401k Plan data: MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN plan

MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN 401k Plan overview

Plan Name	MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN
Plan identification number	001

MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Participant-directed brokerage accounts provided as an investment option under the plan.
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

MEDSTAR SENIOR HOMES CORPATION has sponsored the creation of one or more 401k plans.

Company Name: MEDSTAR SENIOR HOMES CORPATION

Employer identification number (EIN): 475634142

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2018-01-01
001 2017-01-01 ADAM RUGGLES ADAM RUGGLES 2018-10-05
001 2017-01-01
001 2016-01-01 MARC RUGGLES MARC RUGGLES 2017-09-18
001 2016-01-01 ADAM RUGGLES 2018-10-05
001 2016-01-01
001 2015-11-17 ADAM RUGGLES ADAM RUGGLES 2016-10-17

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2018-01-01
001	2017-01-01	ADAM RUGGLES	ADAM RUGGLES	2018-10-05
001	2017-01-01
001	2016-01-01	MARC RUGGLES	MARC RUGGLES	2017-09-18
001	2016-01-01		ADAM RUGGLES	2018-10-05
001	2016-01-01
001	2015-11-17	ADAM RUGGLES	ADAM RUGGLES	2016-10-17

Plan Statistics for MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN

401k plan membership statisitcs for MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN

Measure Date Value
2018: MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 0
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 0
Total of all active and inactive participants 2018-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 0
Number of participants with account balances 2018-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 3
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 0
Total of all active and inactive participants 2017-01-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 3
Number of participants with account balances 2017-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 3
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 0
Total of all active and inactive participants 2016-01-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 3
Number of participants with account balances 2016-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-11-17 2
Total number of active participants reported on line 7a of the Form 5500 2015-11-17 2
Number of retired or separated participants receiving benefits 2015-11-17 0
Number of other retired or separated participants entitled to future benefits 2015-11-17 0
Total of all active and inactive participants 2015-11-17 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-11-17 0
Total participants 2015-11-17 2
Number of participants with account balances 2015-11-17 2

Measure	Date	Value
2018: MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	0
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	0
Total of all active and inactive participants	2018-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	0
Number of participants with account balances	2018-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	3
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	0
Total of all active and inactive participants	2017-01-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	3
Number of participants with account balances	2017-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	3
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	0
Total of all active and inactive participants	2016-01-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	3
Number of participants with account balances	2016-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-11-17	2
Total number of active participants reported on line 7a of the Form 5500	2015-11-17	2
Number of retired or separated participants receiving benefits	2015-11-17	0
Number of other retired or separated participants entitled to future benefits	2015-11-17	0
Total of all active and inactive participants	2015-11-17	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-11-17	0
Total participants	2015-11-17	2
Number of participants with account balances	2015-11-17	2

Financial Data on MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN

Measure	Date	Value
2018 : MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$104,714
Expenses. Total of all expenses incurred	2018-12-31	$114,805
Benefits paid (including direct rollovers)	2018-12-31	$114,805
Total plan assets at end of year	2018-12-31	$0
Total plan assets at beginning of year	2018-12-31	$10,091
Value of fidelity bond covering the plan	2018-12-31	$10,000
Other income received	2018-12-31	$104,714
Net income (gross income less expenses)	2018-12-31	$-10,091
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$10,091
Assets. Value of employer securities	2018-12-31	$0
2017 : MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$-538,417
Expenses. Total of all expenses incurred	2017-12-31	$0
Total plan assets at end of year	2017-12-31	$10,090
Total plan assets at beginning of year	2017-12-31	$548,507
Value of fidelity bond covering the plan	2017-12-31	$55,000
Total contributions received or receivable from participants	2017-12-31	$0
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$-538,417
Net income (gross income less expenses)	2017-12-31	$-538,417
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$10,090
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$548,507
Assets. Value of employer securities	2017-12-31	$9,971
Total contributions received or receivable from employer(s)	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$0
2016 : MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$381,004
Expenses. Total of all expenses incurred	2016-12-31	$0
Benefits paid (including direct rollovers)	2016-12-31	$5,193
Total plan assets at end of year	2016-12-31	$553,700
Total plan assets at beginning of year	2016-12-31	$172,696
Value of fidelity bond covering the plan	2016-12-31	$60,000
Total contributions received or receivable from participants	2016-12-31	$0
Expenses. Other expenses not covered elsewhere	2016-12-31	$0
Contributions received from other sources (not participants or employers)	2016-12-31	$172,617
Other income received	2016-12-31	$208,387
Net income (gross income less expenses)	2016-12-31	$381,004
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$553,700
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$172,696
Assets. Value of participant loans	2016-12-31	$5,193
Assets. Value of employer securities	2016-12-31	$548,387
Total contributions received or receivable from employer(s)	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$0
2015 : MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$172,716
Expenses. Total of all expenses incurred	2015-12-31	$20
Total plan assets at end of year	2015-12-31	$172,696
Value of fidelity bond covering the plan	2015-12-31	$10,000
Expenses. Other expenses not covered elsewhere	2015-12-31	$20
Contributions received from other sources (not participants or employers)	2015-12-31	$172,716
Net income (gross income less expenses)	2015-12-31	$172,696
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$172,696
Assets. Value of employer securities	2015-12-31	$170,000

Form 5500 Responses for MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN

2018: MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	This submission is the final filing	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING 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 – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING 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 – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: MEDSTAR SENIOR HOMES CORPORATION PROFIT SHARING PLAN 2015 form 5500 responses
2015-11-17	Type of plan entity	Single employer plan
2015-11-17	First time form 5500 has been submitted	Yes
2015-11-17	Submission has been amended	No
2015-11-17	This submission is the final filing	No
2015-11-17	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-11-17	Plan is a collectively bargained plan	No
2015-11-17	Plan funding arrangement – Trust	Yes
2015-11-17	Plan benefit arrangement - Trust	Yes

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Company Name:	MEDSTAR SENIOR HOMES CORPATION
Employer identification number (EIN):	475634142
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities