401k Plan data: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN plan

DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 401k Plan overview

Plan Name	DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN
Plan identification number	002

DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

DEKALB MEMORIAL HOSPITAL, INC. has sponsored the creation of one or more 401k plans.

Company Name: DEKALB MEMORIAL HOSPITAL, INC.

Employer identification number (EIN): 351064295

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2020-01-01
002 2019-01-01
002 2018-01-01
002 2017-01-01 BRET CLAGHORN
002 2016-01-01 BRET CLAGHORN
002 2015-01-01 CRAIG POLKOW
002 2014-01-01 CRAIG POLKOW
002 2013-01-01 AMY CROUCH
002 2012-01-01 AMY CROUCH
002 2011-01-01 AMY CROUCH
002 2009-01-01 PAMELA CAVACINI

Plan Statistics for DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN

401k plan membership statisitcs for DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN

Measure Date Value
2020: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 751
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 0
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 0
Number of participants with account balances 2020-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 702
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 649
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 102
Total of all active and inactive participants 2019-01-01 751
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 751
Number of participants with account balances 2019-01-01 173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 622
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 569
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 45
Total of all active and inactive participants 2018-01-01 614
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 614
Number of participants with account balances 2018-01-01 372
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 647
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 574
Number of retired or separated participants receiving benefits 2017-01-01 1
Number of other retired or separated participants entitled to future benefits 2017-01-01 34
Total of all active and inactive participants 2017-01-01 609
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 1
Total participants 2017-01-01 610
Number of participants with account balances 2017-01-01 390
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 360
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 584
Number of retired or separated participants receiving benefits 2016-01-01 1
Number of other retired or separated participants entitled to future benefits 2016-01-01 62
Total of all active and inactive participants 2016-01-01 647
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 647
Number of participants with account balances 2016-01-01 389
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 285
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 314
Number of retired or separated participants receiving benefits 2015-01-01 1
Number of other retired or separated participants entitled to future benefits 2015-01-01 45
Total of all active and inactive participants 2015-01-01 360
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 360
Number of participants with account balances 2015-01-01 360
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 235
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 254
Number of retired or separated participants receiving benefits 2014-01-01 2
Number of other retired or separated participants entitled to future benefits 2014-01-01 29
Total of all active and inactive participants 2014-01-01 285
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 285
Number of participants with account balances 2014-01-01 285
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 222
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 208
Number of retired or separated participants receiving benefits 2013-01-01 1
Number of other retired or separated participants entitled to future benefits 2013-01-01 25
Total of all active and inactive participants 2013-01-01 234
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 1
Total participants 2013-01-01 235
Number of participants with account balances 2013-01-01 235
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 209
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 178
Number of retired or separated participants receiving benefits 2012-01-01 1
Number of other retired or separated participants entitled to future benefits 2012-01-01 42
Total of all active and inactive participants 2012-01-01 221
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 1
Total participants 2012-01-01 222
Number of participants with account balances 2012-01-01 222
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 199
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 196
Number of retired or separated participants receiving benefits 2011-01-01 1
Number of other retired or separated participants entitled to future benefits 2011-01-01 11
Total of all active and inactive participants 2011-01-01 208
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 1
Total participants 2011-01-01 209
Number of participants with account balances 2011-01-01 209
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 197
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 185
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 14
Total of all active and inactive participants 2009-01-01 199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 199
Number of participants with account balances 2009-01-01 199
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2020: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	751
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	0
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	0
Number of participants with account balances	2020-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	702
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	649
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	102
Total of all active and inactive participants	2019-01-01	751
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	751
Number of participants with account balances	2019-01-01	173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	622
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	569
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	45
Total of all active and inactive participants	2018-01-01	614
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	614
Number of participants with account balances	2018-01-01	372
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	647
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	574
Number of retired or separated participants receiving benefits	2017-01-01	1
Number of other retired or separated participants entitled to future benefits	2017-01-01	34
Total of all active and inactive participants	2017-01-01	609
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	1
Total participants	2017-01-01	610
Number of participants with account balances	2017-01-01	390
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	360
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	584
Number of retired or separated participants receiving benefits	2016-01-01	1
Number of other retired or separated participants entitled to future benefits	2016-01-01	62
Total of all active and inactive participants	2016-01-01	647
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	647
Number of participants with account balances	2016-01-01	389
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	285
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	314
Number of retired or separated participants receiving benefits	2015-01-01	1
Number of other retired or separated participants entitled to future benefits	2015-01-01	45
Total of all active and inactive participants	2015-01-01	360
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	360
Number of participants with account balances	2015-01-01	360
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	235
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	254
Number of retired or separated participants receiving benefits	2014-01-01	2
Number of other retired or separated participants entitled to future benefits	2014-01-01	29
Total of all active and inactive participants	2014-01-01	285
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	285
Number of participants with account balances	2014-01-01	285
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	222
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	208
Number of retired or separated participants receiving benefits	2013-01-01	1
Number of other retired or separated participants entitled to future benefits	2013-01-01	25
Total of all active and inactive participants	2013-01-01	234
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	1
Total participants	2013-01-01	235
Number of participants with account balances	2013-01-01	235
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	209
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	178
Number of retired or separated participants receiving benefits	2012-01-01	1
Number of other retired or separated participants entitled to future benefits	2012-01-01	42
Total of all active and inactive participants	2012-01-01	221
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	1
Total participants	2012-01-01	222
Number of participants with account balances	2012-01-01	222
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	199
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	196
Number of retired or separated participants receiving benefits	2011-01-01	1
Number of other retired or separated participants entitled to future benefits	2011-01-01	11
Total of all active and inactive participants	2011-01-01	208
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	1
Total participants	2011-01-01	209
Number of participants with account balances	2011-01-01	209
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	197
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	185
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	14
Total of all active and inactive participants	2009-01-01	199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	199
Number of participants with account balances	2009-01-01	199
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN

Measure	Date	Value
2020 : DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2020 401k financial data
Total income from all sources (including contributions)	2020-07-01	$-251,003
Total of all expenses incurred	2020-07-01	$5,173,980
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-07-01	$5,166,844
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-07-01	$5,466
Value of total assets at end of year	2020-07-01	$0
Value of total assets at beginning of year	2020-07-01	$5,424,983
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-07-01	$7,136
Total interest from all sources	2020-07-01	$409
Total dividends received (eg from common stock, registered investment company shares)	2020-07-01	$4,828
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-07-01	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2020-07-01	$0
Total dividends received from registered investment company shares (eg mutual funds)	2020-07-01	$4,828
Was this plan covered by a fidelity bond	2020-07-01	Yes
Value of fidelity bond cover	2020-07-01	$500,000
If this is an individual account plan, was there a blackout period	2020-07-01	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-07-01	$0
Were there any nonexempt tranactions with any party-in-interest	2020-07-01	No
Participant contributions at end of year	2020-07-01	$0
Participant contributions at beginning of year	2020-07-01	$4,385
Income. Received or receivable in cash from other sources (including rollovers)	2020-07-01	$5,466
Administrative expenses (other) incurred	2020-07-01	$5,904
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-07-01	No
Value of net income/loss	2020-07-01	$-5,424,983
Value of net assets at end of year (total assets less liabilities)	2020-07-01	$0
Value of net assets at beginning of year (total assets less liabilities)	2020-07-01	$5,424,983
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-07-01	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-07-01	No
Were any leases to which the plan was party in default or uncollectible	2020-07-01	No
Investment advisory and management fees	2020-07-01	$1,232
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-07-01	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-07-01	$5,357,050
Interest on participant loans	2020-07-01	$129
Interest earned on other investments	2020-07-01	$280
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-07-01	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-07-01	$63,548
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-07-01	$-261,706
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-07-01	No
Was there a failure to transmit to the plan any participant contributions	2020-07-01	No
Has the plan failed to provide any benefit when due under the plan	2020-07-01	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-07-01	$5,166,844
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	2020-07-01	No
Did the plan have assets held for investment	2020-07-01	No
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	2020-07-01	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-07-01	Yes
Opinion of an independent qualified public accountant for this plan	2020-07-01	Disclaimer
Accountancy firm name	2020-07-01	BLUE & CO., LLC
Accountancy firm EIN	2020-07-01	351178661
2019 : DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2019 401k financial data
Total income from all sources (including contributions)	2019-12-31	$3,833,314
Total of all expenses incurred	2019-12-31	$9,789,809
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$9,745,309
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,518,756
Value of total assets at end of year	2019-12-31	$5,424,983
Value of total assets at beginning of year	2019-12-31	$11,381,478
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$44,500
Total interest from all sources	2019-12-31	$21,086
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$151,190
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2019-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$151,190
Administrative expenses professional fees incurred	2019-12-31	$5,702
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$916,774
Participant contributions at end of year	2019-12-31	$4,385
Participant contributions at beginning of year	2019-12-31	$189,744
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$221,690
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$22,332
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	$-5,956,495
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$5,424,983
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$11,381,478
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Investment advisory and management fees	2019-12-31	$16,466
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$5,357,050
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$10,602,385
Interest on participant loans	2019-12-31	$9,381
Interest earned on other investments	2019-12-31	$11,704
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$1
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$63,548
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$565,445
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$2,142,282
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	$380,292
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$23,904
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$9,745,309
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	2019-12-31	No
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	BLUE & CO., LLC
Accountancy firm EIN	2019-12-31	351178661
2018 : DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$1,123,823
Total of all expenses incurred	2018-12-31	$1,515,918
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$1,502,830
Expenses. Certain deemed distributions of participant loans	2018-12-31	$8,446
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,765,834
Value of total assets at end of year	2018-12-31	$11,381,478
Value of total assets at beginning of year	2018-12-31	$11,773,573
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$4,642
Total interest from all sources	2018-12-31	$21,516
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$227,713
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$227,713
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$1,205,979
Participant contributions at end of year	2018-12-31	$189,744
Participant contributions at beginning of year	2018-12-31	$184,063
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$39,565
Administrative expenses (other) incurred	2018-12-31	$4,642
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	$-392,095
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$11,381,478
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$11,773,573
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	$10,602,385
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$11,033,103
Interest on participant loans	2018-12-31	$9,970
Interest earned on other investments	2018-12-31	$11,546
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$565,445
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$526,365
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-891,240
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	No
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	$520,290
Employer contributions (assets) at end of year	2018-12-31	$23,904
Employer contributions (assets) at beginning of year	2018-12-31	$30,042
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$1,502,830
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	2018-12-31	No
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	BKD LLP
Accountancy firm EIN	2018-12-31	440160260
2017 : DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$3,593,278
Total of all expenses incurred	2017-12-31	$1,061,401
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,055,270
Expenses. Certain deemed distributions of participant loans	2017-12-31	$2,299
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$2,011,424
Value of total assets at end of year	2017-12-31	$11,773,573
Value of total assets at beginning of year	2017-12-31	$9,241,696
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$3,832
Total interest from all sources	2017-12-31	$15,622
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$183,963
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$183,963
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$1,162,428
Participant contributions at end of year	2017-12-31	$184,063
Participant contributions at beginning of year	2017-12-31	$140,208
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$316,025
Administrative expenses (other) incurred	2017-12-31	$3,832
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	$2,531,877
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$11,773,573
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$9,241,696
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	$11,033,103
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$8,518,283
Interest on participant loans	2017-12-31	$6,250
Interest earned on other investments	2017-12-31	$9,372
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$526,365
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$557,616
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$1,382,269
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$532,971
Employer contributions (assets) at end of year	2017-12-31	$30,042
Employer contributions (assets) at beginning of year	2017-12-31	$25,589
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,055,270
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	No
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	BKD LLP
Accountancy firm EIN	2017-12-31	440160260
2016 : DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$2,299,468
Total of all expenses incurred	2016-12-31	$577,482
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$572,362
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,698,657
Value of total assets at end of year	2016-12-31	$9,241,696
Value of total assets at beginning of year	2016-12-31	$7,519,710
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$5,120
Total interest from all sources	2016-12-31	$6,251
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$128,444
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$128,444
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$1,145,652
Participant contributions at end of year	2016-12-31	$140,208
Participant contributions at beginning of year	2016-12-31	$146,781
Participant contributions at beginning of year	2016-12-31	$36,006
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$29,458
Administrative expenses (other) incurred	2016-12-31	$5,120
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	$1,721,986
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$9,241,696
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$7,519,710
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	$8,518,283
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$7,279,869
Interest on participant loans	2016-12-31	$6,251
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$557,616
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$466,116
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	No
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	$523,547
Employer contributions (assets) at end of year	2016-12-31	$25,589
Employer contributions (assets) at beginning of year	2016-12-31	$57,054
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$572,362
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	2016-12-31	No
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	BKD LLP
Accountancy firm EIN	2016-12-31	440160260
2015 : DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$1,666,860
Total of all expenses incurred	2015-12-31	$884,219
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$879,094
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,743,495
Value of total assets at end of year	2015-12-31	$7,519,710
Value of total assets at beginning of year	2015-12-31	$6,737,069
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$5,125
Total interest from all sources	2015-12-31	$4,119
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$109,246
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	$109,246
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$1,088,017
Participant contributions at end of year	2015-12-31	$146,781
Participant contributions at beginning of year	2015-12-31	$79,889
Participant contributions at end of year	2015-12-31	$36,006
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$175,553
Administrative expenses (other) incurred	2015-12-31	$5,125
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	$782,641
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$7,519,710
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$6,737,069
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$7,279,869
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$6,657,180
Interest on participant loans	2015-12-31	$4,119
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-190,000
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$479,925
Employer contributions (assets) at end of year	2015-12-31	$57,054
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$879,094
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	2015-12-31	No
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	BKD LLP
Accountancy firm EIN	2015-12-31	440160260
2014 : DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$1,121,333
Total of all expenses incurred	2014-12-31	$813,480
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$808,766
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$754,699
Value of total assets at end of year	2014-12-31	$6,737,069
Value of total assets at beginning of year	2014-12-31	$6,429,216
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$4,714
Total interest from all sources	2014-12-31	$2,014
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$102,013
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	$102,013
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$752,183
Participant contributions at end of year	2014-12-31	$79,889
Participant contributions at beginning of year	2014-12-31	$57,793
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$2,516
Administrative expenses (other) incurred	2014-12-31	$4,714
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$307,853
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$6,737,069
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$6,429,216
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$6,657,180
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$6,371,423
Interest on participant loans	2014-12-31	$2,014
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$262,607
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$808,766
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	2014-12-31	No
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	BKD LLP
Accountancy firm EIN	2014-12-31	440160260
2013 : DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$1,882,717
Total of all expenses incurred	2013-12-31	$476,710
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$472,577
Expenses. Certain deemed distributions of participant loans	2013-12-31	$672
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$895,322
Value of total assets at end of year	2013-12-31	$6,429,216
Value of total assets at beginning of year	2013-12-31	$5,023,209
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$3,461
Total interest from all sources	2013-12-31	$2,694
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$89,559
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	$89,559
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
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	$738,928
Participant contributions at end of year	2013-12-31	$57,793
Participant contributions at beginning of year	2013-12-31	$63,989
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$156,394
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$0
Administrative expenses (other) incurred	2013-12-31	$3,461
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$1,406,007
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$6,429,216
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$5,023,209
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$6,371,423
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$4,959,220
Interest earned on other investments	2013-12-31	$2,694
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$895,142
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$472,577
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	2013-12-31	No
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	BKD LLP
Accountancy firm EIN	2013-12-31	440160260
2012 : DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2012 401k financial data
Total transfer of assets to this plan	2012-12-31	$21,587
Total income from all sources (including contributions)	2012-12-31	$1,302,964
Total of all expenses incurred	2012-12-31	$772,555
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$769,568
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$693,904
Value of total assets at end of year	2012-12-31	$5,023,209
Value of total assets at beginning of year	2012-12-31	$4,471,213
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$2,987
Total interest from all sources	2012-12-31	$2,352
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$88,109
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	$88,109
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
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	$667,805
Participant contributions at end of year	2012-12-31	$63,989
Participant contributions at beginning of year	2012-12-31	$57,620
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$26,099
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	$2
Administrative expenses (other) incurred	2012-12-31	$2,987
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$530,409
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$5,023,209
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$4,471,213
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$4,959,220
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$4,413,591
Interest on participant loans	2012-12-31	$2,352
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$518,599
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$769,568
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	2012-12-31	No
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	BKD LLP
Accountancy firm EIN	2012-12-31	440160260
2011 : DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$450,746
Total of all expenses incurred	2011-12-31	$807,591
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$804,692
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$553,439
Value of total assets at end of year	2011-12-31	$4,471,213
Value of total assets at beginning of year	2011-12-31	$4,828,058
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$2,899
Total interest from all sources	2011-12-31	$2,734
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$79,356
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	$79,356
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
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	$549,040
Participant contributions at end of year	2011-12-31	$57,620
Participant contributions at beginning of year	2011-12-31	$61,808
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$4,399
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$2
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$4
Administrative expenses (other) incurred	2011-12-31	$2,899
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-356,845
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$4,471,213
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$4,828,058
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$4,413,591
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$4,766,246
Interest on participant loans	2011-12-31	$2,734
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-184,783
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$804,692
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
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	BKD LLP
Accountancy firm EIN	2011-12-31	440160260
2010 : DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2010 401k financial data
Total transfer of assets to this plan	2010-12-31	$63,114
Total income from all sources (including contributions)	2010-12-31	$1,118,124
Total of all expenses incurred	2010-12-31	$422,853
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$418,918
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$567,536
Value of total assets at end of year	2010-12-31	$4,828,058
Value of total assets at beginning of year	2010-12-31	$4,069,673
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$3,935
Total interest from all sources	2010-12-31	$3,220
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$89,615
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	$89,615
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
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	$560,758
Participant contributions at end of year	2010-12-31	$61,808
Participant contributions at beginning of year	2010-12-31	$62,803
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$6,778
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$4
Administrative expenses (other) incurred	2010-12-31	$3,935
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$695,271
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$4,828,058
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$4,069,673
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$4,766,246
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$4,006,870
Interest on participant loans	2010-12-31	$3,220
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$457,753
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$418,918
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	BKD LLP
Accountancy firm EIN	2010-12-31	440160260
2009 : DEKALB MEMORIAL HOSPITAL, INC. 403(B) 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 DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN

2020: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	This submission is the final filing	Yes
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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: DEKALB MEMORIAL HOSPITAL, INC. 403(B) 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: DEKALB MEMORIAL HOSPITAL, INC. 403(B) 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: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
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: DEKALB MEMORIAL HOSPITAL, INC. 403(B) 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: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: DEKALB MEMORIAL HOSPITAL, INC. 403(B) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: DEKALB MEMORIAL HOSPITAL, INC. 403(B) 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

STANDARD (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

TA069193

Policy instance

Insurance contract or identification number	TA069193
Number of Individuals Covered	0
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

TA069193

Policy instance

Insurance contract or identification number	TA069193
Number of Individuals Covered	173
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

TA069193

Policy instance

Insurance contract or identification number	TA069193
Number of Individuals Covered	390
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	DEKALB MEMORIAL HOSPITAL, INC.
Employer identification number (EIN):	351064295
NAIC Classification:	622000
NAIC Description:	Hospitals