401k Plan data: CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN plan

CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN
Plan identification number	001

CLEARVIEW SANITARIUM, INC. 401(K) 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
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.
Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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

CLEARVIEW SANITARIUM, INC. has sponsored the creation of one or more 401k plans.

Company Name: CLEARVIEW SANITARIUM, INC.

Employer identification number (EIN): 952078320

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CLEARVIEW SANITARIUM, 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 2022-01-01
001 2021-01-01 MARK TOWNS 2022-10-17 MARK TOWNS 2022-10-17
001 2020-01-01 MARK TOWNS 2021-10-14 MARK TOWNS 2021-10-14
001 2019-01-01 MARK TOWNS 2020-10-14 MARK TOWNS 2020-10-14
001 2018-01-01 MARK TOWNS 2019-10-15 MARK TOWNS 2019-10-15
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01 MARK TOWNS 2015-10-07
001 2013-01-01 MARK TOWNS 2014-10-09
001 2012-01-01 MARK TOWNS 2013-10-14
001 2011-01-01 MARK TOWNS 2012-10-16
001 2010-01-01 MARK TOWNS 2011-10-04

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01	MARK TOWNS	2022-10-17	MARK TOWNS	2022-10-17
001	2020-01-01	MARK TOWNS	2021-10-14	MARK TOWNS	2021-10-14
001	2019-01-01	MARK TOWNS	2020-10-14	MARK TOWNS	2020-10-14
001	2018-01-01	MARK TOWNS	2019-10-15	MARK TOWNS	2019-10-15
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01	MARK TOWNS	2015-10-07
001	2013-01-01	MARK TOWNS	2014-10-09
001	2012-01-01	MARK TOWNS	2013-10-14
001	2011-01-01	MARK TOWNS	2012-10-16
001	2010-01-01	MARK TOWNS	2011-10-04

Plan Statistics for CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2021: CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 176
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 58
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 5
Total of all active and inactive participants 2021-01-01 63
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 63
Number of participants with account balances 2021-01-01 51
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 6
2020: CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 160
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 135
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 39
Total of all active and inactive participants 2020-01-01 174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 2
Total participants 2020-01-01 176
Number of participants with account balances 2020-01-01 174
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 19
2019: CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 141
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 139
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 21
Total of all active and inactive participants 2019-01-01 160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 160
Number of participants with account balances 2019-01-01 157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 19
2018: CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 141
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 119
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 22
Total of all active and inactive participants 2018-01-01 141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 141
Number of participants with account balances 2018-01-01 139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 5

Measure	Date	Value
2021: CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	176
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	58
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	5
Total of all active and inactive participants	2021-01-01	63
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	63
Number of participants with account balances	2021-01-01	51
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	6
2020: CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	160
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	135
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	39
Total of all active and inactive participants	2020-01-01	174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	2
Total participants	2020-01-01	176
Number of participants with account balances	2020-01-01	174
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	19
2019: CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	141
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	139
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	21
Total of all active and inactive participants	2019-01-01	160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	160
Number of participants with account balances	2019-01-01	157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	19
2018: CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	141
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	119
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	22
Total of all active and inactive participants	2018-01-01	141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	141
Number of participants with account balances	2018-01-01	139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	5

Financial Data on CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2021 : CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total transfer of assets from this plan	2021-12-31	$1,982,322
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$897,040
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$607,429
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$596,917
Value of total corrective distributions	2021-12-31	$2,436
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$505,936
Value of total assets at end of year	2021-12-31	$2,086,256
Value of total assets at beginning of year	2021-12-31	$3,778,967
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$8,076
Total interest from all sources	2021-12-31	$12,273
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Administrative expenses professional fees incurred	2021-12-31	$8,076
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$382,787
Participant contributions at end of year	2021-12-31	$105,313
Participant contributions at beginning of year	2021-12-31	$230,233
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$9,745
Total non interest bearing cash at end of year	2021-12-31	$0
Total non interest bearing cash at beginning of year	2021-12-31	$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	2021-12-31	No
Value of net income/loss	2021-12-31	$289,611
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$2,086,256
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$3,778,967
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in pooled separate accounts at end of year	2021-12-31	$1,887,834
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$3,385,704
Interest on participant loans	2021-12-31	$12,173
Interest earned on other investments	2021-12-31	$100
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$93,109
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$163,030
Net investment gain/loss from pooled separate accounts	2021-12-31	$378,831
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$113,404
Employer contributions (assets) at end of year	2021-12-31	$0
Employer contributions (assets) at beginning of year	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$596,917
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2021-12-31	Yes
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	PRICEKUBECKA, PLLC
Accountancy firm EIN	2021-12-31	752783674
2020 : CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$892,822
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$58,984
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$45,528
Value of total corrective distributions	2020-12-31	$3,833
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$478,988
Value of total assets at end of year	2020-12-31	$3,778,967
Value of total assets at beginning of year	2020-12-31	$2,945,129
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$9,623
Total interest from all sources	2020-12-31	$10,492
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Administrative expenses professional fees incurred	2020-12-31	$9,623
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$300,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$354,709
Participant contributions at end of year	2020-12-31	$230,233
Participant contributions at beginning of year	2020-12-31	$114,162
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$7,836
Total non interest bearing cash at end of year	2020-12-31	$0
Total non interest bearing cash at beginning of year	2020-12-31	$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	2020-12-31	No
Value of net income/loss	2020-12-31	$833,838
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$3,778,967
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$2,945,129
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in pooled separate accounts at end of year	2020-12-31	$3,385,704
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$2,673,194
Interest on participant loans	2020-12-31	$10,485
Interest earned on other investments	2020-12-31	$7
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$163,030
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$157,773
Net investment gain/loss from pooled separate accounts	2020-12-31	$403,342
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$116,443
Employer contributions (assets) at end of year	2020-12-31	$0
Employer contributions (assets) at beginning of year	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$45,528
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	PRICEKUBECKA, PLLC
Accountancy firm EIN	2020-12-31	752783674
2019 : CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$814,501
Total income from all sources (including contributions)	2019-12-31	$814,501
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$89,433
Total of all expenses incurred	2019-12-31	$89,433
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$78,710
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$78,710
Expenses. Certain deemed distributions of participant loans	2019-12-31	$2,359
Expenses. Certain deemed distributions of participant loans	2019-12-31	$2,359
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$426,551
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$426,551
Value of total assets at end of year	2019-12-31	$2,945,129
Value of total assets at end of year	2019-12-31	$2,945,129
Value of total assets at beginning of year	2019-12-31	$2,220,061
Value of total assets at beginning of year	2019-12-31	$2,220,061
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$8,364
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$8,364
Total interest from all sources	2019-12-31	$8,534
Total interest from all sources	2019-12-31	$8,534
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Administrative expenses professional fees incurred	2019-12-31	$8,364
Administrative expenses professional fees incurred	2019-12-31	$8,364
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$300,000
Value of fidelity bond cover	2019-12-31	$300,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$321,985
Contributions received from participants	2019-12-31	$321,985
Participant contributions at end of year	2019-12-31	$114,162
Participant contributions at end of year	2019-12-31	$114,162
Participant contributions at beginning of year	2019-12-31	$154,686
Participant contributions at beginning of year	2019-12-31	$154,686
Participant contributions at end of year	2019-12-31	$0
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-12-31	$43
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-12-31	$43
Total non interest bearing cash at end of year	2019-12-31	$0
Total non interest bearing cash at end of year	2019-12-31	$0
Total non interest bearing cash at beginning of year	2019-12-31	$0
Total non interest bearing cash at beginning of year	2019-12-31	$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	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$725,068
Value of net income/loss	2019-12-31	$725,068
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$2,945,129
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$2,945,129
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$2,220,061
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$2,220,061
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in pooled separate accounts at end of year	2019-12-31	$2,673,194
Value of interest in pooled separate accounts at end of year	2019-12-31	$2,673,194
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$1,924,971
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$1,924,971
Interest on participant loans	2019-12-31	$8,534
Interest on participant loans	2019-12-31	$8,534
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$157,773
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$157,773
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$140,404
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$140,404
Net investment gain/loss from pooled separate accounts	2019-12-31	$379,416
Net investment gain/loss from pooled separate accounts	2019-12-31	$379,416
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$104,566
Contributions received in cash from employer	2019-12-31	$104,566
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$78,667
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$78,667
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	GSC, CERTIFIED PUBLIC ACCOUNTANTS
Accountancy firm name	2019-12-31	GSC, CERTIFIED PUBLIC ACCOUNTANTS
Accountancy firm EIN	2019-12-31	770044249
Accountancy firm EIN	2019-12-31	770044249
2018 : CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING 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	$0
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	$275,503
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$148,138
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$140,950
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$363,215
Value of total assets at end of year	2018-12-31	$2,220,061
Value of total assets at beginning of year	2018-12-31	$2,092,696
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$7,188
Total interest from all sources	2018-12-31	$12,518
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
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	$275,430
Participant contributions at end of year	2018-12-31	$154,686
Participant contributions at beginning of year	2018-12-31	$133,576
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2018-12-31	$750
Administrative expenses (other) incurred	2018-12-31	$7,188
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	$127,365
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$2,220,061
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$2,092,696
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	$1,924,971
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$1,794,855
Interest on participant loans	2018-12-31	$12,496
Interest earned on other investments	2018-12-31	$22
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$140,404
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$164,265
Net investment gain/loss from pooled separate accounts	2018-12-31	$-100,230
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$87,785
Employer contributions (assets) at end of year	2018-12-31	$0
Employer contributions (assets) at beginning of year	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$140,200
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	PENSION ASSURANCE LLP
Accountancy firm EIN	2018-12-31	300840934

Form 5500 Responses for CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN

2021: CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Section 412(e)(3) insurance Contracts	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Section 412(e)(3) insurance Contracts	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Section 412(e)(3) insurance Contracts	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: CLEARVIEW SANITARIUM, INC. 401(K) PROFIT SHARING 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 – Section 412(e)(3) insurance Contracts	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

600991

Policy instance

Insurance contract or identification number	600991
Number of Individuals Covered	51
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $14,044
Total amount of fees paid to insurance company	USD $1,767
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?	Yes
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 $14,044
Insurance broker organization code?	3
Amount paid for insurance broker fees	1767
Additional information about fees paid to insurance broker	0.00

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

600991

Policy instance

Insurance contract or identification number	600991
Number of Individuals Covered	164
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $12,006
Total amount of fees paid to insurance company	USD $1,512
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?	Yes
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 $12,006
Insurance broker organization code?	3
Amount paid for insurance broker fees	1512
Additional information about fees paid to insurance broker	0.00

TRANSAMERICA (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

600991

Policy instance

Insurance contract or identification number	600991
Number of Individuals Covered	143
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $9,725
Total amount of fees paid to insurance company	USD $1,229
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?	Yes
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 $9,725
Insurance broker organization code?	3
Amount paid for insurance broker fees	1229
Additional information about fees paid to insurance broker	0.00

TRANSAMERICA (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

600991

Policy instance

Insurance contract or identification number	600991
Number of Individuals Covered	128
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $8,351
Total amount of fees paid to insurance company	USD $1,051
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?	Yes
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
Other welfare benefits provided	GROUP DEFERRED ANNUITY
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 $8,351
Insurance broker organization code?	3
Amount paid for insurance broker fees	1051
Additional information about fees paid to insurance broker	0.00

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Company Name:	CLEARVIEW SANITARIUM, INC.
Employer identification number (EIN):	952078320
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities