256,582
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 registered invesment companies (eg mutual funds) at end of year	2012-12-31	$311,898
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$181,192
Interest on participant loans	2012-12-31	$144
Value of interest in common/collective trusts at end of year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$33,083
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$71,558
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$71,558
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$18,975
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$36,867
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	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	CARPENTER EVERT & ASSOCIATES, LTD
Accountancy firm EIN	2012-12-31	411534805
2011 : KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$240,494
Total of all expenses incurred	2011-12-31	$72
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$253,586
Value of total assets at end of year	2011-12-31	$256,582
Value of total assets at beginning of year	2011-12-31	$16,160
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$72
Total interest from all sources	2011-12-31	$72
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$4,138
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$4,138
Was this plan covered by a fidelity bond	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$57,974
Participant contributions at end of year	2011-12-31	$3,832
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$195,612
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$240,422
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$256,582
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$16,160
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$181,192
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$12,447
Interest on participant loans	2011-12-31	$72
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$71,558
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$3,713
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$3,713
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-17,302
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contract administrator fees	2011-12-31	$72
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	CARPENTER EVERT & ASSOCIATES, LTD
Accountancy firm EIN	2011-12-31	411534805

Form 5500 Responses for KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST

2015: KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: KEYSTONE COMMUNITIES MANAGEMENT 401(K) PROFIT SHARING PLAN & TRUST 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes

Potentially related plans

KEYSTONE COMMUNITIES LLC 401 K PROFIT SHARING PLAN & TRUST [EIN = 411951966]

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Company Name:	KEYSTONE COMMUNITIES MANAGEMENT GROUP LLC DBA KEYSTONE SENIOR LIVING
Employer identification number (EIN):	272951831
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities