401k Plan data: HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN plan

HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 401k Plan overview

Plan Name	HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN
Plan identification number	002

HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
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.
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

HEALTH SERVICES MANAGEMENT, INC. has sponsored the creation of one or more 401k plans.

Company Name: HEALTH SERVICES MANAGEMENT, INC.

Employer identification number (EIN): 621760995

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

Additional information about HEALTH SERVICES MANAGEMENT, INC.

Jurisdiction of Incorporation: Michigan Secretary of State

Incorporation Date: 0000-00-00

Company Identification Number: 006779

Legal Registered Office Address: 895 S SHORE DR HOLLAND

United States of America (USA)
49423

More information about HEALTH SERVICES MANAGEMENT, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2014-01-01
002 2013-01-01
002 2012-01-01 JAMES E. BELL JAMES E. BELL 2013-10-15
002 2011-01-01 JAMES E. BELL JAMES E. BELL 2012-10-15
002 2009-01-01 JAMES E. BELL JAMES E. BELL 2010-10-15
002 2009-01-01 J. ERIC BELL J. ERIC BELL 2010-10-13
002 2009-01-01 JAMES E. BELL JAMES E. BELL 2010-10-15

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2014-01-01
002	2013-01-01
002	2012-01-01	JAMES E. BELL	JAMES E. BELL	2013-10-15
002	2011-01-01	JAMES E. BELL	JAMES E. BELL	2012-10-15
002	2009-01-01	JAMES E. BELL	JAMES E. BELL	2010-10-15
002	2009-01-01	J. ERIC BELL	J. ERIC BELL	2010-10-13
002	2009-01-01	JAMES E. BELL	JAMES E. BELL	2010-10-15

Plan Statistics for HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN

401k plan membership statisitcs for HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN

Measure Date Value
2014: HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 968
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 933
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 91
Total of all active and inactive participants 2014-01-01 1,024
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 1,024
Number of participants with account balances 2014-01-01 265
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 7
2013: HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 905
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 841
Number of retired or separated participants receiving benefits 2013-01-01 11
Number of other retired or separated participants entitled to future benefits 2013-01-01 83
Total of all active and inactive participants 2013-01-01 935
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 935
Number of participants with account balances 2013-01-01 272
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 7
2012: HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 886
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 829
Number of retired or separated participants receiving benefits 2012-01-01 11
Number of other retired or separated participants entitled to future benefits 2012-01-01 85
Total of all active and inactive participants 2012-01-01 925
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 925
Number of participants with account balances 2012-01-01 274
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 1
2011: HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 902
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 782
Number of retired or separated participants receiving benefits 2011-01-01 18
Number of other retired or separated participants entitled to future benefits 2011-01-01 85
Total of all active and inactive participants 2011-01-01 885
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 885
Number of participants with account balances 2011-01-01 281
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 3
2009: HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 969
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 866
Number of retired or separated participants receiving benefits 2009-01-01 18
Number of other retired or separated participants entitled to future benefits 2009-01-01 88
Total of all active and inactive participants 2009-01-01 972
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 972
Number of participants with account balances 2009-01-01 268
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 4

Measure	Date	Value
2014: HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	968
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	933
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	91
Total of all active and inactive participants	2014-01-01	1,024
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	1,024
Number of participants with account balances	2014-01-01	265
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	7
2013: HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	905
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	841
Number of retired or separated participants receiving benefits	2013-01-01	11
Number of other retired or separated participants entitled to future benefits	2013-01-01	83
Total of all active and inactive participants	2013-01-01	935
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	935
Number of participants with account balances	2013-01-01	272
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	7
2012: HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	886
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	829
Number of retired or separated participants receiving benefits	2012-01-01	11
Number of other retired or separated participants entitled to future benefits	2012-01-01	85
Total of all active and inactive participants	2012-01-01	925
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	925
Number of participants with account balances	2012-01-01	274
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	1
2011: HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	902
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	782
Number of retired or separated participants receiving benefits	2011-01-01	18
Number of other retired or separated participants entitled to future benefits	2011-01-01	85
Total of all active and inactive participants	2011-01-01	885
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	885
Number of participants with account balances	2011-01-01	281
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	3
2009: HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	969
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	866
Number of retired or separated participants receiving benefits	2009-01-01	18
Number of other retired or separated participants entitled to future benefits	2009-01-01	88
Total of all active and inactive participants	2009-01-01	972
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	972
Number of participants with account balances	2009-01-01	268
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	4

Financial Data on HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN

Measure	Date	Value
2014 : HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$436,525
Total of all expenses incurred	2014-12-31	$291,866
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$256,804
Value of total corrective distributions	2014-12-31	$5,231
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$302,451
Value of total assets at end of year	2014-12-31	$3,681,812
Value of total assets at beginning of year	2014-12-31	$3,537,153
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$29,831
Total interest from all sources	2014-12-31	$7,061
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Administrative expenses professional fees incurred	2014-12-31	$9,461
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
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$230,266
Participant contributions at end of year	2014-12-31	$159,572
Participant contributions at beginning of year	2014-12-31	$158,741
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$6,602
Other income not declared elsewhere	2014-12-31	$349
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	$144,659
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$3,681,812
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$3,537,153
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in pooled separate accounts at end of year	2014-12-31	$3,355,552
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$3,107,632
Interest on participant loans	2014-12-31	$6,431
Income. Interest from corporate debt instruments	2014-12-31	$630
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$166,688
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$270,780
Net investment gain/loss from pooled separate accounts	2014-12-31	$126,664
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	$65,583
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$256,804
Contract administrator fees	2014-12-31	$20,370
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	MATLOCK CLEMENTS, P.C.
Accountancy firm EIN	2014-12-31	621717910
2013 : HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$872,806
Total of all expenses incurred	2013-12-31	$320,878
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$276,605
Value of total corrective distributions	2013-12-31	$14,042
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$390,051
Value of total assets at end of year	2013-12-31	$3,537,153
Value of total assets at beginning of year	2013-12-31	$2,985,225
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$30,231
Total interest from all sources	2013-12-31	$7,430
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Administrative expenses professional fees incurred	2013-12-31	$9,743
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$69,495
Participant contributions at end of year	2013-12-31	$158,741
Participant contributions at beginning of year	2013-12-31	$153,466
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$79,322
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	$551,928
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$3,537,153
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$2,985,225
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 pooled separate accounts at end of year	2013-12-31	$3,107,632
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$2,646,411
Interest on participant loans	2013-12-31	$6,501
Income. Interest from loans (other than to participants)	2013-12-31	$0
Income. Interest from corporate debt instruments	2013-12-31	$929
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$270,780
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$185,231
Net investment gain/loss from pooled separate accounts	2013-12-31	$475,325
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	$241,234
Employer contributions (assets) at beginning of year	2013-12-31	$117
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$276,605
Contract administrator fees	2013-12-31	$20,488
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	MATLOCK CLEMENTS, P.C.
Accountancy firm EIN	2013-12-31	621717910
2012 : HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$637,693
Total of all expenses incurred	2012-12-31	$211,927
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$173,463
Expenses. Certain deemed distributions of participant loans	2012-12-31	$3,309
Value of total corrective distributions	2012-12-31	$8,833
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$316,929
Value of total assets at end of year	2012-12-31	$2,985,225
Value of total assets at beginning of year	2012-12-31	$2,559,459
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$26,322
Total interest from all sources	2012-12-31	$6,912
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Administrative expenses professional fees incurred	2012-12-31	$7,941
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$60,853
Participant contributions at end of year	2012-12-31	$153,466
Participant contributions at beginning of year	2012-12-31	$124,620
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$23,418
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	$425,766
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$2,985,225
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$2,559,459
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$2,646,411
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$2,291,485
Income. Interest from loans (other than to participants)	2012-12-31	$5,713
Income. Interest from corporate debt instruments	2012-12-31	$1,199
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$185,231
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$143,354
Net investment gain/loss from pooled separate accounts	2012-12-31	$313,852
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$232,658
Employer contributions (assets) at end of year	2012-12-31	$117
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$173,463
Contract administrator fees	2012-12-31	$18,381
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	RANDALL MATLOCK & ASSOCIATES, P.C.
Accountancy firm EIN	2012-12-31	621717910
2011 : HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2011 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$242,993
Total of all expenses incurred	2011-12-31	$386,454
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$354,769
Value of total corrective distributions	2011-12-31	$5,697
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$280,068
Value of total assets at end of year	2011-12-31	$2,559,459
Value of total assets at beginning of year	2011-12-31	$2,702,920
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$25,988
Total interest from all sources	2011-12-31	$7,043
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Administrative expenses professional fees incurred	2011-12-31	$8,375
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$215,662
Participant contributions at end of year	2011-12-31	$124,620
Participant contributions at beginning of year	2011-12-31	$125,793
Participant contributions at beginning of year	2011-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$3,572
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	$-143,461
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$2,559,459
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$2,702,920
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 pooled separate accounts at end of year	2011-12-31	$2,291,485
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$2,435,085
Interest on participant loans	2011-12-31	$5,417
Income. Interest from corporate debt instruments	2011-12-31	$1,626
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$143,354
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$142,032
Net investment gain/loss from pooled separate accounts	2011-12-31	$-44,118
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$60,834
Employer contributions (assets) at beginning of year	2011-12-31	$10
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$354,769
Contract administrator fees	2011-12-31	$17,613
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	RANDALL MATLOCK & ASSOCIATES, P.C.
Accountancy firm EIN	2011-12-31	621717910
2010 : HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$513,734
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$266,265
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$218,558
Expenses. Certain deemed distributions of participant loans	2010-12-31	$5,181
Value of total corrective distributions	2010-12-31	$19,804
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$235,957
Value of total assets at end of year	2010-12-31	$2,702,920
Value of total assets at beginning of year	2010-12-31	$2,455,451
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$22,722
Total interest from all sources	2010-12-31	$8,709
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Administrative expenses professional fees incurred	2010-12-31	$5,735
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$185,016
Participant contributions at end of year	2010-12-31	$125,793
Participant contributions at beginning of year	2010-12-31	$109,064
Participant contributions at end of year	2010-12-31	$0
Participant contributions at beginning of year	2010-12-31	$125
Total non interest bearing cash at beginning of year	2010-12-31	$653
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	$247,469
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$2,702,920
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$2,455,451
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 pooled separate accounts at end of year	2010-12-31	$2,435,085
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$2,195,395
Interest on participant loans	2010-12-31	$6,038
Interest earned on other investments	2010-12-31	$321
Income. Interest from corporate debt instruments	2010-12-31	$2,350
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$142,032
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$149,303
Net investment gain/loss from pooled separate accounts	2010-12-31	$269,068
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	$50,941
Employer contributions (assets) at end of year	2010-12-31	$10
Employer contributions (assets) at beginning of year	2010-12-31	$911
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$218,558
Contract administrator fees	2010-12-31	$16,987
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	RANDALL MATLOCK & ASSOCIATES, P.C.
Accountancy firm EIN	2010-12-31	621717910

Form 5500 Responses for HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN

2014: HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
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: HEALTH SERVICES MANAGEMENT, INC. OF FLORIDA 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	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

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Company Name:	HEALTH SERVICES MANAGEMENT, INC.
Employer identification number (EIN):	621760995
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Jurisdiction of Incorporation:	Michigan Secretary of State
Incorporation Date:	0000-00-00
Company Identification Number:	006779
Legal Registered Office Address:	895 S SHORE DR HOLLAND United States of America (USA) 49423