401k Plan data: 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. plan

403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 401k Plan overview

Plan Name	403B THRIFT PLAN FOR WOODBOURNE CENTER, INC.
Plan identification number	001

403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.

401k Sponsoring company profile

WOODBOURNE CENTER, INC. has sponsored the creation of one or more 401k plans.

Company Name: WOODBOURNE CENTER, INC.

Employer identification number (EIN): 520909347

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2015-07-01 ALAN NORDBY 2016-01-11 ALAN NORDBY 2016-01-11
001 2014-07-01 ALAN NORDBY ALAN NORDBY 2015-11-24
001 2013-07-01 ALAN NORDBY ALAN NORDBY 2014-11-13
001 2012-07-01 BRITNEY FOSTER BRITNEY FOSTER 2014-04-10
001 2011-07-01 LIZ MCMANN LIZ MCMANN 2013-04-15
001 2009-07-01 ELIZABETH MCMANN SUSAN CRONMILLER 2011-04-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2015-07-01	ALAN NORDBY	2016-01-11	ALAN NORDBY	2016-01-11
001	2014-07-01	ALAN NORDBY		ALAN NORDBY	2015-11-24
001	2013-07-01	ALAN NORDBY		ALAN NORDBY	2014-11-13
001	2012-07-01	BRITNEY FOSTER		BRITNEY FOSTER	2014-04-10
001	2011-07-01	LIZ MCMANN		LIZ MCMANN	2013-04-15
001	2009-07-01	ELIZABETH MCMANN		SUSAN CRONMILLER	2011-04-15

Plan Statistics for 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC.

401k plan membership statisitcs for 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC.

Measure Date Value
2014: 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2014 401k membership
Total participants, beginning-of-year 2014-07-01 117
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 0
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 0
Total of all active and inactive participants 2014-07-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 1
Total participants 2014-07-01 1
Number of participants with account balances 2014-07-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 0
2013: 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2013 401k membership
Total participants, beginning-of-year 2013-07-01 208
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 0
Number of retired or separated participants receiving benefits 2013-07-01 0
Number of other retired or separated participants entitled to future benefits 2013-07-01 117
Total of all active and inactive participants 2013-07-01 117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 0
Total participants 2013-07-01 117
Number of participants with account balances 2013-07-01 117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 0
2012: 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2012 401k membership
Total participants, beginning-of-year 2012-07-01 209
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 157
Number of retired or separated participants receiving benefits 2012-07-01 42
Number of other retired or separated participants entitled to future benefits 2012-07-01 9
Total of all active and inactive participants 2012-07-01 208
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 0
Total participants 2012-07-01 208
Number of participants with account balances 2012-07-01 128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 17
2011: 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2011 401k membership
Total participants, beginning-of-year 2011-07-01 258
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 111
Number of retired or separated participants receiving benefits 2011-07-01 2
Number of other retired or separated participants entitled to future benefits 2011-07-01 51
Total of all active and inactive participants 2011-07-01 164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 0
Total participants 2011-07-01 164
Number of participants with account balances 2011-07-01 135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 8
2009: 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2009 401k membership
Total participants, beginning-of-year 2009-07-01 265
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 184
Number of retired or separated participants receiving benefits 2009-07-01 2
Number of other retired or separated participants entitled to future benefits 2009-07-01 79
Total of all active and inactive participants 2009-07-01 265
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-07-01 0
Total participants 2009-07-01 265
Number of participants with account balances 2009-07-01 139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-07-01 30

Measure	Date	Value
2014: 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2014 401k membership
Total participants, beginning-of-year	2014-07-01	117
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	0
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	0
Total of all active and inactive participants	2014-07-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	1
Total participants	2014-07-01	1
Number of participants with account balances	2014-07-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	0
2013: 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2013 401k membership
Total participants, beginning-of-year	2013-07-01	208
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	0
Number of retired or separated participants receiving benefits	2013-07-01	0
Number of other retired or separated participants entitled to future benefits	2013-07-01	117
Total of all active and inactive participants	2013-07-01	117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	0
Total participants	2013-07-01	117
Number of participants with account balances	2013-07-01	117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	0
2012: 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2012 401k membership
Total participants, beginning-of-year	2012-07-01	209
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	157
Number of retired or separated participants receiving benefits	2012-07-01	42
Number of other retired or separated participants entitled to future benefits	2012-07-01	9
Total of all active and inactive participants	2012-07-01	208
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	0
Total participants	2012-07-01	208
Number of participants with account balances	2012-07-01	128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	17
2011: 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2011 401k membership
Total participants, beginning-of-year	2011-07-01	258
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	111
Number of retired or separated participants receiving benefits	2011-07-01	2
Number of other retired or separated participants entitled to future benefits	2011-07-01	51
Total of all active and inactive participants	2011-07-01	164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	164
Number of participants with account balances	2011-07-01	135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	8
2009: 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2009 401k membership
Total participants, beginning-of-year	2009-07-01	265
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	184
Number of retired or separated participants receiving benefits	2009-07-01	2
Number of other retired or separated participants entitled to future benefits	2009-07-01	79
Total of all active and inactive participants	2009-07-01	265
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-07-01	0
Total participants	2009-07-01	265
Number of participants with account balances	2009-07-01	139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-07-01	30

Financial Data on 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC.

