401k Plan data: COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN plan

COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN 401k Plan overview

Plan Name	COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN
Plan identification number	001

COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN Benefits

401k Plan Type	Defined Benefit Pension
Plan Features/Benefits	Benefits are primarily pay related Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).

401k Sponsoring company profile

COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS, INC. has sponsored the creation of one or more 401k plans.

Company Name: COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS, INC.

Employer identification number (EIN): 390987025

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2013-01-01 JEFFREY VAN DE KREEKE JEFFREY VAN DE KREEKE 2014-10-01
001 2012-01-01 JEFFREY VAN DE KREEKE JEFFREY VAN DE KREEKE 2013-09-27
001 2011-01-01 JEFFERY VAN DE KREEKE JEFFERY VAN DE KREEKE 2012-10-09
001 2009-01-01 JEFFREY VAN DE KREEKE JEFFREY VAN DE KREEKE 2010-10-14

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2013-01-01	JEFFREY VAN DE KREEKE	JEFFREY VAN DE KREEKE	2014-10-01
001	2012-01-01	JEFFREY VAN DE KREEKE	JEFFREY VAN DE KREEKE	2013-09-27
001	2011-01-01	JEFFERY VAN DE KREEKE	JEFFERY VAN DE KREEKE	2012-10-09
001	2009-01-01	JEFFREY VAN DE KREEKE	JEFFREY VAN DE KREEKE	2010-10-14

Plan Statistics for COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN

401k plan membership statisitcs for COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN

Measure Date Value
2013: COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,516
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 686
Number of retired or separated participants receiving benefits 2013-01-01 350
Number of other retired or separated participants entitled to future benefits 2013-01-01 453
Total of all active and inactive participants 2013-01-01 1,489
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 10
Total participants 2013-01-01 1,499
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 1
2012: COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,533
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 734
Number of retired or separated participants receiving benefits 2012-01-01 330
Number of other retired or separated participants entitled to future benefits 2012-01-01 446
Total of all active and inactive participants 2012-01-01 1,510
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 6
Total participants 2012-01-01 1,516
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 12
2011: COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,546
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 805
Number of retired or separated participants receiving benefits 2011-01-01 302
Number of other retired or separated participants entitled to future benefits 2011-01-01 416
Total of all active and inactive participants 2011-01-01 1,523
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 10
Total participants 2011-01-01 1,533
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 11
2009: COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,628
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 951
Number of retired or separated participants receiving benefits 2009-01-01 269
Number of other retired or separated participants entitled to future benefits 2009-01-01 328
Total of all active and inactive participants 2009-01-01 1,548
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 14
Total participants 2009-01-01 1,562
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 33

Measure	Date	Value
2013: COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,516
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	686
Number of retired or separated participants receiving benefits	2013-01-01	350
Number of other retired or separated participants entitled to future benefits	2013-01-01	453
Total of all active and inactive participants	2013-01-01	1,489
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	10
Total participants	2013-01-01	1,499
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	1
2012: COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,533
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	734
Number of retired or separated participants receiving benefits	2012-01-01	330
Number of other retired or separated participants entitled to future benefits	2012-01-01	446
Total of all active and inactive participants	2012-01-01	1,510
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	6
Total participants	2012-01-01	1,516
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	12
2011: COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,546
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	805
Number of retired or separated participants receiving benefits	2011-01-01	302
Number of other retired or separated participants entitled to future benefits	2011-01-01	416
Total of all active and inactive participants	2011-01-01	1,523
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	10
Total participants	2011-01-01	1,533
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	11
2009: COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,628
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	951
Number of retired or separated participants receiving benefits	2009-01-01	269
Number of other retired or separated participants entitled to future benefits	2009-01-01	328
Total of all active and inactive participants	2009-01-01	1,548
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	14
Total participants	2009-01-01	1,562
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	33

Financial Data on COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN

Measure	Date	Value
2013 : COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN 2013 401k financial data
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
Total income from all sources (including contributions)	2013-12-31	$23,371,740
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$3,010,292
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$2,522,454
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$9,427,000
Value of total assets at end of year	2013-12-31	$90,770,239
Value of total assets at beginning of year	2013-12-31	$70,408,791
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$487,838
Total interest from all sources	2013-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Administrative expenses professional fees incurred	2013-12-31	$97,098
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$5,000,000
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
Administrative expenses (other) incurred	2013-12-31	$162,429
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	$20,361,448
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$90,770,239
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$70,408,791
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
Investment advisory and management fees	2013-12-31	$217,073
Value of interest in master investment trust accounts at end of year	2013-12-31	$82,322,239
Value of interest in master investment trust accounts at beginning of year	2013-12-31	$66,152,791
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$9,427,000
Employer contributions (assets) at end of year	2013-12-31	$8,448,000
Employer contributions (assets) at beginning of year	2013-12-31	$4,256,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$2,522,454
Contract administrator fees	2013-12-31	$11,238
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	SCHENCK
Accountancy firm EIN	2013-12-31	391173131
2012 : COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN 2012 401k financial data
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
Total income from all sources (including contributions)	2012-12-31	$12,856,182
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$2,518,234
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$2,114,913
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$5,524,000
Value of total assets at end of year	2012-12-31	$70,408,791
Value of total assets at beginning of year	2012-12-31	$60,070,843
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$403,321
Total interest from all sources	2012-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Administrative expenses professional fees incurred	2012-12-31	$86,732
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$5,000,000
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
Administrative expenses (other) incurred	2012-12-31	$131,450
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	$10,337,948
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$70,408,791
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$60,070,843
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
Investment advisory and management fees	2012-12-31	$176,049
Value of interest in master investment trust accounts at end of year	2012-12-31	$66,152,791
Value of interest in master investment trust accounts at beginning of year	2012-12-31	$53,168,843
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$5,524,000
Employer contributions (assets) at end of year	2012-12-31	$4,256,000
Employer contributions (assets) at beginning of year	2012-12-31	$6,902,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$2,114,913
Contract administrator fees	2012-12-31	$9,090
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	SCHENCK
Accountancy firm EIN	2012-12-31	391173131
2011 : COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	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
Total income from all sources (including contributions)	2011-12-31	$10,234,089
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$2,282,378
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$1,930,079
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$9,905,000
Value of total assets at end of year	2011-12-31	$60,070,843
Value of total assets at beginning of year	2011-12-31	$52,119,132
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$352,299
Total interest from all sources	2011-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Administrative expenses professional fees incurred	2011-12-31	$70,371
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$5,000,000
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
Administrative expenses (other) incurred	2011-12-31	$101,567
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	$7,951,711
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$60,070,843
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$52,119,132
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
Investment advisory and management fees	2011-12-31	$172,545
Value of interest in master investment trust accounts at end of year	2011-12-31	$53,168,843
Value of interest in master investment trust accounts at beginning of year	2011-12-31	$46,215,132
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$9,905,000
Employer contributions (assets) at end of year	2011-12-31	$6,902,000
Employer contributions (assets) at beginning of year	2011-12-31	$5,904,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$1,930,079
Contract administrator fees	2011-12-31	$7,816
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	SCHENCK
Accountancy firm EIN	2011-12-31	391173131
2010 : COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$13,705,808
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$2,204,486
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$1,843,936
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$7,416,000
Value of total assets at end of year	2010-12-31	$52,119,132
Value of total assets at beginning of year	2010-12-31	$40,617,810
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$360,550
Total interest from all sources	2010-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Administrative expenses professional fees incurred	2010-12-31	$109,598
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$5,000,000
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
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$0
Administrative expenses (other) incurred	2010-12-31	$135,275
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$11,501,322
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$52,119,132
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$40,617,810
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
Investment advisory and management fees	2010-12-31	$109,601
Value of interest in master investment trust accounts at end of year	2010-12-31	$46,215,132
Value of interest in master investment trust accounts at beginning of year	2010-12-31	$38,161,810
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	Yes
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
Contributions received in cash from employer	2010-12-31	$7,416,000
Employer contributions (assets) at end of year	2010-12-31	$5,904,000
Employer contributions (assets) at beginning of year	2010-12-31	$2,456,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$1,843,936
Contract administrator fees	2010-12-31	$6,076
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	SCHENCK
Accountancy firm EIN	2010-12-31	391173131

Form 5500 Responses for COMMUNITY MEMORIAL HOSPITAL RETIREMENT PLAN

2013: COMMUNITY MEMORIAL HOSPITAL RETIREMENT 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 – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: COMMUNITY MEMORIAL HOSPITAL RETIREMENT 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 – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: COMMUNITY MEMORIAL HOSPITAL RETIREMENT 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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: COMMUNITY MEMORIAL HOSPITAL RETIREMENT 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

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Company Name:	COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS, INC.
Employer identification number (EIN):	390987025
NAIC Classification:	622000
NAIC Description:	Hospitals