401k Plan data: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN plan

GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 401k Plan overview

Plan Name	GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN
Plan identification number	002

GOOD SHEPHERD MANOR, INC. RETIREMENT 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.
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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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

GOOD SHEPHERD MANOR, INC. has sponsored the creation of one or more 401k plans.

Company Name: GOOD SHEPHERD MANOR, INC.

Employer identification number (EIN): 362693168

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

Additional information about GOOD SHEPHERD MANOR, INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 2334463

More information about GOOD SHEPHERD MANOR, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01
002 2020-01-01
002 2019-01-01
002 2018-01-01
002 2017-01-01
002 2016-01-01
002 2015-01-01
002 2014-01-01 BRUCE FITZPATRICK
002 2013-01-01
002 2012-01-01 BRUCE FITZPATRICK
002 2011-01-01 BRUCE FITZPATRICK
002 2009-01-01 BRUCE FITZPATRICK

Plan Statistics for GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN

401k plan membership statisitcs for GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN

Measure Date Value
2022: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 154
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 137
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 19
Total of all active and inactive participants 2022-01-01 156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 156
Number of participants with account balances 2022-01-01 118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 160
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 123
Number of retired or separated participants receiving benefits 2021-01-01 5
Number of other retired or separated participants entitled to future benefits 2021-01-01 24
Total of all active and inactive participants 2021-01-01 152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 152
Number of participants with account balances 2021-01-01 115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 4
2020: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 165
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 136
Number of retired or separated participants receiving benefits 2020-01-01 1
Number of other retired or separated participants entitled to future benefits 2020-01-01 23
Total of all active and inactive participants 2020-01-01 160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 160
Number of participants with account balances 2020-01-01 120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 7
2019: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 150
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 155
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 23
Total of all active and inactive participants 2019-01-01 178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 178
Number of participants with account balances 2019-01-01 122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 6
2018: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 157
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 120
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 23
Total of all active and inactive participants 2018-01-01 143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 143
Number of participants with account balances 2018-01-01 115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 8
2017: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 171
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 137
Number of other retired or separated participants entitled to future benefits 2017-01-01 11
Total of all active and inactive participants 2017-01-01 148
Total participants 2017-01-01 148
Number of participants with account balances 2017-01-01 148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 16
2016: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 172
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 144
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 26
Total of all active and inactive participants 2016-01-01 170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 1
Total participants 2016-01-01 171
Number of participants with account balances 2016-01-01 146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 21
2015: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 169
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 156
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 16
Total of all active and inactive participants 2015-01-01 172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 172
Number of participants with account balances 2015-01-01 142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 10
2014: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 176
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 158
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 11
Total of all active and inactive participants 2014-01-01 169
Total participants 2014-01-01 169
Number of participants with account balances 2014-01-01 124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 7
2013: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 161
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 161
Number of other retired or separated participants entitled to future benefits 2013-01-01 15
Total of all active and inactive participants 2013-01-01 176
Total participants 2013-01-01 176
Number of participants with account balances 2013-01-01 132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 24
2012: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 164
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 154
Number of other retired or separated participants entitled to future benefits 2012-01-01 9
Total of all active and inactive participants 2012-01-01 163
Total participants 2012-01-01 163
Number of participants with account balances 2012-01-01 124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 17
2011: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 167
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 159
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 5
Total of all active and inactive participants 2011-01-01 164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 1
Total participants 2011-01-01 165
Number of participants with account balances 2011-01-01 121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 9
2009: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 163
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 154
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 19
Total of all active and inactive participants 2009-01-01 173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 1
Total participants 2009-01-01 174
Number of participants with account balances 2009-01-01 111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 11

Measure	Date	Value
2022: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	154
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	137
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	19
Total of all active and inactive participants	2022-01-01	156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	156
Number of participants with account balances	2022-01-01	118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	160
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	123
Number of retired or separated participants receiving benefits	2021-01-01	5
Number of other retired or separated participants entitled to future benefits	2021-01-01	24
Total of all active and inactive participants	2021-01-01	152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	152
Number of participants with account balances	2021-01-01	115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	4
2020: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	165
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	136
Number of retired or separated participants receiving benefits	2020-01-01	1
Number of other retired or separated participants entitled to future benefits	2020-01-01	23
Total of all active and inactive participants	2020-01-01	160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	160
Number of participants with account balances	2020-01-01	120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	7
2019: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	150
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	155
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	23
Total of all active and inactive participants	2019-01-01	178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	178
Number of participants with account balances	2019-01-01	122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	6
2018: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	157
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	120
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	23
Total of all active and inactive participants	2018-01-01	143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	143
Number of participants with account balances	2018-01-01	115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	8
2017: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	171
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	137
Number of other retired or separated participants entitled to future benefits	2017-01-01	11
Total of all active and inactive participants	2017-01-01	148
Total participants	2017-01-01	148
Number of participants with account balances	2017-01-01	148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	16
2016: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	172
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	144
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	26
Total of all active and inactive participants	2016-01-01	170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	1
Total participants	2016-01-01	171
Number of participants with account balances	2016-01-01	146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	21
2015: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	169
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	156
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	16
Total of all active and inactive participants	2015-01-01	172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	172
Number of participants with account balances	2015-01-01	142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	10
2014: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	176
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	158
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	11
Total of all active and inactive participants	2014-01-01	169
Total participants	2014-01-01	169
Number of participants with account balances	2014-01-01	124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	7
2013: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	161
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	161
Number of other retired or separated participants entitled to future benefits	2013-01-01	15
Total of all active and inactive participants	2013-01-01	176
Total participants	2013-01-01	176
Number of participants with account balances	2013-01-01	132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	24
2012: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	164
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	154
Number of other retired or separated participants entitled to future benefits	2012-01-01	9
Total of all active and inactive participants	2012-01-01	163
Total participants	2012-01-01	163
Number of participants with account balances	2012-01-01	124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	17
2011: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	167
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	159
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	5
Total of all active and inactive participants	2011-01-01	164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	1
Total participants	2011-01-01	165
Number of participants with account balances	2011-01-01	121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	9
2009: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	163
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	154
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	19
Total of all active and inactive participants	2009-01-01	173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	1
Total participants	2009-01-01	174
Number of participants with account balances	2009-01-01	111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	11

Financial Data on GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN

Measure	Date	Value
2022 : GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-84,472
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$304,809
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$295,297
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$306,714
Value of total assets at end of year	2022-12-31	$2,699,043
Value of total assets at beginning of year	2022-12-31	$3,088,324
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$9,512
Total interest from all sources	2022-12-31	$5,825
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$125,223
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$125,223
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$218,003
Participant contributions at end of year	2022-12-31	$110,913
Participant contributions at beginning of year	2022-12-31	$138,611
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$19,834
Total non interest bearing cash at end of year	2022-12-31	$0
Total non interest bearing cash at beginning of year	2022-12-31	$15,797
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-389,281
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$2,699,043
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$3,088,324
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Investment advisory and management fees	2022-12-31	$9,512
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$2,003,355
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$2,335,749
Interest on participant loans	2022-12-31	$5,825
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$584,378
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$598,167
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-522,234
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$68,877
Employer contributions (assets) at end of year	2022-12-31	$397
Employer contributions (assets) at beginning of year	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$295,297
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	WIPFLI LLP
Accountancy firm EIN	2022-12-31	390758449
2021 : GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$869,613
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$253,259
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$240,619
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$538,985
Value of total assets at end of year	2021-12-31	$3,088,324
Value of total assets at beginning of year	2021-12-31	$2,471,970
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$12,640
Total interest from all sources	2021-12-31	$5,920
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$7,302
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$7,302
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$196,075
Participant contributions at end of year	2021-12-31	$138,611
Participant contributions at beginning of year	2021-12-31	$127,606
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$4,415
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$269,896
Total non interest bearing cash at end of year	2021-12-31	$15,797
Total non interest bearing cash at beginning of year	2021-12-31	$2
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$616,354
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$3,088,324
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$2,471,970
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$6,804
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$2,335,749
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$1,687,242
Interest on participant loans	2021-12-31	$5,920
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$598,167
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$651,521
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$317,406
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$73,014
Employer contributions (assets) at end of year	2021-12-31	$0
Employer contributions (assets) at beginning of year	2021-12-31	$1,184
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$240,619
Contract administrator fees	2021-12-31	$5,836
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	WIPFLI LLP
Accountancy firm EIN	2021-12-31	390758449
2020 : GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$555,579
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$94,701
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$85,311
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$252,579
Value of total assets at end of year	2020-12-31	$2,471,970
Value of total assets at beginning of year	2020-12-31	$2,011,092
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$9,390
Total interest from all sources	2020-12-31	$15,502
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$191,407
Participant contributions at end of year	2020-12-31	$127,606
Participant contributions at beginning of year	2020-12-31	$131,244
Participant contributions at end of year	2020-12-31	$4,415
Participant contributions at beginning of year	2020-12-31	$0
Total non interest bearing cash at end of year	2020-12-31	$2
Total non interest bearing cash at beginning of year	2020-12-31	$2
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$460,878
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$2,471,970
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$2,011,092
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Investment advisory and management fees	2020-12-31	$4,859
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$1,687,242
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$1,287,344
Interest on participant loans	2020-12-31	$7,028
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$8,474
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$651,521
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$591,653
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$287,498
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$61,172
Employer contributions (assets) at end of year	2020-12-31	$1,184
Employer contributions (assets) at beginning of year	2020-12-31	$849
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$85,311
Contract administrator fees	2020-12-31	$4,531
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	WIPFLI LLP
Accountancy firm EIN	2020-12-31	390758449
2019 : GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$438,151
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$494,182
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$483,474
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$219,770
Value of total assets at end of year	2019-12-31	$2,011,092
Value of total assets at beginning of year	2019-12-31	$2,067,123
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$10,708
Total interest from all sources	2019-12-31	$15,970
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$156,288
Participant contributions at end of year	2019-12-31	$131,244
Participant contributions at beginning of year	2019-12-31	$102,103
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$1,907
Total non interest bearing cash at end of year	2019-12-31	$2
Total non interest bearing cash at beginning of year	2019-12-31	$1
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$-56,031
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$2,011,092
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$2,067,123
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Investment advisory and management fees	2019-12-31	$4,712
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$1,287,344
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$1,223,474
Interest on participant loans	2019-12-31	$6,239
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$9,731
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$591,653
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$741,426
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$202,411
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$61,575
Employer contributions (assets) at end of year	2019-12-31	$849
Employer contributions (assets) at beginning of year	2019-12-31	$119
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$483,474
Contract administrator fees	2019-12-31	$5,996
Did the plan have assets held for investment	2019-12-31	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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	WIPFLI LLP
Accountancy firm EIN	2019-12-31	390758449
2018 : GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$146,215
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$100,264
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$92,395
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$208,354
Value of total assets at end of year	2018-12-31	$2,067,123
Value of total assets at beginning of year	2018-12-31	$2,021,172
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$7,869
Total interest from all sources	2018-12-31	$14,567
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$151,524
Participant contributions at end of year	2018-12-31	$102,103
Participant contributions at beginning of year	2018-12-31	$120,539
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$2,587
Total non interest bearing cash at end of year	2018-12-31	$1
Total non interest bearing cash at beginning of year	2018-12-31	$1,897,094
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$45,951
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$2,067,123
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$2,021,172
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Investment advisory and management fees	2018-12-31	$3,741
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$1,223,474
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$0
Interest on participant loans	2018-12-31	$5,998
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$741,426
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$8,569
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-76,706
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$56,830
Employer contributions (assets) at end of year	2018-12-31	$119
Employer contributions (assets) at beginning of year	2018-12-31	$952
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$92,395
Contract administrator fees	2018-12-31	$4,128
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	WIPFLI LLP
Accountancy firm EIN	2018-12-31	390758449
2017 : GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$398,556
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$331,853
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$319,290
Expenses. Certain deemed distributions of participant loans	2017-12-31	$7,697
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$192,959
Value of total assets at end of year	2017-12-31	$2,021,172
Value of total assets at beginning of year	2017-12-31	$1,954,469
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$4,866
Total interest from all sources	2017-12-31	$45,670
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$17,500
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$17,500
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$141,337
Participant contributions at end of year	2017-12-31	$120,539
Participant contributions at beginning of year	2017-12-31	$98,039
Participant contributions at end of year	2017-12-31	$2,587
Participant contributions at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$1,690
Total non interest bearing cash at end of year	2017-12-31	$1,897,094
Total non interest bearing cash at beginning of year	2017-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$66,703
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$2,021,172
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$1,954,469
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$1,051,215
Interest on participant loans	2017-12-31	$4,865
Interest earned on other investments	2017-12-31	$40,805
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$805,215
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$142,427
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$49,932
Employer contributions (assets) at end of year	2017-12-31	$952
Employer contributions (assets) at beginning of year	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$319,290
Contract administrator fees	2017-12-31	$4,866
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	Yes
Did the plan have assets held for investment	2017-12-31	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	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	WIPFLI LLP
Accountancy firm EIN	2017-12-31	390758449
2016 : GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$278,258
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$194,371
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$189,437
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$185,309
Value of total assets at end of year	2016-12-31	$1,954,469
Value of total assets at beginning of year	2016-12-31	$1,870,582
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$4,934
Total interest from all sources	2016-12-31	$29,273
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$10,935
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$10,935
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$137,717
Participant contributions at end of year	2016-12-31	$98,039
Participant contributions at beginning of year	2016-12-31	$87,996
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$18
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$83,887
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$1,954,469
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,870,582
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$1,051,215
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$907,531
Interest on participant loans	2016-12-31	$4,506
Interest earned on other investments	2016-12-31	$24,767
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$805,215
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$875,055
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$52,741
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$47,574
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$189,437
Contract administrator fees	2016-12-31	$4,934
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	WIPFLI LLP
Accountancy firm EIN	2016-12-31	390758449
2015 : GOOD SHEPHERD MANOR, INC. RETIREMENT 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	$203,407
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$147,754
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$144,343
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$184,268
Value of total assets at end of year	2015-12-31	$1,870,582
Value of total assets at beginning of year	2015-12-31	$1,814,929
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$3,411
Total interest from all sources	2015-12-31	$24,659
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$7,578
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$7,578
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
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	$135,007
Participant contributions at end of year	2015-12-31	$87,996
Participant contributions at beginning of year	2015-12-31	$102,205
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$16
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	$55,653
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,870,582
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,814,929
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	$907,531
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$871,074
Interest on participant loans	2015-12-31	$3,562
Interest earned on other investments	2015-12-31	$21,097
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$875,055
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$841,650
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-13,098
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	$49,245
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$144,343
Contract administrator fees	2015-12-31	$3,411
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	WIPFLI LLP
Accountancy firm EIN	2015-12-31	390758449
2014 : GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$269,550
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$452,608
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$448,193
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$177,164
Value of total assets at end of year	2014-12-31	$1,814,929
Value of total assets at beginning of year	2014-12-31	$1,997,987
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$4,415
Total interest from all sources	2014-12-31	$29,949
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$21,441
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$21,441
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	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	$132,426
Participant contributions at end of year	2014-12-31	$102,205
Participant contributions at beginning of year	2014-12-31	$103,642
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$128
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	$-183,058
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,814,929
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,997,987
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	$871,074
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$884,979
Interest on participant loans	2014-12-31	$4,537
Interest earned on other investments	2014-12-31	$25,412
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$841,650
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$1,009,366
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$40,996
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	$44,610
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$448,193
Contract administrator fees	2014-12-31	$4,415
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	WIPFLI LLP
Accountancy firm EIN	2014-12-31	390758449
2013 : GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$367,604
Total of all expenses incurred	2013-12-31	$152,335
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$148,753
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$184,460
Value of total assets at end of year	2013-12-31	$1,997,987
Value of total assets at beginning of year	2013-12-31	$1,782,718
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$3,582
Total interest from all sources	2013-12-31	$4,629
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$23,723
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$23,723
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$300,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$141,411
Participant contributions at end of year	2013-12-31	$103,642
Participant contributions at beginning of year	2013-12-31	$115,017
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	$215,269
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,997,987
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,782,718
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	$884,979
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$797,872
Interest on participant loans	2013-12-31	$4,629
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$1,009,366
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$869,829
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$154,792
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	$43,049
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$148,753
Contract administrator fees	2013-12-31	$3,582
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	WIPFLI LLP
Accountancy firm EIN	2013-12-31	390758449
2012 : GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$320,252
Total of all expenses incurred	2012-12-31	$116,906
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$114,785
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$199,257
Value of total assets at end of year	2012-12-31	$1,782,718
Value of total assets at beginning of year	2012-12-31	$1,579,372
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$2,121
Total interest from all sources	2012-12-31	$4,862
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$15,910
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	$15,910
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$300,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	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	$150,731
Participant contributions at end of year	2012-12-31	$115,017
Participant contributions at beginning of year	2012-12-31	$139,065
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$203,346
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,782,718
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,579,372
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	$797,872
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$709,891
Interest on participant loans	2012-12-31	$4,862
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$869,829
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$730,416
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$100,223
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	Yes
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	$48,526
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$114,785
Contract administrator fees	2012-12-31	$2,121
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	THE CONDON GROUP, LTD
Accountancy firm EIN	2012-12-31	362920866
2011 : GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$194,283
Total of all expenses incurred	2011-12-31	$83,683
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$80,145
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$165,985
Value of total assets at end of year	2011-12-31	$1,579,372
Value of total assets at beginning of year	2011-12-31	$1,468,772
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$3,538
Total interest from all sources	2011-12-31	$4,503
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$21,778
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	$21,778
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$300,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$140,993
Participant contributions at end of year	2011-12-31	$139,065
Participant contributions at beginning of year	2011-12-31	$115,065
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$590
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	$110,600
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,579,372
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,468,772
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	$709,891
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$653,407
Interest on participant loans	2011-12-31	$4,503
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$730,416
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$700,300
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$2,017
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	Yes
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$24,402
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$80,145
Contract administrator fees	2011-12-31	$3,538
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	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	THE CONDON GROUP, LTD.
Accountancy firm EIN	2011-12-31	362920866
2010 : GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$240,127
Total of all expenses incurred	2010-12-31	$27,178
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$24,985
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$139,365
Value of total assets at end of year	2010-12-31	$1,468,772
Value of total assets at beginning of year	2010-12-31	$1,255,823
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$2,193
Total interest from all sources	2010-12-31	$3,845
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$13,650
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$13,650
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$300,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$136,329
Participant contributions at end of year	2010-12-31	$115,065
Participant contributions at beginning of year	2010-12-31	$76,860
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$3,036
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$212,949
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$1,468,772
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,255,823
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$653,407
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$487,184
Interest on participant loans	2010-12-31	$3,817
Interest earned on other investments	2010-12-31	$28
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$700,300
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$691,779
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$83,267
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$24,985
Contract administrator fees	2010-12-31	$2,193
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	THE CONDON GROUP, LTD.
Accountancy firm EIN	2010-12-31	362920866

Form 5500 Responses for GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN

2022: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: GOOD SHEPHERD MANOR, INC. RETIREMENT 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: GOOD SHEPHERD MANOR, INC. RETIREMENT 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: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
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: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
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
2011: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: GOOD SHEPHERD MANOR, INC. RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

767929-01

Policy instance

Insurance contract or identification number	767929-01
Number of Individuals Covered	21
Insurance policy start date	2022-09-10
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 62739-1

Policy instance

Insurance contract or identification number	MR 62739-1
Number of Individuals Covered	118
Insurance policy start date	2022-01-01
Insurance policy end date	2022-09-09
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 62739-1

Policy instance

Insurance contract or identification number	MR 62739-1
Number of Individuals Covered	152
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 62739-1

Policy instance

Insurance contract or identification number	MR 62739-1
Number of Individuals Covered	149
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $9,390
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	4859
Additional information about fees paid to insurance broker	INVESTMENT ADVISOR
Insurance broker organization code?	6

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 62739-1

Policy instance

Insurance contract or identification number	MR 62739-1
Number of Individuals Covered	167
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $10,708
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	5996
Additional information about fees paid to insurance broker	CONTRACT ADMINISTRATOR
Insurance broker organization code?	6

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 62739-1

Policy instance

Insurance contract or identification number	MR 62739-1
Number of Individuals Covered	143
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $7,869
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	4128
Additional information about fees paid to insurance broker	CONTRACT ADMINISTRATOR
Insurance broker organization code?	6

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

441465

Policy instance

Insurance contract or identification number	441465
Number of Individuals Covered	148
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,919
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,919
Insurance broker organization code?	3
Insurance broker name	WELLS FARGO ADVISORS INS AGENCY LLC

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Company Name:	GOOD SHEPHERD MANOR, INC.
Employer identification number (EIN):	362693168
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	2334463