Measure	Date	Value
2015 : 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total income from all sources (including contributions)	2015-06-30	$50,746
Total loss/gain on sale of assets	2015-06-30	$0
Total of all expenses incurred	2015-06-30	$2,631,407
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-30	$2,621,847
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-30	$0
Value of total assets at end of year	2015-06-30	$666
Value of total assets at beginning of year	2015-06-30	$2,581,327
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-30	$9,560
Total interest from all sources	2015-06-30	$5,572
Total dividends received (eg from common stock, registered investment company shares)	2015-06-30	$11,736
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-06-30	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2015-06-30	$0
Total dividends received from registered investment company shares (eg mutual funds)	2015-06-30	$11,736
Was this plan covered by a fidelity bond	2015-06-30	Yes
Value of fidelity bond cover	2015-06-30	$350,000
If this is an individual account plan, was there a blackout period	2015-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2015-06-30	No
Other income not declared elsewhere	2015-06-30	$29,053
Total non interest bearing cash at end of year	2015-06-30	$0
Total non interest bearing cash at beginning of year	2015-06-30	$8,192
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Value of net income/loss	2015-06-30	$-2,580,661
Value of net assets at end of year (total assets less liabilities)	2015-06-30	$666
Value of net assets at beginning of year (total assets less liabilities)	2015-06-30	$2,581,327
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-06-30	No
Were any leases to which the plan was party in default or uncollectible	2015-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-06-30	$666
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-06-30	$629,284
Value of interest in pooled separate accounts at beginning of year	2015-06-30	$1,566,390
Interest earned on other investments	2015-06-30	$5,572
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-06-30	$44
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-06-30	$44
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-06-30	$377,417
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-06-30	$4,385
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-06-30	No
Was there a failure to transmit to the plan any participant contributions	2015-06-30	No
Has the plan failed to provide any benefit when due under the plan	2015-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-06-30	$2,621,847
Contract administrator fees	2015-06-30	$9,560
Did the plan have assets held for investment	2015-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2015-06-30	Disclaimer
Accountancy firm name	2015-06-30	MESSERLI & SCHADOW, PLLP
Accountancy firm EIN	2015-06-30	411653318
2014 : 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total income from all sources (including contributions)	2014-06-30	$446,767
Total loss/gain on sale of assets	2014-06-30	$0
Total of all expenses incurred	2014-06-30	$892,011
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$891,182
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$0
Value of total assets at end of year	2014-06-30	$2,581,327
Value of total assets at beginning of year	2014-06-30	$3,026,571
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$829
Total interest from all sources	2014-06-30	$12,485
Total dividends received (eg from common stock, registered investment company shares)	2014-06-30	$32,440
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-06-30	$32,440
Was this plan covered by a fidelity bond	2014-06-30	Yes
Value of fidelity bond cover	2014-06-30	$350,000
If this is an individual account plan, was there a blackout period	2014-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2014-06-30	No
Other income not declared elsewhere	2014-06-30	$401,842
Total non interest bearing cash at end of year	2014-06-30	$8,192
Total non interest bearing cash at beginning of year	2014-06-30	$5,078
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Value of net income/loss	2014-06-30	$-445,244
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$2,581,327
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$3,026,571
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-06-30	No
Were any leases to which the plan was party in default or uncollectible	2014-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-06-30	$629,284
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-06-30	$603,650
Value of interest in pooled separate accounts at end of year	2014-06-30	$1,566,390
Value of interest in pooled separate accounts at beginning of year	2014-06-30	$1,958,201
Interest earned on other investments	2014-06-30	$12,485
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-06-30	$44
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-06-30	$45
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-06-30	$45
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-06-30	$377,417
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-06-30	$459,597
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-06-30	No
Was there a failure to transmit to the plan any participant contributions	2014-06-30	No
Has the plan failed to provide any benefit when due under the plan	2014-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$891,182
Contract administrator fees	2014-06-30	$829
Did the plan have assets held for investment	2014-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2014-06-30	Disclaimer
Accountancy firm name	2014-06-30	MESSERLI & SCHADOW, PLLP
Accountancy firm EIN	2014-06-30	411653318
2013 : 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Total income from all sources (including contributions)	2013-06-30	$552,311
Total loss/gain on sale of assets	2013-06-30	$0
Total of all expenses incurred	2013-06-30	$403,908
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$403,032
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$131,462
Value of total assets at end of year	2013-06-30	$3,026,571
Value of total assets at beginning of year	2013-06-30	$2,878,168
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$876
Total interest from all sources	2013-06-30	$12,784
Total dividends received (eg from common stock, registered investment company shares)	2013-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-06-30	No
Was this plan covered by a fidelity bond	2013-06-30	Yes
Value of fidelity bond cover	2013-06-30	$350,000
If this is an individual account plan, was there a blackout period	2013-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2013-06-30	No
Contributions received from participants	2013-06-30	$127,742
Other income not declared elsewhere	2013-06-30	$387,870
Total non interest bearing cash at end of year	2013-06-30	$5,078
Total non interest bearing cash at beginning of year	2013-06-30	$2,490
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Value of net income/loss	2013-06-30	$148,403
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$3,026,571
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$2,878,168
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-06-30	No
Were any leases to which the plan was party in default or uncollectible	2013-06-30	No
Investment advisory and management fees	2013-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-06-30	$603,650
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-06-30	$520,368
Value of interest in pooled separate accounts at end of year	2013-06-30	$1,958,201
Value of interest in pooled separate accounts at beginning of year	2013-06-30	$1,918,676
Interest earned on other investments	2013-06-30	$12,784
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-06-30	$45
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-06-30	$12,942
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-06-30	$12,942
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-06-30	$459,597
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-06-30	$423,692
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-06-30	$20,195
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-06-30	No
Was there a failure to transmit to the plan any participant contributions	2013-06-30	No
Has the plan failed to provide any benefit when due under the plan	2013-06-30	No
Contributions received in cash from employer	2013-06-30	$3,720
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-06-30	$403,032
Contract administrator fees	2013-06-30	$876
Did the plan have assets held for investment	2013-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2013-06-30	Disclaimer
Accountancy firm name	2013-06-30	MESSERLI & SCHADOW, PLLP
Accountancy firm EIN	2013-06-30	411653318
2012 : 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total income from all sources (including contributions)	2012-06-30	$145,806
Total loss/gain on sale of assets	2012-06-30	$0
Total of all expenses incurred	2012-06-30	$361,047
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$359,788
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$193,654
Value of total assets at end of year	2012-06-30	$2,878,169
Value of total assets at beginning of year	2012-06-30	$3,093,410
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$1,259
Total interest from all sources	2012-06-30	$11,520
Total dividends received (eg from common stock, registered investment company shares)	2012-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-06-30	No
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$350,000
If this is an individual account plan, was there a blackout period	2012-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2012-06-30	No
Contributions received from participants	2012-06-30	$187,826
Other income not declared elsewhere	2012-06-30	$-41,063
Total non interest bearing cash at beginning of year	2012-06-30	$979
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Value of net income/loss	2012-06-30	$-215,241
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$2,878,169
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$3,093,410
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-06-30	No
Were any leases to which the plan was party in default or uncollectible	2012-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-06-30	$520,368
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-06-30	$847,672
Value of interest in pooled separate accounts at end of year	2012-06-30	$1,918,677
Value of interest in pooled separate accounts at beginning of year	2012-06-30	$1,846,778
Interest earned on other investments	2012-06-30	$11,520
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-06-30	$12,942
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-06-30	$13,148
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-06-30	$13,148
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-06-30	$426,182
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-06-30	$384,833
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-06-30	$-18,305
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-06-30	No
Was there a failure to transmit to the plan any participant contributions	2012-06-30	No
Has the plan failed to provide any benefit when due under the plan	2012-06-30	No
Contributions received in cash from employer	2012-06-30	$5,828
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$359,788
Contract administrator fees	2012-06-30	$1,259
Did the plan have assets held for investment	2012-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2012-06-30	Disclaimer
Accountancy firm name	2012-06-30	ELLIN & TUCKER, CHARTERED
Accountancy firm EIN	2012-06-30	520959934
2011 : 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total income from all sources (including contributions)	2011-06-30	$798,200
Total loss/gain on sale of assets	2011-06-30	$0
Total of all expenses incurred	2011-06-30	$103,084
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$102,360
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$208,404
Value of total assets at end of year	2011-06-30	$3,093,410
Value of total assets at beginning of year	2011-06-30	$2,398,294
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$724
Total interest from all sources	2011-06-30	$27,202
Total dividends received (eg from common stock, registered investment company shares)	2011-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-06-30	No
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$250,000
If this is an individual account plan, was there a blackout period	2011-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2011-06-30	No
Contributions received from participants	2011-06-30	$201,649
Total non interest bearing cash at end of year	2011-06-30	$979
Total non interest bearing cash at beginning of year	2011-06-30	$212
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Value of net income/loss	2011-06-30	$695,116
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$3,093,410
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$2,398,294
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-06-30	No
Were any leases to which the plan was party in default or uncollectible	2011-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-06-30	$847,672
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-06-30	$698,049
Value of interest in pooled separate accounts at end of year	2011-06-30	$1,846,778
Value of interest in pooled separate accounts at beginning of year	2011-06-30	$1,346,026
Interest earned on other investments	2011-06-30	$27,202
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-06-30	$13,148
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-06-30	$13,346
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-06-30	$13,346
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-06-30	$384,833
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-06-30	$340,661
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-06-30	$562,594
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-06-30	No
Was there a failure to transmit to the plan any participant contributions	2011-06-30	No
Has the plan failed to provide any benefit when due under the plan	2011-06-30	No
Contributions received in cash from employer	2011-06-30	$6,755
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-06-30	$102,360
Contract administrator fees	2011-06-30	$724
Did the plan have assets held for investment	2011-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2011-06-30	Disclaimer
Accountancy firm name	2011-06-30	ELLIN & TUCKER, CHARTERED
Accountancy firm EIN	2011-06-30	520959934
2010 : 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-06-30	$0

Form 5500 Responses for 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC.

2014: 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan funding arrangement – Trust	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement - Trust	Yes
2013: 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan funding arrangement – Trust	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement - Trust	Yes
2012: 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan funding arrangement – Trust	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement - Trust	Yes
2011: 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement - Trust	Yes
2009: 403B THRIFT PLAN FOR WOODBOURNE CENTER, INC. 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	No
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes

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Company Name:	WOODBOURNE CENTER, INC.
Employer identification number (EIN):	520909347
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities