401k Plan data: KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN plan

KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN 401k Plan overview

Plan Name	KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN
Plan identification number	001

KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

SGRNC LLC D/B/A KING DAVID CENTER FOR NURSING AND REHABILITATION has sponsored the creation of one or more 401k plans.

Company Name: SGRNC LLC D/B/A KING DAVID CENTER FOR NURSING AND REHABILITATION

Employer identification number (EIN): 464053569

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 HESHY LICHT 2023-07-10
001 2021-01-01 HESHY LICHT 2022-09-19
001 2020-01-01 HESHY LICHT 2021-09-24
001 2019-01-01 HESHY LICHT 2020-09-21
001 2018-01-01
001 2017-01-01 HESHY LICHT
001 2016-01-01 HESHY LICHT
001 2016-01-01
001 2015-01-01 HESHY LICHT
001 2015-01-01 HESHY LICHT

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	HESHY LICHT	2023-07-10
001	2021-01-01	HESHY LICHT	2022-09-19
001	2020-01-01	HESHY LICHT	2021-09-24
001	2019-01-01	HESHY LICHT	2020-09-21
001	2018-01-01
001	2017-01-01	HESHY LICHT
001	2016-01-01	HESHY LICHT
001	2016-01-01
001	2015-01-01	HESHY LICHT
001	2015-01-01	HESHY LICHT

Plan Statistics for KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN

401k plan membership statisitcs for KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN

Measure Date Value
2018: KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 286
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 74
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 11
Total of all active and inactive participants 2018-01-01 85
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 85
Number of participants with account balances 2018-01-01 30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 251
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 276
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 8
Total of all active and inactive participants 2017-01-01 284
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 284
Number of participants with account balances 2017-01-01 33
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 259
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 232
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 10
Total of all active and inactive participants 2016-01-01 242
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 242
Number of participants with account balances 2016-01-01 37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 326
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 229
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 8
Total of all active and inactive participants 2015-01-01 237
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 237
Number of participants with account balances 2015-01-01 37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0

Measure	Date	Value
2018: KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	286
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	74
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	11
Total of all active and inactive participants	2018-01-01	85
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	85
Number of participants with account balances	2018-01-01	30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	251
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	276
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	8
Total of all active and inactive participants	2017-01-01	284
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	284
Number of participants with account balances	2017-01-01	33
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	259
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	232
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	10
Total of all active and inactive participants	2016-01-01	242
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	242
Number of participants with account balances	2016-01-01	37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	326
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	229
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	8
Total of all active and inactive participants	2015-01-01	237
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	237
Number of participants with account balances	2015-01-01	37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0

Financial Data on KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN

Measure	Date	Value
2018 : KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$6,279
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$-21,340
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$292,571
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$292,231
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$82,660
Value of total assets at end of year	2018-12-31	$1,422,882
Value of total assets at beginning of year	2018-12-31	$1,730,514
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$340
Total interest from all sources	2018-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$200,000
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	$82,660
Participant contributions at end of year	2018-12-31	$3,036
Participant contributions at beginning of year	2018-12-31	$236
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$0
Administrative expenses (other) incurred	2018-12-31	$340
Total non interest bearing cash at end of year	2018-12-31	$0
Total non interest bearing cash at beginning of year	2018-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-313,911
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,416,603
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,730,514
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 pooled separate accounts at end of year	2018-12-31	$1,419,846
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$1,730,278
Net investment gain/loss from pooled separate accounts	2018-12-31	$-104,000
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$292,231
Liabilities. Value of benefit claims payable at end of year	2018-12-31	$6,279
Liabilities. Value of benefit claims payable at beginning of year	2018-12-31	$0
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	C TO JDS PROFESSIONAL GROUP
Accountancy firm EIN	2018-12-31	208019714
2017 : KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$100
Total income from all sources (including contributions)	2017-12-31	$316,220
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$409,716
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$409,276
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$114,584
Value of total assets at end of year	2017-12-31	$1,730,514
Value of total assets at beginning of year	2017-12-31	$1,824,110
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$440
Total interest from all sources	2017-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$200,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
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	$99,953
Participant contributions at end of year	2017-12-31	$236
Participant contributions at beginning of year	2017-12-31	$186
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$14,631
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$100
Administrative expenses (other) incurred	2017-12-31	$440
Total non interest bearing cash at end of year	2017-12-31	$0
Total non interest bearing cash at beginning of year	2017-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$-93,496
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,730,514
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$1,824,010
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 pooled separate accounts at end of year	2017-12-31	$1,730,278
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$1,823,924
Net investment gain/loss from pooled separate accounts	2017-12-31	$201,636
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$409,276
Liabilities. Value of benefit claims payable at end of year	2017-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2017-12-31	$0
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	C TO JDS PROFESSIONAL GROUP
Accountancy firm EIN	2017-12-31	208019714
2016 : KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$100
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$220,842
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$199,479
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$199,304
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$119,682
Value of total assets at end of year	2016-12-31	$1,824,110
Value of total assets at beginning of year	2016-12-31	$1,802,647
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$175
Total interest from all sources	2016-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	No
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	$116,239
Participant contributions at end of year	2016-12-31	$186
Participant contributions at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$3,443
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$100
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$0
Administrative expenses (other) incurred	2016-12-31	$175
Total non interest bearing cash at end of year	2016-12-31	$0
Total non interest bearing cash at beginning of year	2016-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$21,363
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$1,824,010
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,802,647
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 pooled separate accounts at end of year	2016-12-31	$1,823,924
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$1,802,647
Net investment gain/loss from pooled separate accounts	2016-12-31	$101,160
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$199,304
Liabilities. Value of benefit claims payable at end of year	2016-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$0
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	No
Opinion of an independent qualified public accountant for this plan	2016-12-31	Unqualified
Accountancy firm name	2016-12-31	NATIONWIDE CPAS LLC
Accountancy firm EIN	2016-12-31	472867151
2015 : KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$1,894,796
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$92,149
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$92,009
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,986,146
Value of total assets at end of year	2015-12-31	$1,802,647
Value of total assets at beginning of year	2015-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$140
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Was this plan covered by a fidelity bond	2015-12-31	No
Value of fidelity bond cover	2015-12-31	$200,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
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	$139,229
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$1,846,917
Administrative expenses (other) incurred	2015-12-31	$140
Total non interest bearing cash at end of year	2015-12-31	$0
Total non interest bearing cash at beginning of year	2015-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$1,802,647
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,802,647
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$0
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 pooled separate accounts at end of year	2015-12-31	$1,802,647
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$0
Net investment gain/loss from pooled separate accounts	2015-12-31	$-91,350
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$92,009
Liabilities. Value of benefit claims payable at end of year	2015-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$0
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	No
Opinion of an independent qualified public accountant for this plan	2015-12-31	Unqualified
Accountancy firm name	2015-12-31	NATIONWIDE CPAS LLC
Accountancy firm EIN	2015-12-31	472867151

Form 5500 Responses for KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN

2018: KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
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: KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
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: KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
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: KING DAVID CENTER FOR NURSING AND REHABILITATION 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	First time form 5500 has been submitted	Yes
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )

Policy contract number

800986

Policy instance

Insurance contract or identification number	800986
Number of Individuals Covered	31
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $7,543
Total amount of fees paid to insurance company	USD $975
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,543
Insurance broker organization code?	5
Amount paid for insurance broker fees	975
Additional information about fees paid to insurance broker	TPA FEE

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )

Policy contract number

800986

Policy instance

Insurance contract or identification number	800986
Number of Individuals Covered	32
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $7,785
Total amount of fees paid to insurance company	USD $1,164
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,785
Insurance broker organization code?	5
Amount paid for insurance broker fees	1164
Additional information about fees paid to insurance broker	TPA FEE
Insurance broker name	ASSOCIATED PENSION CONSULTANTS, INC

JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )

Policy contract number

800986

Policy instance

Insurance contract or identification number	800986
Number of Individuals Covered	37
Insurance policy start date	2015-04-16
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $4,916
Total amount of fees paid to insurance company	USD $984
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,916
Insurance broker organization code?	5
Amount paid for insurance broker fees	984
Additional information about fees paid to insurance broker	TPA FEE
Insurance broker name	ASSOCIATED PENSION CONSULTANTS, INC

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Company Name:	SGRNC LLC D/B/A KING DAVID CENTER FOR NURSING AND REHABILITATION
Employer identification number (EIN):	464053569
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities