401k Plan data: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN plan

SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN
Plan identification number	001

SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING 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

PAGE REHABILITATION AND HEALTHCARE CENTER has sponsored the creation of one or more 401k plans.

Company Name: PAGE REHABILITATION AND HEALTHCARE CENTER

Employer identification number (EIN): 650850574

NAIC Classification: 805198

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-10-01 FONDA POTTS 2020-10-27 FONDA POTTS 2020-10-27
001 2018-10-01
001 2017-10-01
001 2016-10-01 FONDA POTTS FONDA POTTS 2018-07-02
001 2015-10-01 FONDA POTTS FONDA POTTS 2017-07-14
001 2014-10-01 FONDA POTTS FONDA POTTS 2016-06-14
001 2013-10-01 FONDA POTTS FONDA POTTS 2015-07-14
001 2012-10-01 FONDA POTTS FONDA POTTS 2014-06-30
001 2011-10-01 FONDA POTTS FONDA POTTS 2013-07-09
001 2009-10-01 FOND POTTS FOND POTTS 2011-07-15
001 2009-10-01 FONDA POTTS FONDA POTTS 2011-07-15
001 2009-10-01 FONDA POTTS FONDA POTTS 2011-07-15
001 2009-10-01 FONDA POTTS FONDA POTTS 2011-07-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2019-10-01	FONDA POTTS	2020-10-27	FONDA POTTS	2020-10-27
001	2018-10-01
001	2017-10-01
001	2016-10-01	FONDA POTTS		FONDA POTTS	2018-07-02
001	2015-10-01	FONDA POTTS		FONDA POTTS	2017-07-14
001	2014-10-01	FONDA POTTS		FONDA POTTS	2016-06-14
001	2013-10-01	FONDA POTTS		FONDA POTTS	2015-07-14
001	2012-10-01	FONDA POTTS		FONDA POTTS	2014-06-30
001	2011-10-01	FONDA POTTS		FONDA POTTS	2013-07-09
001	2009-10-01	FOND POTTS		FOND POTTS	2011-07-15
001	2009-10-01	FONDA POTTS		FONDA POTTS	2011-07-15
001	2009-10-01	FONDA POTTS		FONDA POTTS	2011-07-15
001	2009-10-01	FONDA POTTS		FONDA POTTS	2011-07-15

Plan Statistics for SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN

Measure Date Value
2018: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-10-01 474
Total number of active participants reported on line 7a of the Form 5500 2018-10-01 46
Number of retired or separated participants receiving benefits 2018-10-01 63
Total of all active and inactive participants 2018-10-01 109
Total participants 2018-10-01 109
Number of participants with account balances 2018-10-01 74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-10-01 0
2017: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-10-01 408
Total number of active participants reported on line 7a of the Form 5500 2017-10-01 450
Number of retired or separated participants receiving benefits 2017-10-01 24
Total of all active and inactive participants 2017-10-01 474
Total participants 2017-10-01 474
Number of participants with account balances 2017-10-01 145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-10-01 0
2016: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-10-01 378
Total number of active participants reported on line 7a of the Form 5500 2016-10-01 378
Number of retired or separated participants receiving benefits 2016-10-01 30
Number of other retired or separated participants entitled to future benefits 2016-10-01 0
Total of all active and inactive participants 2016-10-01 408
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-10-01 0
Total participants 2016-10-01 408
Number of participants with account balances 2016-10-01 148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-10-01 0
2015: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-10-01 341
Total number of active participants reported on line 7a of the Form 5500 2015-10-01 341
Number of retired or separated participants receiving benefits 2015-10-01 37
Total of all active and inactive participants 2015-10-01 378
Total participants 2015-10-01 378
Number of participants with account balances 2015-10-01 153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-10-01 0
2014: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-10-01 387
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 133
Number of retired or separated participants receiving benefits 2014-10-01 25
Total of all active and inactive participants 2014-10-01 158
Total participants 2014-10-01 158
Number of participants with account balances 2014-10-01 158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-10-01 0
2013: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-10-01 322
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 137
Number of retired or separated participants receiving benefits 2013-10-01 35
Total of all active and inactive participants 2013-10-01 172
Total participants 2013-10-01 172
Number of participants with account balances 2013-10-01 172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-10-01 0
2012: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-10-01 334
Total number of active participants reported on line 7a of the Form 5500 2012-10-01 141
Number of retired or separated participants receiving benefits 2012-10-01 41
Total of all active and inactive participants 2012-10-01 182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-10-01 0
Total participants 2012-10-01 182
Number of participants with account balances 2012-10-01 182
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-10-01 0
2011: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-10-01 237
Total number of active participants reported on line 7a of the Form 5500 2011-10-01 271
Number of other retired or separated participants entitled to future benefits 2011-10-01 35
Total of all active and inactive participants 2011-10-01 306
Total participants 2011-10-01 306
Number of participants with account balances 2011-10-01 167
2009: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-10-01 227
Total number of active participants reported on line 7a of the Form 5500 2009-10-01 192
Number of retired or separated participants receiving benefits 2009-10-01 0
Number of other retired or separated participants entitled to future benefits 2009-10-01 31
Total of all active and inactive participants 2009-10-01 223
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-10-01 0
Total participants 2009-10-01 223
Number of participants with account balances 2009-10-01 153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-10-01 0

Measure	Date	Value
2018: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-10-01	474
Total number of active participants reported on line 7a of the Form 5500	2018-10-01	46
Number of retired or separated participants receiving benefits	2018-10-01	63
Total of all active and inactive participants	2018-10-01	109
Total participants	2018-10-01	109
Number of participants with account balances	2018-10-01	74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-10-01	0
2017: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-10-01	408
Total number of active participants reported on line 7a of the Form 5500	2017-10-01	450
Number of retired or separated participants receiving benefits	2017-10-01	24
Total of all active and inactive participants	2017-10-01	474
Total participants	2017-10-01	474
Number of participants with account balances	2017-10-01	145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-10-01	0
2016: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-10-01	378
Total number of active participants reported on line 7a of the Form 5500	2016-10-01	378
Number of retired or separated participants receiving benefits	2016-10-01	30
Number of other retired or separated participants entitled to future benefits	2016-10-01	0
Total of all active and inactive participants	2016-10-01	408
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-10-01	0
Total participants	2016-10-01	408
Number of participants with account balances	2016-10-01	148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-10-01	0
2015: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-10-01	341
Total number of active participants reported on line 7a of the Form 5500	2015-10-01	341
Number of retired or separated participants receiving benefits	2015-10-01	37
Total of all active and inactive participants	2015-10-01	378
Total participants	2015-10-01	378
Number of participants with account balances	2015-10-01	153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-10-01	0
2014: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-10-01	387
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	133
Number of retired or separated participants receiving benefits	2014-10-01	25
Total of all active and inactive participants	2014-10-01	158
Total participants	2014-10-01	158
Number of participants with account balances	2014-10-01	158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-10-01	0
2013: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-10-01	322
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	137
Number of retired or separated participants receiving benefits	2013-10-01	35
Total of all active and inactive participants	2013-10-01	172
Total participants	2013-10-01	172
Number of participants with account balances	2013-10-01	172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-10-01	0
2012: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-10-01	334
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	141
Number of retired or separated participants receiving benefits	2012-10-01	41
Total of all active and inactive participants	2012-10-01	182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-10-01	0
Total participants	2012-10-01	182
Number of participants with account balances	2012-10-01	182
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-10-01	0
2011: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-10-01	237
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	271
Number of other retired or separated participants entitled to future benefits	2011-10-01	35
Total of all active and inactive participants	2011-10-01	306
Total participants	2011-10-01	306
Number of participants with account balances	2011-10-01	167
2009: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-10-01	227
Total number of active participants reported on line 7a of the Form 5500	2009-10-01	192
Number of retired or separated participants receiving benefits	2009-10-01	0
Number of other retired or separated participants entitled to future benefits	2009-10-01	31
Total of all active and inactive participants	2009-10-01	223
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-10-01	0
Total participants	2009-10-01	223
Number of participants with account balances	2009-10-01	153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-10-01	0

Financial Data on SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2019 : SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total income from all sources (including contributions)	2019-09-30	$294,955
Total of all expenses incurred	2019-09-30	$1,339,357
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-09-30	$1,220,595
Expenses. Certain deemed distributions of participant loans	2019-09-30	$110,142
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-09-30	$252,656
Value of total assets at end of year	2019-09-30	$2,846,467
Value of total assets at beginning of year	2019-09-30	$3,890,869
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-09-30	$8,620
Total interest from all sources	2019-09-30	$42,278
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-09-30	No
Was this plan covered by a fidelity bond	2019-09-30	Yes
Value of fidelity bond cover	2019-09-30	$250,000
If this is an individual account plan, was there a blackout period	2019-09-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-09-30	$0
Were there any nonexempt tranactions with any party-in-interest	2019-09-30	No
Contributions received from participants	2019-09-30	$166,450
Participant contributions at end of year	2019-09-30	$91,128
Participant contributions at beginning of year	2019-09-30	$178,366
Participant contributions at end of year	2019-09-30	$0
Participant contributions at beginning of year	2019-09-30	$-213
Income. Received or receivable in cash from other sources (including rollovers)	2019-09-30	$0
Total non interest bearing cash at end of year	2019-09-30	$0
Total non interest bearing cash at beginning of year	2019-09-30	$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	2019-09-30	No
Income. Non cash contributions	2019-09-30	$0
Value of net income/loss	2019-09-30	$-1,044,402
Value of net assets at end of year (total assets less liabilities)	2019-09-30	$2,846,467
Value of net assets at beginning of year (total assets less liabilities)	2019-09-30	$3,890,869
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-09-30	No
Were any leases to which the plan was party in default or uncollectible	2019-09-30	No
Investment advisory and management fees	2019-09-30	$8,620
Value of interest in pooled separate accounts at end of year	2019-09-30	$1,598,397
Value of interest in pooled separate accounts at beginning of year	2019-09-30	$2,267,711
Interest on participant loans	2019-09-30	$3,793
Interest earned on other investments	2019-09-30	$38,485
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-09-30	$1,156,942
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-09-30	$1,445,005
Net investment gain or loss from common/collective trusts	2019-09-30	$21
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-09-30	No
Was there a failure to transmit to the plan any participant contributions	2019-09-30	No
Has the plan failed to provide any benefit when due under the plan	2019-09-30	No
Contributions received in cash from employer	2019-09-30	$86,206
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-09-30	$1,220,595
Did the plan have assets held for investment	2019-09-30	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	2019-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2019-09-30	Disclaimer
Accountancy firm name	2019-09-30	LEVIN, SILVEY, ZELKO & MACKEY, P.A
Accountancy firm EIN	2019-09-30	592527584
2018 : SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources (including contributions)	2018-09-30	$767,382
Total of all expenses incurred	2018-09-30	$386,111
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-09-30	$320,381
Value of total corrective distributions	2018-09-30	$60,043
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-09-30	$510,291
Value of total assets at end of year	2018-09-30	$3,890,869
Value of total assets at beginning of year	2018-09-30	$3,509,598
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-09-30	$5,687
Total interest from all sources	2018-09-30	$6,156
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-09-30	No
Was this plan covered by a fidelity bond	2018-09-30	Yes
Value of fidelity bond cover	2018-09-30	$250,000
If this is an individual account plan, was there a blackout period	2018-09-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-09-30	$0
Were there any nonexempt tranactions with any party-in-interest	2018-09-30	No
Contributions received from participants	2018-09-30	$280,454
Participant contributions at end of year	2018-09-30	$178,366
Participant contributions at beginning of year	2018-09-30	$202,288
Participant contributions at end of year	2018-09-30	$-213
Participant contributions at beginning of year	2018-09-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-09-30	$41,867
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-09-30	$0
Administrative expenses (other) incurred	2018-09-30	$537
Total non interest bearing cash at end of year	2018-09-30	$0
Total non interest bearing cash at beginning of year	2018-09-30	$127
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-09-30	No
Value of net income/loss	2018-09-30	$381,271
Value of net assets at end of year (total assets less liabilities)	2018-09-30	$3,890,869
Value of net assets at beginning of year (total assets less liabilities)	2018-09-30	$3,509,598
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-09-30	No
Were any leases to which the plan was party in default or uncollectible	2018-09-30	No
Investment advisory and management fees	2018-09-30	$5,150
Value of interest in pooled separate accounts at end of year	2018-09-30	$2,267,711
Value of interest in pooled separate accounts at beginning of year	2018-09-30	$1,969,918
Interest on participant loans	2018-09-30	$6,156
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-09-30	$1,445,005
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-09-30	$1,337,265
Net investment gain or loss from common/collective trusts	2018-09-30	$250,935
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-09-30	No
Was there a failure to transmit to the plan any participant contributions	2018-09-30	No
Has the plan failed to provide any benefit when due under the plan	2018-09-30	No
Contributions received in cash from employer	2018-09-30	$187,970
Employer contributions (assets) at beginning of year	2018-09-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-09-30	$320,381
Did the plan have assets held for investment	2018-09-30	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	2018-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2018-09-30	Disclaimer
Accountancy firm name	2018-09-30	LEVIN, SILVEY, ZELKO & MACKEY, P.A
Accountancy firm EIN	2018-09-30	592527584
2017 : SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-09-30	$687,336
Total of all expenses incurred	2017-09-30	$318,699
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-09-30	$269,699
Value of total corrective distributions	2017-09-30	$44,775
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-09-30	$446,194
Value of total assets at end of year	2017-09-30	$3,509,598
Value of total assets at beginning of year	2017-09-30	$3,140,961
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-09-30	$4,225
Total interest from all sources	2017-09-30	$6,529
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-09-30	No
Was this plan covered by a fidelity bond	2017-09-30	Yes
Value of fidelity bond cover	2017-09-30	$250,000
If this is an individual account plan, was there a blackout period	2017-09-30	No
Were there any nonexempt tranactions with any party-in-interest	2017-09-30	No
Contributions received from participants	2017-09-30	$271,615
Participant contributions at end of year	2017-09-30	$202,288
Participant contributions at beginning of year	2017-09-30	$221,133
Participant contributions at end of year	2017-09-30	$0
Participant contributions at beginning of year	2017-09-30	$-5,212
Income. Received or receivable in cash from other sources (including rollovers)	2017-09-30	$8,501
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-09-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-09-30	$4,519
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-09-30	No
Value of net income/loss	2017-09-30	$368,637
Value of net assets at end of year (total assets less liabilities)	2017-09-30	$3,509,598
Value of net assets at beginning of year (total assets less liabilities)	2017-09-30	$3,140,961
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-09-30	No
Were any leases to which the plan was party in default or uncollectible	2017-09-30	No
Investment advisory and management fees	2017-09-30	$1,650
Value of interest in pooled separate accounts at end of year	2017-09-30	$1,969,918
Value of interest in pooled separate accounts at beginning of year	2017-09-30	$1,387,370
Interest on participant loans	2017-09-30	$6,529
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-09-30	$1,337,265
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-09-30	$1,538,926
Net investment gain or loss from common/collective trusts	2017-09-30	$234,613
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-09-30	No
Was there a failure to transmit to the plan any participant contributions	2017-09-30	Yes
Has the plan failed to provide any benefit when due under the plan	2017-09-30	No
Contributions received in cash from employer	2017-09-30	$166,078
Employer contributions (assets) at end of year	2017-09-30	$127
Employer contributions (assets) at beginning of year	2017-09-30	$-5,775
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-09-30	$269,699
Contract administrator fees	2017-09-30	$2,575
Did the plan have assets held for investment	2017-09-30	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	2017-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2017-09-30	Disclaimer
Accountancy firm name	2017-09-30	LEVIN, SILVEY, ZELKO & MACKEY, P.A
Accountancy firm EIN	2017-09-30	592527584
2016 : SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-09-30	$565,944
Total of all expenses incurred	2016-09-30	$263,783
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-09-30	$230,516
Value of total corrective distributions	2016-09-30	$29,917
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-09-30	$401,533
Value of total assets at end of year	2016-09-30	$3,140,961
Value of total assets at beginning of year	2016-09-30	$2,838,800
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-09-30	$3,350
Total interest from all sources	2016-09-30	$8,283
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-09-30	No
Was this plan covered by a fidelity bond	2016-09-30	Yes
Value of fidelity bond cover	2016-09-30	$250,000
If this is an individual account plan, was there a blackout period	2016-09-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-09-30	$0
Were there any nonexempt tranactions with any party-in-interest	2016-09-30	No
Contributions received from participants	2016-09-30	$233,114
Participant contributions at end of year	2016-09-30	$221,133
Participant contributions at beginning of year	2016-09-30	$223,055
Participant contributions at end of year	2016-09-30	$-5,212
Participant contributions at beginning of year	2016-09-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-09-30	$4,519
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-09-30	$4,519
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-09-30	No
Value of net income/loss	2016-09-30	$302,161
Value of net assets at end of year (total assets less liabilities)	2016-09-30	$3,140,961
Value of net assets at beginning of year (total assets less liabilities)	2016-09-30	$2,838,800
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-09-30	No
Were any leases to which the plan was party in default or uncollectible	2016-09-30	No
Investment advisory and management fees	2016-09-30	$1,989
Value of interest in pooled separate accounts at end of year	2016-09-30	$1,387,370
Value of interest in pooled separate accounts at beginning of year	2016-09-30	$1,325,290
Interest on participant loans	2016-09-30	$8,283
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-09-30	$1,538,926
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-09-30	$1,285,936
Net investment gain/loss from pooled separate accounts	2016-09-30	$156,128
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-09-30	No
Was there a failure to transmit to the plan any participant contributions	2016-09-30	Yes
Has the plan failed to provide any benefit when due under the plan	2016-09-30	No
Contributions received in cash from employer	2016-09-30	$168,419
Employer contributions (assets) at end of year	2016-09-30	$-5,775
Employer contributions (assets) at beginning of year	2016-09-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-09-30	$230,516
Contract administrator fees	2016-09-30	$1,361
Did the plan have assets held for investment	2016-09-30	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	2016-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2016-09-30	Disclaimer
Accountancy firm name	2016-09-30	LEVIN,SILVEY, ZELKO & MACKEY, P.A.
Accountancy firm EIN	2016-09-30	592527584
2015 : SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources (including contributions)	2015-09-30	$434,582
Total of all expenses incurred	2015-09-30	$660,227
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-09-30	$609,801
Expenses. Certain deemed distributions of participant loans	2015-09-30	$47,426
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-09-30	$415,108
Value of total assets at end of year	2015-09-30	$2,838,800
Value of total assets at beginning of year	2015-09-30	$3,064,445
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-09-30	$3,000
Total interest from all sources	2015-09-30	$12,755
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-09-30	No
Was this plan covered by a fidelity bond	2015-09-30	Yes
Value of fidelity bond cover	2015-09-30	$250,000
If this is an individual account plan, was there a blackout period	2015-09-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-09-30	$0
Were there any nonexempt tranactions with any party-in-interest	2015-09-30	No
Contributions received from participants	2015-09-30	$228,877
Participant contributions at end of year	2015-09-30	$223,055
Participant contributions at beginning of year	2015-09-30	$249,942
Participant contributions at end of year	2015-09-30	$0
Participant contributions at beginning of year	2015-09-30	$9
Income. Received or receivable in cash from other sources (including rollovers)	2015-09-30	$3,851
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2015-09-30	$775
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-09-30	$4,519
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-09-30	$6,025
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-09-30	No
Value of net income/loss	2015-09-30	$-225,645
Value of net assets at end of year (total assets less liabilities)	2015-09-30	$2,838,800
Value of net assets at beginning of year (total assets less liabilities)	2015-09-30	$3,064,445
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-09-30	No
Were any leases to which the plan was party in default or uncollectible	2015-09-30	No
Value of interest in pooled separate accounts at end of year	2015-09-30	$1,325,290
Value of interest in pooled separate accounts at beginning of year	2015-09-30	$1,410,375
Interest on participant loans	2015-09-30	$12,755
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-09-30	$1,285,936
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-09-30	$1,398,083
Net investment gain/loss from pooled separate accounts	2015-09-30	$6,719
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-09-30	No
Was there a failure to transmit to the plan any participant contributions	2015-09-30	No
Has the plan failed to provide any benefit when due under the plan	2015-09-30	No
Contributions received in cash from employer	2015-09-30	$182,380
Employer contributions (assets) at end of year	2015-09-30	$0
Employer contributions (assets) at beginning of year	2015-09-30	$11
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-09-30	$609,026
Contract administrator fees	2015-09-30	$3,000
Did the plan have assets held for investment	2015-09-30	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	2015-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2015-09-30	Disclaimer
Accountancy firm name	2015-09-30	THE SPIRES GROUP, P.A.
Accountancy firm EIN	2015-09-30	472882891
2014 : SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-09-30	$0
Total income from all sources (including contributions)	2014-09-30	$588,814
Total of all expenses incurred	2014-09-30	$408,851
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-09-30	$389,064
Expenses. Certain deemed distributions of participant loans	2014-09-30	$16,512
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-09-30	$434,741
Value of total assets at end of year	2014-09-30	$3,064,445
Value of total assets at beginning of year	2014-09-30	$2,884,482
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-09-30	$3,275
Total interest from all sources	2014-09-30	$12,236
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-09-30	No
Was this plan covered by a fidelity bond	2014-09-30	Yes
Value of fidelity bond cover	2014-09-30	$250,000
If this is an individual account plan, was there a blackout period	2014-09-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-09-30	$0
Were there any nonexempt tranactions with any party-in-interest	2014-09-30	No
Contributions received from participants	2014-09-30	$220,251
Participant contributions at end of year	2014-09-30	$249,942
Participant contributions at beginning of year	2014-09-30	$219,723
Participant contributions at end of year	2014-09-30	$9
Participant contributions at beginning of year	2014-09-30	$290
Income. Received or receivable in cash from other sources (including rollovers)	2014-09-30	$41,127
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-09-30	$6,025
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-09-30	$3,389
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-09-30	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-09-30	No
Value of net income/loss	2014-09-30	$179,963
Value of net assets at end of year (total assets less liabilities)	2014-09-30	$3,064,445
Value of net assets at beginning of year (total assets less liabilities)	2014-09-30	$2,884,482
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-09-30	No
Were any leases to which the plan was party in default or uncollectible	2014-09-30	No
Value of interest in pooled separate accounts at end of year	2014-09-30	$1,410,375
Value of interest in pooled separate accounts at beginning of year	2014-09-30	$1,282,530
Income. Interest from loans (other than to participants)	2014-09-30	$12,236
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-09-30	$1,398,083
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-09-30	$1,378,550
Net investment gain/loss from pooled separate accounts	2014-09-30	$141,837
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-09-30	No
Was there a failure to transmit to the plan any participant contributions	2014-09-30	No
Has the plan failed to provide any benefit when due under the plan	2014-09-30	No
Contributions received in cash from employer	2014-09-30	$173,363
Employer contributions (assets) at end of year	2014-09-30	$11
Employer contributions (assets) at beginning of year	2014-09-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-09-30	$389,064
Contract administrator fees	2014-09-30	$3,275
Did the plan have assets held for investment	2014-09-30	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	2014-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2014-09-30	Disclaimer
Accountancy firm name	2014-09-30	SPIRES & ASSOCIATES, P.A.
Accountancy firm EIN	2014-09-30	650865523
2013 : SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-09-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-09-30	$347
Total income from all sources (including contributions)	2013-09-30	$568,859
Total of all expenses incurred	2013-09-30	$228,792
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-09-30	$185,653
Expenses. Certain deemed distributions of participant loans	2013-09-30	$41,589
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-09-30	$410,422
Value of total assets at end of year	2013-09-30	$2,884,482
Value of total assets at beginning of year	2013-09-30	$2,544,762
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-09-30	$1,550
Total interest from all sources	2013-09-30	$5,462
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-09-30	No
Was this plan covered by a fidelity bond	2013-09-30	Yes
Value of fidelity bond cover	2013-09-30	$250,000
If this is an individual account plan, was there a blackout period	2013-09-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-09-30	$0
Were there any nonexempt tranactions with any party-in-interest	2013-09-30	No
Contributions received from participants	2013-09-30	$247,431
Participant contributions at end of year	2013-09-30	$219,723
Participant contributions at beginning of year	2013-09-30	$199,860
Participant contributions at end of year	2013-09-30	$290
Participant contributions at beginning of year	2013-09-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-09-30	$3,389
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-09-30	$1,130
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-09-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-09-30	$347
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-09-30	No
Value of net income/loss	2013-09-30	$340,067
Value of net assets at end of year (total assets less liabilities)	2013-09-30	$2,884,482
Value of net assets at beginning of year (total assets less liabilities)	2013-09-30	$2,544,415
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-09-30	No
Were any leases to which the plan was party in default or uncollectible	2013-09-30	No
Value of interest in pooled separate accounts at end of year	2013-09-30	$1,282,530
Value of interest in pooled separate accounts at beginning of year	2013-09-30	$953,238
Income. Interest from loans (other than to participants)	2013-09-30	$5,462
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-09-30	$1,378,550
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-09-30	$1,390,534
Net investment gain/loss from pooled separate accounts	2013-09-30	$152,975
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-09-30	No
Was there a failure to transmit to the plan any participant contributions	2013-09-30	No
Has the plan failed to provide any benefit when due under the plan	2013-09-30	No
Contributions received in cash from employer	2013-09-30	$162,991
Employer contributions (assets) at end of year	2013-09-30	$0
Employer contributions (assets) at beginning of year	2013-09-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-09-30	$185,653
Contract administrator fees	2013-09-30	$1,550
Did the plan have assets held for investment	2013-09-30	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	2013-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2013-09-30	Disclaimer
Accountancy firm name	2013-09-30	SPIRES & ASSOCIATES, P.A.
Accountancy firm EIN	2013-09-30	650865523
2012 : SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-09-30	$347
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-09-30	$347
Total income from all sources (including contributions)	2012-09-30	$566,897
Total of all expenses incurred	2012-09-30	$276,226
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-09-30	$240,196
Expenses. Certain deemed distributions of participant loans	2012-09-30	$33,940
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-09-30	$410,046
Value of total assets at end of year	2012-09-30	$2,544,762
Value of total assets at beginning of year	2012-09-30	$2,254,091
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-09-30	$2,090
Total interest from all sources	2012-09-30	$5,094
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-09-30	No
Was this plan covered by a fidelity bond	2012-09-30	Yes
Value of fidelity bond cover	2012-09-30	$250,000
If this is an individual account plan, was there a blackout period	2012-09-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-09-30	$0
Were there any nonexempt tranactions with any party-in-interest	2012-09-30	No
Contributions received from participants	2012-09-30	$251,539
Participant contributions at end of year	2012-09-30	$199,860
Participant contributions at beginning of year	2012-09-30	$226,825
Participant contributions at end of year	2012-09-30	$0
Participant contributions at beginning of year	2012-09-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-09-30	$1,130
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-09-30	$347
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-09-30	$347
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-09-30	No
Value of net income/loss	2012-09-30	$290,671
Value of net assets at end of year (total assets less liabilities)	2012-09-30	$2,544,415
Value of net assets at beginning of year (total assets less liabilities)	2012-09-30	$2,253,744
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-09-30	No
Were any leases to which the plan was party in default or uncollectible	2012-09-30	No
Value of interest in pooled separate accounts at end of year	2012-09-30	$953,238
Value of interest in pooled separate accounts at beginning of year	2012-09-30	$791,088
Income. Interest from loans (other than to participants)	2012-09-30	$5,094
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-09-30	$1,390,534
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-09-30	$1,236,178
Net investment gain/loss from pooled separate accounts	2012-09-30	$151,757
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-09-30	No
Was there a failure to transmit to the plan any participant contributions	2012-09-30	No
Has the plan failed to provide any benefit when due under the plan	2012-09-30	No
Contributions received in cash from employer	2012-09-30	$158,507
Employer contributions (assets) at end of year	2012-09-30	$0
Employer contributions (assets) at beginning of year	2012-09-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-09-30	$240,196
Contract administrator fees	2012-09-30	$2,090
Did the plan have assets held for investment	2012-09-30	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	2012-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2012-09-30	Disclaimer
Accountancy firm name	2012-09-30	SPIRES & ASSOCIATES, P.A.
Accountancy firm EIN	2012-09-30	650865523
2011 : SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-09-30	$347
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-09-30	$0
Total income from all sources (including contributions)	2011-09-30	$565,793
Total loss/gain on sale of assets	2011-09-30	$0
Total of all expenses incurred	2011-09-30	$357,667
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-09-30	$339,416
Expenses. Certain deemed distributions of participant loans	2011-09-30	$16,486
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-09-30	$478,618
Value of total assets at end of year	2011-09-30	$2,254,091
Value of total assets at beginning of year	2011-09-30	$2,045,618
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-09-30	$1,765
Total interest from all sources	2011-09-30	$33,150
Total dividends received (eg from common stock, registered investment company shares)	2011-09-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-09-30	No
Was this plan covered by a fidelity bond	2011-09-30	Yes
Value of fidelity bond cover	2011-09-30	$250,000
If this is an individual account plan, was there a blackout period	2011-09-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-09-30	$0
Were there any nonexempt tranactions with any party-in-interest	2011-09-30	No
Contributions received from participants	2011-09-30	$269,416
Participant contributions at end of year	2011-09-30	$226,825
Participant contributions at beginning of year	2011-09-30	$120,893
Participant contributions at end of year	2011-09-30	$0
Participant contributions at beginning of year	2011-09-30	$192
Income. Received or receivable in cash from other sources (including rollovers)	2011-09-30	$43,231
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-09-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-09-30	$347
Administrative expenses (other) incurred	2011-09-30	$1,765
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-09-30	No
Value of net income/loss	2011-09-30	$208,126
Value of net assets at end of year (total assets less liabilities)	2011-09-30	$2,253,744
Value of net assets at beginning of year (total assets less liabilities)	2011-09-30	$2,045,618
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-09-30	No
Were any leases to which the plan was party in default or uncollectible	2011-09-30	No
Value of interest in pooled separate accounts at end of year	2011-09-30	$791,088
Value of interest in pooled separate accounts at beginning of year	2011-09-30	$1,187,325
Income. Interest from loans (other than to participants)	2011-09-30	$3,421
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-09-30	$29,729
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-09-30	$1,236,178
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-09-30	$737,016
Net investment gain/loss from pooled separate accounts	2011-09-30	$54,025
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-09-30	No
Was there a failure to transmit to the plan any participant contributions	2011-09-30	No
Has the plan failed to provide any benefit when due under the plan	2011-09-30	No
Contributions received in cash from employer	2011-09-30	$165,971
Employer contributions (assets) at end of year	2011-09-30	$0
Employer contributions (assets) at beginning of year	2011-09-30	$192
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-09-30	$339,416
Did the plan have assets held for investment	2011-09-30	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	2011-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-09-30	Yes
Opinion of an independent qualified public accountant for this plan	2011-09-30	Disclaimer
Accountancy firm name	2011-09-30	SPIRES & ASSOCIATES, P.A.
Accountancy firm EIN	2011-09-30	650865523
2010 : SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-09-30	$0

Form 5500 Responses for SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN

2018: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2018 form 5500 responses
2018-10-01	Type of plan entity	Single employer plan
2018-10-01	Submission has been amended	No
2018-10-01	This submission is the final filing	No
2018-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-10-01	Plan is a collectively bargained plan	No
2018-10-01	Plan funding arrangement – Insurance	Yes
2018-10-01	Plan funding arrangement – Trust	Yes
2018-10-01	Plan benefit arrangement – Insurance	Yes
2018-10-01	Plan benefit arrangement - Trust	Yes
2017: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2017 form 5500 responses
2017-10-01	Type of plan entity	Single employer plan
2017-10-01	Submission has been amended	No
2017-10-01	This submission is the final filing	No
2017-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-10-01	Plan is a collectively bargained plan	No
2017-10-01	Plan funding arrangement – Insurance	Yes
2017-10-01	Plan funding arrangement – Trust	Yes
2017-10-01	Plan benefit arrangement – Insurance	Yes
2017-10-01	Plan benefit arrangement - Trust	Yes
2016: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-10-01	Type of plan entity	Single employer plan
2016-10-01	Submission has been amended	No
2016-10-01	This submission is the final filing	No
2016-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-10-01	Plan is a collectively bargained plan	No
2016-10-01	Plan funding arrangement – Insurance	Yes
2016-10-01	Plan funding arrangement – Trust	Yes
2016-10-01	Plan benefit arrangement – Insurance	Yes
2016-10-01	Plan benefit arrangement - Trust	Yes
2015: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-10-01	Type of plan entity	Single employer plan
2015-10-01	Submission has been amended	No
2015-10-01	This submission is the final filing	No
2015-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-10-01	Plan is a collectively bargained plan	No
2015-10-01	Plan funding arrangement – Insurance	Yes
2015-10-01	Plan funding arrangement – Trust	Yes
2015-10-01	Plan benefit arrangement – Insurance	Yes
2015-10-01	Plan benefit arrangement - Trust	Yes
2014: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Submission has been amended	No
2014-10-01	This submission is the final filing	No
2014-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-10-01	Plan is a collectively bargained plan	No
2014-10-01	Plan funding arrangement – Insurance	Yes
2014-10-01	Plan funding arrangement – Trust	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement - Trust	Yes
2013: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	Submission has been amended	No
2013-10-01	This submission is the final filing	No
2013-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-10-01	Plan is a collectively bargained plan	No
2013-10-01	Plan funding arrangement – Insurance	Yes
2013-10-01	Plan funding arrangement – Trust	Yes
2013-10-01	Plan benefit arrangement – Insurance	Yes
2013-10-01	Plan benefit arrangement - Trust	Yes
2012: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-10-01	Type of plan entity	Single employer plan
2012-10-01	Submission has been amended	No
2012-10-01	This submission is the final filing	No
2012-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-10-01	Plan is a collectively bargained plan	No
2012-10-01	Plan funding arrangement – Insurance	Yes
2012-10-01	Plan funding arrangement – Trust	Yes
2012-10-01	Plan benefit arrangement – Insurance	Yes
2012-10-01	Plan benefit arrangement - Trust	Yes
2011: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	Submission has been amended	No
2011-10-01	This submission is the final filing	No
2011-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-10-01	Plan is a collectively bargained plan	No
2011-10-01	Plan funding arrangement – Insurance	Yes
2011-10-01	Plan funding arrangement – Trust	Yes
2011-10-01	Plan benefit arrangement – Insurance	Yes
2011-10-01	Plan benefit arrangement - Trust	Yes
2009: SHADY REST CARE PAVILION, INC., 401(K) PROFIT SHARING PLAN 2009 form 5500 responses
2009-10-01	Type of plan entity	Single employer plan
2009-10-01	Submission has been amended	No
2009-10-01	This submission is the final filing	No
2009-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-10-01	Plan is a collectively bargained plan	No
2009-10-01	Plan funding arrangement – Insurance	Yes
2009-10-01	Plan funding arrangement – Trust	Yes
2009-10-01	Plan benefit arrangement – Insurance	Yes
2009-10-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

PHK762

Policy instance

Insurance contract or identification number	PHK762
Number of Individuals Covered	74
Insurance policy start date	2018-10-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

PHK762

Policy instance

Insurance contract or identification number	PHK762
Number of Individuals Covered	145
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

Potentially related plans

SHADY REST, INC. PROFIT SHARING 401(K) PLAN [EIN = 420990720]

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Company Name:	PAGE REHABILITATION AND HEALTHCARE CENTER
Employer identification number (EIN):	650850574
NAIC Classification:	805198