401k Plan data: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN plan

LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 401k Plan overview

Plan Name	LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN
Plan identification number	001

LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Plan covering Self-Employed individuals.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER has sponsored the creation of one or more 401k plans.

Company Name: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER

Employer identification number (EIN): 223191040

NAIC Classification: 621399
NAIC Description: Offices of All Other Miscellaneous Health Practitioners

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 STEVE IZZO 2023-05-10
001 2021-01-01 STEVE IZZO 2022-05-02
001 2020-01-01 STEVE IZZO 2021-09-22
001 2019-01-01 STEVE IZZO 2020-06-23
001 2018-01-01 STEVE IZZO 2019-10-15
001 2017-01-01
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01 MELISSA TONCIC
001 2013-01-01 MELISSA TONCIC
001 2012-01-01 MELISSA TONCIC
001 2011-01-01 MELISSA TONCIC
001 2010-01-01 MELISSA TONCIC
001 2009-01-01 LEAH DAVIS

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	STEVE IZZO	2023-05-10
001	2021-01-01	STEVE IZZO	2022-05-02
001	2020-01-01	STEVE IZZO	2021-09-22
001	2019-01-01	STEVE IZZO	2020-06-23
001	2018-01-01	STEVE IZZO	2019-10-15
001	2017-01-01
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01	MELISSA TONCIC
001	2013-01-01	MELISSA TONCIC
001	2012-01-01	MELISSA TONCIC
001	2011-01-01	MELISSA TONCIC
001	2010-01-01	MELISSA TONCIC
001	2009-01-01	LEAH DAVIS

Plan Statistics for LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN

401k plan membership statisitcs for LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN

Measure Date Value
2022: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 150
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 103
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 38
Total of all active and inactive participants 2022-01-01 141
Total participants 2022-01-01 141
Number of participants with account balances 2022-01-01 96
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 2
2021: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 154
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 100
Number of other retired or separated participants entitled to future benefits 2021-01-01 42
Total of all active and inactive participants 2021-01-01 142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 142
Number of participants with account balances 2021-01-01 101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 5
2020: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) 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 2020-01-01 113
Number of other retired or separated participants entitled to future benefits 2020-01-01 41
Total of all active and inactive participants 2020-01-01 154
Total participants 2020-01-01 154
Number of participants with account balances 2020-01-01 105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 1
2019: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 167
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 130
Number of other retired or separated participants entitled to future benefits 2019-01-01 35
Total of all active and inactive participants 2019-01-01 165
Total participants 2019-01-01 165
Number of participants with account balances 2019-01-01 107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 4
2018: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 162
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 135
Number of other retired or separated participants entitled to future benefits 2018-01-01 32
Total of all active and inactive participants 2018-01-01 167
Total participants 2018-01-01 167
Number of participants with account balances 2018-01-01 104
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 9
2017: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 152
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 134
Number of other retired or separated participants entitled to future benefits 2017-01-01 28
Total of all active and inactive participants 2017-01-01 162
Total participants 2017-01-01 162
Number of participants with account balances 2017-01-01 106
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 5
2016: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 137
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 132
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 20
Total of all active and inactive participants 2016-01-01 152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 152
Number of participants with account balances 2016-01-01 106
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 4
2015: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 147
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 122
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 15
Total of all active and inactive participants 2015-01-01 137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 137
Number of participants with account balances 2015-01-01 90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 32
2014: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 162
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 132
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 15
Total of all active and inactive participants 2014-01-01 147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 147
Number of participants with account balances 2014-01-01 65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 17
2013: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 176
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 140
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 13
Total of all active and inactive participants 2013-01-01 153
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 153
Number of participants with account balances 2013-01-01 69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 10
2012: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 171
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 150
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 14
Total of all active and inactive participants 2012-01-01 164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 164
Number of participants with account balances 2012-01-01 73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 6
2011: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 168
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 145
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 16
Total of all active and inactive participants 2011-01-01 161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 161
Number of participants with account balances 2011-01-01 65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 6
2010: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 156
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 134
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 12
Total of all active and inactive participants 2010-01-01 146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 146
Number of participants with account balances 2010-01-01 54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 161
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 132
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 12
Total of all active and inactive participants 2009-01-01 144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 144
Number of participants with account balances 2009-01-01 56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2022: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	150
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	103
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	38
Total of all active and inactive participants	2022-01-01	141
Total participants	2022-01-01	141
Number of participants with account balances	2022-01-01	96
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	2
2021: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	154
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	100
Number of other retired or separated participants entitled to future benefits	2021-01-01	42
Total of all active and inactive participants	2021-01-01	142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	142
Number of participants with account balances	2021-01-01	101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	5
2020: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) 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	113
Number of other retired or separated participants entitled to future benefits	2020-01-01	41
Total of all active and inactive participants	2020-01-01	154
Total participants	2020-01-01	154
Number of participants with account balances	2020-01-01	105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	1
2019: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	167
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	130
Number of other retired or separated participants entitled to future benefits	2019-01-01	35
Total of all active and inactive participants	2019-01-01	165
Total participants	2019-01-01	165
Number of participants with account balances	2019-01-01	107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	4
2018: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	162
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	135
Number of other retired or separated participants entitled to future benefits	2018-01-01	32
Total of all active and inactive participants	2018-01-01	167
Total participants	2018-01-01	167
Number of participants with account balances	2018-01-01	104
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	9
2017: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	152
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	134
Number of other retired or separated participants entitled to future benefits	2017-01-01	28
Total of all active and inactive participants	2017-01-01	162
Total participants	2017-01-01	162
Number of participants with account balances	2017-01-01	106
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	5
2016: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	137
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	132
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	20
Total of all active and inactive participants	2016-01-01	152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	152
Number of participants with account balances	2016-01-01	106
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	4
2015: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	147
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	122
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	15
Total of all active and inactive participants	2015-01-01	137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	137
Number of participants with account balances	2015-01-01	90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	32
2014: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	162
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	132
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	15
Total of all active and inactive participants	2014-01-01	147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	147
Number of participants with account balances	2014-01-01	65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	17
2013: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	176
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	140
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	13
Total of all active and inactive participants	2013-01-01	153
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	153
Number of participants with account balances	2013-01-01	69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	10
2012: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	171
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	150
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	14
Total of all active and inactive participants	2012-01-01	164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	164
Number of participants with account balances	2012-01-01	73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	6
2011: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	168
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	145
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	16
Total of all active and inactive participants	2011-01-01	161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	161
Number of participants with account balances	2011-01-01	65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	6
2010: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	156
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	134
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	12
Total of all active and inactive participants	2010-01-01	146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	146
Number of participants with account balances	2010-01-01	54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	161
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	132
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	12
Total of all active and inactive participants	2009-01-01	144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	144
Number of participants with account balances	2009-01-01	56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN

Measure	Date	Value
2022 : LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2022 401k financial data
Total income from all sources (including contributions)	2022-12-31	$-422,067
Total of all expenses incurred	2022-12-31	$112,976
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$91,923
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$359,785
Value of total assets at end of year	2022-12-31	$4,334,304
Value of total assets at beginning of year	2022-12-31	$4,869,347
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$21,053
Total interest from all sources	2022-12-31	$11,804
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$400,000
If this is an individual account plan, was there a blackout period	2022-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$272,929
Participant contributions at end of year	2022-12-31	$146,786
Participant contributions at beginning of year	2022-12-31	$157,057
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$53,516
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	$-535,043
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$4,334,304
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$4,869,347
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
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$4,441,380
Value of interest in pooled separate accounts at end of year	2022-12-31	$3,885,418
Interest on participant loans	2022-12-31	$11,804
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$301,055
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$270,503
Net investment gain/loss from pooled separate accounts	2022-12-31	$-793,656
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	$33,340
Employer contributions (assets) at end of year	2022-12-31	$1,045
Employer contributions (assets) at beginning of year	2022-12-31	$407
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$91,923
Contract administrator fees	2022-12-31	$21,053
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	2022-12-31	Yes
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2022-12-31	043499945
2021 : LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2021 401k financial data
Total income from all sources (including contributions)	2021-12-31	$906,306
Total of all expenses incurred	2021-12-31	$166,833
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$142,211
Expenses. Certain deemed distributions of participant loans	2021-12-31	$2,517
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$278,622
Value of total assets at end of year	2021-12-31	$4,869,347
Value of total assets at beginning of year	2021-12-31	$4,129,874
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$22,105
Total interest from all sources	2021-12-31	$9,559
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$400,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$246,894
Participant contributions at end of year	2021-12-31	$157,057
Participant contributions at beginning of year	2021-12-31	$104,572
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$739,473
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$4,869,347
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$4,129,874
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$4,441,380
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$3,908,746
Interest on participant loans	2021-12-31	$9,559
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$270,503
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$116,556
Net investment gain/loss from pooled separate accounts	2021-12-31	$618,125
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	Yes
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	$31,728
Employer contributions (assets) at end of year	2021-12-31	$407
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$142,211
Contract administrator fees	2021-12-31	$22,105
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2021-12-31	043499945
2020 : LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2020 401k financial data
Total income from all sources (including contributions)	2020-12-31	$829,965
Total of all expenses incurred	2020-12-31	$83,455
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$66,087
Expenses. Certain deemed distributions of participant loans	2020-12-31	$420
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$269,450
Value of total assets at end of year	2020-12-31	$4,129,874
Value of total assets at beginning of year	2020-12-31	$3,383,364
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$16,948
Total interest from all sources	2020-12-31	$9,324
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	$400,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$238,635
Participant contributions at end of year	2020-12-31	$104,572
Participant contributions at beginning of year	2020-12-31	$148,135
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	$746,510
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$4,129,874
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$3,383,364
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$3,908,746
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$3,120,338
Interest on participant loans	2020-12-31	$6,987
Interest earned on other investments	2020-12-31	$2,337
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$116,556
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$114,891
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$551,191
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	Yes
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	$30,815
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$66,087
Contract administrator fees	2020-12-31	$16,948
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2020-12-31	043499945
2019 : LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2019 401k financial data
Total income from all sources (including contributions)	2019-12-31	$1,093,114
Total of all expenses incurred	2019-12-31	$91,845
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$68,911
Expenses. Certain deemed distributions of participant loans	2019-12-31	$7,360
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$544,340
Value of total assets at end of year	2019-12-31	$3,383,364
Value of total assets at beginning of year	2019-12-31	$2,382,095
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$15,574
Total interest from all sources	2019-12-31	$12,145
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	$400,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$256,465
Participant contributions at end of year	2019-12-31	$148,135
Participant contributions at beginning of year	2019-12-31	$129,538
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$257,437
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	$1,001,269
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$3,383,364
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$2,382,095
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$3,120,338
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$2,104,752
Interest on participant loans	2019-12-31	$9,301
Interest earned on other investments	2019-12-31	$2,844
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$114,891
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$147,805
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$536,629
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	$30,438
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$68,911
Contract administrator fees	2019-12-31	$15,574
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2019-12-31	043499945
2018 : LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$141,522
Total of all expenses incurred	2018-12-31	$151,294
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$131,549
Expenses. Certain deemed distributions of participant loans	2018-12-31	$11,825
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$289,254
Value of total assets at end of year	2018-12-31	$2,382,095
Value of total assets at beginning of year	2018-12-31	$2,391,867
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$7,920
Total interest from all sources	2018-12-31	$8,586
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	$400,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$251,145
Participant contributions at end of year	2018-12-31	$129,538
Participant contributions at beginning of year	2018-12-31	$111,732
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$6,275
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	$-9,772
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$2,382,095
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$2,391,867
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$2,104,752
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$2,137,525
Interest on participant loans	2018-12-31	$6,515
Interest earned on other investments	2018-12-31	$2,071
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$147,805
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$142,610
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-156,318
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	$31,834
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$131,549
Contract administrator fees	2018-12-31	$7,920
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2018-12-31	043499945
2017 : LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$616,668
Total of all expenses incurred	2017-12-31	$194,881
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$190,635
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$292,980
Value of total assets at end of year	2017-12-31	$2,391,867
Value of total assets at beginning of year	2017-12-31	$1,970,080
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$4,246
Total interest from all sources	2017-12-31	$323,688
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$200,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$226,022
Participant contributions at end of year	2017-12-31	$111,732
Participant contributions at beginning of year	2017-12-31	$101,128
Participant contributions at beginning of year	2017-12-31	$7,989
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$35,560
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	$421,787
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$2,391,867
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$1,970,080
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	$2,137,525
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$1,648,649
Interest on participant loans	2017-12-31	$6,684
Interest earned on other investments	2017-12-31	$317,004
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$142,610
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$211,016
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	Yes
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	$31,398
Employer contributions (assets) at beginning of year	2017-12-31	$1,298
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$190,635
Contract administrator fees	2017-12-31	$4,246
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2017-12-31	043499945
2016 : LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$371,352
Total of all expenses incurred	2016-12-31	$51,122
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$49,836
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$249,085
Value of total assets at end of year	2016-12-31	$1,970,080
Value of total assets at beginning of year	2016-12-31	$1,649,850
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$1,286
Total interest from all sources	2016-12-31	$6,737
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$200,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$215,753
Participant contributions at end of year	2016-12-31	$101,128
Participant contributions at beginning of year	2016-12-31	$63,364
Participant contributions at end of year	2016-12-31	$7,989
Participant contributions at beginning of year	2016-12-31	$8,436
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	$320,230
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$1,970,080
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,649,850
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	$1,648,649
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$1,362,326
Interest on participant loans	2016-12-31	$4,307
Interest earned on other investments	2016-12-31	$2,430
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$211,016
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$214,373
Net investment gain/loss from pooled separate accounts	2016-12-31	$115,530
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	$33,332
Employer contributions (assets) at end of year	2016-12-31	$1,298
Employer contributions (assets) at beginning of year	2016-12-31	$1,351
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$49,836
Contract administrator fees	2016-12-31	$1,286
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2016-12-31	043499945
2015 : LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2015 401k financial data
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	$240,862
Total of all expenses incurred	2015-12-31	$323,271
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$316,934
Value of total corrective distributions	2015-12-31	$127
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$240,830
Value of total assets at end of year	2015-12-31	$1,649,850
Value of total assets at beginning of year	2015-12-31	$1,732,259
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$6,210
Total interest from all sources	2015-12-31	$6,912
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$6,456
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	$6,456
Assets. Real estate other than employer real property at beginning of year	2015-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2015-12-31	$0
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$200,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$209,407
Participant contributions at end of year	2015-12-31	$63,364
Participant contributions at beginning of year	2015-12-31	$87,501
Participant contributions at end of year	2015-12-31	$8,436
Participant contributions at beginning of year	2015-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$7,738
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$0
Total non interest bearing cash at beginning of year	2015-12-31	$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	2015-12-31	No
Value of net income/loss	2015-12-31	$-82,409
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,649,850
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,732,259
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
Assets. partnership/joint venture interests at beginning of year	2015-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$1,362,326
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$1,220,443
Interest on participant loans	2015-12-31	$2,446
Interest earned on other investments	2015-12-31	$4,466
Value of interest in master investment trust accounts at beginning of year	2015-12-31	$0
Value of interest in common/collective trusts at beginning of year	2015-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$214,373
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$424,315
Asset value of US Government securities at beginning of year	2015-12-31	$0
Net investment gain/loss from pooled separate accounts	2015-12-31	$-13,336
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
Assets. Invements in employer securities at beginning of year	2015-12-31	$0
Assets. Value of employer real property at beginning of year	2015-12-31	$0
Contributions received in cash from employer	2015-12-31	$23,685
Employer contributions (assets) at end of year	2015-12-31	$1,351
Employer contributions (assets) at beginning of year	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$316,934
Asset. Corporate debt instrument preferred debt at beginning of year	2015-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2015-12-31	$0
Contract administrator fees	2015-12-31	$6,210
Assets. Corporate common stocks other than exployer securities at beginning of year	2015-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2015-12-31	$0
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
Liabilities. Value of acquisition indebtedness at beginning of year	2015-12-31	$0
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	CARON & BLETZER
Accountancy firm EIN	2015-12-31	043499945
2014 : LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2014 401k financial data
Unrealized appreciation/depreciation of real estate assets	2014-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2014-12-31	$0
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
Expenses. Interest paid	2014-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$289,189
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$87,072
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$74,515
Expenses. Certain deemed distributions of participant loans	2014-12-31	$7,550
Value of total corrective distributions	2014-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$207,232
Value of total assets at end of year	2014-12-31	$1,732,259
Value of total assets at beginning of year	2014-12-31	$1,530,142
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$5,007
Total income from rents	2014-12-31	$0
Total interest from all sources	2014-12-31	$9,099
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$92,091
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	$92,091
Assets. Real estate other than employer real property at end of year	2014-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2014-12-31	$0
Administrative expenses professional fees incurred	2014-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2014-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2014-12-31	$0
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$200,000
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	$185,957
Participant contributions at end of year	2014-12-31	$87,501
Participant contributions at beginning of year	2014-12-31	$118,283
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2014-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2014-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$0
Assets. Loans (other than to participants) at end of year	2014-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$0
Other income not declared elsewhere	2014-12-31	$0
Administrative expenses (other) incurred	2014-12-31	$0
Total non interest bearing cash at end of year	2014-12-31	$0
Total non interest bearing cash at beginning of year	2014-12-31	$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	2014-12-31	No
Income. Non cash contributions	2014-12-31	$0
Value of net income/loss	2014-12-31	$202,117
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,732,259
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,530,142
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
Assets. partnership/joint venture interests at end of year	2014-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2014-12-31	$0
Investment advisory and management fees	2014-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$1,220,443
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$1,049,031
Interest on participant loans	2014-12-31	$4,208
Income. Interest from loans (other than to participants)	2014-12-31	$0
Interest earned on other investments	2014-12-31	$4,891
Income. Interest from US Government securities	2014-12-31	$0
Income. Interest from corporate debt instruments	2014-12-31	$0
Value of interest in master investment trust accounts at end of year	2014-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2014-12-31	$0
Value of interest in common/collective trusts at end of year	2014-12-31	$0
Value of interest in common/collective trusts at beginning of year	2014-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2014-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2014-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$424,315
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$362,828
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$0
Asset value of US Government securities at end of year	2014-12-31	$0
Asset value of US Government securities at beginning of year	2014-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$-19,233
Net investment gain/loss from pooled separate accounts	2014-12-31	$0
Net investment gain or loss from common/collective trusts	2014-12-31	$0
Net gain/loss from 103.12 investment entities	2014-12-31	$0
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	Yes
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Assets. Invements in employer securities at end of year	2014-12-31	$0
Assets. Invements in employer securities at beginning of year	2014-12-31	$0
Assets. Value of employer real property at end of year	2014-12-31	$0
Assets. Value of employer real property at beginning of year	2014-12-31	$0
Contributions received in cash from employer	2014-12-31	$21,275
Employer contributions (assets) at end of year	2014-12-31	$0
Employer contributions (assets) at beginning of year	2014-12-31	$0
Income. Dividends from preferred stock	2014-12-31	$0
Income. Dividends from common stock	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$74,515
Asset. Corporate debt instrument preferred debt at end of year	2014-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2014-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2014-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2014-12-31	$0
Contract administrator fees	2014-12-31	$5,007
Assets. Corporate common stocks other than exployer securities at end of year	2014-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2014-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2014-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2014-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2014-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2014-12-31	$0
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
Aggregate proceeds on sale of assets	2014-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2014-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2014-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2014-12-31	$0
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	CARON & BLETZER
Accountancy firm EIN	2014-12-31	043499945
2013 : LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets	2013-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2013-12-31	$0
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Expenses. Interest paid	2013-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$425,246
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$376,071
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$363,289
Expenses. Certain deemed distributions of participant loans	2013-12-31	$6,539
Value of total corrective distributions	2013-12-31	$1,038
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$207,860
Value of total assets at end of year	2013-12-31	$1,530,142
Value of total assets at beginning of year	2013-12-31	$1,480,967
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$5,205
Total income from rents	2013-12-31	$0
Total interest from all sources	2013-12-31	$7,006
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$66,661
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	$66,661
Assets. Real estate other than employer real property at end of year	2013-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2013-12-31	$0
Administrative expenses professional fees incurred	2013-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2013-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2013-12-31	$0
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$150,000
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	$169,659
Participant contributions at end of year	2013-12-31	$118,283
Participant contributions at beginning of year	2013-12-31	$63,464
Participant contributions at end of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$14,830
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$0
Assets. Loans (other than to participants) at end of year	2013-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$0
Other income not declared elsewhere	2013-12-31	$0
Administrative expenses (other) incurred	2013-12-31	$0
Total non interest bearing cash at end of year	2013-12-31	$0
Total non interest bearing cash at beginning of year	2013-12-31	$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	2013-12-31	No
Income. Non cash contributions	2013-12-31	$0
Value of net income/loss	2013-12-31	$49,175
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,530,142
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,480,967
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
Assets. partnership/joint venture interests at end of year	2013-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2013-12-31	$0
Investment advisory and management fees	2013-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$1,049,031
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$1,136,740
Interest on participant loans	2013-12-31	$2,818
Income. Interest from loans (other than to participants)	2013-12-31	$0
Interest earned on other investments	2013-12-31	$4,188
Income. Interest from US Government securities	2013-12-31	$0
Income. Interest from corporate debt instruments	2013-12-31	$0
Value of interest in master investment trust accounts at end of year	2013-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2013-12-31	$0
Value of interest in common/collective trusts at end of year	2013-12-31	$0
Value of interest in common/collective trusts at beginning of year	2013-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2013-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2013-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$362,828
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$280,763
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$0
Asset value of US Government securities at end of year	2013-12-31	$0
Asset value of US Government securities at beginning of year	2013-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$143,719
Net investment gain/loss from pooled separate accounts	2013-12-31	$0
Net investment gain or loss from common/collective trusts	2013-12-31	$0
Net gain/loss from 103.12 investment entities	2013-12-31	$0
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
Assets. Invements in employer securities at end of year	2013-12-31	$0
Assets. Invements in employer securities at beginning of year	2013-12-31	$0
Assets. Value of employer real property at end of year	2013-12-31	$0
Assets. Value of employer real property at beginning of year	2013-12-31	$0
Contributions received in cash from employer	2013-12-31	$23,371
Employer contributions (assets) at end of year	2013-12-31	$0
Employer contributions (assets) at beginning of year	2013-12-31	$0
Income. Dividends from preferred stock	2013-12-31	$0
Income. Dividends from common stock	2013-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$363,289
Asset. Corporate debt instrument preferred debt at end of year	2013-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2013-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2013-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2013-12-31	$0
Contract administrator fees	2013-12-31	$5,205
Assets. Corporate common stocks other than exployer securities at end of year	2013-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2013-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2013-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2013-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2013-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2013-12-31	$0
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
Aggregate proceeds on sale of assets	2013-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2013-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2013-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2013-12-31	$0
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	CARON & BLETZER, PLLC.
Accountancy firm EIN	2013-12-31	043499945
2012 : LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets	2012-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2012-12-31	$0
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Expenses. Interest paid	2012-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$332,776
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$53,704
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$48,691
Expenses. Certain deemed distributions of participant loans	2012-12-31	$577
Value of total corrective distributions	2012-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$177,940
Value of total assets at end of year	2012-12-31	$1,480,967
Value of total assets at beginning of year	2012-12-31	$1,201,895
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$4,436
Total income from rents	2012-12-31	$0
Total interest from all sources	2012-12-31	$6,156
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$38,332
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	$38,332
Assets. Real estate other than employer real property at end of year	2012-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2012-12-31	$0
Administrative expenses professional fees incurred	2012-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2012-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2012-12-31	$0
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$150,000
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	$155,908
Participant contributions at end of year	2012-12-31	$63,464
Participant contributions at beginning of year	2012-12-31	$79,258
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$1,025
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$0
Assets. Loans (other than to participants) at end of year	2012-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2012-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$0
Other income not declared elsewhere	2012-12-31	$0
Administrative expenses (other) incurred	2012-12-31	$0
Total non interest bearing cash at end of year	2012-12-31	$0
Total non interest bearing cash at beginning of year	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
Income. Non cash contributions	2012-12-31	$0
Value of net income/loss	2012-12-31	$279,072
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,480,967
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,201,895
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
Assets. partnership/joint venture interests at end of year	2012-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2012-12-31	$0
Investment advisory and management fees	2012-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$1,136,740
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$964,169
Interest on participant loans	2012-12-31	$3,010
Income. Interest from loans (other than to participants)	2012-12-31	$0
Interest earned on other investments	2012-12-31	$3,146
Income. Interest from US Government securities	2012-12-31	$0
Income. Interest from corporate debt instruments	2012-12-31	$0
Value of interest in master investment trust accounts at end of year	2012-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2012-12-31	$0
Value of interest in common/collective trusts at end of year	2012-12-31	$0
Value of interest in common/collective trusts at beginning of year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2012-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$280,763
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$158,468
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$0
Asset value of US Government securities at end of year	2012-12-31	$0
Asset value of US Government securities at beginning of year	2012-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$110,348
Net investment gain/loss from pooled separate accounts	2012-12-31	$0
Net investment gain or loss from common/collective trusts	2012-12-31	$0
Net gain/loss from 103.12 investment entities	2012-12-31	$0
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
Assets. Invements in employer securities at end of year	2012-12-31	$0
Assets. Invements in employer securities at beginning of year	2012-12-31	$0
Assets. Value of employer real property at end of year	2012-12-31	$0
Assets. Value of employer real property at beginning of year	2012-12-31	$0
Contributions received in cash from employer	2012-12-31	$21,007
Employer contributions (assets) at end of year	2012-12-31	$0
Employer contributions (assets) at beginning of year	2012-12-31	$0
Income. Dividends from preferred stock	2012-12-31	$0
Income. Dividends from common stock	2012-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$48,691
Asset. Corporate debt instrument preferred debt at end of year	2012-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2012-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2012-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2012-12-31	$0
Contract administrator fees	2012-12-31	$4,436
Assets. Corporate common stocks other than exployer securities at end of year	2012-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2012-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2012-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2012-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2012-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2012-12-31	$0
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
Aggregate proceeds on sale of assets	2012-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2012-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2012-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2012-12-31	$0
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	NASKRET, SELZER AND ASSOCIATES, LLC
Accountancy firm EIN	2012-12-31	800022697
2011 : LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets	2011-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-31	$0
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total transfer of assets to this plan	2011-12-31	$0
Total transfer of assets from this plan	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Expenses. Interest paid	2011-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$98,980
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$39,106
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$37,639
Expenses. Certain deemed distributions of participant loans	2011-12-31	$0
Value of total corrective distributions	2011-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$125,798
Value of total assets at end of year	2011-12-31	$1,201,895
Value of total assets at beginning of year	2011-12-31	$1,142,021
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$1,467
Total income from rents	2011-12-31	$0
Total interest from all sources	2011-12-31	$3,799
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$36,117
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	$36,117
Assets. Real estate other than employer real property at end of year	2011-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2011-12-31	$0
Administrative expenses professional fees incurred	2011-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2011-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2011-12-31	$0
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$150,000
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	$117,532
Participant contributions at end of year	2011-12-31	$79,258
Participant contributions at beginning of year	2011-12-31	$73,926
Participant contributions at end of year	2011-12-31	$0
Participant contributions at beginning of year	2011-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2011-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$0
Assets. Loans (other than to participants) at end of year	2011-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2011-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$0
Other income not declared elsewhere	2011-12-31	$0
Administrative expenses (other) incurred	2011-12-31	$0
Total non interest bearing cash at end of year	2011-12-31	$0
Total non interest bearing cash at beginning of year	2011-12-31	$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	2011-12-31	No
Income. Non cash contributions	2011-12-31	$0
Value of net income/loss	2011-12-31	$59,874
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,201,895
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,142,021
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
Assets. partnership/joint venture interests at end of year	2011-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2011-12-31	$0
Investment advisory and management fees	2011-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$964,169
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$937,529
Interest on participant loans	2011-12-31	$3,515
Income. Interest from loans (other than to participants)	2011-12-31	$0
Interest earned on other investments	2011-12-31	$245
Income. Interest from US Government securities	2011-12-31	$0
Income. Interest from corporate debt instruments	2011-12-31	$0
Value of interest in master investment trust accounts at end of year	2011-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2011-12-31	$0
Value of interest in common/collective trusts at end of year	2011-12-31	$0
Value of interest in common/collective trusts at beginning of year	2011-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$130,566
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$130,566
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$39
Assets. Value of investments in 103.12 investment entities at end of year	2011-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2011-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$158,468
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$0
Asset value of US Government securities at end of year	2011-12-31	$0
Asset value of US Government securities at beginning of year	2011-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-66,734
Net investment gain/loss from pooled separate accounts	2011-12-31	$0
Net investment gain or loss from common/collective trusts	2011-12-31	$0
Net gain/loss from 103.12 investment entities	2011-12-31	$0
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
Assets. Invements in employer securities at end of year	2011-12-31	$0
Assets. Invements in employer securities at beginning of year	2011-12-31	$0
Assets. Value of employer real property at end of year	2011-12-31	$0
Assets. Value of employer real property at beginning of year	2011-12-31	$0
Contributions received in cash from employer	2011-12-31	$8,266
Employer contributions (assets) at end of year	2011-12-31	$0
Employer contributions (assets) at beginning of year	2011-12-31	$0
Income. Dividends from preferred stock	2011-12-31	$0
Income. Dividends from common stock	2011-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$37,639
Asset. Corporate debt instrument preferred debt at end of year	2011-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2011-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2011-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2011-12-31	$0
Contract administrator fees	2011-12-31	$1,467
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	2011-12-31	No
Assets. Corporate common stocks other than exployer securities at end of year	2011-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2011-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2011-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2011-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2011-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2011-12-31	$0
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
Aggregate proceeds on sale of assets	2011-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2011-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2011-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2011-12-31	$0
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	NASKRET, SELZER AND ASSOCIATES, LLC
Accountancy firm EIN	2011-12-31	800022697
2010 : LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2010 401k financial data
Unrealized appreciation/depreciation of real estate assets	2010-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$0
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total transfer of assets to this plan	2010-12-31	$0
Total transfer of assets from this plan	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
Expenses. Interest paid	2010-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$226,181
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$100,561
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$91,829
Expenses. Certain deemed distributions of participant loans	2010-12-31	$6,724
Value of total corrective distributions	2010-12-31	$763
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$123,693
Value of total assets at end of year	2010-12-31	$1,142,021
Value of total assets at beginning of year	2010-12-31	$1,016,401
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$1,245
Total income from rents	2010-12-31	$0
Total interest from all sources	2010-12-31	$4,320
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$17,745
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	$17,745
Assets. Real estate other than employer real property at end of year	2010-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2010-12-31	$0
Administrative expenses professional fees incurred	2010-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2010-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2010-12-31	$0
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$150,000
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	$123,693
Participant contributions at end of year	2010-12-31	$73,926
Participant contributions at beginning of year	2010-12-31	$89,486
Participant contributions at end of year	2010-12-31	$0
Participant contributions at beginning of year	2010-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2010-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$0
Assets. Loans (other than to participants) at end of year	2010-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2010-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$0
Other income not declared elsewhere	2010-12-31	$0
Administrative expenses (other) incurred	2010-12-31	$0
Total non interest bearing cash at end of year	2010-12-31	$0
Total non interest bearing cash at beginning of year	2010-12-31	$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	2010-12-31	No
Income. Non cash contributions	2010-12-31	$0
Value of net income/loss	2010-12-31	$125,620
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$1,142,021
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,016,401
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
Assets. partnership/joint venture interests at end of year	2010-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2010-12-31	$0
Investment advisory and management fees	2010-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$937,529
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$745,557
Interest on participant loans	2010-12-31	$4,303
Income. Interest from loans (other than to participants)	2010-12-31	$0
Interest earned on other investments	2010-12-31	$0
Income. Interest from US Government securities	2010-12-31	$0
Income. Interest from corporate debt instruments	2010-12-31	$0
Value of interest in master investment trust accounts at end of year	2010-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2010-12-31	$0
Value of interest in common/collective trusts at end of year	2010-12-31	$0
Value of interest in common/collective trusts at beginning of year	2010-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$130,566
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$181,358
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$181,358
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$17
Assets. Value of investments in 103.12 investment entities at end of year	2010-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2010-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$0
Asset value of US Government securities at end of year	2010-12-31	$0
Asset value of US Government securities at beginning of year	2010-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$80,423
Net investment gain/loss from pooled separate accounts	2010-12-31	$0
Net investment gain or loss from common/collective trusts	2010-12-31	$0
Net gain/loss from 103.12 investment entities	2010-12-31	$0
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	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Assets. Invements in employer securities at end of year	2010-12-31	$0
Assets. Invements in employer securities at beginning of year	2010-12-31	$0
Assets. Value of employer real property at end of year	2010-12-31	$0
Assets. Value of employer real property at beginning of year	2010-12-31	$0
Contributions received in cash from employer	2010-12-31	$0
Employer contributions (assets) at end of year	2010-12-31	$0
Employer contributions (assets) at beginning of year	2010-12-31	$0
Income. Dividends from preferred stock	2010-12-31	$0
Income. Dividends from common stock	2010-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$91,829
Asset. Corporate debt instrument preferred debt at end of year	2010-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2010-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2010-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2010-12-31	$0
Contract administrator fees	2010-12-31	$1,245
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
Assets. Corporate common stocks other than exployer securities at end of year	2010-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2010-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2010-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2010-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2010-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2010-12-31	$0
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
Aggregate proceeds on sale of assets	2010-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2010-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2010-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2010-12-31	$0
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	NASKRET, SELZER & ASSOCIATES LLC
Accountancy firm EIN	2010-12-31	800022697
2009 : LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN

2022: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
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: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
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: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
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: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
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: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
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: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	Yes
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: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
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: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
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: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 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
2010: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER 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 – Trust	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

75630401

Policy instance

Insurance contract or identification number	75630401
Number of Individuals Covered	97
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
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

GA836582

Policy instance

Insurance contract or identification number	GA836582
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of fees paid to insurance company	USD $1,136
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1136
Insurance broker organization code?	5

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

Policy contract number

GA836582

Policy instance

Insurance contract or identification number	GA836582
Number of Individuals Covered	102
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of fees paid to insurance company	USD $2,104
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	5

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

Policy contract number

GA836582

Policy instance

Insurance contract or identification number	GA836582
Number of Individuals Covered	105
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of fees paid to insurance company	USD $1,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1615
Insurance broker organization code?	5

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

Policy contract number

GA836582

Policy instance

Insurance contract or identification number	GA836582
Number of Individuals Covered	107
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of fees paid to insurance company	USD $1,299
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1299
Insurance broker organization code?	5

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

Policy contract number

GA836582

Policy instance

Insurance contract or identification number	GA836582
Number of Individuals Covered	104
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $1,744
Total amount of fees paid to insurance company	USD $884
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,744
Insurance broker organization code?	3
Amount paid for insurance broker fees	884

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

Policy contract number

GA836582

Policy instance

Insurance contract or identification number	GA836582
Number of Individuals Covered	162
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $7,681
Total amount of fees paid to insurance company	USD $1,280
Insurance broker organization code?	3
Insurance broker name	PLANNED RETIREMENT CONSULTANTS

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

Policy contract number

GA836582

Policy instance

Insurance contract or identification number	GA836582
Number of Individuals Covered	84
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $10,710
Total amount of fees paid to insurance company	USD $5,000
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,710
Insurance broker organization code?	3
Amount paid for insurance broker fees	5000
Insurance broker name	PLANNED RETIREMENT CONSULTANTS

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

384930-01

Policy instance

Insurance contract or identification number	384930-01
Number of Individuals Covered	26
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $4,455
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,455
Insurance broker organization code?	3
Insurance broker name	LPL FINANCIAL LLC

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

384930-01

Policy instance

Insurance contract or identification number	384930-01
Number of Individuals Covered	43
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,362
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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 $1,243
Insurance broker organization code?	3
Insurance broker name	LPL FINANCIAL LLC

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

384930-01

Policy instance

Insurance contract or identification number	384930-01
Number of Individuals Covered	44
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,368
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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 $1,368
Insurance broker organization code?	3
Insurance broker name	FINANCIAL TELESIS JHW FINANCIAL SVC

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

384930-01

Policy instance

Insurance contract or identification number	384930-01
Number of Individuals Covered	45
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $862
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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 $862
Insurance broker organization code?	3
Insurance broker name	FINANCIAL TELESIS JHW FINANCIAL SVC

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

384930-01

Policy instance

Insurance contract or identification number	384930-01
Number of Individuals Covered	39
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $963
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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

Potentially related plans

LIVINGSTON CARE ASSOCIATES, INC. DBA TIMBERWOOD NURSING & REHABILITATION CENTER OCCUPATIONAL INJURY PLAN [EIN = 760825002]

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Company Name:	LIVINGSTON CARE CENTER DBA INGLEMOOR REHABILITATION AND CARE CENTER
Employer identification number (EIN):	223191040
NAIC Classification:	621399
NAIC Description:	Offices of All Other Miscellaneous Health Practitioners